These are extremely trying times for health systems across the country. Some states are dealing with ongoing COVID-19 surges, some seem to be turning a corner in new cases, and some are gearing up for patient influxes. Regardless of location, COVID-19 has the full attention of the world.
As health systems adjust to this unprecedented pandemic, they must also continue to plan for a largely unknown future. How many patients will actively engage in telehealth services in 6, 12, or even 18 months? What will primary care clinics look like tomorrow? Should projects, investments, and expansion be put on hold until teams are able to effectively handle care management and capacity concerns?
There are few projects that can be started in the near-term that will provide ongoing benefits, regardless of the uncomfortable unknowns we are facing. One of them is real-time prescription benefit (RTPB). RxRevu clients continue to appreciate the easy win of turning on RTPB and the basically non-existent upkeep of the tool. While IT resources are being stretched thin due to COVID-19 demands like telemedicine, patient influxes, and remote work/security, many hospitals are looking for ways to remove administrative burden, improve provider efficiency, and streamline care. RTPB checks those boxes, and can be turned on quickly, with limited IT labor.
RxRevu brings patient-specific drug costs into the prescribing workflow, allowing providers to see patients’ exact out-of-pocket responsibility for the drugs they are prescribing. With real-time prescription benefit turned on, providers do not need to leave the EHR to get coverage information or pharmacy preferences. Instead, they are shown flags when prior authorization (PA) is required and will see formulary-driven alternatives so they can select cheaper medications and avoid PAs when possible. This point-of-care data allows for a streamlined experience and helps providers care for more patients in less time.
This week, I had the chance to speak with two members of RxRevu’s Client Services team (virtually), who work with hospitals and health systems across the country. Below are their insightful responses to my questions.
How can RTPB help hospitals during this pandemic?
Jacqueline Kostelec, Director of Client Services:
Prescribers must care for their patients more efficiently now than ever before. RTPB can reduce administrative hassles like pharmacy callbacks and prior authorization, which in turn gives prescribers more time to spend treating their patients. This pandemic will hopefully end soon and the streamlined processes put in place now can help organizations address some of the detrimental downstream effects. Also, as more and more people are affected by our current economic situation, having a RTPB solution in place will allow organizations to provide the lowest-cost options to their cost-conscious patients.
What kinds of ongoing value are you seeing across RxRevu’s RTPB clients?
Our health system clients find many benefits from our RTPB service. It’s really a win for the prescribers and their patients. We know that nearly 50% of patients have abandoned a prescription at the pharmacy due to cost. This causes additional work for teams managing prescriptions, since they have to follow-up with these patients and their pharmacies. Frankly, no one has time to spare for such avoidable work, even on a normal day. With so much energy dedicated to managing COVID now, time is even more precious.
Jade Perkins, Director of Client Services:
It’s interesting – we expected to see a significant drop in routine prescribing due to COVID-19, and while there has been a slight dip in overall transactions due to a reduction of non-essential visits, people still are dealing with chronic conditions and emergency situations. Physicians are still prescribing medications, and our clients find tremendous value in being able to discuss pricing and coverage with their patients before a medication is ordered. As Jacqui mentioned, these conversations with patients are incredibly important during a time when so many patients are more cost-conscious than ever before.
What about internal resources? What is needed?
The great part about our tool is that all happens natively in the EHR workflow, and it only takes about 8-10 hours to build and turn on. That’s it. When it comes to IT projects and resources being prioritized, our clients recognize that turning on access to RTPB was likely the smallest lift of any of their recent IT projects. Resources required for the build include an ambulatory and interface analyst and a clinical decision maker. The tool is also free for health systems to use, which is an imperative when margins are so tight.
What kind of ongoing maintenance is needed?
None! Our solution is fully integrated into both Epic and Cerner, so there is nothing that needs to be done on the client’s end from an upkeep perspective, other than continuing standard upgrades via the EHR vendor. Once RTPB is launched, our Client Services team remains focused on providing value and ensuring health systems receive the highest level of service, including ongoing reporting and support.
We are always working to expand our payer and PBM coverage network. Why is this so important for health systems?
While we’re already connected to some of the largest payers and PBMs in the market, we are continuing to add more to our network over time. These new connections will bring additional data to the tool and will reduce situations where patient coverage isn’t available. One of the main pillars of our business is the idea that the patient comes first, so if we are able to provide more robust patient data, we are able to better serve our clients and their patients.
What other considerations should a health system know before connecting to RxRevu?
We are the only vendor in the market that is funded by health systems, which helps us to bring a unique perspective to our approach. We do everything in our power to make the deployment of RTPB a seamless process, whether clients need support through the build or want resources for provider engagement. We put our health system clients first to make RTPB a value-add every single day.
Written by: Lori Murphy MPH, Director of Provider Growth