HUBS — like Electronic Medical Records/EMRs in the late 90s – are a highly efficient form of electronic medical infrastructure. Now is the perfect opportunity to use them to their maximum capacity.
The adoption of HUBs has been significant in the specialty pharmacy area primarily in the biologics area. The specialty pharmacy takes Prior Authorizations (PAs, or Prior Auths) off the hands of the medical practice and into the automated cloud infrastructure of the HUB. Specialty pharmacy HUBs also generate auto-refills to keep patients consistently supplied with the product. That’s a win for the three Ps – physicians, pharmacies, and patients. But could that win be much larger and more beneficial?
Patients, often unbeknownst to their physicians and pharmacies, take “breaks” from their meds. Sure, some continue to receive the meds and pay for them so that everything looks normal from the electronic point of view (other times patients slow down on prescription refills). But the patient may be taking a medication vacation – there are various reasons for this phenomena. One is that they figure that they are doing well on the medication (don’t experience symptoms) and can afford to skip a few doses/treatments. Or they might be having difficulty with side effects. Or the meds are too expensive. Or long-term treatment has triggered depression and/or medication routine fatigue. Missed doses can mean recurrence or breakthroughs in their condition, sometimes leading to death (as in the case of missed arrhythmia or HIV meds).
HUBs have the ability to reach out to patients and follow-up with them to gather information such as patient-reported outcomes (PROs). “Improving adherence rates can easily take place within the hub with behavior change initiatives. While collecting PROs we would learn the behavior patterns in the patient’s lives; we could easily address the barriers, motivate for positive behaviors,” says Dyan Bryson, President of Inspired Health Strategies, LLC www.inspiredhealthstrategies.com who specializes in building and working with HUBS. HUBS, according to Bryson, are also a great solution to collecting PROS and using them as real world milestones – solving an industry problem of defining milestones for performance. And they can help in clinical trials with recruitment, retention, and remote monitoring.
Nicholas Basta, in his 2017 Hub Services report in Pharmaceutical Commerce (April 9, 2017) predicts a significant growth focused on the patient in HUBS over the next two years – adherence program management alone will increase by 73%. In the chart below, Basta outlines growth opportunities across the board, almost all helping patients either directly or indirectly.
The adoption and expansion rate of HUBS (another area of opportunity it in retail pharmacies) is mirroring the path taken by EMRs. For now, it appears to be only a matter of time. Those who are at the forefront of adoption stand to benefit the most and the soonest.