Empowering Patients Through Greater Price Transparency in the EHR

^{Image has been resized and cropped. Licensed from sepy - stock.adobe.com.}

The clamor over greater transparency in healthcare continues to define key movements across the industry — including the most recent overhaul of the Medicare and Medicaid Promoting Interoperability Programs (formerly Meaningful Use) to advance patient-centered care. Whether the objective is to improve population health, lower costs or empower patients, stakeholders recognize the inherent opportunity of the seamless and efficient flow of information across the continuum.

>> LISTEN: The Slow, Frustrating Rise of the Electronic Health Record

Electronic health records (EHRs) are foundational to the transparency movement as the catalyst and channel for information exchange. Now mainstream, this infrastructure has become the dominant place for provider attention and workflow. Consequently, strategies have shifted from adoption to optimization of EHRs in recent years as providers look for ways to extract the greatest value from their technology investments.

In evolving value-based care models, providers rely on point-of-care information in EHR-enabled workflows to help fuel quality improvement initiatives such as population health and cost containment. Medication adherence, in particular, is a focal point of national quality initiatives aimed at improving patient outcomes and lowering costs. But cost and health literacy remain two distinct barriers to improving the outlook on adherence.

A significant opportunity exists to positively impact medication adherence rates by embedding cost savings opportunities, education and refill transparency directly into EHR workflows, especially since ePrescribing now exceeds 85 percent of prescriptions. When pharmaceutical manufacturers and providers can establish a direct line of communication, patients receive greater transparency into tools and offerings that can engage them more fully in care and help them achieve better outcomes.

The Challenge of Medication Adherence

Industry research points to high drug costs as a primary contributing factor to medication non-adherence — an avoidable problem that is connected to billions in healthcare costs annually due to poor outcomes and disease progression. Multiple trends are converging to create unprecedented cost burdens for patients, including high-deductible health plans (HDHPs), higher co-pays and a wide range of generic drug options. These trends often result in patients failing to fill their prescriptions the first time, skipping refills or opting to not follow medication therapy plans at all.

Notably, research also suggests that medication adherence improves when patients can identify ways of lowering their co-payments. Patients increasingly rely on providers to offer information on financial assistance programs for prescription medications to alleviate out-of-pocket expense. Yet it is difficult for providers to efficiently locate opportunities at the point of care. Often, they must take time out of an already tight patient schedule to research available co-pay coupons and vouchers. The reality is that billions in savings opportunities go unclaimed every year because physicians are simply unaware of available offers — especially as insurers crack down on coupon programs.

In tandem with the cost challenge, the U.S. Department of Health and Human Services estimates that only 12 percent of U.S. adults have proficient health literacy, and more than one-third have difficulty with common tasks such as following directions on a prescription drug label. In sync with the challenge of identifying cost savings, many physicians unfortunately lack easy access to resources to educate patients on their medications at the point of care, where questions are commonly posed.

Physicians, by and large, want to partner with patients in their care and proactively help them successfully navigate care plans. They simply need greater transparency into industry solutions to improve costs, equip patients with knowledge and monitor patient adherence to medications.

Improving Transparency Through Direct Provider-Pharma Communication Lines

As the industry debate over coupon and voucher programs continues, the simple reality is that many patients depend on these offerings to afford needed medications. For instance, 90 of the top 200 drugs offer coupons, and more than 75 percent of those offering coupons have no generic equivalent. In addition, generic options are not the best option for all patients.

When a direct communication line exists between pharmaceutical manufacturers and physicians, patient savings opportunities can be embedded directly into the ePrescribing workflows of an EHR. Platforms exist that allow delivery, tracking and reporting of content across a large point-of-prescribe promotional network.

As physicians conduct a patient encounter, available co-pay coupons and vouchers appear within their existing workflow and can be immediately printed to help bridge the knowledge gap regarding patient savings opportunities. Physicians simply search for a brand name drug in the EHR, and in real-time, they are alerted to available offerings for a specific patient. The coupon or voucher is then printed for the patient to present to a retail pharmacy provider, improving medication affordability, encouraging adherence and fostering better clinical outcomes on a sustainable basis.

Customized patient education materials can also be easily printed, texted or emailed to patients. Physicians can provide education at the point of care and gain confidence that patients are equipped with the information needed to successfully adhere to medication regimens.

This direct line of communication also allows physicians to access key information on patient follow-through. For instance, once an order for a medication is made within an ePrescribing workflow, data are sent back to the physician regarding whether the patient picks up the medication from a retail pharmacy. Information on refill follow-through is also available. Armed with this important insight into patient activity, physicians can then get ahead of the medication non-adherence problem by proactively reaching out to patients to determine the reasons behind their lack of adherence.

The consumer challenges associated with HDHPs and higher co-pays are not going away in the near-term, and physicians can expect that patients will continue to have greater needs for information and resources. In tandem, providers must become more proactive in care to move the needle on population health outcomes, while also improving operational efficiencies and containing costs. By drawing on solutions that provide direct communication channels with pharmaceutical manufacturers, physicians can extract greater value from their EHR investments by improving patient medication adherence and overall quality outcomes.

Get the best insights in healthcare analytics directly to your inbox.

Related

Interoperability and Tech: Death of the Small Practice

How to Minimize Data Chaos in Healthcare

Has Health IT Adoption Improved Patient Outcomes?