Specialty pharmacy turnaround time impediments, facilitators, and good practices.

BACKGROUND: Patients receiving specialty medications have conditions that are often complex, high cost, and high need. Prompt treatment initiation is essential for the appropriate management of many conditions treated by specialty products. Improving the turnaround time (TAT) of specialty pharmacy prescriptions helps ensure patients receive the medication they need in the necessary time frame to optimize health outcomes. Despite a clinical justification for improved TAT, there is a gap in the literature describing what factors impact these times. OBJECTIVE: To determine factors that may influence specialty pharmacy TATs and to identify good practices that specialty pharmacies use to improve TAT. METHODS: This qualitative study used 4 focus groups with specialty pharmacy subject matter experts. Each focus group represented different specialty pharmacy types, including health system, payer-associated, retail chain, and independent specialty pharmacies. Attitudes, beliefs, and experiences regarding specialty pharmacy TAT were captured. Open-ended questions and prompts eliciting impediments, facilitators, and good practices associated with specialty pharmacy TAT were asked of participants. Data were analyzed thematically. RESULTS: Fifteen individuals participated across 4 focus groups: payer-associated (n = 4), independent (n = 3), health system (n = 5), and retail chain (n = 3) specialty pharmacies. Average TATs varied across specialty pharmacy type and by prescription type (clean vs intervention). Several interconnected themes were identified, including barriers with health benefits formulary management, prior authorization delays, differences in requirements between managed care organizations, and miscommunication with physicians, among others. Five subthemes were identified during the discussion of factors influencing TAT, including patient characteristics, pharmacy characteristics, provider characteristics, clinical situations, and health benefit design and formulary considerations. Pharmacy workflow improvements through technology integration are thought to improve TAT. In addition, participants noted facilitators including specialization among pharmacists and technicians in certain diseases, particularly hepatitis C and cancer. Some good practices included using patient financial advocates, technology integration, and a structured patient onboarding process, which were found to minimize delays caused by prior authorization, communication, and formularies. CONCLUSIONS: A multitude of factors impacting specialty pharmacy prescription TAT were identified. Multidisciplinary coordination between pharmacies, physicians, and managed care organizations is essential to ensure patients receive medications in the necessary time frame to optimize health outcomes. DISCLOSURES: This study was conducted with support from Pfizer.

HemPHL: A Personal Health Library and mHealth Recommender to Promote Self-Management of Hemophilia.

Hemophilia is a rare inherited bleeding disorder characterized by the blood's inability to clot and could result in potentially life-threatening spontaneous bleeding into joints, organs, and tissues. Moreover, long-term management of this chronic disease is complex and costly. Current scientific evidence demonstrates that personalized digital health technologies could promote and facilitate the self-management of chronic diseases. This study introduces HemPHL a Personal Health Library and mHealth Recommender platform to gather, manage, and exchange tailored health information and recommendations to facilitate self-management and home therapy among individuals with hemophilia. The proposed digital health solution will adopt novel data science, artificial intelligence tools and techniques to manage and use information, as well as promote best practices for health education to enable patients to make informed decisions about their health. To accomplish this, an array of complex health and non-health information will be obtained from multi-dimensional sources to develop a secure, single access point of information for patient use. Patient's access to personalized health information could harness their engagement and independence as well as empower them to remotely monitor their health progress and improve compliance with treatment plans. This hemophilia-focused, user-centered app can markedly improve patients' clinical outcomes and overall quality of life.