The PioneerRx pharmacy software was built to streamline pharmacy workflow. With the ever-changing industry, PioneerRx is focusing on streamlining specialty pharmacy services with RxLocal™.
What is Specialty Pharmacy?
When patients with serious health conditions require in-depth management or special handling, their medications are commonly filled through a specialty pharmacy. Specialty pharmacy is crucial to patient health because improper medication use or non-adherence will result in harmful events, or even death.
According to the Express Scripts 2015 Drug Trend Report, specialty pharmacy will represent 50% of US drug spending by 2020; therefore, the need to control costs is critical for three groups:
- Copays/coinsurance add more costs to the patient.
- Overutilization of hospital services and expensive therapies add more costs to payers.
- Increased burdens on healthcare sources (hospitals, Medicare and/or Medicaid, etc.) make for additional costs for taxpayers.
The Traditional Pharmacy Model
Traditional specialty pharmacy forces a disconnect between primary care providers and local pharmacies. This model limits the type of pharmacies that can dispense specialty drugs, and specialty pharmacy is limited to the specific medications they dispense. This dichotomy forced patients to use at least two pharmacies if they require specialty medications.
Specialty physicians send patient medications to specialty pharmacies. They fill the medications, call the patient for counseling, and mail the prescription to the patient.
On the other hand, primary care providers send “regular” medications to the local pharmacy. The pharmacist fills the prescription and counsels the patient when they pick up their medications.
Despite the large amount of patient communication, there is virtually no communication between the specialty pharmacy and the local pharmacy, nor between the primary care provider and the specialty physician. The key players in patient health are struggling to keep track of the entire patient profile.
The Ongoing Change
Our current healthcare system revolves around a fee-for-service (FFS) model. Every healthcare service a patient receives is billed by quantity of care, not quality.
However, in a quality-based model, more importance will be placed on preventive care; managing chronic conditions effectively the first time; and increased monitoring for higher risk patients. Simply put, if patients do not achieve better outcomes, then providers, payers, and manufacturers may not get paid.
A new payment model demands a new approach to healthcare. Open communication and collaborative interactions are necessary among the pharmacies, providers, and patients, which is the foundation of the RxLocal™ Model.
The RxLocal™ Model
A patient may go to their doctor 1-3 times a year, but they will go to a pharmacy monthly. There is an exceptional opportunity for patient engagement at a local pharmacy. For this reason, the Rx Local Model puts the local independent pharmacy in the center.
First, both primary care and specialty providers send their prescriptions to the local pharmacy. Then, the local pharmacy uses PioneerRx to automatically triage the prescriptions to the appropriate location. Normal medications are filled at the local pharmacy, and if a specialty pharmacy is required to fill the script, PioneerRx automatically transfers the script to the correct pharmacy. The specialty pharmacy fills the prescription, counsels the patient, and sends the specialty medication back to the local pharmacy. Once the specialty medication is delivered to the local pharmacy, the patient can pick up all of their medications at one time in one location, or have them delivered.
Meanwhile, RxLocal™ will share information with interested parties during the process, such as:
- The local pharmacy will know which specialty medication the patient is on
- Specialty pharmacy will receive a script they know they can fill
- Specialty pharmacy can access the full patient profile from PioneerRx pharmacies
- Providers will be updated with medication profiles
- Patients receive real-time updates about when their prescriptions will be ready
Pharmacies will need the right tools as the pharmacy industry leans towards a more quality-based system of care. That standard of higher quality begins with a more collaborative approach to pharmacy. With RxLocal™, everyone – patients, pharmacies, and providers – will receive a more personal, truly connected healthcare experience.