At the intersection of specialty drugs and chronic medical disease are specialty practices. Providers who practice oncology, gastroenterology, neurology and other medical specialties connect patients with the medications they need to successfully manage their illnesses.
In six recent blog posts on McKesson.com, specialty experts offer advice to providers on strengthening that connection to improve patient care and business results. The strategies range from clinical trials to clinical pathways to behavioral coaching.
In “Maximizing Immunotherapy Clinical Trials for Community Oncologists,” McKesson’s Michael Seiden, M.D., explained the important role that community oncology practices play in developing new immunotherapy drugs to treat patients with cancer. Dr. Seiden, chief medical officer for The US Oncology Network and McKesson Specialty Health, said community-based oncology practices are desirable clinical trial locations for drug manufacturers because the practices offer a high volume of patients most often diagnosed with the types of cancer that the new drug therapies target. Dr. Seiden outlined five actions oncology practices can take to fulfill that role successfully. Among the strategies are educating physicians and staff on the safe and effective administration of the new drugs, and proactively communicating the potential out-of-pocket cost of new immunotherapy drugs to patients.
In “Optimizing Data Analytics for Oncology Practice Success,” McKesson’s Dan Lodder offered a clinical and financial rationale for community-based oncology practices to adopt advanced analytics capabilities and competencies to provide high-value care to cancer patients. On the clinical side, analytics can comb through and make sense of unstructured data like physician notes and lab reports to provide actionable information to physicians at the point of care with patients, according to Lodder, who is vice president and general manager of technology solutions for McKesson Specialty Health. On the financial side, analytics can capture, analyze and report performance data on functions like revenue cycle, supply chain and workflow. “A practice can understand how its human capital is being utilized, whether it’s being utilized optimally and where improvements can be made,” Lodder said.
In “Preparing Specialty Practices for Alternative Payment Models,” McKesson’s Jane Clayton reinforced that the ability to capture, analyze and report performance data is critically important for specialty practices to succeed clinically and financially under alternative payment models (APMs). As risk increases with each type of APM, so too does the need for practices to know by which criteria their performance is being judged and how to collect and send relevant data to payers, according to Clayton, director of managed care, innovative practice services, for McKesson Specialty Health. The four APMs with the highest risk are: shared savings; shared risk; full risk or capitation; and global payment arrangements. “A practice must be aware [of] and agree with the payer on terms, including performance metrics and benchmarking, as well as comparative data from providers in their market,” Clayton said.
In “How Oncology Practices Can Use Clinical Pathways for Value-Based Care Success,” McKesson’s Marcus Neubauer described how community-based oncology practices can use clinical pathways to pick the most appropriate course of treatment for individual cancer patients. Dr. Neubauer is vice president and medical director, payer and clinical services, for McKesson Specialty Health and The US Oncology Network. Clinical pathways are evidence-based protocols that narrow treatment options down to a succinct list of choices that offer the best possible outcome at the lowest possible cost. Practices should embed pathways into EHR systems. “The system prompts the physician to use the pathway and enables the oncologist to have the best and most current treatment information at the point of care, ready to discuss with the patient,” Dr. Neubauer recommended.
In “Community Oncology Practices as Clinical Trial Partners,” Dr. Seiden followed up his earlier post on the important role community-based oncology practices can play in the development of new immunotherapy drugs for cancer patients with a piece on what pharmaceutical manufacturers should look for in their clinical trial site partners. In theory, community-based practices are ideal clinical trial partners because they offer manufacturers the right scale, patient population and market to test new drug therapies. In practice, according to Dr. Seiden, drug makers need oncology groups that excel at three competencies: research culture, clinical protocols and data reporting. “If a practice can do those three things—accrue patients, follow protocols and do the paperwork—it’s an ‘A’ site, and drug manufacturers will want the practice for their clinical trial,” Dr. Seiden said.
In “Applying Behavioral Coaching to Specialty Drug Adherence,” McKesson pharmacy experts advocated the use of behavioral coaching techniques to improve patient adherence to specialty medications. The adherence stakes are high for all involved—for manufacturers that have invested hundreds of millions of dollars in a new specialty drug, for specialty practices that are relying on a specialty drug to improve clinical results, and for ill patients who have been prescribed a specialty drug to manage, if not cure, a chronic disease. But common barriers like cost and convenience can derail all of those desired objectives. Behavioral coaching can overcome those barriers, according to the experts. Behavioral coaching uses evidence-based clinical strategies and interventions to engage patients in a conversation that identifies barriers and collaborate on an action plan to address those barriers and maximize adherence.
As these six blog posts illustrate, there are a variety of strategies and tactics specialty practices can use to bring patients with chronic medical illnesses closer to the specialty drugs that help them manage their conditions and improve their health status.