At PANTHERx Specialty Pharmacy in Pittsburgh, finding a niche in specialty pharmacy has been driven by the leadership of its pharmacist partner-owners, including Jonathan Ogurchak, Pharm.D., C.S.P., director of clinical programs and pharmacy operations, and Tim Davis, Pharm.D., director of special projects, and a dedication to customizing software to support the unique combination of data, patient care, and business relationships that are required to make a specialty pharmacy successful.

Jonathan Ogurchak, Pharm.D.

When Ogurchak started with PANTHERx Specialty in 2013, there were three pharmacists working in borrowed garage space beside Tim Davis’ family business, Beaver Falls Health Mart Pharmacy in Beaver Falls, Pa. Today, there are 45 employees at PANTHERx in a 32,000-square-foot modernized facility, handling 4,500 to 5,000 patients monthly in all 50 states and Washington, D.C.

“The business has grown by leaps and bounds,” says Ogurchak. “What’s key to the business side of what we do is there’s a lot of benefit to differentiating ourselves to the manufacturers and the payers.” This requires a software system and workflow that track data and patient engagement, and provide nimble reporting tools to communicate with business partners. “If a health plan wants to know how a certain group of patients has been handled, we have to be able to extract that information and pass it on,” says Ogurchak.

In addition to a dedicated staff, a commitment to customizing software to meet the business’s needs has made the growth possible. “We wanted a way to manage patients differently from everyone else,” he adds. “And we felt that this service was tied to the software.”

Partnerships for Success

PANTHERx Specialty executives knew they could do more with the patient information they collected from regular calls to follow specialty drug protocols. The information gathered about side effects for a specific population with an unusual disease state would be valuable for the staff to develop better clinical responses and would give PANTHERx Specialty results to share with manufacturers. To do this well, Ogurchak says, the team envisioned a workflow system that would allow staff to intuitively track the patient experience and be flexible enough to extract data to build reports to pass on to business partners. PANTHERx Specialty was pleased with their specialty dispensing platform, CPR+, but needed some enhanced tools to take their patient care to the next level. Partnering with Arkansas-based Rock-Pond Solutions, PANTHERx Specialty custom-built data and analytic features required for specialty to extend patient management beyond single-encounter reporting. Together they developed SWFT (Specialty Workflow Technology), which drives the experience around the patient and collects data about rare disease states to add to a growing clinical library. This combination of patient care and valuable information was key to the workflow implementation, says Ogurchak.

“If we are going into a contract as a preferred pharmacy with a payer, we want to make sure we can manage the patient’s adherence,” he says. “SWFT helps us gain efficiency and customize that care component. We can see what makes sense for the patient, and verify that necessary testing is done or that a patient stays on an antibiotic even after he’s feeling better. And we can track it.”

What was key with the new workflow was the ability to manage a patient outside of an individual encounter. Before this, the staff had to review each encounter to get a full picture of where the patient was in therapy. The new software automatically adapts the questions based on the ongoing feedback from the patient.

“It’s like a choose-your-own-adventure book,” says Ogurchak. “We utilize the current information we capture from a patient to drive our next action.” If a pharmacist gets an after-hours call from a patient and records a side effect of a headache, the next time the staff calls the patient, they can ask if the pharmacist recommendation made a difference. Or if the therapy requires a follow-up call five days after the drug has shipped, that is noted in SWFT, and it triggers a call to the patient. “With the new platform we have the ability to apply documented encounters to the next call. Our staff is able to be responsive to the various scenarios and be more effective in managing the patients,” says Ogurchak.

Since the drugs dispensed are for a group of rare disease states, the experience of this narrow patient population becomes increasingly important to manufacturers.

“It’s revolutionizing what we are doing with our line of business in customizing the patient care when dealing with specific disease states,” says Ogurchak. “You have to have the ability to document at the patient encounter level, to show that there was true patient management.”

If there are missed doses or complications, the workflow software needed to reflect the full timeline of the patient’s experience and what a PANTHERx Specialty pharmacist learns during each encounter.

“There are huge ties at the payer level,” says Ogurchak. “If a payer is paying for a high-cost therapy, there is an expectation of high touch to guarantee there is patient utilization and benefit.”

Investing to Drive Growth

The investment in SWFT is specifically to drive growth. Ogurchak says the software’s ability to capture patient data and report it easily makes PANTHERx Specialty an appealing business partner. “We can provide value to our partners as we can show the outcomes for various therapies,” he says.

Turning the data into a valuable business tool is what SWFT was designed to allow PANTHERx Specialty to do. The previous system let staff document the patient encounters, but there was no way to integrate that information into the rest of the patient’s health record. Anticipated side effects are automatically suggested within clinical notes, and can more easily tailor a conversation with a patient to elicit appropriate outcomes. The information can be formatted and emailed to a drug manufacturer or the FDA as real-time data on a drug’s effectiveness. “It’s a huge efficiency to automate the drug and payer activities,” says Ogurchak.

PANTHERx Specialty has enabled their clinical team to build comprehensive drug databases to not only drive the communication of outcomes to prescribers and manufacturers, but also continue the enhancement of clinical counseling to help improve intended results.

Specialty therapies typically have very stringent prior-authorization criteria that demonstrate medical necessity for the therapy, explains Ogurchak. SWFT can track outreach to payers and prescribers for prior authorizations. “For example,” he says, “showing that one therapy failed to work for a patient before moving on to something else. This all comes at a cost, and there is the therapeutic complexity. We have to have a higher level of engagement and coordination with the patient.”

Looking Ahead

With the high-touch and responsive nature of the specialty pharmacy workflow, Ogurchak and executives at PANTHERx Specialty see SWFT as a way to automate what had been tedious reporting procedures and free them to respond more quickly to data requests and patient care overall. “Our director of business development and managed markets was working with a health plan and brought up that, thanks to SWFT, we’re launching an exclusive distribution therapy to manage next quarter,” says Ogurchak. “They were so interested in how we would manage their patients they wanted to see a demo of the system, and now want to send business our way.”

And as new disease states and drugs to treat them expand, PANTHERx Specialty staff is in a position to learn how to manage those novel populations. With more documented encounters and outcomes, Ogurchak envisions PANTHERx Specialty developing a library of clinical literature and a standard of care for specialty disease state therapies.

Ogurchak sees the data in SWFT as important for writing white papers that show how to tailor patient care to a therapy. Since the populations taking specialty drugs are much smaller than for traditional drugs — potentially a few hundred patients rather than thousands — the data on outcomes is vital to manufacturers. “We can look at data retrospectively and find more questions that need to be addressed during patient encounters to gather more clinical data,” explains Ogurchak. “We can do a better job as a company and allow us to grow.”  CT

Maggie Lockwood is VP and a senior editor at ComputerTalk. If you’d like to share an
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