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Jason recently had heart surgery, and he also has rheumatoid arthritis, which requires a specialty medication. So when he was discharged from the hospital, it triggered a series of actions by his care team that helped him stay healthy.

After the system issued an alert about Jason’s discharge:

  • A pharmacist called him right away to make sure he was following his medication plan.
  • Additional care providers arranged in-home care, like a home blood pressure monitor and even personalized diet and health counseling.

Watch how OptumRx helped Jason benefit from six points of coordinated care:

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Synchronized care describes our approach to connecting the data and expertise of pharmacy care with other medical services. This approach helps us to deliver improved, coordinated care for the people we serve. Coordinated care is vital for people who require complex specialty medications, since they often have multiple medical conditions and take multiple medications. For example, meet Jason, a specialty pharmacy patient whose recent medical journey encompassed 6 unique synchronized care opportunities. Jason is living with two very complex medical conditions: Rheumatoid Arthritis (RA), which he manages with a specialty medication, and severe coronary heart disease, which requires additional medications as well as a recent surgical procedure. Patients like Jason are constantly tracked through our synchronized medical and pharmacy data. So when Jason is released from the hospital, an automatic discharge notification alerts Brendan, an OptumRx Specialty Pharmacist. This is in contrast to conventional PBMs; they rely on just pharmacy claims data, delaying notifications by weeks or months. Within 24 hours of discharge, Brendan and Jason discuss and document Jason's treatment history and any prescriptions he got in the hospital.
Documenting medication records is a key pillar of quality care and helps reduce the chances of problems later on. With Synchronized Care, Jason's information is automatically shared with both pharmacy and medical teams so they have complete visibility into his situation. Acting on this information, Brendan was able to provide Jason with advice on managing RA symptoms while OptumHealth nurses coordinated in-home care to support his recovery. As a heart patient, having a heart rate/blood pressure monitor for home use is essential for Jason. Brendan discovered he didn't have one and flagged the issue for the OptumHealth nurses. They confirmed that Jason's benefit plan would cover a monitor and one was delivered. This corrected a potential gap in his medical care. Synchronized care extends far beyond just pharmacy, during follow-up calls, Jason revealed he had a poor diet and was flagged for referral into a wellness program. Because all of Jason's case history is contained within one seamless network, health care professionals across Optum were able to easily identify his needs and quickly offer holistic support. Finally, when Jason's RA symptoms became disruptive Brendan could quickly brief the rheumatologist on Jason's medication history, so the doctor could make an informed decision about resuming his medication. Jason's story is not only real; it's a real success. His RA symptoms are well controlled. His cardiac follow up has been trending in the right direction, and he is very happy with his diet changes and is feeling better. Jason's experience is just one example of how Synchronization allows health care professionals from across OptumRx and OptumHealth to work seamlessly together to deliver high-quality health outcomes for patients, and help our clients reduce their overall health care costs.

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Connecting care is critical to the success of an individual's health, especially in an area as complex as specialty pharmacy. Take a look at this real-life example where one patient benefits from six points of coordinated care.

Read the full article on Jason's health care story.

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