For too long, a lack of actionable, real-time information has hindered the optimal distribution of prescription medications to the patients that need them.
For physicians picking up the pen to prescribe medications for their patients, this lack of relevant data presents significant challenges. While doctors may have had sufficient information regarding a medication’s clinical efficacy and safety, too often prescribers have lacked insight into the other elements essential to high-quality patient care and service. These elements include patient-specific drug benefit limitations, out-of-pocket costs, factors affecting drug utilization and adherence, and lower cost alternatives. From the patient’s perspective, this lack of insight into their member-level information would often result in unnecessary delays. Worse yet, it could leave them unable to get their prescription filled at the pharmacy counter. Or, consider the case where a physician is blindly prescribing the most expensive drug in a class when less expensive, but clinically identical alternatives exist. This creates a cost burden for both the patient and the plan sponsor.
The problem isn’t a lack of data – doctors, in particular, are swimming in data. The real problem is creating transparency into the data that already exists within pharmacy benefit managers. Currently, for physicians, gaining access to this data requires a degree of time and manual effort that most providers just can’t afford. Put simply, what prescribers need are tools that would permit insight into key member-level data in a real-time or near real-time fashion. What’s more, these tools need to be integrated into their daily patient management workflow in a seamless fashion. With these challenges in mind, we have built a better way to provide physicians with the information they need. OptumRx Script Connect is an innovative suite of tools designed to fit comfortably within a physician’s existing workflow. It provides drug-specific, benefit-specific, and clinical program data for individual patients at the point of prescribing.
Script Connect gives the physician visibility into:
- Drug cost
- Member-specific cost sharing information
- Lower cost alternatives
- Prior authorization
- Step therapy
- Supply limits
Taken together, this wealth of information promises enhanced care coordination and quality of care for the patient and savings for the plan sponsor. Script Connect represents an early effort to synchronize patient care in real-time, and leverage all touchpoints to create the optimal consumer experience by improving affordability, adherence and overall outcomes.
How Script Connect works
Script Connect integrates with existing workflows and many of the Electronic Medical Record (EMR) systems that physicians are already utilizing today. Another way Script Connect is different is through its Electronic Prescription (eRx) capabilities. Historically, some doctors were reluctant to adopt eRx solutions because of their limited capabilities. By working in conjunction with offerings from many leading eRx providers, Script Connect encourages use of eRx, which reduces turnaround times and avoids patient disruption.
Importantly, these long-sought synergies are invisible from a patient perspective. With Script Connect, as soon as a patient checks in, their prescription coverage eligibility is confirmed, and their formulary data is retrieved. Next, as the doctor adds prescription details into the EMR, the benefit check process begins, giving the doctor information on the price of the drug, potential alternatives and coverage information, including prior authorization (PA) requirements. If the result is that a prior authorization is not needed, an eRx is routed to the pharmacy. If PA is required for that medication, information can be pre-populated into a patient- specific request ePA form. Seamlessly condensing the often multi-day PA process into the span of the office visit, Script Connect avoids unnecessary delays, and also eliminates the chance that patient will learn of a claim’s rejection at the pharmacy counter.
The impact of empowered physicians and engaged patients
Despite the revolutionary implications of Script Connect on the PA process, there’s much more to the story, as the access to real time formulary info, patient plan design, and clinical alerts will empower physicians in a variety of ways. By providing instant access to this vital information, Script Connect helps unburden care providers from time-sapping administrative tasks and enables them to spend more time with the patient. With better doctor-patient relations, we can expect more engaged patients and improved clinical outcomes with attendant cost savings.
This is only the beginning. Going forward, Script Connect is designed to evolve and deliver an even wider array of real-time patient-specific pharmacy information, making it easier for members and their physicians, and supporting smarter decisions for healthier outcomes.