Rujul Desai, Occam Health Services

Fig. 1. Hub service elements. Credit: Occam

		A hub represents a key set of services to support patient access to specialty drug therapies across the entire patient journey—from initial coverage determination and drug start, through continuation of therapy (Fig. 1). With the growing emphasis on specialty pharmaceuticals, personalized medicine and “high touch” products (requiring, for example, infusion services or complex patient followup), the biopharma industry is putting more effort into setting up optimal hub services. This critical hub role is being organized in a variety of service models such as internal, external, hybrid, or hosted onsite and along a continuum of service options that integrate with distribution and data strategy.

		More and more we see the use of cloud technology becoming the preferred platform for everything from file storage, video content delivery, telephony, and banking to a range of business and enterprise based service solutions. But what about in healthcare, and biopharma in particular? Biopharma companies have been leveraging cloud based business process solutions for quite some time, but one often overlooked opportunity for cloud-based improvements is better connectivity with patients and physicians—especially for platforms used to perform and enhance hub services, as well as the use of predictive analytics for actionable insights.

		No matter which hub model is used, the opportunity to improve patient and physician connectivity, as well as lower costs, has never been greater with secure cloud technology. Early adopters in biopharma, and those service providers helping them, are leading the way to predictive, data-driven patient and physician interactions that are dynamic, Web-based, and mobile-enabled. These efforts have helped to increase market share for specialty products in billion-dollar therapy areas.

		While it is true that many of the physician office interactions that happen today with hub providers still rely heavily on modes of communication like faxes that must continue to be supported more efficiently, it is also true that there are powerful technologies and platforms now available in the hub service market to better integrate into office workflows, advance the tools used to perform the common hub tasks, and remove speed-to-therapy obstacles. These new cloud-based IT tools also augment the gathering, use, and coordination of predictive analytic data along the patient journey (Fig. 2).

Fig. 2. Advantages of cloud-based hub services.

		Hallmarks of secure, cloud-based services include lower costs, faster time to deployment, dynamic web forms, real-time actionable information, simpler administration and better controls, automatic updates, system compatibility, enhanced collaboration, and mobile access under a software-as-a-service (SaaS) model. There is no better technology to build and maintain an adaptable ecosystem to connect with patients and physicians, as well as the varied vendors deploying your support and messaging programs.

		For example, these platforms improve front-end activity on any Web-enabled device with real time coverage information for the patient’s pharmacy and medical benefit, electronic consent capture and follow up, and auto-fill smart forms. They also improve back-end hub processes with benefits such as real-time intake integration, auto case distribution, dynamic custom prior-authorization generation, and interconnectivity with ancillary programs such as copay, patient assistance programs (PAPs), and nursing support. Utilize and combine just a few of these examples and the improvements in efficiency and speed-to-fill are significant.

		These advances also power the ability for biopharma to now deploy enterprise-level solutions in areas such as provider segmentation, payer analytics, therapy monitoring and management, care coordination services, and integrated data-sharing that more easily connect custom therapy workflows with multiple layers of third party program support vendors, including at the core hub services level.

		At a strategic level, these enterprise solutions put greater control and visibility back in the hands of biopharma, while still allowing for the agility needed for the varied product specific support needs of their pipeline of specialty therapies—all the while reducing the overall cost burden carried with using the fractured set of stale technology options for connecting with patients and physicians offered by most current hub vendors.

Fig. 3. Growth in e-prescribing. Credit: SureScripts

		The best of these modern platforms don’t just stop at making the most of secure cloud based technology; they also integrate the rapidly growing demands and efficiencies offered through e-prescribing (Fig. 3).

		The challenge has been to go from mere e-referral captures that are commonplace today, to the next frontier of generating clean, accurate, and immediately fillable e-prescriptions that have the Surescripts certification seal of authenticity for a specialty product. A cloud-based, Surescripts-certified platform allows for efficient exchanges of information within the larger healthcare data stream through the use of Web-based application program interfaces (APIs) and the clinical interoperability standards being driven by the federal government. This is an invaluable advantage when dealing with chronically ill patients and those with severe diseases that are serviced by the specialty market.

		When certified e-scripts and traditional fax scripts are all collected, processed, managed, and reported with real-time integration on a secure cloud platform, the benefits are real and substantial. Specialty drugs are delivered more quickly, providing less anxiety and more comfort to patients. Physicians and their staff will know that no script was left behind and that a thoughtful and reportable process has been integrated with their unique workflow and varied set of devices they use today. Moreover, all of this happens with fewer burdens on their limited time and resources.

		Coordination across the continuum of care is critical to drive better patient-centric outcomes. This coordination effort includes attracting patients to a therapy, as well as initiating and retaining them on that therapy. In order to accomplish these coordination goals, several data repositories are used across a number of vendors, campaigns, and touch points along the patient journey.

		We are all too aware of the many issues and challenges relating to the current state of care coordination, including disparate data access, inconsistent data types, and lack of specific customer insights, archaic customer and vendor data interfaces, as well as inadequate and inefficient business processes. Therefore it has become imperative for biopharma to find innovative solutions to these data coordination problems while also driving the adoption of process enabled and cloud-based technology solutions.

		This imperative has led to successful pilot programs by biopharma for deployment of new cloud-based technology for enhanced data mining, newer analytical algorithms to drive better access and usage insights, metrics-driven improvements in the patient and physician experience with hub services, as well as use of advanced analytics for physician targeting and segmentation.

		For example, the use of intelligent, event-based alerts that incorporate provider segmentation and payer analytics can help drive provider behavior when patients try switching to a competitor product, or when there is a change in the reimbursement landscape.

		Improved technology in dashboard and reporting tools are helping both biopharma and their hub providers have a shared and real-time view of patient on-boarding, adherence metrics, customer services, and program performance. This comprehensive view enables enhanced customer service at the time of request, improving both the response time and the quality of the response to patients and physicians. Along with that comes linked data reporting to access, for example, adherence data for review and proactive intervention.

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Cloud-based IT technologies are a natural fit for patient-support hubs