Pharmacy, MedCity Influencers

How AI Will Change the Way Patients Get Medication

There is a huge opportunity for PBMs and health systems to use AI to help address the challenges surrounding the affordability and accessibility of medicines, from navigating formularies to resolving prior authorization. More automation in pharmacies and with ordering workflows is one piece of that puzzle.

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At a time when emerging technologies are changing the role of human workers in so many industries, pharmacies are often stuck in an earlier era.

Despite the rise of digital tech, getting medication still mostly relies on people to execute rote tasks, from processing payments and resolving prior authorizations, to calling patients for refills and mailing customers satisfaction surveys.

All of that is finally starting to change.

It’s become clear that many pharmacy tasks could be performed using technology, freeing up time to tackle more complex and rewarding work, like patient care. Further, health systems have realized that scaling their pharmacy business is only possible when technology and automation become the norm.

That’s why some innovative organizations are building technologies that can be deployed within pharmacies to automate many of the manual tasks. These technologies aim to address two major challenges facing the healthcare industry: staffing shortages and drug adherence.

The pandemic created a scarcity of healthcare personnel, including pharmacists and pharmacy technicians. Drug Store News reported that 80% of pharmacies nationwide are struggling to find pharmacists, even as the workload continues to grow, with an astounding 6.49 billion prescriptions filled last year. By automating certain tasks, such as identifying barriers to refill, helping patients with specialty medication onboarding, or resolving the barriers that stand between patients and their medications, technology can help alleviate this shortage. AI-driven conversations help patients receive answers to their urgent questions, drive pharmacy engagement, and allow pharmacists to spend their time with the patients who need additional support.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

The other major challenge that automation can impact is drug adherence. The truth is that as many as half of all prescriptions are not taken correctly – either not followed according to the doctor’s orders, or not picked up from the pharmacy at all. Three reasons for this include cost, inconvenience, and medical concerns. Automation can lead to more consistent patient communication, which can help address those issues. For example, proactively engaging with patients about side-effects and which pharmacies have medications in stock can help resolve potential issues before doses are missed. Automation is a win for patients, too, since waiting in long lines or on hold to get answers is never an enjoyable experience.

AI, and specifically ChatGPT, is starting to infiltrate just about every conversation about the future of business, and healthcare is no exception. But in healthcare, the initial impact of these new technologies isn’t likely to be clinical intervention–that is years away. Instead, the earliest opportunities will be behind the scenes, simplifying any number of administrative tasks.

There is a huge opportunity for PBMs and health systems to use AI to help address the challenges surrounding the affordability and accessibility of medicines, from navigating formularies to resolving prior authorization. It is about laying the digital tracks that will enable patients to have a smoother, more cost-effective experience with the healthcare system—one that begins to feel more like the digital experiences we have in other aspects of our lives.

More automation in pharmacies and with ordering workflows is one piece of that puzzle—using the latest technology to make the behind the scenes work more efficient so that front-facing clinicians have more time to focus on patients.

Automation solutions can include a sophisticated patient management interface and virtual assistant that can do outreach autonomously, collect patient responses, and create prioritized lists for pharmacy teams when care team intervention is necessary. They allow pharmacies to manage their operations more efficiently and scale, while also improving patient outcomes.

The slow pace of technology adoption in pharmacies has made life tougher both for pharmacy employees and patients in need of medicines. Now that AI is starting to gain wider adoption, it’s creating new possibilities for pharmacies. I look forward to working with partners to modernize the industry. With the potential to address staffing shortages and improve adherence to prescriptions, this is an important development in our ongoing work to improve affordability and adherence.

Photo: Who_I_am, Getty Images

Kyle Kiser is the CEO of Arrive Health, an industry-leading technology company whose data network provides real-time, patient-specific insights at points of care and throughout the patient journey.