The pharmaceutical industry is undergoing significant changes that are transforming current patient processes. While major treatment advancements across all therapeutic areas have significantly increased the quality of life for patients, they continue to face obstacles when they need to access specialty medications and new treatment regimens. Some of the challenges include  high costs, difficult treatment journeys and a hard-to-navigate approval process.

Pharmaceutical manufacturers have developed programs to optimize access to specialty medications and targeted therapeutic treatments and these programs have reduced the complexities and burdens involved in connecting clinicians and patients. However, many challenges remain related to access, including:

• Delays — from days to weeks — from the time a prescription is written to the time a patient receives first dose
• Intensive manual processes that are dependent on non-digital resources
• Poor patient medication adherence due to difficulties in access
• Third-party ownership of digital assets and inconsistency in patient data results
• Limited visibility into the patient journey which increases difficulty in helping patients and forecasting their needs
• Siloed access to programs, often each established by the brand, limiting the ability to generate insights across the pharmaceutical organization
• Slow introduction of new products and program roll-out delays that stall benefits to patients

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The need for a patient services platform

In the crowded specialty medications market for chronic and rare diseases, it is imperative that pharmaceutical manufacturers establish a strong connection to their patients. A robust patient services platform with an optimized patient experience is central to achieving this objective.

Most pharmaceutical manufacturers currently offer patient-access programs, but new approaches are required to accelerate innovation, inspire effective ways of working and activate ideas in real-time while increasing the speed of adoption with new processes and technology.

IBM Consulting offers the IBM Patient Services Platform that combines services and technology to facilitate treatment journeys for healthcare providers and patients. IBM’s platform helps organizations with a patient services platform to enable the essential services required to improve patient experience while streamlining operations and obtaining valuable market insights.

IBM’s solution is designed to help clients enhance user experience and engagement for patient-access programs with the following approach:

• Champion patient centricity through enhanced digital-engagement channels
• Streamline operations that work seamlessly within the care system
• Use data and technology to discover deeper insights

How the platform works

The modular patient services platform has two components: a Customer Engagement Layer (CEL) and an Integration and Data Layer (IDL).

The customer engagement layer is built on Salesforce Health Cloud, with portals for patient, healthcare provider, field agents and a control hub call-center console. The CEL-enhanced data model addresses specific requirements including patient access, affordability and treatment assistance. With its modular architecture, the CEL can be configured to address specific treatment requirements and patient programs.

The IDL is hosted on the IBM Cloud and uses best-in-class IBM software for real-time integration and bulk data transfers. The transaction data generated in the CEL is aggregated on the proprietary IBM Unified Data Model for Healthcare. The data model derives valuable patient and operational insights to enhance treatment access and adherence.

IBM uses business-associate agreements to exchange patient data and obtain value-added services including copay enrollment, copay claims processing, electronic benefit verification, prior authorization, specialty pharmacy fulfillment, and free goods and vouchers.

The IDL is secured by the IBM security suite to protect patient health information and provides resiliency to ensure uninterrupted service. Both the customer engagement layer and the integration and data layer are HIPAA-enabled and compliant with privacy and payment card regulations.

The IBM patient services platform enables the essential services needed to improve patient experience while streamlining operations and obtaining valuable market insights. IBM is dedicated to enabling health professionals and pharmaceutical manufacturers to make meaningful and impactful progress toward a healthier future.

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