Paulo B. Pinho, MD
Vice President & Medical Director of Innovation
Surescripts, a health information network representing 98% of the U.S. population and delivering 84% of U.S prescriptions with a central tenant of safety, cost effectiveness and care quality, has partnered with Diameter Health to expand its clinical intelligence capabilities, and simplify and expedite specialty medication prescribing and fulfillment. The partnership with Diameter Health will enable Surescripts to make timely and comprehensive clinical data more accessible to specialty pharmacists, to shorten, standardize, and streamline medication approval for improved clinical outcomes.
Access to patient health data is critical for specialty pharmacists who are handling targeted therapies with complex approval requirements. Independent research from Surescripts found that 40% of specialty pharmacists documented a two-week delay between prescription and dispensing for the average patient’s specialty medication handling based simply on the need to gather necessary clinical evidence. The research highlights the administrative inefficiencies that lead to increased costs.
From a patient perspective, treatment delays, medication side effects, non-adherence can lead to unnecessary clinical decline. As a clinician, I have seen the impact of these delays, and the extraordinary benefit of these advanced treatments. Stories from my patients illustrate this. (Please note, no personal health information is shared but my patients and families have agreed to have their stories told.)
In July of 2020, BC, a 12-year-old boy with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a disease leading to progressive weakness and sensory impairment in the arms and legs, was prescribed rituximab after failure to improve with first line therapy. Weeks later, the medication was finally approved with immediate evidence of clinical improvement in the child’s abilities to perform activities of daily living.
KH was diagnosed with crippling Rheumatoid Arthritis in 2008. With aggressive treatment, she improved and at her peak in 2012, she was able to complete a half marathon. In 2013, she flared, and her rheumatologist prescribed a medication switch to tocilizumab. Due to challenges in medication approval, she was prescribed an alternative two-medication regimen. After 2 months, this recent half marathon finisher was unable to get out of bed due to chronic pain, fatigue and the concomitant emotional toll that ensued because of her disease progression. Additionally, she developed medication-induced liver fibrosis. Only then was her prescribed medication approved. While she has never returned to her 2012 physical peak and requires hepatology follow up, since being on tocilizumab, she has enjoyed clinical stability.
Moreover, a 2020 study by Wallace, et al, published in Arthritis Care & Research in 2020 showed that, after the time-consuming and inefficient approval process, 96% of medications ultimately were approved. Provision of the right clinical data at the right time could eliminate the wait.
Diameter Health will give clinicians and pharmacists the information they need to put patients on appropriate specialty medicines as quickly as possible. Patient data will be available within Surescripts’ Specialty Medications Gateway that uses a record locator exchange (RLE) service, allowing pharmacies to search for a patient’s care episodes across the country, and retrieve continuity of care documents (CCDs) from their various sites of care. Once received, the CCDs are processed through Diameter Health’s solution, which normalizes, enhances, reorganizes and deduplicates disparate data to present a summarized longitudinal patient record to enhance the approval process.
Mike Pritts, Chief Product Officer at Surescripts, explained, “As we innovate in this area, we are excited to partner with Diameter Health to deliver enhanced clinical intelligence for specialty pharmacies. By providing fast and easy access to simple-to-understand, normalized, patient-centric clinical data, we can help providers avoid the back-and-forth phone calls and faxes that slow the approval of specialty therapies and ultimately delay treatments.”
The future of healthcare is packed with opportunities to deliver increasingly predictive, proactive, personalized, and poignant care in an equitable fashion to all. Data is primed to be the impetus for this change at an extremely critical tipping point. The partnership between Surescripts and Diameter Health catalyzes this pendulum swing by allowing enriched and actionable data to improve the care delivery journey for payers, providers, pharmacists, and most importantly, patients.
To learn more, please click here to read the press release.
