Home Healthcare Q&A: Surescripts CEO Frank Harvey

Q&A: Surescripts CEO Frank Harvey

Q&A: Surescripts CEO Frank Harvey


Frank Harvey, CEO of Surescripts, lately spoke with Healthcare Innovation a few vary of points, together with a current acquisition, the potential for pharmacists to play a bigger position on major care groups, and why Surescripts Well being Data Community LLC is making use of to change into a Certified Well being Data Community (QHIN) below the Trusted Trade Framework and Widespread Settlement (TEFCA). 

Harvey succeeded Tom Skelton as CEO in 2022. A pharmacist himself, Harvey has held management positions within the healthcare know-how, pharmacy and pharmaceutical sectors. He joined Surescripts from ATLS Investments LLC, the place he led non-public fairness investing in healthcare know-how firms.

Healthcare Innovation: May you speak a bit bit about how the position that pharmacists play within the healthcare ecosystem is evolving? 

Harvey: There are two main issues that we’re going through. One is the silver tsunami. Proper now we have now 58 million folks aged 65 and older. By 2030, it is estimated that we’ll have 70 million folks. By age 65, 80 p.c of individuals have a minimum of one power situation and 60 p.c of individuals have two power circumstances. As well as, you’ve the burnout that clinicians are feeling due to the pandemic — however it’s not simply the pandemic. It is all this administrative burden that we have placed on physicians, pharmacists and the whole care staff. It is estimated that 20 p.c of physicians plan to retire within the subsequent two years. So you have acquired an ageing inhabitants, and you have got an estimated scarcity of about 135,000 major care physicians by 2034.

We’re not changing them quickly sufficient. So that basically forces us to take a look at the care staff construction — how they work collectively, and who can decide up a few of that slack. If you have a look at the care staff, pharmacists have the scope of coaching to choose up quite a lot of that first degree of major care. They wish to try this and it’ll assist with a number of the pharmacist burnout we have seen, too. Pharmacists are burning out identical to physicians as a result of they’re centered on the menial duties that they need to be faraway from to allow them to concentrate on extra of the first care-focused areas.

HCI: In lots of areas, the impartial pharmacies have largely disappeared and the big retail chains dominate. Can the pharmacists in these retail environments tackle this position? And are these chains curious about seeing their pharmacist tackle that position?

Harvey: Completely. I believe in the event you have a look at all the key chains, they’re already acknowledging the necessity for the pharmacist job to evolve, together with doing immunizations that we did such a terrific job of throughout the pandemic. Now we have to change into power care managers, which suggests we have now to let pharmacists try this decrease degree of major care to alleviate a few of that burden from the doctor. There’s actually a three-legged stool. One is know-how. That’s the position of Surescripts, ensuring we have got the correct scientific data within the fingers of the pharmacist or the doctor after they’re making these care selections. A pharmacist or a doctor does not have all day to learn via a 300-page medical chart, so our know-how helps boil that all the way down to a abstract.

One other leg of the stool is the reimbursement coverage. Now we have to amend reimbursement coverage each on the CMS degree and on the well being plan degree to pay pharmacists for this extra exercise. There’s acquired to be compensation for that or they cannot afford to do it. 

The third piece is we’d like legislative adjustments throughout the U.S. and within the states. Through the pandemic, HHS gave pharmacists broader privileges and so they prolonged that via December of 2024. I believe we have to make these privileges go on from there. As a result of states are answerable for licensure and monitoring, quite a lot of the states should move laws to acknowledge the scope of the pharmacists’ coaching and empower them to offer these features. The research we have finished have proven that physicians are in favor of a pharmacist doing extra as a part of a collaborative care staff and it actually opens up their capacity to concentrate on the issues which are on the prime of their their coaching.

HCI: Surescripts does surveys of pharmacists about their prime challenges, and a current report stated they spoke in regards to the want for digital entry to scientific data, profit eligibility data, and digital prior authorization. How tough is it to collect that data and current it to them on the level of care? 

Harvey: It is not that tough in any respect. As a matter of truth, we try this proper now via their pharmacy working techniques. I believe certainly one of your articles within the final day or so was about some statistics in regards to the burden of prior authorization. It is one of the crucial burdensome factor for the doctor’s workplace. It is not solely administratively burdening for the doctor, however it additionally delays look after the affected person.

Now we have an digital prior authorization answer that is proactive. So when the doctor is writing the prescription, our answer goes out instantly quite than having to take two or three days to undergo a course of. As well as, with the Surescripts real-time prescription profit product, the doctor pulls up what treatment he needs to offer that affected person, and it exhibits him therapeutic alternate options. It exhibits him and the affected person what their profit covers. It exhibits them what the prices will probably be at retail. Virtually 20 p.c of sufferers will go to the pharmacy, after which the pharmacy has to name again to say ‘hey, this affected person cannot afford this. What are you able to do? Can you alter it?’ You get that taken care of proper on the doctor’s workplace.

HCI: Surescripts lately purchased an organization known as ActiveRadar. Are you able to clarify what was engaging about that firm?

Harvey: We checked out all the businesses on the market and we actually felt like ActiveRadar had the very best therapeutic different answer out there. All of the well being plans and all PBMs should have a therapeutic PMT committee that decides what medicine are interchangeable. It’s a very costly proposition, notably for smaller regional plans. By way of their know-how, ActiveRadar kind of does that work for for the plans and for the PBMs. That enables them to say, ‘Okay, I will simply use yours quite than having to make use of all these further people to do it.’ It creates extra consistency throughout all of the totally different plans as properly. 

For those who have a look at real-time prescription profit, ensuring the correct therapeutic alternate options are introduced as part of that answer is essential as properly.

HCI: Surescripts Well being Data Community simply introduced it is making use of to be a QHIN below the TEFCA framework. Who could be logical companions to be sub-participants below the TEFCA framework? 

Harvey: The pharmacies, the labs, PBMs, the well being plans. We’re the biggest interoperability firm within the nation already. We did 22 billion transactions final 12 months. Solely about 2.35 billion of these are literally prescriptions. The remaining is all of the scientific knowledge. 

We’re very assured that we will serve everybody throughout the spectrum of healthcare. And if you consider the Certified Well being Data, Networks in TEFCA, it actually does change into a community of networks, as you’ll, as a result of every one goes to achieve success bringing in individuals who will probably be their clients. We actually suppose the staff at ONC has finished an exquisite job. If you consider what is the significance of this, it comes again to the affected person’s capacity to verify they’re getting the correct therapy after they’re in entrance of a care supplier, as a result of with an incomplete medical report, they’re by no means positive that the correct selections are being made.

HCI: In September, the corporate named Lynne Nowak, M.D., its first chief knowledge and analytics officer. Why did Surescripts see a necessity for that position? And what are a number of the issues that she and her staff are engaged on?

Harvey: Properly, a terrific instance is that ActiveRadar goes to be part of her group. We all know the information has energy to ensure that we’re centered on the issues that might be bettering the standard of care, bettering affected person security and reducing the price of care. When you’ve 22 billion transactions, there’s so many issues that may come out of that, that data, making an attempt to establish these issues which are greatest for the affected person. We imagine there is a vital alternative for Lynne and our knowledge scientists to actually construct out the issues that can help these core elements of our mission.

HCI: Looking forward to 2024, are there every other plans you wish to discuss?

Harvey: We’re centered on making an attempt to take the executive burden away from the care suppliers as a result of we actually do see it as a disaster if you see the pharmacists taking turns happening strike, if you’ll, due to their working circumstances and so they’re not capable of concentrate on the issues that they wish to. So our goal is to look throughout the entire issues we offer and proceed to excellent them. Within the final 4 years, we have improved the standard of e-prescriptions by over 200 p.c. We’re engaged on ensuring that our scientific direct messaging product is on the market and pervasive via healthcare so the pharmacist can message the doctor, the doctor can message the pharmacist proper in workflow, eradicating the executive burden of getting to ship a fax. Healthcare might be one of many final bastions of the fax machine. We would love to see an finish of that fax machine and we imagine quite a lot of our applied sciences will probably be useful in that finish.

HCI: Are there some ways in which all this pleasure and improvement round synthetic intelligence and enormous language fashions can apply to the work you guys do?

Harvey: Individuals typically combine up machine studying and generative AI. We have been utilizing machine studying because the very starting inside our merchandise. We’re beginning to take a look at generative AI. We do suppose there are some issues we will put it to use for. Nevertheless, I will say we’re being actually cautious as a result of there are nonetheless quite a lot of unknowns about generative AI and it has hallucinations. If you’re coping with the affected person’s report, you possibly can’t have hallucinations. So we’re it, we’re testing it, doing quite a lot of pilot issues round it, however till we’re completely positive that it is what it must be, we’re not going to roll it out into our general portfolio.




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