June 12, 2019
By Julie Gould
During this discussion, Jim Adams of AllianceRx Walgreens Prime and Sean Creehan of Inovalon, break down the different uses of technology in the health care sector and they highlight how patients can benefit from cloud‑based technologies.
Julie Gould: Please tell us a little bit about yourself and your history at each of your companies.
Jim Adams: Absolutely. My name is Jim Adams. I'm chief information officer for AllianceRx Walgreens Prime. We're a joint venture that was formed approximately two years ago. The goal of the joint venture was to supply specialty and home delivery medications to our patients. It's formed between Walgreens and Prime Therapeutics, two leading providers in the space.
We've had a longstanding history of working together. My history with Walgreens stems back 10 years. I've been with them. Prior to that, I did work at Abbott Pharmaceuticals. Prior to that, I worked for Specialty Scripts, which was a specialty pharmacy that was stood up by Cardinal Healthcare.
Sean Creehan: I'm Sean Creehan. I head up the pharmacy technology business of Inovalon. My career started many years ago, more than I'd like to admit, maybe 25 or so, focused on pharmacy technology, and spent most of my time dedicated to specifically the specialty pharmacy segment from the onset, essentially.
Still carry the same passion. We were fortunate to be in a position to build software for generation one, generation two, and now next generation. Excited to be here and share where we're headed.
Jim: When did we first working together? Was it between gen one and two?
Sean: I think so. Yup.
Jim: It was right there.
Sean: It is exactly at that inflection point.
Julie: What are the core benefits of leveraging technology in a consistently changing healthcare landscape?
Sean: I can start with that one. I guess in the question itself, it answers it. When there's change, technology is the only way to survive those changes. Obviously, technology that is adaptable, configurable is what minimizes the impact of that change, and in fact, turns those changes into opportunities for business differentiation and strategy. That's how I would look at it.
Jim: Without question, as a segment of healthcare, pharmacy is an area that sees a tremendous amount of change. It happens at the state level from a regulations perspective. It happens at a individual drug level. As products are released, it needs to service those.
Within how we do business and actually provide those medications to patients cause us to have to operate differently. As Sean said, having a platform that is highly configurable is ideal. It allows us to be adaptable to meet the market needs.
Julie: Based from your experiences in each of your positions, how have you seen significant innovations with various technologies in the healthcare sector?
Jim: You want to go first on that one.
Sean: We see a lot of innovation, frankly. We see innovation come in personal technology, biometric devices, and different ways to engage patients in this evolving Internet of Things. You have that whole spectrum. We see innovation in engagement models, ways to engage with patients telephonically, digitally, and other methods.
In our focus, we bring to life data. We've focused on an innovation that takes large data ‑‑ patient data, healthcare data ‑‑ and leverages that data to create new opportunities to better serve patients, to streamline processes, and innovate in ways that that data can change the conversation with patients.
Jim: I would say maybe a big contrarian of a view, I would say that we have a tremendous amount of energy around innovation and a lot of ideas that start. I would feel that many of them don't actually take root.
There is a lot of opportunity from reach to the patient and getting patient engagement down to technologies that are more on the terms of the patient, because the healthcare systems themselves and pharmacy often don't allow patients to engage on their own terms.
We're holding them hostage, if you will, to the methods that we use, which are largely rooted and fairly antiquated technologies that aren't highly integrated. We talk a lot about it. It is a very complicated problem to solve, to use technology to actually innovate and do something radically different.
Every single segment of market where we've seen transformative change, the underlying enablement is the data and the access to the consumer.
These are the things that Sean and I are quite focused on in the new endeavor that we're focused on, is to deliver completely different operating models that are rooted in access to data that we didn't previously have, and make sure that we maximize the reach that we have to the patient as the pharmacy itself through whatever means we possibly can.
Julie: What are the challenges when implementing a cloud‑based technology into practice?
Sean: While the technology itself has tremendous benefits in, obviously, its scale, its reliability, its accessibility, closeness to the data, challenges are there. The technology stack from a technical standpoint is complicated, complex, requires different thought processes and managing.
You have that aspect of it. Frankly, the technology itself and what it brings to bear for the user experience and our focus on that user experience, both clinicians, non‑clinicians, and operators.
The opportunity both for being cloud and just thinking of things a new way makes it an exciting positive experience of change, but doesn't come without challenge when you're coming from a different type of user experience. That change management is Jim's challenge.
Jim: [laughs] Indeed, it is.
Sean: We just support him in that.
Jim: I would say to, in fact, transition to cloud technology, it's all the buzz.
It's what everybody is focused on trying to get to, because of the core benefit which is in the technologies themselves, the ability to administer them allows companies to transport the dollars they would spend administering those infrastructures in their own four walls and reinvest those into things that are highly innovative.
It's about moving your investment away from things that are highly commoditized, and moving it into things that are meaningful and drive value. In order to do that, everybody, all companies, all markets are racing to try and leverage cloud and cloud technology. Because of that, resources are fairly constrained and fairly expensive.
Add to that the complexity that we feel and face around required subject matter expertise in the healthcare space and in pharmacy. We're uniquely challenged in finding the right resources to get the work done. That is something Sean gets to address and deal with.
It is well worth it, the value side of it, to actually be able to redirect those dollars into something that is meaningful to drive value is absolutely worth it.
Julie: Jim, during your discussion at the Asembia 2019 Specialty Pharmacy Summit you talked about your mom and her battle with chronic illness.
Jim: I did.
Julie: What chronic illnesses currently benefit from cloud‑based technologies? Do you believe there are illnesses on the rise that can also benefit from these services?
Jim: Absolutely anything. It doesn't even have to be a specialty condition. Patient engagement is absolutely required in order for us to achieve the outcomes that medications promise, whether they're for chronic illnesses such as diabetes, all the way up to the very most difficult conditions.
I look at it in two ways. Number one, reaching a patient, engaging them, and doing so on their terms will bring them closer to participating with us in their journey towards whatever their best outcome can be. It isn't always health.
Helping a patient navigate that, again, on their terms, leveraging technology, I believe, is vital. I believe it's vital for us to be able to find those inflection points along the way, help attenuate their journey to the best possible outcome.
When we don't have those engagement technologies functioning well, and we don't yet, we're going to find that these retrospective moments where we can talk to patients and look back, for instance if they go to visit their doctor and the doctor says, "How have the last three months been?"
There's a lot that we lose in three months' time in our ability to communicate with one another, predict, decide, and act on something very important that we're seeing. These engagement technologies are going to help that. It's a pervasive opportunity we have to leverage those to try and make meaningful differences for patients. Sean, any...
Sean: Yeah. I would add the operating model that we live in today based on the technologies that underpin that operating model don't lend themselves true collaboration, where there is a truly shared view of the patient journey with distinct purpose and process for different constituents to participate in.
I look at that as a really neat thing that cloud brings to the table. When you overlay that with that common view with bona fide data about patient, it can make that difference in how that patient's treated and how efficient it can be to reduce the discovery of unknowns between one provider and another.
Julie: Are the certain patient populations such as Medicare Advantage and fee‑for‑service Medicare, that benefit more from cloud‑based technology?
Jim: I don't think that that would be true. Patients segmented by who they happen to be insured by at any given moment, I don't think that changes the nature of the patient needs. I don't think it changes the benefit that they would receive from being engaged.
Sean: I concur. I don't see it so much as a differentiator relating to their benefit type.
Albeit, I would take advantage of the opportunity to point out that having a unified data source of analytical capabilities to differentiate what might be different that isn't obvious to us among those different benefit types and what behaviors and practices that just maybe in there to tell us something would be something that could yield from the technology and from the deployment.
Something to look at.
Jim: Fairly stated.
Julie: Can you tell me how companies use cloud‑based technologies to provide holistic care and improve outcomes?
Jim: Yeah. The fundamental thing that is different about the cloud‑based solutions is that we have a single place where multiple constituents can be to collaborate with one another as Sean shared. That is the single most important thing that we could do to drive better outcomes and create that holistic view.
The challenge will always be to ensure that those that participating find credible use of what they find there, are able to look at it, and qualify the data, the experience, the journey, or the intervention, whatever it is we were making available on that cloud technology find it to be credible and useful at the time that it's offered up.
That is, to me, the core of what we're able to do with the cloud technologies and, candidly, the most exciting thing that we're looking forward to as we implement this new platform.
Sean: We just add to that the business aspect of it from a contracting perspective and the measurement aspect that you have a call it unified source and objective source to look at together, where it's not just a handoff and exchange of a certain set of data that is now reinterpreted by the other side and creates sometimes not the right dialog.
By creating a better contracting model and a better data visibility to what really binds that contracting model allows people to look past the mechanics of putting data together, and instead, find usage for the data that is together to make things better.
Jim: To your point from a contracting perspective, contracting, agreeing upfront what together you will measure and how you might measure it is precisely what you're getting at, Sean. It's the opportunity for multiple constituents. Not just point to point, but point to multipoint to agree on the terms, the nomenclature, the meaning of the data itself and contract around those things.
To Sean's point, you rise above the mechanics of the data itself and get to the value and what is the story that the data is telling you. Contracting based on that story with the patient as your center and your focal point, we believe it's going to differentiate the value we can drive the patients.
Julie: Finally, do you foresee where companies utilizing cloud‑based technologies in the future? How will utilization, as well as cost be impacted?
Sean: The answer to the question about are there going to be more, as Jim stated earlier, it's essentially a race at this point to get into that state to gain the values that it brings. There's no question about that.
What happens with cost? That's a trickier question. It's, as I said, a very expensive proposition with the text act that exists in cloud. Time will tell, as with anything in technology when you create a platform that enables more technology, certain costs go down and more costs go up. [laughs]
Sean: We can expect that. The value offset for what goes up assuredly will be there.
Jim: I'm in full agreement. Without question, there is a race that's on. We have a variety of very good capabilities that are emerging and will continue to grow in their strength. As those mature, we will learn along the way what the implications are from a cost perspective. We'll react to that new norm that develops.