← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Breaking Barriers to Medication Access: Accelerating Therapy Starts with Integrated EHR Solutions
00:20:22
Loading summary
Transcript26 lines
- [00:00]
A
Hi, everyone. This is Lucas Voss with Becker's Healthcare. Thanks so much for tuning into the Becker's Healthcare podcast series. It's fantastic to have you. Today we're talking about why accelerating therapy starts with integrated EHR solutions. And I'm so excited to have two wonderful guests for today's discussion. David Ward, he's the vice president of business development at CoverMyMeds. And Molly Brady, she's the director of customer success at Ontada. David Amali, thank you. Thanks so much for being here today and taking some time for us. It's great to have you.
- [00:30]
B
Thanks, Lucas. Good to be here.
- [00:31]
C
Thank you.
- [00:32]
A
Well, David and Molly, thanks so much for being here today. It's great to have you. For those that might not know you yet, at least, I do want to start us off with introductions here today. David, we'll start off with you. Can you just share a little bit about yourself and your work in healthcare?
- [00:46]
B
Yeah. Thanks, Lucas. Really happy and excited to be here with you today. So I've been in healthcare really my entire career, 20 plus years, seeing, you know, different parts of the healthcare industry. For the last four years almost, I've been here with CoverMyMeds working in, you know, various roles in product, product strategy and business development. And it's really given me the opportunity to see things, you know, from that provider lens and that health system and, and clinical perspective of things in healthcare. And then, you know, prior to my time at CoverMyMeds, I saw things from the pharmaceutical industry and that perspective where I spent my time doing market access and commercialization consulting, you know, branded pharmaceutical manufacturers on launching their drugs. On the personal side, I'm based in Columbus, Ohio, where we have the headquarters of CoverMyMeds and live here with my wife, who is actually a healthcare practitioner and my two small children.
- [01:47]
A
Yeah, Molly, same question for you. It's great to have. You can share a bit about yourself and your work in healthcare.
- [01:52]
C
You bet. Thanks. I'm an oncology nurse by trade and I began my relationship with McKesson as a customer in 2003. I worked in a community oncology practice in Nebraska for 10 years prior to coming to work for McKesson. I helped take our practice live from paper to Inomed EHR and then the transition from Inomed EHR to Inomed Generation 2 as we know it today. Shortly after our go live to generation two, I went to work for McKesson and there I've worked as an account manager, a product manager, and now I'm the director of Customer Success team and My team of 10 support 119 community oncology practices. Both part of the US Oncology Network and Open Market. I'm based in Omaha, Nebraska, living my best life with my husband and our Bernadoodle Scout. We're busy with our three adult kids and their spouses and our three very busy grandchildren. This partnership with I know Med Generation 2 and CoverMyMeds is so important and I've seen firsthand the real time benefits of this functionality and I'm excited for this opportunity. Let's start with an overview of cmm.
- [03:11]
B
Yeah. Thanks, Molly. So, just to give everybody a little more background, CoverMyMeds is one of the kind of pillars of McKesson Corporation along with Ontada. And our focus really is on medication access, helping patients get the medications they need to live to live healthier lives. And through our technology and our CoverMyMeds platform, we really are reinventing how patients are accessing their medications through where we've historically had success within electronic prior authorization, but really moving beyond that to other parts of that patient and prescriber journey again with that goal of helping patients get on the medications that they need to live healthier.
- [03:53]
A
Yeah, it's great to have you both on. I think again, you've mentioned a couple of important points here. Both of you have mentioned a couple of important aspects to this and again, it's so excited to have you both. You've talked about the shortages piece quite a bit and we certainly still see a lot of pricing pressures and administrative complexity in the space itself. And medication access is a major challenge. We know that for both patients and care teams, certainly from your perspective. And David, I'd love to start off with you on this. What is the most critical workflow issue that needs improvement today and why?
- [04:31]
B
Yeah, it's a great question. In our experience working with our healthcare provider customers within our network, the biggest thing we really see is the fragmentation that exists across healthcare, particularly from a workflow perspective, that healthcare providers and their staffs are working in. So, you know, in our research, it's not uncommon that we've seen that, you know, these users and these healthcare providers are sometimes going across nine different digital tools. And that's not including, you know, the old ways of doing things like phone and fax, just to complete these access steps to get patients onto therapy. And, you know, there's a lot that this fragmentation creates. So, you know, you know, number one is just increasing administrative tasks, particularly around duplication of data, where we see a lot of our customers and our Users looking into their electronic health record system and then copying that information over into a prior authorization form or into a benefits investigation. These things can create gaps in data and information and contribute to a lot of the clinician burnout that we all hear about. You know, and I think really the unlock to a lot of this is, you know, starting with that electronic health record system where you know, we could, we could really unlock and make things simpler by having that integration directly into that electronic health record for all types of medications, both pharmacy and medical benefit, to kind of remove that context, switching that chair swivel that are that users are experiencing, improving a lot of the quality of data and really giving both practices and patients cleaner and faster paths to start therapy. So we're really excited to be here today and share how our new Cover MYEDS platform will help solve these barriers and really be a game changer in the industry. And we'll be talking a lot more about it at HIMSS this year.
- [06:39]
A
Yeah, you know you have a problem, David, when in 2026 you still talk about facts, right? How does the facts what is effects machine? Some people might not know that, but yes, you do know. Molly, I wanted to ask you the same question too. Specifically since you're so close to some of the workflow pieces, et cetera, what's that most critical workflow piece that needs improvement today for you?
- [07:04]
C
Yeah, and I'm going to start with giving a little bit of background about ONTADA for our listeners. ONTADA is a specialized oncology data insights and technology business housed within McKesson where I like to call it kind of a stripe if you will, of McKesson. And our mission is to advance cancer research and care so we can help transform the fight against cancer. Something I just as an oncology nurse like live and breathe every day. We enable real world evidence, we support oncology providers and strengthen life science partnerships through those advanced analytics and point of care technology. So I can totally echo what David said when various steps of the medication access sit inside the electronic health record. It's a win for both providers and most importantly the patient when treatment plans and drug orders immediately trigger prior auth and benefits investigation at that point of ordering, this totally avoids delays and status visibility aligns with scheduling. Since I know Med is an oncology specific electronic health record developed by Ontada, it's designed specifically for ontology and hematology practices supporting that high quality evidence based cancer care. The result of this partnership between Cover MindMed and Inomed is fewer delays, fewer faxes there's that word. And more predictable chair utilization and positive patient experience. We're excited about the collaboration between Ontada and CoverMyMeds and the promise we've seen from the pilot work thus far.
- [08:59]
A
Certainly the big piece here is integration and just the ease of workflow through integration in itself. And David, when you're thinking about all of these challenges, and you've highlighted some of this already here in your previous answer, but what are some of those tools and approaches, initiatives, et cetera, that you're seeing that really make a difference and more importantly that you are encouraged by right now that you think, okay, this is actually working, we're making a difference here.
- [09:25]
B
Yeah, let me maybe take a little step back and let's kind of walk through a scenario on this and see how it plays out. And I think that'll kind of better help, kind of illustrate and show how this works in practice. So imagine, you know, a, a new cancer patient starting a very complex treatment plan and therapy plan. There are going to be significant barriers to getting that patient through that treatment plan. Some of these things are delays in getting prior authorizations done, uncertainty of coverage from either the health plan or the pharmacy benefit manager on the drug side, fragmented communication along, along all of the different people who are part of that patient journey. So this isn't just the provider's office. This could be different labs, this could be a specialty pharmacy, and this can also be the health plans and payers as well. And you know, just think about how challenging that is just from a real world situation. You know, these, these patients are already very sick. These are, you know, life and death situations in a lot of cases. And it's placing, you know, a lot of emotional strain on, on top of just the difficulty of that treatment journey. So when an oncology practice like where Molly came from and works with every day, lack a lot of those integrated and real time tools and access to clinical information, benefits information and authorization information at the point of care. This is where the office staff, the nurses, the physicians, the support staff are having to get on those phones. They're having to check that fax machine, they're re entering data and they're doing it across multiple portals and multiple systems where it's hard to really see the complete status of that treatment plan at that patient level. And so when you ask, you know, what am I encouraged by right now? It is, it is things like the partnership that we have, but with CoverMyMeds and our platform and ONTADA and the INOMED electronic medical record system where we can really put all these things in workflow connected to that data to help make this journey just a little bit easier. Molly, is this a story that resonates with you? I'm sure you have a lot of experience with this in your clinical experience as well, David?
- [11:44]
C
100%. I mean, the time spent in clinic, I've seen it firsthand and I still see it today. Trying to gain approval for therapies ordered or validating payer coverage is absolutely enormous and it's very time consuming. And unfortunately, the patient is, as you said, directly affected by these delays. We work so closely with the largest network of community oncology providers, and we have a clear understanding of their challenges and workflow. And this is such a great solution. We built I know MED based on that clinician workflow. So continuing to provide the tools that make their jobs more efficient is something we just are continually looking to integrate. We're trying to address the challenge of medication access and the standardized oncology workflows. So this. Absolutely. I can 100% relate.
- [12:42]
A
And I want to shift the focus a little bit too, because we've talked about this in sort of the administrative processes piece. Right. And technology playing a larger role in streaming the process in itself, too. I do want to talk a little bit about the pharmacy and medication access space here because certainly technology is making a difference there as well. How is all of this translating to that space, to the pharmacy and medication access space? And what are some of the outcomes you're seeing for patients and practices right now out there? David, we'll start with you.
- [13:18]
B
Yeah. So, you know, you hear a lot of, you know, buzzwords in the industry, particularly in health care now, around, like artificial intelligence and automation, and they really are making a lot of positive impact in healthcare already, even in these early days. But I do want to make kind of a quick clarification here around automation and AI. You hear these things used interchangeably quite a bit, but they're actually kind of very different things. And I think understanding those and the audience being able to understand that will really help see where kind of each one of these is making an impact. So let me start with automation. This is something that's actually not new in healthcare. We've been using it for many years to streamline structured tasks. So again, things like benefits verification, eligibility checks, and the more simple prior authorization submissions. When we talk about automation, we're Talking about building APIs with clear business rules and really focused on making a lot of repetitive tasks easier. That really does matter, because even though Most providers have adopted some form of electronic prior authorizations that manual process, the phone calls and the fax machine. It really does still persist. This automation over time is really starting to make that electronic prior authorization process more efficient, simplifying it and you know, ultimately getting patients on therapy faster.
- [14:51]
A
The confusion between the two is definitely present across all of healthcare and certainly continues to be. And I think that the differentiation will be a big difference in 2026 and beyond. Molly, from an oncology perspective, how do you see this making the biggest difference?
- [15:10]
C
Yeah, there's several that come to mind. The medical benefit prior authorizations for the infusion therapies. AI helps match regimen and diagnoses to health plans or pharmacy benefits criteria. And that just reduces the back and forth ordering and canceled infusion. And it ultimately leads to that which ultimately leads to treatment delays and the patient again, the patient is directly affected. Oral oncolytics and specialty enrollment. That automated enrollment and benefit checks shorten the time to dispense and connects patients to the financial assistance that is often needed. The biomarker, pathology alignment, ensuring the right clinical evidence is present at submission to prevent avoidable denials. And then the scheduling and visibility links prior AUTH status to infusion scheduling in in Med. And that avoids the chair underutilization and same day surprises. It also it makes staffing more efficient with smaller community teams. We often see, you know, shaving those minutes and eliminating faxes at each step adds up to meaningful capacity gains for those practices and the ambient AI. Noting willingness to leverage the advanced technologies and how this can be applied to other clinician workflows is huge.
- [16:38]
B
And Molly maybe to build on that too. Those are a lot of the benefits that we're seeing with AI and how that's different than automation and how it can really take the much more complex tasks and start making them simpler. But there's one thing I always think about here too that's key is still having that clinical oversight is really critical within that process. So you know, having the AI to help support the decision making, but it, it, you know, not replacing it. Right. So still having clinicians and staff in the loop to ensure that the recommendations are safe and appropriate and really aligned with, you know, patient, the, the full patient context. So you know, when we're thinking about AI at CoverMyMeds and as a, as a technology company company in healthcare, it's something we talk about every day. It's, you know, really why we, we believe that AI is something that has to be done both in a responsible and very scalable way again to keep patient safety first and, and keep that those clinical decision makers in the loop at all times.
- [17:42]
C
Absolutely.
- [17:42]
A
That's my, one of my favorite buzzwords is the human in the loop piece for, for healthcare right now. It's very, very important, especially in a clinical context. Well, again, it's so great to have you both on. As we close our episode here. I'd love to leave our, our audience with some actionable, actionable takeaways as they head through 2026 and beyond. As you are looking ahead from your perspective, how do you envision medication access evolving here in the next year or two? And what's that one step right, that one step leaders can take right now to prepare. David, we'll start off with you.
- [18:16]
B
Yeah, I mean I, I think it is moving, you know, faster than I, than I have seen in the 20 plus years that, you know, I, I've been in healthcare. And I know we talked about this a little bit earlier on, but everything in my mind really starts with that source of truth, which is the electronic health record systems that healthcare providers and, and practices are using. And that's why, you know, I'm so excited about, about the CoverMyMeds platform that we've been building being really kind of a first of its kind EHR integrated solution that is, you know, unifying benefits, investigations, prior authorizations of both medical and pharmacy benefit and patient services and enrollments into a single experience. You know, by centralizing all these access functions, it really unlocks insights for health system lead leaders, helps provide aggregated de identified market insights that help life sciences companies understand access challenges and ultimately is going to help us improve those time to initiation and time to therapy for patients. So you know, this is, this is really an exciting time to be in right now with all these advances and you know, really looking forward to see what's going to be coming in the next year or so.
- [19:31]
A
Molly, same question for you here. What's that one step that you would like leaders to take right now and how are you seeing this evolve?
- [19:40]
C
Take the step, take the plunge and check us out for more information. As David said, this is just such a valuable tool integrated directly into the ehr. I'm excited about what's going on and what's to come.
- [19:57]
A
Well, Molly and David, it's so great to have you both on. We'll send you a fax, right. That's how we'll do things. I want to thank you both for your time and insights. It's so fantastic to have you. And we also want to thank our podcast sponsor. Cover my meds and you can certainly tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.