MedAdvisor Solutions, a company focused on pharmacy-driven patient engagement solutions, recently unveiled an AI-driven medication advisor to enhance interactions, from personalized conversations about medication management to answers related to complex health inquiries.
"The integration of advanced AI solutions into pharmacies’ patient engagement services will help to improve customer experience and reduce burden on pharmacy staff,” said Rick Ratliff, CEO of MedAdvisor Solutions, in a statement. ”Our AI-enabled medication advisor represents MedAdvisor Solutions' commitment to digital innovation, as well as our commitment to elevating patient engagement and empowering pharmacies to deliver superior care efficiently.”
Ratliff, former CEO of Surescripts, recently sat down with Healthcare Innovation to talk about innovations in patient engagement in the pharmacy space.
Healthcare Innovation: Before we talk about MedAdvisor Solutions, can you talk about your experience at Surescripts and how it led you here?
Ratliff: When we started Surescripts, I was the chief operating officer, and Kevin Hutchinson was the CEO. We built a network in the U.S. to connect doctors to the pharmacy to enable prescriptions to flow electronically from the electronic medical record into the pharmacy dispensing system, eliminating the paper prescription. So the whole focus was to eliminate the paper prescription and start to streamline the overall prescription communication process between the doctor's office and the pharmacy. We built that network over the first six to seven years of the business, and then I did become the CEO. At that point, we merged Surescripts with a competing network that had been started up by the pharmacy benefit managers. It was called RxHub. We merged those two businesses together, which enabled us to create a streamlined workflow for the electronic medical record, so that we could allow for automated determination of eligibility of a patient's prescription benefit inside of the electronic prescribing workflow and then tie that to the formulary. That is specific to that individual and their employer, so that the physician can hopefully select a medication that's going to be the most cost-effective and clinically appropriate for the patient.
We were working very closely with the associations and with the community pharmacy stakeholders and PBM stakeholders to influence legislation around Medicare Part D, and create a program through the Medicare Medicare Modernization Act that would actually create incentives for doctors to write prescriptions electronically for Medicare and Medicaid patients. If they wrote a certain percentage of their prescriptions electronically, they received a bonus, and eventually that turned into a more of a stick, so it was more of a penalty if you didn't write your prescriptions electronically. That evolved over time, but it was the alignment of the industry and government on the incentives that helped us to drive electronic prescribing up significantly.
HCI: So when did you leave Surescripts and how did you find your way to MedAdvisor?
Ratliff: In the 2010 timeframe, we had merged the businesses, we had built the network, and the business itself was starting to turn profitable. I then went to Accenture to lead the digital healthcare practice. It was an opportunity to work globally and actually use technology to help governments to integrate healthcare across their particular government. We started with Singapore and Australia. I then worked at a company called ConnectiveRX, which is a private equity-backed pharma tech services business. It actually enables financial services types of transactions for patients to help bring down the cost of medications through manufacturer-sponsored copay programs and patient support programs for high medications. I then made my way to MedAdvisor, which is based out of Melbourne, Australia. They had acquired a company in the U.S. called Adheris Health in 2020, with the intent that MedAdvisor was looking for an entree into the United States. That acquisition created an opportunity to get relationships with a large portion of the U.S. pharmacy business very quickly.
HCI: What’s the business model for MedAdvisor’s omnichannel engagement for pharmacy? Can you explain how it works?
Ratliff: It is designed to allow for us to engage the patient in their pharmacy, and do that in such a way that it complements any type of communications processes that are already in place with the pharmacy today. As an example, the Adheris health business is actually 30 years old, and it started with direct mail, doing pharma-sponsored communications to their patients. Then we evolved that into print in the pharmacy. So we actually integrated into the pharmacy workflow so that when you pick up your prescription for Lipitor, you might get information on Lipitor that's attached to the prescription itself to help you understand the statin,. Now we've been evolving those communications channels to include text messaging, and recently launched through the omnichannel engagement, the ability to communicate to patients in their pharmacy’s app.
The idea here is that we can aggregate information from the pharmacies, and we can target certain types of messages. These are brand-sponsored messages to individuals. So if you've been prescribed Ozempic or Eliquis or Trulicity, we would coordinate the communications around that information on that medication you're filling through the pharmacy. So again, it's coming through the pharmacy. We're not trying to replace what the pharmacies do. We're trying to complement it.
HCI: Is there an option for that to be a two-way communication if the patient has a question based on the information they're receiving?
Ratliff: The two-way communication would be with the pharmacist at this point. The intent in all situations would be that if you need follow-up, you're going to follow up with the pharmacist. However, we are about to implement a two-way chat capability, which would allow you more of an online capability you're used to with other kinds of products and services.
Also, we are going to launch a proof of concept around what we're calling the medication advisor, which is a virtual assistant type technology using AI. If you go and pick up your prescription and you get a really detailed piece of paper on the medication, you're not likely going to read it. Or if you do, it's very difficult because of the way it's written. But then, with the medication assistant or medication advisor, you can actually ask questions in an interactive fashion about your medication and get responses back. And in this case, the responses are all informed by FDA-approved data. So we're not implementing an open AI platform. It's more of a ring-fenced, confined AI platform where the responses in the information shared with the individual is really driven off of approved content. So it is conversational, but it's very, very narrowly focused and confined.
HCI: Getting back to the business model, the pharma companies are the ones who are paying for this, and the pharmacies are interested because they want to increase medication adherence, or for other reasons?
Ratliff: A primary reason is medication adherence. Related to that is engaging patients in the way they want to be engaged. Part of that is enabling an approach to get information in the hands of the patient in a variety of ways that may hopefully help to offload some burden on the pharmacy tech staff or pharmacist as well. Hopefully as you create this interaction, you can get more questions answered offline.
HCI: Last year I interviewed Frank Harvey, who is Surescripts’ current CEO, and he was talking about the evolving role of the pharmacists in the healthcare ecosystem with them playing a bigger role. I said to him that my experience at the local pharmacy is that there are 25 people waiting for a prescription. The pharmacist has very little time with each person, and there’s not much of an effort to build a relationship. There may be places where people treat the pharmacist as a trusted advisor, but I've not seen that. Is that really happening?
Ratliff: That's a good question. And I would say it is happening. Is it happening across the board and across the the market? I doubt it, and for a variety of reasons. One of the reasons is related to your point. There have been fewer individuals graduating out of pharmacy schools over the last couple of years. And with COVID, a high percentage of vaccines are now administered in the pharmacy. Pharmacists are filling more prescriptions, not fewer prescriptions. As they start to fill more specialty medications in the pharmacy, then the kinds of questions you get and the complexities put more burden on the pharmacy, and it does put more strain on the ability to to create that relationship.
I've been involved in this industry for well over 30 years, and, you know, since I really got engaged on the pharmacy side, pharmacists have been advocating to become a more integral part of the healthcare system. In the U.S. as well as in Australia, Canada and the UK, access to healthcare is more and more of a challenge in general. So pharmacists have been trained, and they're the experts on managing your medications. An individual sees a pharmacist 10 to 12 more times per year than they see their doctor. Now, do they get the right amount of time, and do they have — to your point — a quality interaction? That's a different question, but, there is the interaction there. So there is an effort underway.
The CEO of the National Community Pharmacists Association, Doug Hoey, is advocating for a designation of pharmacists as primary care providers, not with the intent of replacing primary care, but with the intent of being able to provide a broader set of services, so that pharmacies are not just fulfilling the medication, they're counseling the individuals on appropriately taking their medications. But potentially they're actually providing more clinical services like women's health services or basic services around ear infections or sore throats or those types of things, and being able to diagnose and even prescribe medications.
There's a very limited amount of that happening in the U.S. It's a significant part of what we're doing in Australia, so we're seeing it start to pick up. Now, the question is, if you have staffing challenges and you have higher volume and you have more requirements coming into the pharmacy, how do you manage that? Well, technology is an interesting tool to help enable. It doesn't eliminate all of the issues, but it does create opportunities, as we experience in other parts of our lives, in the retail world and restaurants. The pharmacies are starting to make it easier to engage the patient, to do it through their mobile apps, to do it through their websites, through text messaging, and you'll start to see artificial intelligence and other kinds of technologies being used to streamline the workflow and help to improve the way they interact with an individual.
HCI: It seems like a good opportunity to build that type of a connection might be in smaller, independent pharmacies, but they have been struggling financially. Do you work with them as well as regional chains?
Ratliff: We do work with independent pharmacies, as well as the the larger regional chains. We are starting to do more on the independent side to enable them to provide the kinds of services that might help them to become an even more integral part of the healthcare community. A lot of the independent pharmacies truly are small-business owners. They are truly a part of the community. They actually do know their customers and know their community, and in many cases, are doing very innovative types of programs with local healthcare systems, so that they can complement what they're doing relative to medication management and adherence and maybe even in-home monitoring.
We’re starting to do some work in that space in the U.S. and more so actually in Australia. Our software in Australia runs in about 95% of the pharmacies, and it is more of a clinical workflow type solution. It helps the pharmacist to engage the patient in managing multiple medications or their diabetes, etc. We're a little more ingrained there. We’re looking at the synergies between the U.S. and Australia. Because even though scales are different and the payment systems are different, the challenges are very similar, actually, from a healthcare access standpoint and managing the overall cost of healthcare.
