The Specialty Pharmacy: Adding the RX to PX

Association for Specialty Pharmacy

Association for Patient Experience
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Amanda Walker, RN, BSN

As the healthcare landscape continues to rapidly evolve, the outpatient setting of care is becoming increasingly more critical in managing patient outcomes. Traditionally, Patient Experience (PX) programs have been focused in the inpatient hospital setting with HCAHPS metrics used as the measurement tool. This progress has had a dramatic impact on improving healthcare, but has also identified a significant opportunity for improvement.


Over 8,400 patients complete the HCAHPS survey each day in the US. On average, only 52% of these patients report feeling that they “Strongly Agree” they understand their care when they leave the hospital. That means nearly 3,360 patients daily are reporting on their HCAHPS surveys that they are not comfortable in their care as they exit the inpatient setting and transition into the outpatient environment. What are the implications of this? What is being done to address this critical gap in the PX? This is where our focus has been in leading a new national movement for Specialty Pharmacies (SPs).

SPs find themselves in an area of healthcare that can “Bridge the Gap” for patients, and provide a continuation of the PX programs that partnering hospitals have invested so heavily on. More importantly, SPs can remove the barriers that keep patients from reporting that they “Strongly Agree” they understand their care. The healthcare continuum relies on effective collaboration across all providers involved in a patient’s therapeutic care plan. This sounds like a relatively simple task, but as providers, we know it is far from easy to achieve.

RXPX is a natural partner to inpatient PX programs. We have developed a software program called “rarecare” that allows our nurses and pharmacists to capture Clinical, Quality of Life, RXPX, and Patient Reported Outcome Measures (PROMs). This data allows us to identify areas to improve in patient care that previously went undetected. From patient education to medication adherence to social issues, the data collected provides an entirely new perspective on a patient’s journey. The key is actually having the data and turning it into actionable insights.


We have determined that the antiquated Production Based Pharmacy model needs to be replaced with a Therapeutic Management Partnership approach. This collaborative strategy is rooted in measuring, reporting, and sharing outcomes. It’s a shift from filling prescriptions to sharing more of a collaborative role in managing a patient’s therapeutic care plan. Measuring is the way to determine the value of health services provided by pharmacies, but this simply hasn’t been done. The traditional metrics have been based on the medications and therapies that a pharmacy dispenses, not on actual health outcomes

We have launched a “Measure it!” program to align with hospital systems that are also shifting towards the value based approach to measuring their healthcare service. Data levels the playing field and allows for fact-based decisions to be made in a patient’s care. This commitment puts the patient at the center of the care continuum and keeps the outcome as the common goal for all stakeholders involved.


SPs have the ability to unify the healthcare providers around a patient’s care plan. This collaborative approach provides a platform for gathering insights and data that can dramatically impact a patient’s outcome. SPs can measure many endpoints outside of the traditional prescription data. We have combined our RXPX data, PROMs data, Clinical data, Nursing data, and Prescription data into proprietary insights called “Collaboralytics.” This breakthrough technology allows for clinical evaluation of a patient’s health from multiple perspectives that previously weren’t captured. Most importantly, these insights are used in a continued collaborative manner with partner healthcare providers in working towards the shared patient health outcome.


Selecting the right SP partner can enhance the overall patient experience on multiple fronts. Our commitment is to deliver an ongoing RXPX feedback loop to our partner health systems. Patients are not rare because of their rare disorders or diseases. They are individuals with their own circumstances, needs, desires, abilities, and stories. If we don’t understand and capture their journeys into measurable insights, then how are we to provide the best change for a positive health outcome?


We recognize that SPs can serve as Patient Advocates and become more than a provider of medications. The time is now for providers on all sides to speak the language of measurable outcomes. Creating a learning environment is crucial, but measuring remains the only true way to evaluate the impact providers are having on patient care. Technology is here, but application must come in the form of commitment to measure our efforts.