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Automating Specialty Pharmacy

August 3 2021

3 min read

The Expiration Date on Your Existing Processes is Here

Global medicine use was predicted to exceed 4.5 trillion doses in 20201. A birds-eye view into the implications of trillions of prescriptions being filled yearly opens up the can of worms that is the paper problem within the pharmaceutical industry. Why does it take at least four days from the time it’s received to fill the average specialty prescription, with common wait times of 7-10 days?2

Some of the transactions that occur between a prescriber writing a prescription and the patient actually receiving the drug include:

  • The prescriber sending a prescription to the pharmacy
  • Intake form from the pharmacy to the prescriber and back to the pharmacy
  • Benefit verification from the pharmacy to the payer and back to the pharmacy
  • Prior Authorization from the prescriber to the payer and back to the prescriber
  • Dispense from the pharmacy to the patient

Each step outlined above involves one or more forms. To simplify the process, hub services act as an intermediary, single point of contact between providers, drug manufacturers, and patients, which means they are the ones processing each specialty pharmacy form for enrollment, prior authorization, fulfillment, etc.

The continued reliance on manually processing these forms, particularly handwritten forms from prescribers who are notorious for poor handwriting, results in hours of valuable employee time spent on manual data entry and increased errors.

So how can the industry reclaim effectiveness to ensure providers, payers, and manufacturers are working from the same accurate, complete information and giving patients the correct medicine?

Refill Efficiencies with Intelligent Automation

Experts predict the pharmacy automation industry will grow at a CAGR of 8.35% and be worth $8.03 billion by 2027.3

Let’s discuss the elephant in the room. Accuracy.

Specialty pharma workflows face high error rates due to humans manually entering vast volumes of fields with handwriting interpretation under tight timelines. Errors decrease hub services credibility. If an incorrect, higher dosage of a prescription is sent to an insurance provider who later discovers the mistake – or worse yet not caught until the patient’s follow-up appointment – additional time and money is lost validating and correcting the information while potentially jeopardizing patient safety.

To prevent errors, some hub services are doubling the work by having a second person double-check the data entry, which is inefficient and further delays processing. And since humans aren’t machines, there’s a limit to how many documents can be processed in a day.

While no machine is 100% accurate either, advanced solutions like intelligent automation perform at a higher accuracy threshold than humans without lost downtime. Intelligent automation merges Artificial Intelligence (AI), Machine Learning (ML), and automation technologies to streamline complex specialty pharma processes—with greater accuracy and fewer downstream steps.

One of the key benefits of an intelligent automation offering like Hyperscience is the ability to reliably read handwritten text. Humans have different handwriting styles that make it near impossible to create a single rules-based algorithm to determine if something is a “1” vs. 7” or a “0” vs. “O,” which is the approach legacy character recognition technology uses.

Instead, Hyperscience is trained to understand context. When facing a name field and a data point that looks like a zero, it will know that it should be an “O,” ultimately decreasing the steps in your downstream workflow.

The New Prescription is Hyperscience & Invoke 

Hyperscience and INVOKE have partnered to deliver a powerful and elegant solution to the paper madness that plagues this industry.

ARIA for specialty pharma provides a single Software as a Service platform that combines the power of the Hyperscience Platform with turnkey process automation from ARIA. The solution solves many difficult challenges all at once including:

  • Extracting document information: The Hyperscience Platform has been developed to ingest, classify, and extract data from diverse documents, including handwritten forms, PDFs, low-resolution images, and more.
  • Consistently applying your business rules: The solution allows you to define your business rules to ensure all controls are performed consistently and accurately.
  • Integration into existing infrastructure: There is no need to implement any new systems. ARIA integrates with your existing applications allowing for easy deployment with little to no changes required to your existing environment.

  • Human validation: The solution is smart enough to raise its hand when it needs a human to review. This turns processors into exception managers, resulting in improved data quality and transformed business practices and procedures.
  • Accuracy: Hyperscience provides better accuracy, greater connectivity, and increased configurability. Better yet, you can set your desired target accuracy and the machine will automate against it, generally achieving over 80% automation out-of-the-box.

Customers typically see an average 67% increase in accuracy, 10x faster processing times, and up to 90% in cost reduction.

More on how Hyperscience automates with accuracy

Leveraging the innovative technology of Hyperscience and INVOKE, clients can experience faster time-to-value, removing the need to purchase and manage multiple technologies. In addition to drug enrollment processing, ARIA contains an ever-growing list of pre-built processes that can be turned on to drive more automation in your business. From back-office processes like payment processing and invoicing to front office processes like contact management and customer onboarding.

“Companies are looking for ways to take advantage of next generation technology without big investments, high risk and long implementations,” said Johnny Ramondino, President, INVOKE. “With Hyperscience, we are taking complex processes that have been difficult for customers to automate in the past and remove all the guesswork. Customers can subscribe to one process at a time or start building themselves on the platform.”

Our partnership allows drug manufacturers to speed time to therapy and hub services to respond to patients faster and with correct information by:

  • Lowering total cost of ownership and ease of scaling to more use cases and lines of business
  • Confirming and verifying extracted, machine-readable data with external systems or industry database software (e.g. trigger a flow that automatically checks an external system or website to confirm that the prescriber’s license number extracted by Hyperscience is active)

INVOKE is an Intelligent Automation services and solution provider across North America and Europe. Through innovative solutions and services INVOKE is on a mission to simplify the customer journey of digital transformation through the lens of Intelligent Automation.