Why Your Pharmacy May Be Texting You -- WSJ

Stephen J. Gold, CIO of CVS, says its customer data is crucial to improving patient health

Since Stephen J. Gold was appointed executive vice president and chief information officer of CVS Health Corp. in 2012, getting the company to push the boundaries of innovation has been a top priority.

Among other things, he has opened an innovation lab in Boston and is overseeing the deployment of a so-called health-engagement engine that uses data analytics to provide clinical advice on pharmacy care to patients. Mr. Gold also is in charge of creating and deploying digital tools, such as those that send text messages to patients about coming prescription refills. About 28 million people, or 30% of the company's customer base, are currently using the text-messaging platform for pickup and refill.

Mr. Gold, the former CIO of Avaya Holdings Corp., spoke with The Wall Street Journal about the opportunities and technological challenges that come with managing an $80 billion pharmacy-benefit-management and drugstore business. Edited excerpts follow.

WSJ: What have you done since 2012 to ensure that CVS Health is innovating to improve patient care?

MR. GOLD: Some of it is technological, some of it is process, and some of it is people and culture. At the tip of the spear would be what we're doing in our innovation laboratory in Boston, where the goal is to basically operate in a mode that mimics a startup. A mind-set of experimentation, iteration, rapid testing and failure is part of the process. This laboratory is focused on bringing new digital products and services to market.

One example of an innovative idea coming out of the lab is Fast Mobile Prescription Pickup. It uses a bar code or unique number to ensure fast, private and easy pickup at the pharmacy counter or drive-through. The real value for patients is that they no longer have to provide their name or birth date when picking up a prescription. They simply have the bar code scanned or have the pickup number entered.

WSJ: What sources of data do you have, and what opportunities do you see in it related to patient health?

MR. GOLD: The data we get from patients' prescription behaviors is key. It's the patient's profile, their gender, their age, any allergies they may have, any disease state. All the information that is needed to appropriately care for the patient. We also have a proprietary platform that we call the health engagement engine, which is basically a very sophisticated, clinically focused customer-relationship management system that allows us to transform health-care data into actionable interventions that improve outcomes and reduce costs. We're constantly expanding the number of interventions and use cases that can be delivered through this platform.

WSJ: Can you describe a scenario where this health-engagement engine is put into practice?

MR. GOLD: If we've noticed that based on our calculations it appears a person isn't taking his or her medications as prescribed, we could deliver a message on the importance of adherence.

For patients with diabetes, it could be a reminder about blood-glucose testing. We can identify when such a test hasn't been done by looking at claims records from health plans. We can set up our systems to identify that and create a message in the health-engagement engine. When that patient is next seen at our pharmacy or a MinuteClinic, the pharmacist or nurse practitioner can encourage the patient to get the test done. The nurse practitioner at MinuteClinic can actually do the test, and send the results to the patient's primary-care physician and to the insurer.

Another example of a potential intervention could be a patient who comes in for one medication and receives a reminder to fill another medication that has lapsed, or a patient who is eligible for a vaccination gets reminded about that.

WSJ: Do you have any concerns that patients don't want to hear such reminders from their pharmacy?

MR. GOLD: Almost never. Many consumers see CVS Pharmacy as the "front door of care," and they expect us to help them better manage their health care.

Ahead of the curve

WSJ: Can you describe some of the challenges you've experienced as it relates to the massive amounts of data being generated about patients?

MR. GOLD: I don't think of them as challenges. I think of them as opportunities, and our biggest opportunity is to continue to stay ahead of the innovation curve. Health care is complex to begin with, and now we have a rate of change that is unprecedented. This is being driven by the consumerization of health care, where consumers are taking more responsibility for managing their health-care dollars, combined with the rapid adoption of technology by patients.

This convergence provides us with a unique opportunity to develop and deliver innovative tools that help our clients and patients save money and keep patients on a path to better health. The use of data analytics to help identify the most cost-effective treatment for each patient will play a very important role in the future of health care. This is one of the fundamental reasons we opened the innovation lab -- to help accelerate the delivery of these digital solutions to our customers.

WSJ: What are some examples of digital tools you've helped deploy that are gaining traction among consumers?

MR. GOLD: People use multiple doctors and they have medications that aren't on the same schedule, so they wind up having to make multiple trips to the pharmacy. ScriptSync is a digital tool that allows them to synchronize all of these prescriptions. Patients can make one trip to the pharmacy and pick up all medications. In addition to convenience, we see an adherence benefit. The data show that our prescription benefit management members who are using ScriptSync have improved their adherence anywhere from 6% to 10%. And statistics show that if the national adherence rate was increased by just 1 percentage point, it would generate $6 billion of health-care savings a year.

We also have refill reminder programs. We monitor the time that it has been since you filled your last prescription, and aligned with the plan rules and appropriate safety and compliance rules, we'll send an email or text that says your prescription that begins with these three letters is available for refill.

We're able to geotarget those text messages in advance of storms, to let our patients know they've got a prescription coming due and they might want to get it early because of the potential storm.

WSJ: These seem like convenient solutions; they aren't necessarily novel ideas. What are the technological challenges behind the scenes to be able to deliver these solutions?

MR. GOLD: All of the business rules that reside in our systems that sit behind the mobile app are where the heavy lifting is. Business rules or requirements define your business, and are often a constraint or a description of an operation within your business. Examples include: Is this drug covered? Is this pharmacy in my network? Can I get this prescription through a mail-service pharmacy?

These systems need to support the unique prescription-benefit plan designs of thousands of clients. They also need to support clinical rules like drug-to-drug interactions that help ensure our patients' health and safety. These systems also need to support our patients' desire to communicate with us through multiple channels, like mobile, web, phone, mail, with complete integration across all of these channels. A pure-play digital business only needs to do this through one channel and in most cases doesn't have to worry about a multitude of extremely complex business rules to fulfill customers' orders or requests.

Ms. Castellanos is a Wall Street Journal reporter in New York. Email her at sara.castellanos@wsj.com.

(END) Dow Jones Newswires

May 17, 2017 02:47 ET (06:47 GMT)