The Evolution to Event-Based Architecture is Transforming Patient Care

Reducing time to therapy is a critical goal for pharmaceutical manufacturers and the patients who rely on their specialty drugs. The sooner the patient begins taking the prescribed medication, the sooner their health and quality of life can improve. Yet many obstacles can slow time to therapy, especially along a complex care journey. Leading digital hubs like CareMetx are responding to this challenge by evolving to an event-based technology architecture that improves the patient experience and enhances patient care. 

Manual Processes Create Friction 

Historically, moving a patient onto a new therapeutic has been a labor-intensive and people-centric process. A provider or office staff member needs to fill out a prior authorization (PA) form and fax it to the payer, or call the payer to follow up on the status of a requested benefit verification, for example. At a minimum, this manual process creates delays that slow time to therapy and jeopardize patient care. In the worst case, the patient might abandon the script and forego treatment. 

The initiation process for a specialty drug is riddled with potential points of failure. If the benefit verification doesn’t happen in a timely way or the necessary PA isn’t submitted, the provider may fail to be reimbursed for a buy-and-bill drug. If the patient doesn’t receive accurate information about their out-of-pocket responsibility or guidance on how to apply for financial assistance, financial constraints can become a barrier to getting on treatment.  

To eliminate these obstacles, digital hubs have automated the drug initiation process to the greatest degree possible, removing slow manual steps with accelerated, technology-driven processes. But despite these efforts, in many cases the initiation journey still requires a human to kick off each step in the process. 

Event-Based Architecture Smooths the Journey 

The move to an event-based architecture aims to reduce this friction and eliminate the hurdles that slow or prevent getting a patient on a new therapy. An event-based architecture detects events that should trigger downstream activities and acts on those triggers in real time or near-real time. The objective is to kick off the necessary tasks and processes automatically, without waiting for human intervention.  

There are many triggering events along a patient’s healthcare journey: the patient is successfully enrolled in the manufacturer’s drug program, or the prior authorization is approved by the payer, or the prescription is filled by the specialty pharmacy, for example. Within an event-based architecture, each of these events automatically kicks off the next logical downstream activity, without relying on a person to act. This approach greatly reduces the work involved to complete the many tasks necessary to initiate therapy—and in turn reduces the risk that a required step will fall through the cracks due to human error. The more near-real time an event triggers the next activity, the faster the patient can begin taking a life-altering therapy.   

While improving drug access and affordability are key objectives for CareMetx and the specialty manufacturers we serve, supporting patients throughout their journey is an equally important focus of our event-based architecture evolution. By better automating how we engage with patients before and after they’ve initiated treatment—using events to trigger the next logical interaction—we ensure that each patient receives the right outreach at the right time, customized to address their potential barriers and using the delivery channel they prefer.   

The Hallmarks of an Event-Based Architecture 

As a leading digital hub committed to enhancing patient care, CareMetx is leveraging the value of an event-based architecture to keep the patient journey moving quickly and unimpeded to accelerate time to therapy. The evolution to an event-based architecture is an important component of our technology roadmap and a strong demonstration of our commitment to continually modernize the CareMetx technology platform to ensure the best patient care. It also builds on a larger digital transformation initiative that is simplifying the way we integrate systems and data to improve hub operations.  

The CareMetx event-based architecture will serve as the gateway for all the data required to support a patient’s care journey and the many processes required to initiate therapy. Under this model, all the necessary data is streamed into a central repository and accessible in near-real time to every downstream activity and process involved. With broader data availability and greater data transparency, every professional involved gains better end-to-end visibility into the journey, so they’re equipped to make informed decisions about delivering the right support to the right patient at the right time.  

Deep integration with the third-party applications and data needed to support an end-to-end journey is a foundational element of our event-based architecture. With integrations into dozens of leading EMR and EHR systems, the CareMetx platform makes it easy for providers to support patients effectively from within their native workflows, regardless of the drug brand or therapeutic area. In addition to addressing administrative burdens for the provider and their staff, this nearly plug-and-play environment ensures that both internal hub systems and third-party applications have ready access to the information to activate the next step in the process.  

An effective event-based architecture also requires that a robust network of providers has access to the platform, representing various therapeutic areas and supporting patients across varied disease states. CareMetx is enabling its provider network to use our gateway to seamlessly transact with both the hub and the manufacturers whose drugs they prescribe, supporting the patient journey at every step.  

Of course, when patient information is involved, data security and privacy are paramount. While an event-based architecture opens up data access, the CareMetx platform also includes role-based controls that govern that access to comply with HIPAA and other relevant regulations regarding protected health information.  

CareMetx recognizes that patients diagnosed with a rare or complex condition need support that goes beyond any automated process. Our event-based architecture doesn’t replace the high-touch service that’s critical to supporting those patients through their journey. Instead, it facilitates personalized service by automating routine tasks, addressing administrative burdens, and freeing skilled professionals like providers and hub patient navigators to focus more time and energy on what they do best: serving the patient. Our latest technology innovations are further evidence of our commitment to applying technology to enable and enhance the human element of our services. 

Contact CareMetx to learn how our Digital Hub can improve time to therapy and drive efficiencies and better outcomes for patients.