Stephen J. Gold, CIO of CVS, says its customer data is crucial
to improving patient health
By Sara Castellanos
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)
Copyright (c) 2017 Dow Jones & Company, Inc.
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