CVS / Pharmacare / MinuteClinic

What a perfect opportunity.  CVS (retail pharmacy chain) owns Pharmacare (pharmacy benefit management company) and owns MinuteClinic (onsite medical clinics).  Right now, if you went to a clinic or physician or hospital, you have created one customer record.  At your retail pharmacy, you have another customer record.  The PBM that processes your pharmacy claims has another customer record of you.  And, the health plan with which you are affiliated has a fourth customer record of you.

There has been talk for years about Personal Health Records (PHR) or Electronic Health Records (EHR).  Although some of the technology exists, the integration and adoption challenges are barriers.  That being said BPM offer some of the core benefits.  The patient can be viewed as having one customer record that follows their path of care.  Each constituent along the way adds information and can view information based on HIPAA guidelines and role based security.

If such a solution made sense, this would create a great opportunity for CVS.  They could capture patients at their clinics and learn about them.  This information could follow the prescription to the retail pharmacy where they could learn more about the patient.  Eventually, they could use the diagnosis data to help inform the treatment suggestions or pharmacy-patient dialog about side-effects.  This data could then be integrated at the PBM level to capture other data from mail pharmacy use and other retailers.

CVS could see where people stop taking therapy.  MinuteClinic could see where people don’t fill prescriptions.  Triggers could be created to generate automatic outbound calls or e-mails or care management calls for follow-up.  But, each event is part of a case management framework so they have history and information to build upon each other.

If you leverage some model like this from a CDHC (Consumer Driven Health Care) perspective, you enable the patient to manage their care by setting reminders for refills, electing to have information pushed to them based on diagnosis codes, seeing reports about costs versus payments, and having the ability to track status of open items – labs, payments, prior authorizations, etc.  In a competitive industry built around complexity, there is a way to simplify it for the patient.

One Response to “CVS / Pharmacare / MinuteClinic”

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