My Visit To The Express Script’s Lab

The topic of innovation labs in healthcare is an interesting one (see other post). The other day, I had the chance to go and visit the Express Script’s Lab here in St. Louis.

This is a newer facility built back in November 2010 and has 26 scientists working there. It’s where some of the research team that I worked with years ago still is, but it now has a big focus as both a showcase facility and a hub for managing pilots.

There are a few key things in the facility:

1. An open floor plan for collaboration with a giant whiteboard and chalkboard and several meeting rooms.
2. The large screen you can see above which shows different metrics and can have any section expanded to drill down on current pilots or other activities.
3. An interactive board in one area for a more intimate client discussion looking at their data.

There are now some people on the research team from Franklin Lakes (i.e., Medco). It will be interesting to see how they incorporate some of their research studies. Someone had recently told me about some cool work they had done using technology on the bottle (similar to my augmented reality idea).

A big focus of the team is on predictive modeling drawing from work in the financial services industry. They are looking at things like fraud and abuse, re-admissions, and adherence.

Like the team has always done, they use a champion / challenger approach to evaluating pilots. I thought the example they showed me on the big screen was interesting. It looked at both linguistics changes (i.e., words) and graphical changes on the web to evaluate consumer behavior. They carve out 10% of the population to randomly get these different scenarios and compare their success to the “champion” which is the existing strategy.

I had a chance to then see the interactive client board which focused a lot on network, generics, mail, and predicting adherence. They have some very cool mapping software to break all this data down to the block level and let you see how things compare. For example, they showed me claims based adherence on the map versus predicted adherence. This is important to think about where you focus resources especially when you understand that a majority of non-adherence (according to their studies) is due to procrastination. They are thinking about and treating adherence like you would a disease. How can you act preventively?

Right now, their ScreenRx^SM solution is focused on 9 different conditions and uses their model to identify and trigger tailored interventions based on patient identified barriers or obstacles. As I’ve talked about before, while most people think it’s cost…it’s only about 16% (according to their research). Therefore, you can focus your more expensive interventions on the patients with cost and clinical barriers versus simply waiving copays for everyone (for example).