By Tal Rapke, MD
As a physician with 20 years of healthcare experience, I've been driven by one desire: To improve healthcare accessibility.
I left the clinical setting, and after some years in digital health, I joined the pharmaceutical industry as an executive responsible for bringing the transformative power of medicines to market. According to research published in Economics & Human Biology, life expectancy in the U.S. increased by 9.5 months between 2006 and 2018, with pharmaceutical innovation accounting for 66% of this increase. But there's one problem: People don't always take their medications. In fact, the U.S. Food & Drug Administration states that 30% of prescriptions for chronic conditions are never filled and 50% of adults on medication are non-adherent.
However, the adherence issue is simply a symptom of the fact that patients are disengaged, alone, unsupported and organizations with a desire to help have limited access to patients in real time. I believed there had to be a way to help solve this intractable problem. I knew the only way to improve healthcare is to tap into innovative ways to access and influence patients. That's why in 2017, I started the company ScalaMed.
How ScalaMed is changing healthcare for the better
As a healthcare innovator, my job is to bring novel solutions to big problems. I founded ScalaMed with the belief that if we could find a way into the patient's pocket via their phone — and frequently — we could solve for a myriad of health problems. ScalaMed is a smart platform that lets doctors send prescriptions directly to a HIPAA-compliant mobile app, allowing patients to access their prescriptions in the palm of their hand. In simple terms, it's a prescription wallet. This is revolutionary because, for the first time, patients take the lead role in the most common transaction in healthcare: prescriptions. The power to direct clinical interventions in real time, based on behavioral, economic and social circumstances allows patients to shape an experience that works for them, thus increasing their connection to their healthcare journey.
There is an excellent definition for health in the constitution of the World Health Organization which states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." This vision encompasses my journey with ScalaMed, and it's the reason why Outcomes™ and ScalaMed joined forces — to holistically impact health.
ScalaMed and Outcomes™ share a common goal to make giant strides in healthcare by taking patients from the periphery of the healthcare journey and bringing them back into the center. How do you do that? You find a way to access and engage the patient and then leverage that touchpoint, to customize the support of health professionals like pharmacists to enhance and support patients. True innovation occurs when you're driving down the cost of healthcare, improving pharmacy and clinical workflows or making things a little bit easier for patients.
Outcomes™ integrates digital communication tools into the pharmacy management system, allowing pharmacists to maintain a personal, high-touch relationship with their patients, provide health education, improve adherence and reduce costs. Simultaneously, ScalaMed enables seamless digital patient engagements when patients are on their own, even prior to them visiting a pharmacy.
We have effective drugs and we have patients who want to be healthy. So, why is medication mismanagement such a big issue in American healthcare?
Outcomes™ and ScalaMed: Tackling medication adherence
Medication adherence is not a clear-cut problem. Some people have trouble getting to a pharmacy, others must choose between buying groceries or filling their prescriptions, some patients don't understand why their meds are so important, and many simply forget to take their medications.
By integrating the ScalaMed technology with the Outcomes™ ecosystem, we're bridging a gap in the pharmacist and patient relationship and empowering the patient to take full control of their prescriptions.
Outcomes™ has a robust network and platform of solutions that enables patient-focused clinical care at scale, offering pharmacists, payers and pharmaceutical brands new opportunities to engage patients. I've seen firsthand that when pharmacists take an active role in managing patients' medications, adherence improves. Including the app capability within the Outcomes ecosystem lays the foundation for a future in which patients can easily manage their health, providing them with the highest level of personalized care at every moment of the prescription journey. ScalaMed is a flexible tool that empowers individuals to access their health through a prescription wallet on their phone. As the demand for individualized and simplified healthcare experiences grows, smart prescriptions are part of the answer.
This technology enables patients to receive their prescriptions on their smartphones immediately as it is prescribed, and before they visit a pharmacy. One of the most confusing questions patients get asked regarding their prescriptions is, "Where do you want me to send it?" Patients are often unsure of the "correct" answer — price, network, access and cost are all unknowns for both the patient and for the healthcare provider at this point. In giving patients better control and empowerment by intercepting their own prescription, and taking control, they can locate a pharmacy near their home or on the road while traveling, choose a pharmacy with flexible hours, and — most importantly — identify the lowest cost option. From here, they can learn about their medications and how to use them safely and effectively. Then with just a few taps on their phone, the patient can send their prescriptions to any pharmacy in the country for pickup or for delivery. Most importantly, because the prescription is now at their fingertips, we can deliver a cascade of nuanced and personalized messages to help a patient make the right medication related decision and link them into care when they require assistance.
Connected healthcare: The needed revolution
To truly revolutionize healthcare, we need to put patients at the center of the conversation and leverage technology to provide safe, scalable, and efficient services tailored to their needs.
Medication optimization creates a virtuous cycle that positively impacts pharmacists, patients, payers, pharma brands and even pharmacy benefit managers (PBMs).
Optimized medication management like smart prescriptions enables pharmacists to confidently make targeted recommendations based on reliable information, and in turn, they empower patients to take control of their own health.
Ultimately, payers take on the responsibility for patients' health; they must ensure that patients stay out of the hospital and remain healthy. ScalaMed is here to help payers achieve their value targets by offering health plans an elegant way to access and influence their patients every time they use a prescription. Prescription management is exceptionally time consuming. I faced the challenge of helping patients to remember what medicines they take. This included calling around pharmacies to reconcile medicine lists and arranging pharmacy pick up for patients.
ScalaMed removes this friction by keeping all this information in one convenient spot. In turn, payers can utilize ScalaMed technology as a source of truth that prevents inappropriate prescriptions, reducing costly errors.
Pharmacy benefit managers (PBMs) are responsible for managing medications and delivering the outcomes that medications promise. Most pharmacy benefit managers are looking to further add value to their offering by moving up the value chain and offering additional services to drive down the cost of care and the cost of medications for patients and payers.
ScalaMed technology alerts of lower-cost alternatives such as biosimilars prior to patients forwarding their Rx for fill. According to a 2021 report by the Association for Accessible Medicines, Medicare saved $338 billion in 2020 using generics and biosimilars. With ScalaMed, this process is seamless and streamlined between PBMs, pharmacies and payers, finding ways to intervene early in a prescription journey, to keep a patient on formula and in-network, while delivering tangible and real time cost benefits and savings for all.
Finally, pharmaceutical companies play a valuable role in facilitating access to treatment. They know the importance of bringing the right tools to connect with consumers. They develop all kinds of patient resources and assistance programs to empower those on their therapy. But, it's not always easy to get those resources in the hands of the patient at the right time and place. Through ScalaMed, we have a channel that knows exactly where the patient is in their treatment journey.
Pharma brands use ScalaMed to engage and support patients from the inception of the Rx — prior to the first fill — creating a white glove experience to educate and support them in every step of their journey, ultimately leading to better outcomes and improved adherence.
Outcomes™: Engagement that works
Outcomes™ and ScalaMed share the same mission. Using the best technology available in a simple, transparent and efficient manner, we connect with patients to generate healthier outcomes. The Outcomes ecosystem brings patient engagement to life and leverages technology to better patient health.
The scale of Outcomes™ will accelerate the impact of ScalaMed. By tapping into the Outcomes network of 60k+ pharmacies, 40+ million patients will start feeling more confident and better informed about their medications today.
Although I no longer work in a clinical setting, by joining the Outcomes™ ecosystem, I can now care for millions of patients, every day, meeting them where they are. I'm excited to see what's next.