Webinar Recording: Enhancing Hospice Care Through Real-Time Medication Management: BetterRX + WorldView

WEBINAR TRANSCRIPT

All right. Welcome everyone, and thank you for joining today's discussion on improving medication management in Hospice care with BetterRX and WorldView. So today we're going to be talking about critical issue in Hospice, which is medication delays. We know that getting medications to patients quickly is essential to their comfort, and yet the process is often slow, inefficient and frustrating for not only Hospice teams, but caregivers and families. So we're going to break down why this happens, how it impacts patient care, and most importantly, how BetterRX and WorldView are working together to help solve these challenges.

So let's dive right in. So I'm Chelsey Heil, Head of Marketing at WorldView, and I'm joined by two incredible experts from BetterRX. Welcome Rebecca and Sara. Hello, thanks for having us. Yeah. Can you guys introduce yourselves? Tell us a little bit about you? Sure, Rebecca, you want to kick us off? Sure. My name is Rebecca Christensen. I've been with BetterRX for 14 years and working hospice for over 20.

So lots of experience and love to share what we have for you. Yeah, Thank you. And I'm Sara Nigro. I'm the VP of Partnerships for BetterRX. I've been here just under 2 1/2 years. And my background's been more on the technology side. So coming into hospice pretty new in the last 2 1/2 years and just really appreciate conversations like this, the opportunity to share what we've learned, share what we're seeing from customers, from prospects, but also bringing it into the fold with connecting the ease of use of technology and how needed it's in how needed it is in this industry.

We're going to start by talking about some of the reality of medications and how they really slow down getting to the patient and some of those barriers. I've worked with hospices without BetterRX and with BetterRX, and some of those problems that pop up are so emergent that any little delay can really impact the patient quality of life. I, it is often difficult when we're looking at getting those prescriptions from the hospice to the pharmacy and reading them and understanding the changes that are going on. And then when those insurances and those PBMS though you don't get that payment and the call back and forth or if we have somebody that is really emergent and they can't get a doctor to sign that paper to get it faxed over.

So EPCS and electronic prescribing is really speed up getting those prescriptions to the pharmacy. We unfortunately in pharmacy it's one of those last fields that have really embraced technology. We still like that paper and that pen and those phone calls and all of those things really hinder good patient care. So getting those prescriptions and using those electronic systems can be very helpful. Sara, you have anything to add? Definitely do and to kind of echo your sentiment, the the fact that we don't have everybody digitized at this point just to help from an efficiency standpoint, but also like a making sure that the quality of life of the care teams.

You know, we talk a lot about nurse burnout, caregiver burnout, but it's the truth, you know. And so connecting these systems together is really one way to kind of help tackle some of the delays, some of the errors that we seek most common associated with medical medications. But just even from a family perspective in seeing the hospice journey, you know, you want to produce this effect of everybody should be on hospice. That's the end goal is that you're going to join a hospice someday and be really well taken care of in the future. And so just setting that foundation now and for each patient is so vital.

But timeliness of care, you know, it's, it is really to ensure that patients do not suffer. And that's what really brings together WorldView and BetterRX for the purpose of today's conversation. All right, so this is a great look at day by day, how long it can really take to get an order from the patients and the nurses to the doctors and to the pharmacy. And you can see here that from assessment to just getting the doctor to review it is 2 1/2 hours. What if you can get that down to two minutes? That is a huge change from two hours. And then that from getting it to the doctor to the pharmacy is again, another 30 minutes.

And most of that time, if you're calling it in, is spent on hold at the pharmacy. What if you could get it to them before you even leave the patient's home? That would be huge. And you can reassure the the patient and their carriers that, yes, the pharmacy has it and it should be delivered within this time rather than having to track down those prescriptions. I remember a time when a lot of the time on the phone was just tracking down where's that prescription, who has the order? Did it get lost in the fax machine?

And it's a lot of time. So really speeding that up and using that technology to do that really impacts patient care and the timeliness of those medications. Absolutely. And if I could just add, you know, some of the most common challenges that we at least see with medication delays are just the lack of that timeliness. So it's helping a patient get on service faster, which a service like WorldView, you know, they're helping streamline referrals through their referral AI system so that that patient isn't having to wait for the admit to be approved. They can start showing up within that EMR to import into BetterRX, get those medications ordered as quickly as possible.

And the real goal is there is to ensure that no patient has unnecessary pain so that you know, they're able to we're able to gain access to their medical records. We're able to really access everything through that interoperability channel and provide them with a comfort kit, get them those kind of basic essentials so that when they are getting on service, at least they're taken care of. So something like this, this, you know, schedule really scares me. It's, it's not ideal to see how long it takes for an outdated PBM or prescribing model to really enact care.

And of course, this isn't the same for every hospice and every care team, but it is something that we see pretty commonly when we're working with an agency. And then just to kind of double down on care team communication. You know, Rebecca, you're talking about having a lot of time spent on the phone and that is also something that you know, is out dated a little bit. But, but when you say faxing, like I wouldn't even know how to send a fax these days. You know, it's actually seems like it would be a harder thing to do than just making sure that teams have effective communication that overnights, weekends and 3rd party vendors are all talking to each other for that care in the after hours care during, during the work day.

You know, but poor communication and poor processes can significantly impact the patient experience, but also the caregiver effectiveness. So we want to wipe this out as quickly as we can. Absolutely. And this kind of leads us into it's not just impacting the patients, right. This impacts the hospice agencies and staff as well. So it creates this ripple effect across the whole hospice team where nurses are constantly having to follow up on the medication orders instead of providing care for the patients, which is what they want to do and what we want them to do.

And families lose confidence in hospice providers when they see these delays and they see their loved ones suffering. And hospice staff experiences burnout from having to deal with all of these inefficiencies day after day. This is not what they signed up for. And from a compliance perspective, finally, the delays in symptom management can put agencies at risk, right? We need to be following certain protocols and when those aren't followed, there's a risk there. So why is this happening? Which kind of leads us to our next slide here. Yeah. I mean, in addition to just some of these kind of manual processes, paper based, not lack of digitization, poor visibility, so the lack of communication across teams, not getting your IDG meetings into kind of a working order, pharmacy bottlenecks.

That's a big one for sure. Not having a consistent workflow set up with your PBM or local pharmacy or pharmacy solution and just communication gaps, right? So we talked about this a little bit, but just not having everybody be on the same page about the patient or whether it's the family. And so this really has to be a cohesive working unit to make sure that a patient is at the foremost the priority. Everything else becomes kind of supplementary at that point, but where the system is seemingly causing the most issues for hospices that don't operate in full working order, you know, that results in low reimbursement, lower star ratings, increased hospitalizations, and a really poor death experience.

And so it's vital that while we talk about these things as if they're nice to have, like no, these are requirements. This is where the industry is heading to make sure that the patient is always cared for as quickly and as as wonderfully as possible. Trying to get everybody on the same page, whether it's on formulary or what's going to be covered and what's not, from admission to the pharmacy and even to wherever if they're living in the facility. And having that seamless visibility on those items is really important and really helps speed up getting those medications to the patient.

Definitely. And so this is fun. We've been partnered with WorldView for just over two years. What we've seen the most is truly that connectivity between getting a patient implemented into or admitted, excuse me, into the hospice setting as quickly as possible. Where we kind of take over is truly from being that more modern pharmacy option. So we don't actually own the medications ourselves. We're helping connect pharmacies to hospice agencies to ensure that the the patient is being cared for as close to their home as possible or as close to their inpatient unit, so there aren't those delays.

And you know, what we've seen the most value for from our customers is really that reduction in documentation. So imagine, you know, you're a nurse or the case manager or admissions director and you're going into the patient's home and you're leaving with a stack of paper and then you have to go and actually manually plug that in. That's very much still happening across the country. Where we've seen WorldView really be advantageous is that they can take all those photos of those documents and import them immediately into the EMR so that you have that single source of truth. And we're talking minutes and not hours, which has been really ideal.

So we've seen that through our connectivity, we have access can time home care home base, some of the leading EMRs and EHRs in the hospice industry. And then it's primarily been, you know, for BetterRX creating that just continuity across the, the communication lines. So everybody's knowing where the medications are and there's no question as to when is that patient getting those meds. It's really more of an accountability tool. So that's kind of what we're seeing as we've worked together for over 2 years. Absolutely. So everything like you said, from getting the referral in the 1st place happens through a referral AI.

And then when the patient's record is in the system, then you're getting those orders turned around much quicker. We have a myriad of different solutions to help doctors sign those orders. And again, the communication, the mobile app to make sure that when they're out there that anything that they need in in the EMR, they can do that mobily. So great point, Sara. And then just kind of doubling down on some of these things. We really don't want any guesswork. You know, there should be no Gray area in hospice. So understanding that everybody's able to see those medication statuses in real time, physicians can sign orders digitally, again, getting them away from the faxes or missed messages from a med perspective, orders going straight to the pharmacy without kind of that bottleneck or that back and forth.

And then truly just on the compliance aspect of this and the reporting aspect of this, that WorldView also brings to the table, you know, there's so much more that really goes into this that I want to touch on. And truly where what it comes down to is just quality care measurement. You know, these are suggestions, right? And it's up to the hospice and their philosophy of care whether they want to take them or not. But some of the things that we're truly hoping an agency can assess is their approach to quality measurement. So that's things like your hospice survey. Are you considering, you know, what timeliness of care is doing for your, your survey at the end of the day and how patients and families are experiencing your agency?

It's the medication adoption adherence, You know, making sure that when you're recommending a medication to that patient that they're actually taking it and receiving the benefits and what your team's able to do to proactively communicate with the patient or the family to make sure that they are getting the care that they need. And I think, you know, the HOPE assessment will do a lot for us in 2025 with that ensuring that patients that have issues or moderate or severe, just like pain, that they're getting that care as quickly as possible. So a lot more will be tied to reimbursement and planning towards better care for the patient as a whole and not just some of these kind of subsets that we've seen so far.

And then, of course, technology vendors, making sure that you're choosing the right technology vendors who are going to show up as partners to you and make sure that they're counseling you on your business. Because at the end of the day, a hospice is still a business and it has to be in full working order. Sir, I'd also like to point out that when we have this connectivity and when we're all on the same page, it does decrease errors, whether it's a medication error or transcription error or a human error, re-transcribing everything from paper to into your EMR or wherever, all of this will decrease those errors and improve patient care.

Absolutely. And then kind of lastly, small changes, big impact, you know, we're striving for excellence in timely Med management and timely hospice care. And so prioritizing quick and effective responses for the patient, for the family needs, fostering a really strong sense of communication and coordination among your care teams. Continuous improvement, right? So what can you be doing to regularly assess your care practices? This is something that I think is vital, especially with all of the new regulations coming out constantly. It's making sure that your objective as an agency is still meeting the requirements of those regulations, but also following your philosophy of care.

And so making sure that you're really aligned with strong partners so that you know you are making every effort to meet your patients where they are today and also where Healthcare is heading today in the post acute setting. And then lastly, just always prioritizing patient comfort and dignity that that should be probably the biggest take away today is that we should always be questioning how we're doing things. Change management is hard. It's hard for everybody, but ensuring that you're challenging your internal team to think bigger, I think will lead to some of those better outcomes for your patient. Absolutely.

I think the, the biggest thing is we want technology. You know, we, we have these products here and we just want them to make care easier, right? We, we want to eliminate those unnecessary steps and give care teams more time to deliver the best care that they can. And that's really what this is about. It's taking out some of those steps that are so cumbersome and wear down the staff and making it giving them the time to do what they do best. Exactly. And it's truly, you know, it's limitless at this point. If a pain, if or if a patient has that timely pain relief, that symptom control and we're considering the patient from their overall well-being, this gets so much easier.

But we know that a lot of key things create issues, you know, those delays. So it's making sure that everybody's rowing in the same direction across partners too. So, you know, that's why we really value our partnership with you all. We really value our partnerships with EMRs, with DME companies, the consultants, because we get to hear and see and learn about all the issues kind of across the board from a hospice perspective and bring them together and distill it down into the key things that will help ensure patient comfort. Ensure you know that the bottom line of a of a hospice is well taken care of so that you can continue to grow your business and, and sustain your business.

So we all, you know, the value is us all working together as this ecosystem of partners. So we're really grateful for conversations like this. So thank you. Absolutely. And thank you to everyone that is joining us today. We hope that this has been informative and we'd love to hear from you. So if you have questions, please drop them in the chat and we're happy to answer those for you. And I'm seeing a few pop up, so this might be a good one for Rebecca. What are the biggest communication gaps between prescribers, pharmacies and hospice providers?

There's a couple. A big one is what is on formulary and doctors have their preferences and hospice has their formulary and then the pharmacy has a list and they don't know. So it's a big guess and then trying to track down that information and get that approval, you're playing phone tag and it really slows down. Another one is, is the hospice going to cover it? But sometimes that doesn't get put over to the pharmacy. So they're going to bill it anyway or make calls. And so either they proactively just send it out as something covered and then it's not. And then they have to, you know, spend time getting the that billing.

But those are the biggest issues of getting those orders to the to the families. I see another one up here. So how do these two solutions integrate and what does the process look like from prescription to delivery? So we touched on this a little bit. So when a referral comes in to the hospice WorldView helps get that referral into the EMR very quickly. And then from there, Sara, do you kind of want to take over what the BetterRX side of that looks like? Yeah. So as soon as a patient is hospice ready, we are importing them from the EMR into BetterRX.

Like we said, access can't time, home care, home base matrix scare just to kind of rattle off a few. But we're able to then take that profile for those patient demographics and their Med history and allow for a care team to order, manage and eat, prescribe those medications that are pulled in or deep prescribe them when appropriate, and actually get those out to that pharmacy that we've already connected to in about 3 minutes or less from an ordering perspective. So it is very quick care. They're able to determine if they want it delivered, if they want to pick it up, whether that's a family or a care team doing that or the patient themselves.

So we really do try to meet the patient wherever they need to be for the care that they need to receive. I'll also add, Sara, that when it comes over from your EMR and that import, it imports with whether or not it's formulary or non formulary, whether it's hospice covered or not hospice covered. And and then that same information goes on to the pharmacy. So they get all of that information and there's no guesswork. So really speeds up getting that medication. Approved.

OK. Let me see what else. We have really good questions in here. So how does how do these solutions ensure compliance with hospice regulations? You know, I think it comes down to the digital records, right? So at least with BetterRX, I know for sure that we are reducing the risk of medication errors, we're reducing the risk of things going out that are non hospice covered or that they're not going to be reimbursed with reimbursed for. But outside of that, it's truly just keeping like a clean low risk, fully compliant ordering process on our end.

There's no guesswork to Rebecca's point, you know things are going out and you know that they're compliant. But I think it also comes down to the agency too, and what they're outside of medication ordering, what they're doing for their internal communications. Sometimes that's quite an issue when you know you're considering HIPAA compliance. So just something to consider outside of the WorldView and BetterRX technologies. Absolutely. And from a WorldView perspective, as far as compliance, you know, we store all of those records and push them into the EMR.

So there is a full paper trail from again, that referral all the way through end of life care. So really all the steps along the way, whether you're in the home and doing that mobily or whether you're on your computer and updating records, those orders are there. We can track, you know, E signatures as well. So really that full record is getting passed along that you can prove that that care plan is being fulfilled. All right, here's another one. So what are some common concerns agencies have when adopting automation and how do you address them? I think it's always when there's a new technology, you have to have an owner, right?

And so we hear that a lot. It's, I can't train my team on all of this or this is a completely new process. Our nurses have been ordering medications via the phone for 20 years. So I think change is always, you know, going to be a constant that we consider. But when we see new agencies come to us, they're coming to us because they have issues, right? So we try to make it as easy as possible for them to onboard their team so that they're not having to worry about who's the owner here. We make it so that the whole team has access to the system.

There's not necessarily one single owner because it's everybody's responsibility to care for that patient. So I would say, you know, it has to really come down to ensuring that the the care team has a point person to help advocate for it, but that it's everybody's shared responsibility. Absolutely, I agree with that. I would say also from the WorldView side, our platform is very user friendly. So I love like showing people around what it looks like and the dashboards that we create. And we're really able to customize the workflows to what works best for the agency, not the other way around, which goes a long way to make it very adaptable to getting set up because it's how you want the workflow to go anyway.

So it just makes sense. All right, another one here. How does the hospice? Oh, sorry, go ahead. No, no, go ahead, go ahead. How does the hospice team ensure after hours delivery from pharmacy carrier is able to contact caregivers and patient effectively and deliver medications timely? Rebecca, I'll let you take that one. So we work with the pharmacies directly and have those after hours pharmacies and those that do the after hours delivery. And when we send over that information, it does have the caregivers information on it.

So if it's late at night, they can call that patient or that caregiver and and ask him, are you going to be home? Where do you need me to be or can you meet me at the door? And so that ensures that continuity because they have that information at hand and when it needs to be delivered, they also have the nurses, hospice nurses information. So if all else fails, they can call that hospice and get there after hours also for direction to ensure that we get that medication to the patient. And even just to add to that, you know, for more rural locations or for pharmacies that maybe haven't delivered in the past or currently don't, you know, we're able to really partner with them.

Our model is not the traditional PBM model. And while we can do everything a PBM does, what really changes is how we make our money as a company. And so we don't make any money off of medications or take a spread on that pricing. So we're reimbursing the pharmacy so that they're profitable typically for the first time in hospice. So we're able to kind of pull those levers to ensure that if a hospice has specific needs or requirements that the pharmacy that we're partnering with to service their customers and their patients is able to be a little bit more flexible in how they're, you know, delivering or offering after hours solutions.

That was a great question. OK. Are there any upcoming regulations or industry trends that could impact how hospice agencies handle medication management? Definitely with the HOPE assessment, I kind of touched on that one earlier, but I would say that, you know, agencies are really going to see some change. You know, they're going to be really judged on the full patient and on how timely they were able to get those symptoms managed if they were moderate or severe. So we definitely see that one as being pivotal for them. Okay, I think those are all the questions that I see coming through.

Yeah. So thank you again Sara and Rebecca for joining me today and thanks to everyone that's attended. If your agency is facing medication challenges, we'd love to help. Sara is wonderful to talk to so you can reach out to her and or myself if you would like to talk about WorldView. We don't want you to settle for slow, frustrating medication workflows, so we're here to help fix it. So that's all hope everyone have a great day. Thank you Sara. Thank you, Rebecca.

Thank you for having me. Yeah. Take care.