Geisinger Health System and pharmaceutical manufacturer Merck recently announced that they will collaborate on a multi-year collaboration designed to improve patient health outcomes by focusing on innovative solutions that facilitate shared decision making between patients and physicians and improve adherence to treatment plans and clinical care processes.
Geisinger is an integrated health services organization widely recognized for its innovative use of the electronic health record, and the development and implementation of innovative care models including ProvenHealth Navigator, an advanced medical home model, and ProvenCare program. The system serves more than 2.6 million residents throughout 44 counties in central and northeastern Pennsylvania.
“We believe that healthcare is most effective when patients are active partners in their care,” said Glenn Steele Jr., M.D., Ph.D., president and chief executive officer of Geisinger Health System. “Our collaboration with Merck will allow both organizations to leverage our individual expertise and joint resources to improve patient engagement, including finding new interventions to increase the likelihood that patients will adhere to their treatment plans.”
Other companies like Janssen and Sanofi have initiated competitions with hospitals and companies to devise ways to reduce healthcare costs.
New Adherence Project
Teams from Geisinger and Merck will work together to improve patient adherence, increase the role of patients in making decisions to help manage their conditions, share information among extended care teams, and improve clinical care processes. The first tool being developed is an interactive web application designed to help primary care clinicians assess and engage patients at risk for cardiometabolic syndrome.
Cardiometabolic syndrome is a clustering of various risk factors that put an individual at risk of developing type 2 diabetes and cardiovascular disease. All three sets of patient populations will help test any ideas spinning out of the collaboration with Merck, said Dr. Thomas Graf, chairman of Geisinger’s Community Practice. The cloud-based application will be designed to integrate with any EHR system. Over 18 months, development will be adjusted on a weekly basis, reports MedCity News.
“When you have two leading healthcare companies that share a commitment to improve health outcomes and are focused on fundamental problems that have plagued the healthcare system for years, the results have the potential to be transformative,” said Mark Timney, Merck’s President of Global Human Health – U.S. Market. “We’re excited about the opportunity to work with Geisinger to address these critical areas.”
The web application and other care management solutions that Merck and Geisinger develop will initially be tested within the Geisinger system. Geisinger has been at the forefront of the development of innovative healthcare delivery models focused on improving adherence and developing methods to better engage patients. Merck has conducted scientific research to better understand the drivers of non-adherence and develop evidence-based interventions.
“A rapid learning process will be used to integrate, evaluate and improve the performance of each solution in primary care clinical settings,” Dr. Steele said. “We will closely monitor patient acceptance, treatment adherence, and other metrics to determine which tools and solutions have the ability to improve patient care and are ready to be deployed on a broader scale.”
Timney told the Philadelphia Inquirer that the program will be brand agnostic for prescriptions. He said the pharmaceutical company will contribute millions of dollars in employee time and energy, but not its products; meaning Geisinger doctors will not be obligated to write prescriptions for Merck drugs ahead of competitors. Critics, however, believe that efforts such as this are have a “marketing purpose behind” them, said Erik Gordon, a University of Michigan business professor. Gordon maintained that an adherence program such as this is a way for companies to get access to doctors because of the declining access sales reps are having. Such concerns are misplaced.
“There is nothing specific in this contract about,” using Merck products, Timney said. “A big focus is adherence and this collaboration is agnostic regarding brand or company in what that solution might look like.” Merck has medicine for both diseases, but one of its four core strategies is to expand into complementary areas of health care. “If the solution is successful,” Timney said, “perhaps it is something we can commercialize and scale up.”
James Peters, one of the Geisinger leaders on the project, said that Geisinger respects Merck’s research in this area, but that the “spirit” of the project was not to create a “Merck-specific”product, adding, “I can’t imagine that would make sense.”
Conclusion
Although keeping patients on schedule with their medications would mean more sales volume for drug makers, it also could prevent emergency room visits and hospital stays, according to recent research. One recent study found that 63 percent of patients do not take their medication as directed. Improving adherence is critical for hospitals in particular because the Affordable Care Act penalizes hospitals for high readmission rates.
Two recent efforts to reduce readmissions included text message medication reminders for diabetics and embedding nurse care managers within primary care practices to coordinate care for patients with multiple chronic conditions and patients who require a lot of services.
Ultimately, many health-care professionals with no particular allegiance to pharmaceutical companies recognize that improved adherence dramatically decreases catastrophic health events that result in emergency room visits, hospital stays, and huge costs. Merck’s program should be applauded and other companies and health care systems should follow through with similar programs. As long as adherence programs focus on making sure patients take medications they are already prescribed and in no way interfere with a physicians ability to prescribe generics, there should be no issue with companies support such initiatives.