Specialty Pharmacy Digital Transformation: What’s Next?

9.12.19 By Matthew Stoltz



Holistic IT adaptation addresses key challenges such as data integrity and patient service delays. Digital-driven companies are embracing sustainable adaptation. You likely already know this, but does your IT partner?

A good IT partner will deliver technology services on your behalf. A great IT partner will learn your business. They tend to ask questions like, "how can we help you better serve patients, how can you remain competitive, cost-effective, and ensure your digital systems are up to date?" Technology, alone (without any business context), has not been the answer to dollars siphoned by inefficiency. Add regulatory issues and growing technology skill gaps to the equation, and it may seem you're digging yourself an inescapable hole.


The CSI Group, in its 2018 State of Specialty Pharmacy Report, found that data processes will be a key factor in both patient services and in remaining competitive. Specifically, the report found that “40% of [specialty pharmacies] believe their patients have challenges coming onto service 20% of the time. This represents significant dollars lost either in delays or in patients having to switch to other therapies.” Delays, patient services, and driving outcomes can all be improved with a combination of system performance, data, and process.


Technology in a vacuum will not drive outcomes.  For that, we'll need to rethink the role of digital services.


Rethinking Digital

Instead of asking "what's next?" the subject matter experts at 4th Source tend to ask "what's working?" How can we better serve patients, remain competitive, and ensure our IT systems are current while avoiding costly mistakes? How can we systematically drive out inefficiency without affecting operations?

Digital transformation is more of a skill than a state of being, one that requires three components (rooted in process, people, and tool) to be effective:

  • IT experience
  • Industry experience
  • Adaptation as a skill


Most “heads-on-sticks” IT vendors operate at a pure IT level, limiting their ability to add value to an organization. 


Industry experience is where IT vendors contribute holistically, understanding your processes and leveraging technology to solve problems. Today, many digital consultancies provide industry insight as well as technology services.


Adaptation as a skill, however, is driven by team empowerment and continuous training. It is vertical agnostic and takes into account cross-functional skill sets. It enables every-day system users to deliver valuable insight, and recognizes that systems, processes, and teams are part of a larger ecosystem.



How to Achieve Adaptation as a Skill

The CSI report goes on to say that “41% of [specialty pharmacies] said they could only service between 40% and 60% of the patients they receive.” There are a number of productivity hindrances, but focusing on business drivers, with an experienced team, will strengthen your operations regardless of the technology.


Focusing on customer service processes, for example, could be one solution, but what if you ran a deeper investigation and found duplicate patient records were slowing response time, or that RCM processes could leverage machine learning to detect bad debt, or that prior authorizations can be automated to save pharmacists time?


Industry experience drives digital modernization, but also provides the operational insight to know when to hit the brakes. We know this because we’ve experienced it, and, in one case, ended up saving our largest pharmacy customer four and a half million dollars  – simply because our teams knew their system so well that they developed a workaround at one-tenth the cost. 


Adaptation as a skill comes from a company-wide effort over time. There are no shortcuts. We have been working with leading specialty pharmacies for fifteen years. Our subject matter experts closely mentor team managers while the company invests in continuous training. Communication is open and problem-solving is cultural. These teams drive stronger outcomes because they’ve “grown up” in this environment. 


Drivers of a Digital Strong Specialty Pharmacy

The subject matter experts at 4th Source have defined six core drivers in Specialty Pharmacy. In addition to full-stack development, QE, informatics, and QA, 4th Source offers unique, experience-driven services around:



Leverage automation, machine learning, and process improvements to drive down costs and increase productivity.


Performance Reliability

Reduce technology issues that impact your ability to enhance the patient journey and meet prescriber commitments.


Data Analytics

Improve operational and manufacturer reporting and align line-of-business operations with core IT functions.


Regulatory Compliance

Remain current with government regulations and compliance guidelines.


Application Implementation & Integration

Identify gaps in current systems, implement packaged applications and integrate existing platforms without impacting operations.


Patient Experience

Create tools and functions to improve patient experience and remain competitive with system and process enhancements.

WARNING: Pharmacy ops teams may experience a floating sensation due to the excessive weight lifted off their shoulders.



Whats the Experts are Saying

Over the past fifteen years, 4th Source has worked with many of the largest specialty pharmacy organizations in the world and has delivered tens of millions of dollars in IT cost benefits. In addition to full-stack development, QE, informatics, and QA, 4th Source serves multiple areas in specialty pharmacy such as automation, regulatory compliance, system reliability, and manufacturing reporting.


Doug Miller_01_small

“We were automating before it was on everyone’s radar – because it made sense in many areas. Now it’s expected, but if a vendor doesn’t have system-wide experience, and operations experience, they’ll tread water. This is why we end up training other vendors with larger clients. We’d rather see a project end up as a success by teaming up with another vendor, or managing them, than cost our customers extra time and money – especially in healthcare.”

~Doug Miller

4th Source Senior Director, Client Services 




Download The Big Book of Specialty Pharmacy IT Success Stories

Our client services team got together and thought, "We have so many success stories in healthcare and specialty pharmacy; why not consolidate and share them?!"  So here it is; with examples of how to leverage automation, how to improve BPI, optimizing RCM, compliance solutions, and a lot more.


Get your copy here