Specialty innovation at CVS Health: From vision to execution

Christine Sawicki, Executive Director of Product Development & Innovation, oversees the innovation pipeline for CVS Caremark, working to design creative solutions to help clients manage cost and care. Through careful listening and a keen eye on data and trends, Christine and her team conceive, test and deploy technology, tools and features to help plan members on their journey to better health. She recently shared her personal take on the work.

What is the guiding philosophy around innovation at CVS Health?

For me, innovation is about empowering patients to have a voice in their care. With any health condition, when you are diagnosed, it’s all new information. All too often the health care system assumes patients’ ability to understand complicated topics. Our mission is to simplify it for patients so they can have a voice, share their experience and make more informed choices about their care

How does innovation benefit clients?

We’re using digital not only to support patient care, but to intervene with questions and specialty pharmacist support to monitor medication therapy. For example, digital tools make it possible for patients to share their experience with their medication, which allows us to assess effectiveness and intervene at the right time if a change seems to be indicated. A change in drug regimen results from 23 percent of those interventions, saving clients an average of $2,000 per intervention.¹

As another example, sometimes patients have a routine of filling their medications on a specific day every month. That could result in accumulation – too much medication on hand. Every day, our systems calculate adherence and supply on hand to support optimal medication therapy; it prompts the patient to receive their shipment at a time that reduces oversupply. This activity saves clients an average of $2,600 per targeted specialty patient.²

As a pharmacist, you have worked in multiple settings that brought you face-to-face with patients. But these days, innovation is synonymous with digital. How do you keep that close, personal relationship alive in digital interactions?

Digital innovation is purposeful and based on different dimensions that can affect medication therapy, such as affordability, symptoms and social determinants of health. Our proprietary digital engine establishes a conversation with patients, with relevant topics based on the medication and many other inputs. Essentially, the experience creates an ongoing conversation between the times when patients are filling a prescription. By doing that, we’re letting them know we’re here to talk or answer questions and giving them information they would get if they walked into any pharmacy. We test innovation with patients, and they’ve responded well to digital tools that allow interpersonal interaction at times that are convenient for the patient.

We design solutions with the customer in mind. We include them in the process and get their feedback right away. Patients want to be engaged on a personal level and we want to use digital tools to communicate and collect essential information to ensure they are okay. By doing this, we remind them that we’re here for them; we have their backs so they can focus on their life priorities.

What infrastructure and investment is required to provide a fertile ground for innovation at CVS Health?

CVS Health has made a $100 million investment over several years to build up digital architecture and support the digital experience and help our clients control costs. Our investment allows us to be agile, nimble and flexible. Connectivity to prescribers is essential to ensure that we’re gathering the most accurate information during the prior authorization process. We use an interoperable electronic health record system and with integration, we gather information directly from the electronic health record to inform interventions or to identify changes, for example.

We regularly solicit feedback on the user experience and implement enhancements quickly to continuously exceed consumer expectations. Center of Excellence clinicians, support and financial specialists are behind the digital tools to answer questions in real time, and we have robust reporting tools. Our systems are integrated, which provides comprehensive tracking of digital messages, member engagement, intervention, and outcomes. Our clinical advisors provide detailed insights and savings with enhanced reporting that is available with no additional fee.

How is CVS Health using artificial intelligence and machine learning?

We use them to do predictive modeling and behavioral analytics. Those technologies are helping us connect with members and patients at the moment when a clinical intervention is likely to influence a situation or outcome. That takes the connection point to a new level, making it convenient for the patient, which results in increased likelihood of success.

What is your approach to failure?

Failure is mandatory. If we don’t fail, we’re not trying hard enough. We ask, why did it fail? We conduct a root cause analysis. With every failure, there is a success, and it may appear in a different way than we planned. That cycle of innovation is continuous and data-driven.

We have a culture of solving problems. We have root cause analysis from customer and product perspectives. We go at least five layers deep to find failure points and fix them globally.

For example, during the pandemic, a digital interaction with patients included a COVID vaccine topic. A pilot test of the engagement showed a response rate several hundred times greater than expected. When we looked at that question, we reached out to respondents and discovered that they wanted more information tailored to a specialty condition with access to a nurse or pharmacist on-demand. Understanding the greater demand and what information would be helpful allowed our teams to update educational materials and increase clinician availability for chat. This represented a new opportunity for innovation and has influenced how we might address similar situations in the future.

What exciting innovations are on the horizon for CVS Health in the next few years?

I’m excited about increasing use of sensor data and more patient-reported outcomes into the data sets that are used to inform member interactions. In that way, we can ask fewer questions, because we are getting the information from the sensors. By doing that, we can start a conversation with a patient by validating the information we’ve received and get right to working together. This maximizes the valuable time we spend with our patients and has a higher impact. We’re transforming the experience so the clinician and patient can have more meaningful and enriching conversations about health care instead of just collecting information.

The source for data on this page is CVS Health Enterprise Analytics, unless otherwise noted. Savings will vary based upon a variety of factors, including things such as plan design, demographics and programs implemented by the plan

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106-55125A  July 6, 2021