Prescribe Wellness helps improve patient health and reduces health care costs through improving patient-centric communication. For example, by enabling pharmacists to remind patients when it is time to get prescriptions refilled or time to take their medication, Prescribe Wellness can increase patient adherence with physician orders.

Prescribe Wellness is also involved with mass communication with patients in support of population health initiatives. Currently, the company is leading a movement called A Million More (http://amillionmore.com) aimed at encouraging the public to get flu shots this season. The movement hopes to get 1,000 people in 1,000 different communities to get a flu shot (thus the “million more”), and incorporates a public-facing web site, outbound telephone calls, TV spots, sweepstakes, and extensive social media components.

Prescribe Wellness is fostering still other types of patient-centric communication by providing health care professionals and institutions with tools to enhance patient communication. Three such tools include:

• Transitional Care product used by hospitals to maintain contact with and gather information from a patient post-discharge from the hospital in an effort to significantly reduce hospital readmission rates
• Medication Therapy Management product used by pharmacists on behalf of payers or PBM’s to facilitate MTM counseling and recommendations regarding drug interactions, dosages, and an overall holistic view of medications for patients taking more than 3 different drugs
• Behavioral and chronic disease-related communication aimed at altering patient behavior—such as smoking cessation, weight loss, and diabetes management.

Prescribe wellness has many facets to their business, but each of these involves communication with patients.

From a systems standpoint, Prescribe Wellness needs very flexible and scalable systems to coordinate and automate patient communication, internal operations, secure patient data aggregation, and cross-stakeholder collaboration.

Prescribe Wellness selected OpsStream as their company-wide technology platform to automate and support all of the facets of their business.

Each specific facet of OpsStream’s usage within Prescribe Wellness really is a separate “use case” that deserves to be explored in depth. The following is a very abbreviated enumeration of these:

1. Empowering national campaign and public-facing web site (http://amillionmore.com).

   The web site is a standard web site, developed and hosted using typical web development and hosting platforms. However ey areas of web site functionality currently rely on OpsStream:

   1. Store Locator

      This is a map and zip-code driven lookup of participating pharmacies. The actual store locator uses a standard off-the-shelf module called “Store Locator Plus”. However OpsStream provided an integration bridge that allows this module to be updated automatically without human intervention directly from OpsStream data. This means that as Prescribe Wellness staff signs up new pharmacies and moves them through the defined business process, the pharmacy will automatically appear in the store locator at the right time.

   2. Appointment Scheduler

      This is a zip-code driven lookup of participating pharmacies (separate from the store locator described above.) A pharmacy can be selected, and then the user is presented with a calendar of available appointment days and available times within each day. The visitor can then schedule a flu shot appointment on a particular day. The entire appointment scheduler is OpsStream-based:
      1. When a zip code is entered on the web site, a real-time REST call is made to OpsStream to retrieve a list of Pharmacies. OpsStream returns this list, including map thumbnails, in a JSON array—and javascript code is then able to display this list.
      2. When a pharmacy is selected on the web site, a real-time REST call is made to OpsStream to retrieve a list of available days within the month specified by a target date. These dates are returned in a JSON array—and javascript code is then able to render a date picker control. As the user navigates to different months, the process is repeated to return the correct available dates for that month.
      3. Pharmacy-specific available date and time information is maintained by the pharmacy through an OpsStream-provided pharmacy portal. See below for more information.
      4. When a date is selected, the pharmacy identifier and specified date is provided to OpsStream in an REST call to retrieve a JSON array containing available times on that day.
      5. When a specific time is selected, a form is presented to the visitor to capture name, phone number, e-mail address, and preferred appointment reminder communication method. This form is posted back to an OpsStream URL.
      6. Upon appointment form post, OpsStream immediately sends out a confirmation e-mail to the visitor, and updates the OpsStream data with the appointment. OpsStream also makes the appointment available for the Pharmacy to see on the pharmacy portal.
      7. The pharmacy is also alerted via a daily e-mail digest that lists all new appointments added today, as well as all upcoming appointments scheduled for tomorrow.
      8. On the day before the appointment, OpsStream will automatically send out an appointment reminder (via e-mail, text message, or voice call—depending on the preferred method selected by the visitor).
      9. Prescribe Wellness staff also has access to appointment data through the standard OpsStream user interface so that they can provide real-time support to pharmacies as needed.

   3. Internal Operations Support

      Prescribe Wellness enrolls patients in the A Million More initiative primarily through outbound phone calls. Once a pharmacy indicates that they wish to participate, the pharmacy’s information is entered into OpsStream and a business process is initiated. This business process walks appropriate Prescribe Wellness staff through many steps, including: collecting payment, setting up a Facebook page, enrolling in social media tools, sending pharmacy portal instructions, collecting available appointment slots, collecting patient phone number data for outbound calling, recording outbound voice message, and more.

   4. Outbound phone campaigns for A Million More

      A major component of the A Million More initiative is to allow a pharmacist to call his or her own patients and play a message in the pharmacist’s own voice encouraging his or her patients to get a flu shot. (Through use of this “voice of authority” patient response rates are high and opt-out rates are low.) To actually place these calls, Prescribe Wellness must collect the target phone numbers—up to 1,500 per pharmacy (for this specific initiative), must capture a recording of the pharmacist speaking the message to be delivered, and must configure velocity parameters that define the days, times of day, and number of calls per hour to be initiated. OpsStream provides all of this functionality:
   1. The pharmacist records a message by clicking a “Call Me Now” button on a page of the pharmacy portal. The pharmacist’s phone rings. When he or she answers the phone, he or she reads the on-screen text and hangs up. The pharmacist can then click a “Play” button on the portal page to immediately re-play the newly recorded message.
   2. The pharmacist provides patient phone number data either by copy-and-paste from a report, file, Excel spreadsheet, or the like, or by uploading a data file. This is performed through an Upload Data page on the pharmacy portal.
   3. OpsStream maintains detailed campaign information for each pharmacy, including storing the digital audio recording, the call velocity parameters, and the patient phone number data.
   4. When released by Prescribe Wellness staff, OpsStream then begins to dial and deliver the recorded message to the specified phone numbers according to the velocity parameters defined. OpsStream also captures detailed call statistics (date time of call placed, answered, completed, etc., whether answered by human or machine, et al) and can provide informative reports.

   5. Overall pharmacy portal

      The pharmacy portal (mentioned in several points above) consists of a number of private web pages. Each pharmacy has a unique URL to access their pages. The pages are directly generated and served by OpsStream (i.e. no other web server involved in these pages). This provides a secure, turn-key web interface for the pharmacists to use.

   6. Process-centric communication

      Outbound phone calls to patients and appointment reminders are described above. These, and other communications with various stakeholders (e-mails, text messages, voice messages) are initiated automatically according to business processes defined in OpsStream. For example, if a pharmacy fails to record a message within a specified period of time, OpsStream automatically sends out a reminder e-mail.

   7. Inbound phone calls

      OpsStream also answers inbound calls, and can take action on receipt of such calls. For example, the outbound caller ID number used for A Million More patient calls is a toll-free number that is answered by OpsStream. When someone calls this number, based on caller ID OpsStream is able to tell the caller why he or she was called, able to replay the message that was originally delivered, and able to accept an opt-out request. If the caller opts out, phone number information is immediately added to an OpsStream managed opt-out list, thereby immediately preventing any future calls to that number.

2. Complex communication campaign management.

   In addition to simple single-call outbound communication campaigns, OpsStream can manage complex multi-call and multi-mode campaigns. For example, upon discharge form a hospital a complex campaign can be launched that specifies various voice, e-mail or text messages be delivered at various days and times. Also, these messages can ask questions of the patient, and can result in this information not only being stored by OpsStream, but actually being used by OpsStream—to deliver different messages based on responses or to escalate the patient to a health care professional if needed. Finally, OpsStream can also incorporate communication with family members or other “advocates” as part of these campaigns, including initiating live conferences between patient and family member if needed.

3. Case management tools.

   Medication Therapy Management (MTM), Smoking Cessation, Transitional Care, Chronic Disease Management and Patient Behavior Modification (healthy living) all require case management functionality in which some patient information is maintained. Throughout the course of interaction with the patient, this information is used and added too. The original source of patient information may come from one or multiple external sources. All of this data is sensitive data protected under HIPAA regulations. OpsStream manages all of this data, and provides the needed case management functionality.