HIStalk Interviews Frank Harvey, CEO, Surescripts

Frank Harvey, RPh, MBA is CEO of Surescripts of Arlington, VA.

Tell me about yourself and the company.

I have been interested in healthcare since I was six years old. My father used to take me on Saturday mornings to the soda fountain at the local pharmacy. I was interested in what our local pharmacists were able to do with patients and the members of the community. From that time on, I’ve wanted to be in healthcare, specifically as a pharmacist.

I’ve been in pharmacy throughout my career. I have been fortunate to be a part of life sciences, with Lilly and Hoffman-LaRoche, and companies such as Liberty Medical and Mirixa, which is a medication therapy management company. I ran my own venture fund for bit. I was excited to get the opportunity to come to Surescripts because it’s such a wonderful company. Surescripts is a mission-driven health information network that is focused on enhancing the prescribing process and forming care decisions. Our mission is to continue to lower the cost of healthcare, improve patient safety, and improve the overall quality of care.

How has the role of the pharmacist, along with the technologies and data that are part of their work, changed?

During COVID, pharmacists really raised their level and used the full scope of practice of their degree. It was critical during that time, because in many cases, physicians weren’t available because they were tied up with so many COVID patients. Pharmacists stepped in to do much more, such as administering vaccines and  counseling chronic care patients.

We expect pharmacists to continue operating through the full scope of their license, particularly because there’s such a shortage not only of primary care physicians, but also of endocrinologists and rheumatologists. We’re seeing a burnout of physicians and many of them are retiring. Pharmacists will have the opportunity to step up their level of their practice to be operating more at the full scope of their license.

How has the Surescripts network changed over time?

When Surescripts first came into being over 22 years ago, prescriptions were transferred back and forth, either by patients carrying the prescriber’s handwritten prescription to a pharmacy or having it called in. Surescripts was put in place to make that process electronic, as the first health interoperability network, if you will. Now the vast majority of prescriptions go from the physician to the pharmacy electronically through our health information network. 

We have continued to expand far beyond that to help with price transparency and to support pharmacists and physicians being able to message each other electronically, with no more faxes or having to jump on the phone. We’ve continued to focus on enhancing the prescribing process and informing the care decisions that physicians, nurse practitioners, and PAs make by providing medication histories of the patients to the physician.

Has the launch of a competing e-prescribing network changed your strategy?

No. We will continue to focus on being a mission-driven company and will continue to enhance the prescribing process and informing that care decision. Competition is always good. We welcome competition that helps move our mission forward. Whether it’s Surescripts doing it or other companies doing it, we’re happy about that.

How will you continue to enhance the Surescripts network?

Even in the last four years, we’ve improved the quality of prescribing, the prescriptions coming across, by about 85%. We continue to focus on enhancing that prescribing process. The other thing we continue to work on is ensuring that, from an administrative standpoint, we’re providing the right information at the right time to physicians, so they don’t have to cull through volumes of information to get to what’s important at care decision time.

How much emphasis is placed on inserting the connectivity result into the prescriber’s EHR workflow?

It is really critical that it’s in the workflow. We’re integrated in every EHR across the country. Last year, over 2 million practitioners prescribed over 7 billion transactions. All of those were integrated into the electronic health record that the physician was working with.

An example is that at the time of prescribing, when the physician is with the patient, transparency apps allow the physician to see not only the therapeutic alternatives, but also the pricing of each based on the insurance coverage that the patient has. It allows a physician to make the right therapeutic decision for the patient as well.

Are you seeing benefits for both the prescriber and the patient?

Absolutely. That’s one of the most important things about having a real-time prescription benefit tool in the physician’s EHR. They can see everything about the prescription and the therapeutic alternatives. Before, they would write a prescription without understanding the price consequences. The patient would take it to the pharmacy, find that they couldn’t afford that medication, and then ask the pharmacy to call back to have the prescription changed to a different medication that they could afford. Integrating that into the overall workflow cuts down a lot of demonstrated burden of the physician, the pharmacy, and the physician staff.

Have you seen statistics documenting outcomes improvement since cost issues might have led to the patient either not having the prescription filled or taking it in lower doses to stretch it out?

We absolutely have. Most recent studies shows that the prescription pickup rate increases by 3% to 5% with use of a price transparency tool with real-time prescription benefits. The patient knows what they are facing from a pricing standpoint, they’re more likely to pick it up, and the doctor is more likely to have written a medication that is affordable to the patient. The most expensive medications are the ones that the patient never picks up, because they never get their health condition taken care of. These tools help the patient.

How has the federal government influenced interoperability?

Micky Tripathi and his team have done a tremendous job. They have so much energy behind their efforts. Interoperability is so critical in being able to get that full patient’s record. A new proposed rule focuses on advancing that interoperability and improving transparency, supporting the access and exchange of electronic health information. 

The role that Micky and his team have played has been critical to moving us forward more rapidly than would have happened without their participation, their urging, and their hard work over a long time. We are a great example of what interoperability does, with 21.7 billion transactions a year across all of our products. We are looking forward to everything that’s happening with TEFCA.

What will the company’s strategy be over the next few years?

We are going to continue to focus on what has been our bread and butter, which is our mission of improving the quality of care, improving patient safety, and lowering cost. We will do that by broadening the areas that we work on across enhancing prescribing as well as informing care. We are looking to work to help broaden the care team, to enable the care team as it expands and pharmacists take a more active role, to make sure that they’ve got the right data to make the right decisions and can communicate that information back into the health record. We will continue to lobby for the right legislation to be in place to enable and empower pharmacists to do what they’re able to do, in partnership and collaboration with physicians, nurse practitioners, and physician assistants.

Healthcare in this country is at a critical phase. We are seeing the continued burnout of our healthcare practitioners and a lack of enough healthcare practitioners, particularly in rural and urban areas. We have areas where patients may have to travel 100 miles to see a physician. It will be important that pharmacists can play a larger role. I believe that we will see, over the next five years, that the healthcare team will continue to evolve, and that will be the best thing for the patient.