Tara Herington, VP of Cardinal Health Sonexus™ Access and Patient Support

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Saul Marquez:
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Saul Marquez:
All right, everyone, welcome back to the Outcomes Rocket. Saul Marquez here. And today I have a treat for you. I’ve got Tara Harrington as a guest. She’s the Vice President of Cardinal Health Specialty Solutions, overseeing Sonexus™ Access and Patient Support, a patient services hub that works on behalf of pharmaceutical manufacturers to provide tailored solutions based on the needs of their patients and their treatment journey. Tara began her more than 20-year career in health care as a registered nurse before transitioning to the business side of the pharmaceutical world, which taught her the importance of keeping patients’ needs at the center of the health care system. Today, Tara leads the Sonexus™ Patient Services Hub, developing customized patient support programs for biopharmaceutical companies ranging from top 10 pharmaceutical manufacturers to emerging biotech innovators and cell and gene therapy developers. Such a pleasure to have you here, Tara. I know you guys are working on some really phenomenal programs and really excited to dive into those today. Thanks for joining us.

Tara Herington:
Well, thank you for having me, Sal. This is a great opportunity to get the word out, so thank you.

Saul Marquez:
Absolutely. So before we dive into the great work that you guys do, Tara, tell us a little bit more about you and why you’re inspired to do the work that you do in health care.

Tara Herington:
Well, I think it came by it naturally. My father was a physician, so and he was a physician in a small town, a general practitioner. So I really got to know the community in the way health care impacts the community. And then as a teenager, I was a junior volunteer or we call them candy stripers back then, and spent many, many hours every week at the hospital in those early experiences, whether it was being able to take flowers into a patient’s room or push a patient down the hallway as they were going to radiology and getting to hear their stories really sparked my passion for patient care at a young age. And then after I became a nurse, I started out as a bedside nurse and also worked in hospice, and caring for patients and definitely their families during that difficult time taught me so much about patient centricity and health care. And we can’t ever forget that at the heart of anything we do in health care as practitioners, that we need to make sure that patients stay at the heart and really valuing and empowering patients to advocate for their own care. Although I no longer work in that clinical setting, I still very much still think of myself as a nurse. I keep my R.N. license up and those experiences that I gained as a nurse still inspire me and guide my work in health care. Today, in my role at Cardinal Health Sonexus™, I lead a team and we work, as you said, with those biopharma companies and develop and implement programs to support patients who are facing barriers, barriers to care, things that can impact their health outcomes. We talked about what was my inspiration as a child. And my inspiration today is really in that Problem-Solving and collaborating with our clients to remove those obstacles to care so that patients can achieve the best possible outcomes over the course of their treatment journey.

Saul Marquez:
I think that’s great. And so how exactly are you and the Sonexus team adding value to the health care ecosystem?

Tara Herington:
Patients with chronic care conditions, things like cancer, things like most things like rheumatoid arthritis, things like psoriatic arthritis. They often face challenges when it comes to managing their treatment regimen. These patients generally don’t have, quote, just one thing. And they’re not just their disease. Patients have their whole 360 around them. And we have to remember that when we’re helping them manage things like their prior authorizations and their benefits investigations. Before a pair will pay the cost for some of these specialty medications, they require these hurdles that patients have to go through before they can access their therapy. And these requirements can be very time-consuming. I’m talking weeks, sometimes months, and it significantly delays the start of therapy for patients. In addition to delaying that start of therapy, it causes a lot of angst for patients as they’re worried about whether or not their therapy is going to be approved and how quickly it will be approved. And even after patients do initially access their therapy many still struggle.

Tara Herington:
There’s, as I said, patients have a lot on their plate. So when some of the barriers that come up or anything from financial obstacles, concerns about side effects can be social or emotional challenges. So there are just things that come up for these patients. And at Sonexus we have experience in delivering reimbursement support and clinical education and other ways to help patients get started on their therapy and maintain their therapy. We provide assistance to more than two hundred and fifty thousand patients every year, and we also have technology that helps patients achieve better outcomes. For example, we have done a lot when it comes to automation, but the prior authorization and the benefits verification process, things that used to take weeks, days to weeks now can be done in a matter of hours or a couple of days. So definitely reducing that time to therapy. And then we also work with our biopharma clients to manage the free drug programs for patients who cannot afford their medications. This is for patients who are uninsured or maybe other underinsured. And so we have what’s called a noncommercial specialty pharmacy, and we dispense as many as four thousand doses of free medication every day for these types of patients. So it’s one of those things that a lot of people don’t know about. But most manufacturers do have this free drug program.

Saul Marquez:
That’s fantastic. And some of the data around how fast can you get what you need therapy wise and the obstacles to get there. It’s just mind-boggling. It’s frustrating. So it’s fantastic to hear that you guys are helping 250,000 plus patients every single year. How would you say what you do is unique and different than what’s available and how is it improving outcomes?

Tara Herington:
I would say one of the things that we’re doing to improve outcomes is by capturing some of the data around those patients and their journeys. From a unique perspective, that’s also a bit unique. So having the ability to capture that information, put it in ways that are consumable for our clients so that they can make different decisions to help more patients. So that’s a big push for us and something we’ve made a lot of movement in over the last couple of years.

Saul Marquez:
Fantastic. Congratulations on that. And the other thing that’s impressive is the number of free doses a day. When you said four thousand, I was like, OK, four thousand. You know, a day like, whoa, that’s a lot.

Tara Herington:
Yes, our pharmacy team does a great job. They really look at the fact that there is a patient behind every prescription that goes out and if they have four thousand, they need to go out in a day. They’re not leaving that pharmacy until every one of those goes out because those are patients. We’re waiting on medication. We have a team that’s worked together for years and they are amazing.

Tara Herington:
Well, and I’m glad they have a nurse leading this team just because nurses are just incredible people and insightful, super-connected across the organization. Just brilliant that Cardinal made you the leader. As far as you think about setbacks Tara what would you say? One of those setbacks is key learning that came out of it?

Tara Herington:
I would say this is a little bit of a shift, but a key learning from the last year that probably, I would say all of us had some learning about is COVID. We were definitely challenged by the sudden onset of COVID. And knowing that, again, these are patients that we need to help, whether it’s in our pharmacy or if it’s on the reimbursement side. And we knew that we had to keep business going. Luckily, I’ll take luck any day. Luckily, we were already at about 40 percent remote workforce prior to COVID hitting. And that was something that we started and we’re very deliberate about. So we already knew how to hire people remotely, how to train people remotely, how to monitor people remotely, and things like that. But still, we were only at about 40 percent. But then after COVID hit, all of a sudden we had to get really ninety-five percent of our workforce home and we had to do it in a matter of two or three days.

Tara Herington:
And just the mountains that were moved by everyone on the team, from I.T. to facilities to H.R., I mean, we really moved mountains and everyone pulled together to make that happen. We still, of course, have an onsite staff because the folks that are actually dispensing the medications, they need to be in our pharmacy, the folks that are in our warehouse getting that the new product for us, they have to be there. Our mailroom people, the people in our shipping group, they need to be there. But right now we’re ninety-five percent working remotely. And most of our team provides really that front line support to patients who are struggling to access therapy. And so these are sick patients, patients who rely on our team. And it was also important not only to be there to meet those patients but for the service levels to remain high. So it wasn’t enough just to say, hey, let’s just all move to the home. We needed to make sure that the quality did not suffer. And through this, we were able to maintain quality and in fact, are finding that some of our performance measures have improved since moving to the remote environment.

Saul Marquez:
That’s outstanding. Well, congratulations on that. And wow, going from forty to ninety-five percent is no joke. It’s a beast of a job to do. And on top of that, to also see the rate of just improvement. The business itself is a testament to how you guys did it, but also your commitment to keeping that patient at the center. What are you most excited about today?

Tara Herington:
What am I most excited about? I’m really excited about how we’re leveraging technology to better meet the needs in the future. So we are not about technology just for kind of that shiny penny’s sake when technology is just for fun and that’s a toy. And that’s well, that’s fun. But that’s not what we’re really about. It’s about how can we leverage technology to impact patients in the right way. So with things that we’re doing, whether it’s new ways to interact with patients using A.I., with texting or emails to really meet patients where they are with the message that they’re ready to receive at the right point in time through the channel that they’re most comfortable with is something I’m really excited about for sure.

Saul Marquez:
And so we’re still dealing with the pandemic Tara and there’s still a lot of patients out there with chronic conditions. How has the COVID-19 pandemic affected chronic care patients?

Tara Herington:
Yeah, that’s a rough one. You know, chronic care patients represent more than 40 percent of the American population, and four out of the five of the most expensive health conditions are chronic conditions. The one is not that there is cancer is not considered a chronic condition, but with some of the advances we’ve made in medicine, somewhat almost considered certain types of cancer to even be chronic may actually be higher than that. And managing these chronic conditions are very complex. Patients see multiple doctors. There are multiple medications coping with a variety of symptoms and side effects, managing these high costs. And every one of these medications comes with another copay. In addition to the physical challenges related to their disease, many chronic patients also face mental health challenges. Depression comes to mind immediately. And so a public health crisis like COVID-19 just adds to these already very full plates. Keep going back to that full plates that these people have. And so these people who are living with chronic illnesses are already at that higher risk for declining health. And the pandemic has just further created health challenges. I would say also looking at things like financial security, housing, food security, social isolation, these are just again impacting patients with chronic illnesses in an even bigger way than it’s affecting all of us.

Tara Herington:
Folks that were already isolated, maybe only got a visit by a family member once a month, maybe now it’s been months. It’s been months. Higher unemployment rates caused by the pandemic has resulted in more and more patients facing financial hardships. A lot of people have lost their insurance, and that’s something that is very difficult to face. And one of the reasons that we have our free goods pharmacy program and in addition, people may be cut off from their caregivers. And that’s certainly been a problem this year as well. And with the social distancing guidelines and stay at home orders, it’s really difficult for those caregivers to get to the patients who need the care. I would say the other thing is just a recognition of this. So programs like yours are great for raising awareness that in all of us who are in health care, it’s incumbent on us to really get the word out that chronic care patients need extra attention during this time to ensure that they don’t fall through the cracks of the health care system.

Saul Marquez:
Yeah, you’ve mentioned so much, Tara, and it’s so on point. I’m glad you covered it. Fact, if you’re listening to this. Rewind that. That was good and the opportunity to really understand how complex it is to help patients with chronic conditions, it’s so important and COVID-19 made it so difficult. What resources are available to help with these issues?

Tara Herington:
Of course, health care providers play a central role in supporting chronic care patients. And I would never want to do anything that gets in between a provider and a patient. But let’s face it, health care providers are their resources are limited and stretched at this point as well. So anything that can be done to support that patient and the health care provider are important. So pharmaceutical companies are playing really an increasingly valuable role in facilitating access to treatment and ensuring that continuity of care. And unfortunately, many patients just don’t even know what assistance is available to them. Fewer than one in five patients are even aware of these programs that are available to them from the manufacturers. And only 40 percent of health care providers are very, very aware of manufacturer copay assistance and free drug programs. So these are folks that do this day in and day out, and it’s their profession. And even that it’s only 40 percent. Have a couple of examples that really hit home and are things that get me going every day when I understand the importance of the work I do. I had a neighbor of mine and when I met her, she was a widow and a very young widow. And it turns out that her husband had a heart attack. He survived the heart attack, but his drug regimen that he was on afterwards required some pretty hefty co-pays. And here’s somebody. He was employed. His wife was employed. They had insurance. But in an effort to save money, he stopped taking a lot of his medications. And then he had a second heart attack, which was much, much worse, and he passed away. And it turns out that most of the medications he was on, there were copay programs available to him that could have brought the cost down to zero or five dollars a month and just not aware.

Saul Marquez:
Oh my gosh. That’s terrible.

Tara Herington:
I also met a chronic care patient who received an inheritance from her grandmother, and she ended up spending that entire inheritance on co-pays for her, a chronic condition, chronic cancer condition. And it was only after she went through all of the inheritance and was reaching out and Googling, Googling ways to help to afford her medication, that she thought that there was a program available to her that she could have been using all along and just didn’t know about it. So I’m always like every place I go, whether it’s a grocery store and talking to people online back when we did that. And we don’t do that so much anymore or just people I meet randomly, I let them know that, hey, these programs exist to get the word out.

Saul Marquez:
Wow. Well, two gut-wrenching examples Tara, and two of of millions that happen every single day in this country. And so you’re listening to this right now. Take action. You have the responsibility to share this with somebody that you care about, that you love. In the show notes, we’re going to leave links to these resources. So so make sure you check those out. Just type in Tara in the search bar or type in Cardinal in the search bar Sonexus and you’ll find that, too. So make sure you do that. What would you say are some of the ways biopharma companies can support chronic care patients facing these challenges because they’re listening.

Tara Herington:
Yeah, for sure. So with so many patients in HCP’s that are unaware of these programs, the opportunity for biopharma companies is to take a larger role in bringing awareness to patients in need, whether that’s transportation services. That’s another thing we haven’t really talked about. But if people can’t get to the clinic for their infusion, then it doesn’t do any good. If the infusion is paid for, if they can’t even get there, so transportation service assistance, clinical support programs, just things that can remove these barriers to care, bring awareness, I would say is number one. And then also at a time when patients may have more limited access to health care resources is supporting patients and supporting these patient assistance programs. So whether it’s called PAP’s patient assistance programs or supporting those the free goods programs, it’s the formal name of the patient assistance program. They’re often provided to enable financially insecure patients to access their therapy and PAPs may also be there for bridge product. So if a patient is technically or is temporarily between jobs, they may still qualify for one of these PAP programs or free good programs. If a patient is starting on medication and it’s taking a while for the coverage to start, they also may be open and eligible for a free goods program.

Tara Herington:
So I always say, just always ask, don’t assume the answer is no. I always ask. And then some biopharma companies also support that needs to be on the medication, like the access, the transportation doctors appointments or to the clinic for their infusions, sometimes they’ll even help pay for lodging if a patient in their family needs to stay at a center for an extended period of time. So, again, somebody needs a family or support with them when they’re at a visit, then that is another thing that the pharmaceutical manufacturers often support. Sonexus, as we have many programs that have clinical nurse educators that can also support. More patients are connected to registered nurses who can answer questions about their treatments, provide wellness coaching, reminders, can talk through injection training, can talk about site rotation, how to travel with your medication, how to dispose of your needles, all that kind of stuff. Side effects management. So the clinical nurse educators are another way that biopharma companies can support these patients. And then these services can be particularly valuable for patients who are isolated or lacking that caregiver support. For example, if our nurse educators hear about a patient who’s struggling with depression, they can connect that patient with counseling services or other helpful source resources in the community.

Saul Marquez:
That’s wonderful, Tara. And just thinking about the patient hub, what’s the role of the patient hub in delivering the support?

Tara Herington:
Our biopharma clients often engage with help services like Sonexus because we have the expertise and the technology to implement these programs quickly, effectively and compliantly. And at Sonexus, we have hundreds of patient specialists who are explicitly trained to engage with providers and payers to help patients when they’re overcoming their access barriers. And our teams are experienced in a wide range of disease categories, everything from oncology to dermatology to rheumatology. It’s just really all over the map cardiology. And that means that we’re able to bring new programs on board quickly and with minimal ramp up time because we have that expertise. We also have our state of the art technology program that allows us to automate tasks such as prior authorizations and benefit verifications to reduce the time that it takes for a patient to get on therapy. And then if it does take longer than anticipated, we have the free goods program to bridge those patients while they’re waiting to get started. We also I mentioned earlier about how important it is to collect data and the information and the analytics. Well collecting that data on the patient journey through our AI and analytics tools can provide our clients with valuable insights that help them provide a better experience for patients. I can give another example from COVID. Last spring we were able to mine through a lot of our patients phone calls to listen to what patients were talking about and a lot of patients were experiencing or expressing verbiage like lost job or affordability or can’t make it to the doctor or things like that to let us know that COVID was really impacting these patients. So as a result, we were able to work with our clients and they broadened expanded the eligibility criteria for the free goods program so that a broader segment of patients could receive the free medication to make it easier for patients.

Saul Marquez:
I think that’s great. Kudos to you and the team there for having taking that data-driven approach. Listen to the patient and broadening those qualification criteria. I think that’s fantastic. Congratulations to you and your team for that. And thank you.

Tara Herington:
We’re happy to do it.

Saul Marquez:
It’s wonderful. And so folks take advantage of today, this interview with Tarah sharing this knowledge. Now that you know it, take it a step further and share it with your colleagues, your friends, your loved ones. Tara, before we conclude first, just want to say thank you. This has been such an informative podcast with you. Give us a closing thought. What should we be thinking about and where should the listeners go to get in touch with you? They want to learn more.

Tara Herington:
Accessing therapy and managing chronic diseases is more challenging today than ever before. Every year it gets harder, and particularly with the added complexity of the COVID pandemic. And we want to see patients achieve better outcomes. Support programs and patient resources need to be made more widely available. I always encourage patients to feel empowered to seek out information, ask the right questions about what assistance might be available for them. Patients can find out about these programs by reaching out to their health care provider, finding hotlines and also looking specifically for the name brand of the medication that they’re prescribed, patients can and should be encouraged to advocate on their own behalf with payers, they can even write their own emails or letters outlining why doctors recommend a course of treatment as best and share information about how their condition is affecting their lives and really take control. True patient empowerment is long overdue. Some people say patients aren’t patient anymore. And really, it’s about time for patients to to really get in there and roll up their sleeves and be empowered. You can find me on LinkedIn who isn’t on LinkedIn? Right., but my last name is a weird spelling. It’s H E and only one R. So Tara Herington. And you can also visit the Cardinal Health Sonexus website at www.cardinalhealth.com/sonexus.

Saul Marquez:
Outstanding, Tara. Well, couldn’t agree with you more. Now is the time. Just take your own health in your own hands and make the most out of it all. The resources you heard today could be found in the show notes. Just make sure to type in Tara and Cardinal Health inside of the search bar and you’ll find all the links there. Tara, thank you so much for the work that you and your team do to make health care better for us.

Tara Herington:
Thank you all for having us today. And this is you have a great forum here and I appreciate being a part of it. Thank you.

Saul Marquez:
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