They Keys to Effective Biologic Management By Alisa Redmon

The Keys to Effective Biologic Management

By Alisa Redmon, Biologic Coordinator

As Biologic Coordinators (BCs), our job is never truly done. Managing biologic therapies comes with a host of responsibilities, from overseeing new initiations to maintaining the care of established patients. Each day can bring varying numbers of biologic initiations, and with that, an increasing pool of patients and information to track. Staying organized is critical—not only for efficiency but also for ensuring patients receive uninterrupted care and maintain optimal health outcomes.

An effective tracking system can simplify your workflow, improve patient satisfaction, and enhance the quality of care you provide. Here’s a comprehensive guide to keeping your biologic management system organized and ensuring success.

The Foundation of Patient Tracking

To effectively manage biologic patients, it’s essential to track key information for each patient. Here are the critical elements to include in your system:

The Basics

• Patient Details: Name, date of birth, medication, and contact information.

• These fundamental details are the starting point for organizing your workflow.

Insurance Information

• Coverage: Medical insurance, Pharmacy Benefit Manager (PBM), and Specialty Pharmacy (SP).

• Changes: This information can change at any time, and patients often don’t inform their healthcare providers until their next visit.

• Efficiency Tip: Familiarize yourself with which insurance plans, PBMs, and SPs are contracted together to streamline your process.

Coverage Status

• Determinations: Keep track of coverage determinations and patient assistance statuses.

• End Dates: Monitor end dates monthly to ensure re-evaluations and renewals are submitted on time.

Appointments

• Timing: Once approval is secured, time is critical to getting the patient started on therapy.

• Follow-ups: Plan follow-ups around approval windows, as these are becoming increasingly shorter. Avoid lapses in therapy by scheduling re-evaluations well in advance of coverage end dates.

Lab Tests

• Compliance: Many plans require specific labs, such as a negative TB test, both at initiation and renewal.

• Annual Testing: Ensure tests are completed as needed for patient safety and to satisfy insurance criteria.

Additional Notes

• Use this section for brief reminders or updates, such as SP correspondence, pending information, or specific scheduling conflicts.

Using the Swiss Cheese Model for Biologic Management

The Swiss Cheese Model, introduced by James T. Reason, is a risk analysis and management framework. While originally used in risk mitigation, it’s highly applicable to biologic management. The model emphasizes the need for multiple safety barriers to prevent breakdowns in a system. Here’s how you can apply its principles to your practice:

Organizational Culture

• Foster a shared commitment to achieving access and acquisition for patients.

• Encourage open communication among your team and prescribers to learn from each other.

• Build strong rapport with your patients to ensure trust and cooperation throughout their treatment journey.

Operational Processes

• Create clear, consistent documentation protocols to track each patient’s journey from initiation to acquisition.

• Develop a reliable follow-up system to monitor patients’ progress and address any potential gaps in therapy proactively.

Resource Management

• Advocate for support from senior leadership to access the tools, technology, and resources you need for efficient management.

• Leverage available apps, software, and organizational aids to optimize your workflow.

Practical Tools for Biologic Management

Medication Calendars

• Use tools like Google Calendar, Medisafe, or RxRemind to track key dates such as PA expiration, follow-up appointments, and medication administration schedules.

Document Organization

• Maintain digital or physical folders for storing PA documentation, approval letters, and insurance communications.

• Create a system for flagging upcoming expirations or pending renewals.

Integrated Tracking Systems

• Use platforms like Excel or Google Sheets for customized tracking solutions.

• Explore specialized software designed for healthcare professionals, such as Modernized Medicine’s task management features.

The Impact of an Organized System

Investing time and effort into an organized tracking system not only improves efficiency but also safeguards patient compliance and health outcomes. By staying current with each patient’s status, you can:

• Mitigate therapy interruptions.

• Enhance your time management.

• Strengthen patient confidence in their treatment plan.

The ultimate goal is to provide uninterrupted care for patients whose therapy is improving their quality of life. As BCs, we play a critical role in ensuring patients stay on track, fostering trust, and achieving the best possible outcomes.

When you’re confident in your system and processes, patients will feel the same confidence in their care. Organize for success, and you’ll create a seamless, efficient environment that benefits everyone involved.

By taking a proactive approach and prioritizing organization, you can ensure that your work as a Biologic Coordinator remains effective, impactful, and rewarding. Let your system work for you, so you can focus on what truly matters—your patients’ well-being.