Shields Uses AI to Help Specialty Pharmacists Identify At-Risk Patients Earlier
Predictive analytics help care teams close treatment gaps, reduce hospital visits and focus attention on patients who need the most support
Shields Health Solutions is reporting promising preliminary results from its AI-enabled Clinical Risk Model, which helps specialty pharmacists identify patients at risk of complications and intervene earlier in their treatment journeys.
The technology uses machine learning and predictive analytics to help pharmacists prioritize patients who may need additional support, potentially reducing adverse reactions, emergency department visits and hospital readmissions.
Built on 15 years of specialty pharmacy experience and more than 2 billion data points, the model incorporates clinical and operational information to generate patient risk scores. More than 40 disease-specific models help care teams identify changing patient needs and determine where interventions may have the greatest impact.
Evaluations involving oncology, inflammatory disease and transplant patients showed several positive clinical and operational results:
- 63% improvement in treatment efficacy
- 35% reduction in emergency department visits and hospitalizations
- 35% increase in pharmacist time spent with high-risk patients
- 95% pharmacist acceptance rate for model recommendations
- 93% medication adherence rate
- 76% reduction in missed activities of daily living
- No reported safety concerns during a 12-month comparison
One example involved a cancer patient receiving oral therapy whose risk profile changed despite having no pharmacist follow-up scheduled for another six months.
The model flagged the patient for earlier attention, prompting a pharmacist to reach out five months ahead of schedule. The conversation revealed gastrointestinal side effects that were significantly affecting the patient’s quality of life.
The pharmacist worked with the patient’s provider and care team to adjust treatment and develop a more personalized care plan. Shields also coordinated insurance authorization, medication access and ongoing patient counseling.
The early intervention helped the patient manage symptoms and avoid potential treatment disruption or an emergency department visit.
According to Shields, the results demonstrate how AI can strengthen specialty pharmacy care by helping clinicians identify problems sooner and direct resources toward patients with the greatest needs.
“AI enables us to scale the impact of our proven care model, helping more patients receive the right support at the right time while preserving the human touch that defines specialty care,” said Brian S. Smith, PharmD, chief pharmacy officer at Shields.
Shields Health Solutions works with nearly 80 health systems nationwide, combining specialty pharmacy technology with more than 3,000 clinical and operational professionals to improve access, patient outcomes and specialty pharmacy performance.
For healthcare executives, the findings highlight the potential of predictive analytics to improve patient monitoring, support earlier clinical intervention and make better use of pharmacy resources.
