Both models can work. The key is to design around documentation, access barriers, and patient follow‑up—then pick a model (or hybrid) that makes that easier, not harder.
Strengths of MID
- Care‑team proximity: counseling, adherence checks, and toxicity calls stay close to the clinic.
- Documentation: orders, counseling notes, and interventions land in the same EHR.
- Speed: fewer handoffs; better visibility into prior auth and benefits navigation.
Strengths of external SP
- Broader payer contracts and distribution for limited‑network drugs.
- Scale for shipping logistics and refill reminders.
- Patient assistance infrastructure for certain manufacturers/plans.
Choosing a model (or hybrid)
Map your top regimens, payers, and access barriers. Use MID where you can document and act quickly within the EHR; use SP where contracts or distribution require it. Build a shared workflow and data exchange to prevent gaps and duplicate calls.
What to measure
- Time from Rx to first dose
- Documented education rate
- Refill possession ratio and gaps in therapy
- Adverse event interventions and escalations
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