Shields Health Solutions (Shields), the leading specialty pharmacy operating partner to over one-third of health systems nationwide, today announced preliminary results demonstrating how its AI-enabled Clinical Risk Model, part of its Clinical Intelligence capabilities, are helping patients receive the right support at the right time through earlier risk identification, more proactive interventions, and personalized care.

The Clinical Risk Model uses advanced machine learning and predictive analytics to help pharmacists and care teams prioritize where timely interventions mitigate adverse reactions, emergency department visits, and readmissions. The Clinical Risk Model was built combining 15 years of deep health system specialty pharmacy experience, with over 2 billion data points representing all aspects of a patient’s specialty pharmacy care journey, including both operational and clinical data. The result is over 40 disease specific models that generate dynamic risk scores while continuously learning from new data and clinician feedback. Combining AI-enabled intelligence with the real-world expertise of Shields’ clinicians, it can identify risk earlier, prioritize patient engagements, identify interventions with highest impact, and improve patient outcomes, delivering connected performance across the specialty care continuum.

“We built the Shields care model with the patient at the center, and that will never change,” said Brian S. Smith, PharmD, Chief Pharmacy Officer at Shields. “For more than 15 years, we’ve supported patients through some of their most complex health journeys. By combining that experience with predictive insights that identify risk earlier, we empower our pharmacists and liaisons to focus their time where it matters most, with the patient. 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.”

Evaluations across oncology, inflammatory, and transplant patient populations demonstrated strong clinical and operational results including:

  • 63% improvement in treatment efficacy

  • 35% reduction in ER visits and hospitalizations

  • 95% pharmacist acceptance rate, indicating high trust in model recommendations

  • 35% increase in pharmacist time allocated to high-risk patients

  • 93% medication adherence rate

  • 76% reduction in missed activities of daily living

  • 0 safety concerns across 12-month comparison

One example from a Shields health system partner highlights the impact of proactive intervention. Shields’ Clinical Risk Model flagged a cancer patient on oral therapy whose risk profile had changed, despite not being scheduled for a pharmacist follow-up for another six months. Acting on the model’s risk prediction, a pharmacist proactively reached out to the patient five months earlier than scheduled and identified uncontrolled gastrointestinal side effects that were significantly impacting quality of life. After evaluating the patient’s therapy, symptoms, and risk factors, the pharmacist partnered with the provider and care team to adjust treatment, resulting in a new prescription and a more personalized care plan. The liaison then evaluated the patient’s benefits, recommended the appropriate treatment plan, obtained prior authorization, ensured the out-of-pocket expense was affordable, and coordinated delivery. Through counseling and ongoing monitoring, the proactive intervention allowed the patient to manage symptoms and avoid potential treatment disruption or emergency department visit.

This case illustrates how AI-enabled insights, combined with pharmacist expertise and coordinated care, can identify at-risk patients sooner, enabling earlier intervention, improving the patient experience, and ultimately driving better outcomes.

By combining predictive insights with the expertise of pharmacists and clinicians, Clinical Intelligence helps patients receive the right care at the right time, leading to better outcomes, improved adherence, and a more seamless care journey.

For more information, visit the Shields Health Solutions website.

About Shields Health Solutions

Shields Health Solutions (Shields), the specialty pharmacy operating partner for health systems, is working with nearly 80 of the nation’s leading health systems to deliver an integrated, connected experience that results in quality outcomes at-scale. By combining proprietary technology with 3,000+ clinical and operational experts, leveraging relationships across 90% of commercial payers and access to 90% of limited distribution drugs, Shields helps health systems expand access, improve clinical outcomes, and drive specialty pharmacy growth. Follow Shields on LinkedIn or visit the website for more.

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