2019 Pharmacy Innovator of the Year: Publix's relationship-based pharmacy
What does it look like when a regional power player gets serious about its pharmacy operation? Just ask the team at Publix.
The employee-owned company already had been in business for nearly 60 years when it opened its first pharmacy in 1986. Despite the late start, and with a great deal of knowledge and experience, Publix has managed to grow its pharmacy operation into one that goes beyond simply providing a place for shoppers to fill a script while they pick up their weekly groceries.
From investing in technology and offering free and discounted medication to building out an accredited specialty pharmacy arm and positioning itself as a health-and-wellness partner — not just for its patients, but for payers and health systems — Publix has excelled at a time when pharmacy has become a tough game to even stay afloat in, let alone get ahead.
Publix’s dedication to its patients, embodied in its focus on strategic investments and partnerships aimed at improving healthcare access and outcomes — coupled with its sterling reputation among both patients and workers in the areas it serves — are the reasons the company has been named the 2019 Drug Store News Pharmacy Innovator of the Year.
One of the company’s strengths, according to vice president of pharmacy Dain Rusk, who joined Publix in June 2018, is its focus on becoming a health-and-wellness resource for people who might not automatically associate the purveyor of their favorite sub sandwich with the pharmacy, as well as building loyalty through personalized care.
“I think the strategy has been pretty consistent, namely, how do we allow our pharmacists to be more customer-facing and provide better patient access to the point where we can become a health-and-wellness destination pharmacy versus just the traditional pharmacy?” Rusk said. “The landscape is definitely changing. It used to be about just filling as many prescriptions as possible. Now it’s really about trying to help people achieve their health-and-wellness goals.”
In the time since he joined Publix, Rusk said he and his team have been refining the strategy to focus on three key pillars: investing in innovation, driving the prescription business and building out an omnichannel offering. Publix’s innovation focus is the key driver to both of the subsequent pillars of the company’s strategy, particularly because of the unique way that Publix defines innovation.
“Innovation for us is both technology, as well as strategic partnerships that we’ve established,” Rusk said. “Innovation for us is how we’re improving access for patients, whether that be using unique solutions to drive better adherence or even using technology to improve efficiencies. Additionally, it’s also about strategic relationships and how we look at collaborating with other healthcare providers to improve access to high-quality, affordable health care.”
On the technology side, Publix has invested in one of the largest central-fill facilities among grocery operators. The company’s Orlando, Fla.-based central-fill facility services all of its 733 Florida locations with pharmacies, from the Florida Keys to the panhandle, and features state-of-the-art automation from Innovation. It plays a key role in keeping Publix patients adherent, while also improving pharmacy workflow, taking refills of common maintenance medications — or particularly costly, less commonly prescribed medications — out of the store entirely.
“Because of our medication synchronization program, we’ve really been able to manage the workflow in the pharmacy and know when patients are coming in for their medication, so that those drop into a workflow before they’re due,” said Katie Petti, Publix director of central and specialty pharmacy. “It gives the pharmacies plenty of time to get them filled centrally and sent back to the store, which has enabled our pharmacists to carry out clinical rather than administrative work, which allows them to personally engage with patients.”
“As a pharmacy department, we’re really focused on taking care of customers and their health and well-being,” said Toan Do, Publix director of retail pharmacy operations. “I think the key is we allow pharmacists to be pharmacists. They actually feel that they can be engaged and, as leaders, we support that. We want to ensure that they’re able to provide immunizations or engage in the aisles when patients are looking for vitamins or cough and cold remedies to provide them expertise on what products to select.”
While technological innovation can help improve patient adherence and build loyalty, Publix’s innovative partnerships are designed to improve convenience and gain new loyal patients simultaneously. The cornerstone of the company’s partnership innovation is its working relationship with health systems throughout Florida and in South Carolina.
At the center of its health system partnerships is Publix’s “Meds to Beds” program, through which Publix uses retail pharmacies located inside hospitals to fill prescriptions for patients being discharged. Once discharge becomes an option, the on-site pharmacy receives a patient’s prescriptions and insurance information, fills the prescription, and has the medication taken to patients by delivery specialists who answer any questions before the patient leaves the hospital.
“It gives the patient a sense of comfort that their prescriptions are being filled by a reputable, well-known pharmacy in the area, and we are there to help during their transition back to home, so we provide that continuity of care,” said David Kirkus, Publix director of pharmacy administration. “Also, what is strategically important for us is the fact that it makes Publix part of the consideration process for a patient who may have never even thought of Publix pharmacy before.”
The partnerships are very beneficial for Publix and the hospitals, as well as patients. “By ensuring patients are leaving the hospital with their medications in hand prevents any delays in patients getting their prescriptions filled upon discharge and decreases the likelihood of future hospital readmissions due to better medication adherence,” Kirkus said. “In providing our hospital partners with this important service, there is a positive financial impact for them, as well as better customer service and clinical outcomes for the patients.”
Publix also conducts follow-up calls from its central facility to ensure it has seen its primary care physician and checks that it has refills. “We’re making sure there are no gaps in care whenever possible,” Kirkus said.
Filling gaps in care also is the motivation behind another element of Publix’s health system partnerships — telehealth clinics. More than 36 Publix locations house health system-branded telehealth consultation clinics, which virtually connect patients with physicians for acute medical needs. Consultation rooms are adjacent to the pharmacy and a pharmacy technician walks patients through the consultation process as needed. Patients have access to medical devices for self-exam, while guided by the physician. It’s a service that’s convenient and affordable for patients, while allowing the physicians to be located remotely and oversee multiple clinic locations.
The track record of success is something that plays into both Publix’s and its partners’ strategies, namely patient care. “It puts us in a position to work on things that are beneficial to both Publix and our health system partners,” Kirkus said. “Ultimately, our goal is to improve access to lower-cost, high-quality healthcare services for the broader patient population that we are both serving.”
Dedication to patient care also has informed the development of the company’s specialty pharmacy offering, which enables patients who are prescribed a specialty medication to receive it in a setting they are familiar with. Petti, who worked to build out the company’s closed-door specialty pharmacy in Orlando, Fla. that houses support staff and inventory, said that it has helped bolster its pharmacists’ clinical role, providing counseling on how to administer the drugs and answer any questions they may have.
“We want to empower our pharmacists to know that we’re going to be able to take care of those patients with specialty needs,” Petti said. “So, of course, growing our access to payers and limited distribution drugs is what we’re going to continue to work on so that we are able to address all of our patients’ pharmacy needs.”
Beyond pharmacist care, Publix has worked to make the patient experience seamless when preparing to visit the store. “Obviously, in today’s world, technology plays a key role,” Do said. “We focus on offering tools and services that our customers can utilize that allow them to better manage their health-and-wellness needs, beyond being able to fill a prescription, to be able to monitor their profiles, interact with us digitally, and remind them take their medications as prescribed.” Rusk also said that the company has been moving toward allowing online payment for prescription pickup and creating express lanes for patients who have paid online.
All the elements of Publix’s pharmacy ecosystem have been built with one thing in mind — supporting the relationship between pharmacist and patient. “We have invested in technology and in these health-system partnerships ultimately to make the pharmacist’s job less production- and process-oriented, and more where they can be customer facing,” Rusk said. Foremost in achieving this for the company has been its ability to decide on a strategy and stay the course, while being agile enough to achieve its goals.
“We’re not approaching our strategy like a yo-yo,” Rusk said. “We’ve looked out and said, ‘This is what our three-year strategy looks like. I think we’re very committed to where we believe we need to go. We don’t have a different strategy every year. We have clear direction where tactics may deviate a little each year, but the pillars we’re driving toward aren’t going to change, and that’s very important.”
And Publix is just getting started. “The company has invested heavily in pharmacy, which has allowed us to do some creative and unique things,” Kirkus said. “And I think we’re really at the beginning of how we plan to continue to innovate — not anywhere close to the goal line.” dsn