Automation, tech companies rethink pharmacy pain points
Pharmacists have taken their rightful place in the delivery of health care, engaging with patients and making a noticeable improvement in their patients’ health outcomes. As the clinical role of pharmacists has grown, so too has the imperative to fill an ever-increasing number of prescriptions in a day. As a result, pharmacy technology and automation companies are stepping up to the plate to ensure that pharmacists can juggle their role successfully.
Solutions in this area range from central-fill automation to small-footprint options that are meant to make filling faster in small operations. Additionally, beyond automation, companies are looking at how software can help improve pharmacy workflows and rethink tried and true — if not particularly efficient — areas of the business like will call.
Speeding up Dispensing
Mountain View, Calif.-based Omnicell is among the companies on the forefront of automation, with its Autonomous Pharmacy vision, which Jim Stevenson, vice president of medication systems strategy, said is a cloud-based approach leveraging automation, predictive intelligence and expert service to automate the entire medication use process. It also supports sharing of information in an efficient manner across different components of the healthcare ecosystem.
“The autonomous pharmacy is the ability to automate all of the things in the medication use process that are repetitive,” Stevenson said. “The story is around tying this all together into an ecosystem that interacts and communicates, and allows improvements in efficiency, safety and regulatory compliance, while allowing pharmacists to practice at the top of their license.”
Omnicell offers automated dispensing cabinets and several different types of robots, as well as IV compounding robotic and workflow solutions for hospital and long-term settings. For the outpatient pharmacy setting, it provides medication synchronization software programs, multiple medication adherence packaging, and tools for pharmacists to conduct comprehensive medication reviews.
In addition to showing the name and description of the drug, Omnicell’s blister pack includes pictures of the medication. The company’s software tools also enable pharmacists to identify patients who are candidates for medication adherence packaging and medication synchronization.
“As commercial payers begin to pay pharmacists for comprehensive medication reviews, Omnicell has reacted by offering tools to make that process more efficient,” Stevenson said.
Compliance packaging and dispensing efficiency also are a focus for Canada-based Synergy Medical. For more than a decade, the company has played an important role in promoting medication adherence with blister packaging, using a robot dubbed SynMed XF. More recently, the company launched SynMed Ultra to cater to retailers with central fill sites that are dispensing high volumes of prescriptions.
Samantha Cockburn, Synergy Medical’s director of marketing, said that the software was built and written internally to interface with all pharmacy and e-mail systems, and it is being upgraded constantly.
“It allows us to generate customizable features on the product label. For example, we have a proprietary drug database, so for every drug that is put in the blister pack, there’s a high-resolution color picture of that drug on the label for quick reference by a nurse or patient, or anyone checking the pack,” Cockburn said.
SynMed’s blister packaging also promotes medication adherence and improves a pharmacy’s Star Ratings. “Adherence scores account for about 60% of the Star Ratings. The outcomes of patients taking chronic meds for hypertension, cholesterol and diabetes contribute to the measure of the pharmacy and it affects their reimbursement, and which insurance plans they can be included in,” she said.
While the SynMed XF can fill up to 1,000 blister packs a week, SynMed Ultra technology can handle larger volumes for central fill.
One area of the pharmacy-patient relationships that companies see as ripe for reinvention is outreach. Rarely do patients hand in a paper script and walk the aisles until a PA announcement informs them that their prescription is ready.
Among the software offerings from Irving, Texas-based PioneerRx is an alert that tells pharmacists to reach out to patients to inquire if their medication regiment has changed, if they have seen their doctor, or if they were recently hospitalized. Effective as this may be, the company also is developing its outreach solutions to keep pace with how patients want to receive information — namely on mobile.
Currently, PioneerRx is using two-way HIPAA secure messaging, and the company is testing machine learning to drive SMS messages back and forth that are designed to feel more personal than a standard robot’s usual messages.
“The message would say, ‘Hey Josh, hope you’re doing OK today. We have a prescription ready from your doctor. It costs $10. When do you want to come pick this up?’ The patient can type in 2 p.m. We can use technology and machine learning in the background to say, ‘Great, we’ll see you at 2 today, thank you.’ It’s a much richer conversation than from a weird robot,” Howland said.
Once patients know their medication is ready, they have to pick it up, and Mountain View, Calif.-based PerceptiMed has created a way to make will-call pickups more efficient for pharmacy staff — and ultimately patients. CEO Frank Starn said that the company’s first product, ScripClip, provides safety in the prescription packaging process and makes the pharmacy workflow more efficient.
ScripClip uses verification processes to prevent inaccurate packaging, and for will-call features, hanging bags with an LED light will blink when the pharmacist or technician scans the bar code on a patient’s driver’s license. “On average, it’s 50% faster than the manual process,” Starn said.
The company also provides clips to secure white paper prescription bags that require refrigeration, additional security in a safe, or are located in another area of the pharmacy. Drugs that have not been picked up for a certain number of days also will light up, so technicians and pharmacists can call patients and increase medication adherence, or return the drugs to inventory.
Beyond simplifying and speeding up will call, such companies as Bell and Howell, based in Durham, N.C., are looking to reshape the entire pickup process. The company is using its retail expertise to launch an automated consumer pharmacy pickup solution via an app-based system that alerts consumers with an e-mail or text message informing them that their prescription is ready.
Christopher Hill, general manager at Bell and Howell’s click-and-collect solutions, said the technology, which allows for autonomous pick up, is similar to an ATM. “Customers are able to come up to our solution and scan a bar code in a fraction of a second,” Hill said. “There may be a signature or ID required, or interaction with the pharmacist, and that is all configurable to our screen. As soon as that is done, the process is completed, the prescription is presented to the consumer, and they can walk away. There’s no retrieval from a will-call bin or need for the pharmacy staff to go grab the prescriptions.”
Brian Irish, vice president of marketing at Bell and Howell, said that the automated pickup enables the pharmacist, who is an expensive resource, to focus on patient care, while making the customer’s experience convenient and fast.
Bell and Howell’s automated pickup system is innovative in that it has integrated a telepharmacy consultation feature. “We’re providing a solution that improves the customer experience, while helping the pharmacies from an ROI perspective,” Hill said. “The more you can do to build an elegant customer experience, it will definitely have an impact on loyalty.”
Irish also said, “It’s about meeting the customer how and where they want to be met to have their transaction take place. We’re leveraging industry-leading solutions and service installations in the traditional retail environment and applying that now to the pharmacy space.”
For companies that offer drive-through service as a convenience, Cincinnati-based Bavis Drive-Thru works to elevate all aspects of the experience. Part of this effort is to ensure that the audio in pharmacy drive-throughs enables communication that clearly can be understood.
“The industry continues to use analogue audio systems, which rely on the human ear to distinguish between background noise and voice, but today’s digital VOIP (voice over Internet provider) phone systems do not have enough bandwidth to do that,” said Bavis president William Sieber, adding that the company’s BEAM system significantly eliminates background noise and enhances the voice.
“There can be dire consequences if a pharmacist says, ‘Take a teaspoon’ and the patient thinks they heard the word tablespoon,” Sieber said. “Instead of going through a typical audio system with a microphone and speaker, we decided to go through the phone system. Any phone in the pharmacy can now be a portal to the drive-through.”
Bavis’ system can transfer the drive-through audio via the phone system to the desired pharmacy station. The pharmacist can take the call and provide consultation to the patient cost effectively, without having to leave their position in the pharmacy.
Bavis also has integrated card processing equipment into its hardware, allowing customers to put their credit card into a chip reader instead of a chute, or give the employees their pin number, and have them return the card.
Software and Workflow
One of the key time-saving areas in the pharmacy has to do with administrative tasks, including prior authorization and ensuring that a patient’s medications are covered to save time during pickup. Atlanta-based RxBenefit Clarity, a pharmacy benefit inquiry platform that is a joint McKesson collaboration between RelayHealth and CoverMyMeds, focuses on these two tasks. The software acquires real-time patient benefit coverage information and out-of-pocket costs directly from the pharmacy where patients will fill their prescription.
RxBenefit Clarity also eliminates various prescribing barriers that may lead to callbacks from the pharmacy by contacting physicians. “The solution notifies the provider when a prior authorization is needed to fill a prescription, and gives the prescriber the option to proactively initiate an electronic prior authorization,” said Kerry Stanfield, RelayHealth senior manager of product marketing, noting that accurate patient cost share information and formulary restrictions allow the provider to select the most appropriate therapy for the patient.
When it comes to pharmacy management software, PioneerRx does more than just offer pharmacy outreach solutions. The company, which has made the decision to tailor its pharmacy management system to independent pharmacies, aims to be a one-stop shop, according to Josh Howland, vice president of clinical strategy. He said that PioneerRx’s pharmacy management software supports all of the functions of independent pharmacy, including dispensing, data entry, insurance submission, integrated point-of-sale, e-prescribing, documenting clinical activities, inventory reconciliation and accounting.
With independent pharmacies serving large populations of elderly and chronically ill patients, PioneerRx developed an e-care functionality to help pharmacists document their clinical services, including diabetes education, disease state management, A1C testing and medication synchronization. “We are able to submit that data to show the standards they are meeting, and to prove pharmacy’s value in the healthcare system,” Howland said.
For pharmacies working with high volumes of prescriptions, Kennesaw, Ga.-based Knapp specializes in central-fill and mail-order pharmacy software, serving pharmacies that dispense as few as 5,000-to-10,000 scripts per day, up to 50,000 prescriptions per shift.
“We provide everything from the overall KiSoft One pharmacy execution software that controls the pharmacy and the automation that we manufacture, down to the ergonomic work stations that we put in place,” said Brian Sullivan, Knapp senior systems sales manager for healthcare solutions.
The company’s KMeD system is a robotic tablet and capsule dispenser that is designed for mid-to-slow moving drugs.
Knapp also offers high capacity, 4-liter replenishment canisters that are replenished offline. “We have several hundred of these canisters in one of our central-fill pharmacies that are concurrently dispensing 90-day vials every 45 seconds,” Sullivan said.