Empowering pharmacists: Technology and automation companies offer operational solutions for pharmacies
Call it the year of the pharmacist.
Never have pharmacists’ roles been more expansive, more complex or more visible to patients. While the pandemic pummeled numerous businesses, pharmacies thrived by stepping up and filling the void.
While continuing to face mounting pressures from crushing DIR fees, low reimbursement and the requirement to quickly fill a high volume of prescriptions, pharmacists also are providing a host of clinical services, including COVID-19 testing, immunizations, point-of-care testing, medication therapy counseling, preventive care and prescribing medications in many states where they recently have been granted authorization.
When asked, automation and technology companies concur that amid the pandemic, patients have become increasingly reliant on pharmacists to provide a vast array of clinical services, even as pharmacists have been under increased pressure to be more efficient.
[Read more: EnlivenHealth adds vaccine scheduling, reporting tool to CareScheduler]
Determined to lighten pharmacists’ workload so they can focus more on patients, technology and automation companies are amplifying their products and services.
Many technology companies are helping pharmacies address the critical responsibility of adherence, which has become more challenging for pharmacists amid the pandemic.
For example, Irving, Texas-based McKesson stepped up to the plate with its Adherence Performance Solution and Clinical Programs Solution to help pharmacies identify non-adherent patients and patients at risk of becoming non-adherent. The APSCP is built into the workflow of its EnterpriseRx pharmacy management system.
John Beardsley, McKesson senior vice president of corporate strategy and business development, said that the solution provides a means to document and manage patient care. It also alerts the pharmacist to have meaningful counseling sessions to evaluate reasons for nonadherence as well as opportunities to improve patient outcomes.
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“Often simple changes, such as adjusting the dosing regimen, synchronizing medication refills or offering delivery services can increase adherence,” Beardsley said, noting that McKesson also can help the pharmacy make it easier for a patient to take their drugs through automation of adherence packaging options, such as pill pouches and blister cards.
Quebec, Canada-based SynMed, a Parata company, also answered pharmacists’ call to be more efficient while delivering patient care amid the pandemic.
“During COVID, the capacity to automate as many workflows as possible became absolutely critical, as pharmacists became clinical care providers and front-line workers nearly overnight,” said Jean Boutin, president and founder of SynMed technology. “Automation is a time-saver and a lifesaver. Both institutional caregivers, as well as our seniors who favor staying healthy at home, are looking for practical solutions that facilitate adherence to their therapeutic treatments,” he said, noting that the need for these solutions only became greater with COVID, and keeping this population safe became critical to preventing the spread of illness and supporting vaccine initiatives.
SynMed’s automation portfolio consists of SynMed XF, SynMed Ultra and SynMed Assist, which are designed to support blister card adherence programs.
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The XF, which is the smaller footprint of the two packing robots, has an output of 30-plus blister cards per hour and requires only one technician for its operation. The Ultra is designed for high-volume pharmacy operations and can produce 180 single dose cards, or 90 multidose cards per hour. “Only two technicians are needed to do the packing work of 17 staff members over the course of a 40-hour week,” Boutin said.
The SynMed Assist works both for smaller pharmacies that want to increase the output and efficiency of hand packing blister cards, or as a supplemental assist for exception meds not stored in the XF or Ultra robots like half tabs and cytotoxics.
Boutin pointed out that automating adherence packaging helps pharmacies maintain adherence programs with minimal staff, freeing up valuable in-person time for vaccines and consults. It also provides a service that safely manages medications for vulnerable populations that need to remain at home. “Another benefit is that less time handling recurring fill requests from both patients and caregivers means more personnel available for consults and vaccine delivery,” he said.
Adding Efficiency
When it comes to enabling pharmacists to provide more clinical services, automation solutions have become more important than ever.
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Kennesaw, Ga.-based KNAPP offers three solutions that free up pharmacy space for clinical activities, and also free pharmacists from performing more mundane tasks.
Brian Sullivan, KNAPP senior systems sales manager of healthcare solutions USA and Canada, explained that the company’s traditional mail order and central fill systems provide a greater level of automation for maintenance medications.
“A high percentage of prescription fulfillment is pulled out of the retail pharmacy and dispensed at significantly lower cost per script,” he said. “The retail site now opens space for additional clinical operations and frees up the technicians and pharmacists for more value-added activities to practice at the top of their licenses.”
KNAPP’s micro fulfillment centers provide similar benefits for pharmacies at a regional level. Sullivan said that they are designed to provide a lower cost of entry, and servicing stores in a close geographic area, these micro fulfillment centers automatically fulfill prescriptions for same-day delivery to stores and their patients’ homes.
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If that weren’t enough, KNAPP’s Apostore retail pharmacy systems are used at a local level to open space behind the counter out front. “By densely storing both prescription and OTC medications, and automatically dispensing in a much smaller footprint, the space for clinical activities is created,” he said.
“Each of these solutions is driven around the individual needs and goals of the pharmacy that we are working with,” Sullivan said. “While a national chain may use a mix of all three design models, a smaller independent pharmacy would find more value in the individual store solutions.”
Pharmacy technology companies also are offering medication synchronization solutions that provide numerous benefits for pharmacists as they seek to deliver more clinical services.
EnlivenHealth, a division of Raleigh, N.C.-based Omnicell, is a front-runner in medication synchronization, which the company describes as a game-changing technology that is transforming both the practice and business of retail pharmacy.
[Read more: Future of pharmacy: Tech and automation experts size up where the industry is headed]
Med sync leverages an appointment-based model that aligns a patient’s chronic medications to a single refill date, improving convenience for the patient and allowing pharmacies to plan for ongoing administration of other services. By simplifying when patients refill and pick up their medications, med sync offers unprecedented opportunities for script growth, enhanced workflow efficiency, patient retention, and direct and indirect remuneration fee mitigation. With resulting improvements in PDC (proportion of days covered) scores, pharmacies can demonstrate value to health plans and be compensated for Star Ratings performance improvement.
“The simple act of helping patients consolidate their medications creates true value for retail pharmacies,” said Danny Sanchez, vice president and general manager of EnlivenHealth. “Our med sync solutions help pharmacies to increase script growth, drive patient retention and increase overall profitability. These proven technologies are empowering pharmacies to grow and thrive in the new era of digital-first health care.”
Conshohocken, Pa.-based AmerisourceBergen also is a leader in helping its independent pharmacies to increase patient adherence and identify patient adherence gaps and medication risk scores.
“Good Neighbor Pharmacy provides its independent pharmacists with a digital patient engagement center, which is a patient-centric hub that gives pharmacists all the data they need to focus their efforts on non-adherent patients,” said Phyllis Houston, AmerisourceBergen vice president of program development and market intelligence. “It also provides them with one-click access to pharmacy benchmarking reports and patient outliers, so pharmacists can deliver more personalized patient care to those who need it most.”
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An important component of patient adherence initiatives is ensuring that patients refill their prescriptions, and it’s crucial that it’s easy for them to get their refills.
To accomplish this, AmerisourceBergen created My GNP mobile app, which allows patients to refill their prescriptions with ease and have them sent directly to their local Good Neighbor Pharmacy. “Mobile app integration has and will continue to remain essential for pharmacies and patients,” Houston said.
For patients who may not have smartphones or who prefer texting, AmerisourceBergen offers its community pharmacies text message support for refill reminders.
A Shot in the Arm
As with so many aspects of pharmacists’ daily work, administering the COVID-19 vaccines entails the completion of paperwork and pharmacy technology companies have solutions to shave time off this task, as well as to make sure patients are vaccinated.
[Read more: State of the Pharmacy 2021: Executives weigh in]
For example, Phoenix-based STChealth’s Pharmacy Clinical Services platform empowers clinicians to query immunization registries for up-to-date patient immunization histories at the point of care. This automated clinical decision support enables pharmacies to close gaps in care for patients who are past due for routine immunizations. After an immunization has been administered to a patient, STChealth’s platform automatically sends data to the appropriate public health registries to ensure compliance with vaccine reporting requirements.
“Technology enables us to build solutions that automate workflows for clinicians. This is incredibly important as the scope of practice for pharmacies continues to expand,” said Billy Chow, chief pharmacy officer at STChealth. “Any amount of time you can give back to a clinician results in more time for patient care and ultimately benefits the pharmacy-patient relationship.”
Arlington, Va.-based Surescripts also is relieving pharmacists from some of the tasks associated with administering vaccines.
Larry King, Surescripts manager of clinical informatics, said that Surescripts Clinical Direct Messaging helps pharmacies electronically send immunization notifications and other reporting to prescribers as well as to federal and state authorities.
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“Pharmacists used Surescripts Clinical Direct Messaging to send COVID-19 vaccine information to primary care providers, eliminating the need to share this information via paper forms, fax machines and phone calls,” said King, noting that since December 2020, pharmacies across the country have used this solution to share more than 8 million COVID-19 immunization notifications to primary care providers.
Freeing up pharmacists from the burdensome task of obtaining prior authorizations also is beneficial in helping them provide better patient care. “Fortunately, increased use of Electronic Prior Authorization among prescribers will reduce callbacks and faxes to pharmacists, keeping them in their electronic workflow and helping them stay focused on counseling patients,” King said.
Getting Pharmacies Paid
Documentation to support medical care reimbursement is yet another time-consuming task that technology companies are prepared to simplify for pharmacists.
McKesson’s Beardsley said that as pharmacies continue to partner with payers in a true value-based model of care, having tools such as McKesson’s Clinical Program Solutions built into their daily workflow provides pharmacists with reporting and documentation to support medical care reimbursement through medical billing functionality offered by RelayHealth.
[Read more: Tools of the trade: How tech, automation are helping pharmacies manage the COVID crunch]
Additionally, the company’s Macro Helix helps covered entities and contract pharmacies maximize 340B program participation through software and services that target the operational, financial and regulatory complexities associated with the program that requires drug manufacturers to provide outpatient drugs to eligible healthcare organizations and covered entities at significantly reduced prices.
“By bringing real-world experience and subject matter expertise, Macro Helix 340B solution ensures pharmacies successfully navigate today’s increasingly complex 340B environment,” Beardsley said.
With only so many hours in a day, managing expensive drug inventory, especially across multiple locations, is yet another issue that technology firms are helping pharmacies address.
McKesson’s Supplylogix provides pharmacies with visibility to manage inventory purchasing habits.
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“Supplylogix Pinpoint Inventory Management product suite can allow pharmacies to realize as much as a 35% improvement in inventory turns and minimize losses from unsalable returns by as much as 25%, all leading to bottom line savings,” Beardsley said. “Another way to reduce costs is to automate the many manual processes that go into filling a script. Adding a central fill facility can certainly help pharmacies enhance their productivity (lower cost to fill); better control their inventory, with almost a 20% reduction in days in inventory; increase capacity; and offer higher quality of care to their patients.
Supplylogix’s integration with EnterpriseRx provides real-time, accurate information and the analytical capabilities to improve decision-making and automate the transfer process between stores.
Meeting federal and state regulations prior to dispensing is yet another drag on pharmacists’ precious time, and pharmacy technology companies are coming to the rescue on this front too.
Take the case of LexisNexis Risk Solutions in Alpharetta, Ga. Jessica Hertzler, the company’s manager of healthcare strategy, said that pharmacists have an obligation to ensure that a prescription meets all federal and state regulations prior to dispensing.
[Read more: Proof is in the packing]
“Operationally, this is quite challenging as providers are licensed by a state board specific to their practice and not all are authorized to prescribe,” she said. “Some state boards will allow for manual verification of a provider’s license online, but the time it takes to manually verify prescriber licensure for each prescription they are presented with is astronomical, and that is only one validation that must be performed. There are many others. While necessary, these validations take time away from patient care.”
LexisNexis engineered VerifyRx to perform real-time compliance checks on prescription transactions before they are dispensed and transmitted to payers.
“This really helps support reducing regulatory risk and increase the percentage of paid prescription claims, but it also benefits the pharmacist because it adds efficiencies to the dispensing workflow and gives them opportunities to provide additional patient care services,” Hertzler said.
Embedded into the pharmacy dispensing system workflow, VerifyRx works behind the scenes to check the licensure and sanctions of prescribers to ensure compliance with regulations.
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“Pharmacy transactions are processed in milliseconds and workflow is only interrupted when a transaction fails one or more of the configured validations,” Hertzler said. “This one piece of technology affords the pharmacist time to work with their patients to counsel them, educate them and support their ongoing well-being. “
Adheris Health, a MedAdvisor company in Burlington, Mass., also is providing pharmacists with a patient adherence solution that focuses on enabling patient engagement.
The company’s latest innovation, THRiV, is an intelligent patient engagement platform that uses predictive analytics and the latest digital solutions to further support pharmacy staff to empower patients to live their healthiest lives.
“It is essential to support patients even when staff time and resources are short,” said Jim Rotsart, executive vice president of client services at Adheris Health. “The best way to do this is to provide patients with the information they need in supplemental channels.”
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Adheris Health also has had success in offering solutions that provide the important education and resources to help patients successfully start and stay on therapy via a multichannel approach — at the pharmacy counter, through direct mail and in text messages.
“This reduces the amount of information the pharmacy staff needs to provide while still being available for more in-depth questions,” Rotsart said.
Helping pharmacists educate patients also is a focus of AmerisourceBergen. “Another area pharmacists have played a huge role in over the last 19 months is educating patients about COVID-19 and vaccines,” Houston said.
GNP developed digital marketing tools and custom resources to assist community pharmacists with the dissemination of key information to their communities so they can focus more on their patients.
[Read more: Who’s who in pharmacy automation and technology]
“At no time has the critical role of a pharmacist been more evident than now, and Good Neighbor Pharmacy is proud to be the trusted partner of countless community pharmacies across the United States,” Houston said.
Helping pharmacists educate patients is the bailiwick of Surescripts as well. “The pandemic also changed pharmacists’ and patients’ relationships,” King said. He cited a recent Surescripts survey, which showed that over the past 18 months, 68% of pharmacists reported receiving more questions from patients related to general health than medications (56%). “Surescripts’ new Real-Time Prescription Benefit for Pharmacy can help pharmacists proactively address questions and cost concerns, and help improve medication adherence for patients,” he said.
Filling More Efficiently
Finally, technology companies also are assisting pharmacists from some of the stresses that come with filling and dispensing functions.
For example, St. Paul, Minn.-based Crocus Medical has several pharmacy automation offerings that can help alleviate the pressures related to the logistics of filling and dispensing prescriptions.
[Read more: Euclid Medical Products updates Vantage software]
These products include RM1, a simple countertop pill counter; automated multidose strip packagers for adherence packaging; and prescription self-retrieval cabinets, which eliminate waiting in line to pick up prescriptions.
John Webster, Crocus Medical vice president of innovation and product development, said these offerings not only help to automate the functions, but they also require less labor.
“Most of our systems offer higher output or greater efficiency, with less workload,” he said. “For example, with the multidose packaging robot, a pharmacy can use one tech instead of three or four techs to create adherence packs. And with the pill counters, one person can really increase their output, freeing up more time for other activities. Once in use, each of our products help provide more time for patient care, patient counseling and a better customer experience, which of course builds customer loyalty.”
While no one knows when the pandemic will finally be a relic of the past, it appears that pharmacists’ enhanced clinical role will continue to grow. Given their vast clinical capabilities and desire to help patients stay healthy, as well as the fact that many retailers are making a foray into primary care, means we will likely see technology companies continue to ratchet up their products and services to assist them.
[Read more: Q&A: McKesson HVS, R/X Automation Solutions execs discuss new chapter]
King envisions a rosy future. “COVID-19 has only enhanced the need for better information sharing across providers and prescribers, improved prescription affordability and solutions for relieving provider burnout,” he said. “Technology that already exists can help pharmacists today and better prepare them for whatever tomorrow may bring.”
Perhaps Beardsley summed up best about where pharmacy technology companies are headed: “As the future of pharmacy technology continues to expand past simple workflow tools, pharmacies are beginning to shift their focus to implementing solutions that not only help them deliver better patient care, but also help reduce costs, improve work efficiencies, address medication adherence and improve the patient experience,” he said.
“Systems that fully integrate with each other across all stakeholders can not only improve workflow communications and efficiencies, but also improve overall pharmacy logistics,” Beardsley said. “Use of these technologies can help raise patient adherence rates, lower overall pharmacy costs, improve quality of care, simplify adjudication, improve patient outcomes and strengthen the pharmacy’s financial performance.