Leveraging robotics to increase pharmacists’ time for clinical services
Picture this: A patient who has been newly diagnosed with diabetes visits a community pharmacy. The pharmacist provides counseling on monitoring glucose levels and how to manage out-of-range levels, and develops a plan for the patient if sugar levels go too low. The pharmacist also recommends an appropriate diet and exercise routine to complement medication management.
This scenario and similar situations, in which pharmacists help patients manage their chronic disease, is being played out in pharmacies nationwide. But how can pharmacists perform vital clinical services, and provide COVID-19 testing, immunizations and point-of-care testing, while meeting the requirement to fill a high volume of prescriptions?
Enter pharmacy technology and automation companies, which are amplifying their products and services.
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Many technology companies are offering products that help pharmacies more efficiently handle a higher volume of prescriptions, which has become even more challenging as COVID-19 ebbs and flows. Crocus Medical, based in Minneapolis, is a case in point.
John Webster, Crocus Medical vice president of innovation and product development, said the company’s range of pill counters, including countertop and larger stand-alone robots, can help pharmacies and pharmacists deal with higher dispensing demands as they grow their businesses, and also maintain their volumes if faced with staff shortages.
For pharmacies involved in long-term care or assisted living, Crocus Medical’s multidose cellophane packaging machines and blister-filling robots can help package high-volume clients’ medications quickly and accurately. Moreover, the company’s inventory software management informs pharmacists about products that are running low, those that are in excess and “how they can better utilize these high-cost items without hours of human oversight,” Webster said.
Lastly, Crocus Medical’s Self-Collect Rx lockers, which enable patients to “click and collect” their refills at their pharmacy, enable pharmacies to compete against mail order dispensaries that offer contactless delivery.
iA, based in Indianapolis, is on a mission to reduce pharmacists’ heavy workload by streamlining the prescription-filling process through off-site automation, giving time back to pharmacists as they seek to focus on clinical work.
Alecia Lashier, chief automation officer at iA, pointed out that clinical services can result in new revenue sources. “It’s a win-win for the pharmacist and pharmacy,” she said, while noting that automating the work of low-reimbursement tasks to increase overall quality of care and efficiency “trickles down to patient satisfaction.”
“Human error during repetitive tasks, such as manually filling prescriptions, is inevitable, but by automating the prescription-filling process, we can leverage robotics for tasks that are prone to human error,” she said. “As our solutions become more intelligent, we can expand tracking updates for both pharmacists and patients, creating more ease, convenience and flexibility.”
Centralizing inventory also helps pharmacies mitigate holding costs. “Additionally, enterprise remote verification and analytics aid in the optimization for each patient’s prescription fulfillment,” Lashier said.
EnlivenHealth, the Raleigh, N.C.-based division of Omnicell, also is a leader in providing automation that frees up pharmacists to pursue clinical opportunities.
Danny Sanchez, senior vice president and general manager of EnlivenHealth, described the company’s latest release, Personalized IVR, as a game-changer for pharmacies, based on its beta partner, which experienced a 15% reduction in transfer time from the phone system to the pharmacy.
Personalized IVR can identify a patient, look at their profile, tell them what medications they are taking, suggest a refill or offer to text a link to schedule a vaccine or other clinical services via the company’s CareScheduler.
“We’re bringing intelligence and automation into the pharmacy,” Sanchez said. “The patient is calling in and having a personalized discussion with our technology. Personalization can include giving patients the opportunity to pick up prescriptions curbside or even have them delivered.”
In the future, if patients have questions about the medications they are taking for their disease states, the IVR will connect them to educational materials or send a link to schedule a meeting with a pharmacist.
Pharmacy technology companies also are focusing on reducing the inefficiencies of current prescription pickup methods, which improves medication adherence.
Durham, N.C.-based Bell and Howell’s Pharmacy Solutions is a front-runner in this area. The company’s advanced QuickCollect Rx kiosk system improves workflows by automating the prescription pickup process with a multi-portal design, allowing simultaneous prescription pickups and reducing staff workload.
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James Hermanowski, vice president of BH QuickCollect Solutions, said the kiosk allows secure unattended pickup of prescriptions and other items. “The solution also reduces wait times, which is a major source of customer frustration and prescription abandonment,” he said. “It also improves patient compliance and satisfaction.”
Additionally, the QuickCollect Rx is integrated with McKesson’s EnterpriseRx, which allows secure communication with the pharmacy for prescription validation and assurance that a prescription’s chain of custody is maintained.
“Pharmacy staff can load prescriptions into the QuickCollect Rx in seconds, freeing up time to focus on patient wellness programs and pharmacy services,” Hermanowski said. “Our solution allows pharmacies to expand their pickup hours and provide contactless pickup experiences at a time that is most convenient for the patient. Patients are notified that their prescriptions are ready using the current pharmacy process, and they can quickly pick them up via an intuitive display on the kiosk.
Parata Systems, based in Durham, N.C., also is focused on improving medication adherence with an automated adherence packaging solution.
“Parata Systems offers solutions that provide exponential benefits whether pharmacies are just getting started or are scaling for growth,” said Elleny Johnson, associate segment marketing manager at Parata Systems. “Beyond creating time for pharmacies to do more value-based care, our solutions increase medication adherence and provide a convenient and reliable patient experience. Seventy one percent of patients are more likely to take their medications on time each day when enrolled in an adherence packaging program, and 86% are more confident with managing their medications.”
Pointing out that Parata Systems offers solutions to support better health outcomes, safety, efficiency and business growth, Johnson said, “This new normal requires pharmacies to be seen as part of the overall healthcare landscape and offer the clinically focused care that patients demand and deserve. To do that, pharmacies need to free up time to devote to point-of-care testing, immunizations, medication therapy management, patient counseling and more. Automation creates that time.”
With only so many hours in a day, pharmacists also are looking for ways to handle time-consuming responsibilities, such as dealing with discontinued medications, prior authorizations and some of the tasks associated with administering vaccines.
For example, Arlington, Va.-based Surescripts offers several solutions to meet these challenges, including CancelRx, which prescribers use to alert pharmacists to discontinued prescriptions without taking them out of their workflow.
Surescripts’ RxChange enables pharmacists to reach out to prescribers electronically to initiate prior authorizations, to suggest more affordable therapeutic alternatives, request clarifications on prescriptions and receive replies in the same workflow. Additionally, Surescripts Real-Time Prescription Benefit gives pharmacists the power to address cost concerns by helping to identify lower-cost alternatives and facilitating changes to cost-effective therapeutic alternatives within their workflows.
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“This helps to avoid costly issues such as prescription abandonment and restocking that often result from prescription processing delays,” said Ken Whittemore Jr., Surescripts vice president of pharmacy and regulatory affairs.
If that weren’t enough, Clinical Direct Messaging provides pharmacists with an automated way to report vaccination administrations to patients’ primary care providers.
Preventing medication errors while accelerating prescription fulfillment is yet another major challenge for pharmacies. Kennesaw, Ga.-based Knapp is a leader in providing automated solutions that tackle these two concerns.
Brian Sullivan, senior systems sales manager for healthcare solutions at Kapp USA and Canada, said the company offers fully automated, patient-centric solutions that are risk ready, auto compliant and error free.
“Knapp’s smart pharmacy system provides real-time visibility from the central pharmacy to the last mile,” he said. “From dispensing to order sorting, deeply integrated intelligence and analytics guide inventory management, staffing and maintenance to assure on-time, same-day fulfillment across the network. Our software-driven system is integrated, interconnected and intelligent, and can handle fulfillment for prescriptions, OTCs and e-commerce orders.”
Sullivan also noted that micro-fulfillment centers deployed today can become regional hubs that support up to 200 retail, specialty and long-term care pharmacies tomorrow. Additionally, in-store automated storage and retrieval systems can accelerate fulfillment and provide 24/7 dispensing of prescription and OTC medications. “This transformation is happening now,” Sullivan said. “Our customers have redefined the expectations of a typical pharmacy with new business models and new revenue-generating services.”
Moorestown, N.J.-based Tabula Rasa Health-Care’s MedWise Science analyzes a patient’s risk of medication-related harm and helps pharmacists make recommendations to reduce patient risk.
Michael Awadalla, executive vice president, office of applied pharmacotherapy at Tabula Rasa HealthCare, said that MedWise Science analyzes all of an individual’s medications at once, helping pharmacists to identify simultaneous, multi-drug interactions and determine a patient’s specific risk of medication-related harm, or their MedWise Risk Score.
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“Research has highlighted the association between MedWise Risk Score and various outcomes, including medical costs, adverse drug events, falls, mortality, emergency department visits, hospital admissions and hospital length of stay,” Awadalla said.
MedWise Science also supports pharmacists by conveying a patient’s risk through visualizations rather than alerts. These visualizations enable pharmacists to evaluate various areas of risk at once. “With MedWise Science, pharmacists avoid alert fatigue, which is especially critical as they take on greater workloads,” he said.
Pharmacy tech companies also are assisting pharmacies in meeting consumers’ heightened demands for a safe and convenient shopping experience.
For instance, Toronto, Canada-based Magstar provides an all-in-one ERP solution that is catered to help small- and medium-sized retailers grow and unify their online and offline shopping experiences.
Among the company’s solutions are mobile devices that allow clerks to process orders for a safe, touchless experience. Magstar also provides retailers with the ability to vary their payment methods for customers by supporting other types of payments, such as PayPal and Venmo.
Magstar also is helping pharmacies keep up with increasingly complex supply chains. “Our auto replenishment system was designed to ensure that small- and medium-sized pharmacies have the right product mix, based on the activity at the location level, to meet changing customer demands,” said Magstar president Steven Greenwood.
Additionally, Magstar’s direct integrations with a variety of pharmacy systems, such as PDX, Pioneer Rx, McKesson and Enterprise Rx, reduce complexities for retailers, Greenwood noted. “On the front end, things like internal gift card programs benefit retailers by fostering loyalty. We also interface with BlackHawk and Incomm to support retailers selling third-party gift cards.”
Moreover, Magstar helps pharmacists meet their requirements involving dispensing transactions, including signature capture for HIPPA, easy-off caps and Rx pickup for acknowledgement.
Helping pharmacists handle the administrative tasks that are crucial to providing immunizations and point-of-care testing is the bailiwick of STChealth. The Phoenix-based company’s immunization and COVID-19 testing data exchange network connects retail pharmacies across the country to public health agencies and the Centers for Disease Control and Prevention.
In 2021, this network handled more than 1 billion patient events. “As pharmacy continues to play a bigger role in clinical services, the new normal will be providing a greater percentage of immunizations and increasing patient point-of-care test options for disease prevention and awareness,” said Mike Popovich, CEO of STChealth.
“This expanding capability requires real-time data reporting and patient data record access, which is the core of STChealth’s business. Our goal is to ensure every pharmacist and pharmacy technician has the information they need to engage their patients as they provide clinical services and comply with requests for information,” he said.
STChealth’s vaccine intelligence allows pharmacies to identify populations at risk of vaccine-preventable diseases in the region they serve and provide specific recommendations to individual patients based on their immunization history.
“Integrating STChealth vaccine intelligence with a pharmacy management system creates opportunities in point-of-care testing for early warning disease detection and public health reporting,” Popovich said.
Lastly, as pharmacists expand their clinical roles beyond vaccinations, automated drug pricing and patient-engagement solutions become even more critical.
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Dallas-based OmniSYS is offering solutions in each of these areas.
“At OmniSYS, empowering pharmacists to practice at the top of their license is the core of what we do through data, workflow and interoperability solutions,” said David Pope, executive vice president of innovation and industry solutions at OmniSYS.
“Pharmacy retailers are using OmniSYS’ billing-enabled EHR, intelligent patient-engagement solutions and suite of callable services to expand their clinical practices beyond vaccinations,” he said. “We take the back-end stress off pharmacists and the pharmacy, enabling the provision of care in the pharmacy environment.”
While it’s difficult to predict what the next innovation will be, perhaps Pope summed up what lies ahead best with this sentiment: “The future of pharmacy is value-based clinical care deeply focused on patient outcomes and equitable access. The solutions to power that future must be interoperable, integrated and sustainable for pharmacy organizations, granting pharmacists a realistic pathway for clinical practice.”