Pharmacies look to tech to deliver outcomes efficiently

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Pharmacies look to tech to deliver outcomes efficiently

By Jim Frederick - 01/08/2018

For pharmacy technology providers, a fundamental mission has become helping retail pharmacies in their urgent quest to complete their evolution from pill counting and basic medication counseling to being fully engaged, frontline patient care providers. That includes supporting the drive by pharmacists to more fully integrate with the collaborative healthcare team now coming into focus. 


Costly investments in robotics, central-fill systems and other devices have helped free pharmacists to engage with patients at a higher level of care. Additionally, they offer labor- and cost-saving benefits, as well as higher accuracy and the elimination of common human errors. 


But pharmacy technology’s equally important role is now generating, measuring and analyzing prescription data — and sharing that data with other providers in the patient-care network to build a more complete picture and medical history of each patient. The goal, of course, is better treatment outcomes and healthier patients.


“Outcomes-based measures are the next wave of the future,” said Laura Cranston, executive director of the Alexandria, Va.-based Pharmacy Quality Alliance. “Everyone is going to be held accountable and required to take action when they know their performance in the marketplace. And contractually, health plans and PBMs and other payer entities are driving this move to value-based care.”


That shift, in turn, is driving the increasing use and sharing of electronic patient health records, or EHRs — including the reams of prescription use and patient-interaction data generated daily by pharmacies’ software. The goal: to create a fully integrated, team-based health system that connects pharmacists, physicians, hospitals, health plan coordinators and PBMs in an accountable, hub-and-spoke model of care, with the patient at the center.


Thus, pharmacy’s ongoing quest to gain full health provider status for pharmacists — and to fully engage with patients, payers and the emerging team-based system of health care — hinges on its ability to capture, manage and share up-to-date patient health records in real time with other members of the health provider team. It also includes connecting with patients — both in and out of the pharmacy. 


From Product to Knowledge

The task currently facing pharmacy is “the transformation from a product industry to a knowledge industry,” according to Mission, Kan.-based ScriptPro president and CEO Mike Coughlin.


“Pharmacy operators who want to participate in this future should begin to view their primary product as knowledge and put systems in place to acquire it, embed it in their organizations and make it available at the right place, at the right time, at the right price and with a plan for how they will be reimbursed for it,” Coughlin said.


With the shift toward value-based reimbursement, integrated technology is becoming more of an imperative, according to Bernie Reese, senior vice president and general manager of San Francisco-based McKesson Pharmacy Systems. 


“With today’s healthcare system moving toward a value-based reimbursement approach, integrated technology … becomes more essential,” Reese said. “By leveraging new technologies to execute clinical services at a high level, community retail pharmacies can carve out new, sustained revenue streams and become key stakeholders in value-based healthcare models.”


To that end, McKesson Pharmacy Systems joined forces last year with Rochester, N.Y.-based PharmaSmart, which provides health screening systems and online health management services, to incorporate PharmaSmart patient data into McKesson’s EnterpriseRx pharmacy management system. The result is McKesson’s new Clinical Programs Solution, which Reese said is aimed at helping pharmacies use their pharmacy management system to manage their clinical programs directly. With an increase in the clinical role of pharmacists, leveraging patient data is becoming one of their main roles if they want to stay ahead. 


“Integrating comprehensive pharmacy data analytics to track and monitor drug spend and use, patient care and quality is a top priority for health systems,” McKesson noted in a 2017 report on health system pharmacy trends. “Organizations can use this information to make better financial, clinical and operational decisions, and drive improved outcomes. This type of investment can provide meaningful drug-spend analysis, giving pharmacy leaders the evidence they need to successfully establish and track cost-containment initiatives. This also can help to reduce drug spend, decrease manual work hours and improve efficiency so health systems can focus on medication safety and patient care.”


Both retailers and their technology vendors are working to align pharmacists’ patient-care and disease-prevention activities with the overall clinical efforts of hospital systems, physician groups and other health providers. Data sharing and electronic health records are the conduits.


“As pharmacists expand their scope of services and play a more prominent role in the healthcare continuum, their ability to exchange information with primary care providers will … be of vital importance,” noted Healthcare Data Solutions, or HDS, in its report “How Real-Time Data Integration is Changing the Face of Healthcare IT.” “Pharmacists will need the ability to send information about patient immunizations, health screenings, medication compliance and more to the right primary care provider.”


The Mobile Pharmacy Connection

To be sure, the automation and data-mining revolution extends well beyond the pharmacy workspace. It’s something that John Standley, former chairman and CEO of Camp Hill, Pa.-based Rite Aid observed in 2017 before he departed the retailer to lead Vitamin Shoppe. 


“Improving digital connectivity between patients and providers is critical to achieving value-based, patient-centered care,” the New York City-based Deloitte Center for Health Solutions reported. “Many healthcare organizations are exploring strategies to leverage technology, including telehealth, to increase consumer engagement and focus on prevention and chronic care management.”


In order to keep up with its connected consumer, Woonsocket, R.I.-based CVS Health is using digital technology to personalize the shopping experience in its CVS Pharmacy stores, according to CVS Pharmacy president Helena Foulkes. “We’ve seen great adoption of our CVS Pharmacy app,” she said. 


At its Digital Innovation Lab in Boston, Foulkes said CVS Health “is focused on developing cutting-edge digital services and personalized capabilities that offer an accessible and integrated personal pharmacy and health experience.”


Though discussions about reaching digitally engaged patiens largely focus on younger, tech-savvy one, some retailers are expanding the scope of who they want to reach. Increasingly, older Americans also are embracing mobile technology to connect with their local pharmacy for prescription refills, dosage reminders, online chats with a pharmacist or appointment scheduling.


Walgreens, for instance, has seen its mobile pharmacy app gain a lot of traction with seniors. According to the Deerfield, Ill.- based company, patients age 55 years old and older account for 27% of its mobile app users in general, and 37% of customers use its refill-by-scan feature and other mobile pharmacy tools. They also can use the app to upload prescription insurance eligibility information to the Walgreens pharmacy, schedule app

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