Leveraging technology to enable a high-touch care model
It’s called medication synchronization, and the concept is simple enough — shifting patients to a synchronized, easy-to-comply-with, once-a-month prescription refill program so they can pick up all their medications with one visit to the pharmacy each month, instead of multiple trips.
Med sync has numerous benefits to patients, payers, prescribers, and, of course, community pharmacy. Early adopters are leveraging different models to increase medication adherence; to decrease gaps in therapy; to increase the number of first fills that actually get picked up by patients; to provide a higher level of patient care; and to increase pharmacist, patient and prescriber satisfaction. The increased focus on patient consultations is also an important first step in community pharmacy’s enhanced role in an outcomes-based healthcare model.
With all of the excitement, interest — and burning questions — about medication synchronization, DSN recently assembled five of the top technology providers in the industry for a virtual roundtable discussion.
DSN: How does your technology seamlessly integrate with retailer pharmacy systems?
GEORGE OWENS, SVP BUSINESS DEVELOPMENT, PDX: Business and technology are not on separate tracks but rather are intertwined. When we are talking about the new outcomes-based pharmacy business model, I think we would all agree that the core ingredient is a central patient record — one where the data has been cleansed and merged. This type of database can then be set to create a portable, interoperable healthcare data record. The ease at which patient data is transported and dispersed to various healthcare programs defines the efficiencies of that business. Healthcare data will soon be required to be interchangeable between healthcare providers, which means all of a patient’s healthcare data — including ICD-10s and labs — belongs to the patient. The patient should be able to easily access it and move it at any time. It all falls back to an integrated, well-constructed, centralized patient database, and pharmacy is the most logical healthcare provider to offer that.
MATT NOFFSINGER, SVP SALES AND MARKETING, TCGRX: Ten or 15 years ago, integration was more difficult than it is today. Automation, inventory management and workflow software have been integrated time and time again and are now commonplace. It is particularly helpful that the pharmacy systems have been moving toward more standardized interfaces, such as HL7.
MIKE COUGHLIN, PRESIDENT AND CEO, SCRIPTPRO: It is possible for technology to seamlessly integrate the entire patient/pharmacy interaction experience — from selecting the pharmacy, time and method for receiving the prescriptions to follow-up support. This can be accomplished through a unified system that is designed to cover all the bases. ScriptPro offers such a system through its Perfect Integration model that supports the entire pharmacy process. It also integrates such functions as long-term care support, compounding, 340B processing and third-party management. However, other than the large chains, most pharmacies operate with a conglomeration of systems that are far from integrated and certainly not seamless. And the large chains typically avoid the complexities of long-term care, compounding and managing delivery routes. So, this is an ideal to reach, but far from the real world. ScriptPro truly has integrated all of these functions into a seamless platform that is unmatched.
TOM MULLEN, DIRECTOR OF BUSINESS DEVELOPMENT AND STRATEGY, MCKESSON PHARMACY SYSTEMS AND AUTOMATION: Most of the medication synchronization tools on the market require an automated patient data feed from our pharmacy management system to their system. They then apply their algorithm to the patient data to determine the best synchronization option for the patient. If the pharmacy management system includes other features that support a synchronization program, then those data sets also can be sent to provide additional analysis. For example, our EnterpriseRx system includes an auto refill feature that allows the patient to enroll in an automated refill program that’s used to give the pharmacy more flexibility when managing the synchronization of a patient’s medication.
FRANK SHEPPARD, CEO, ATEB: The better a system integrates with the existing infrastructure, the more likely it is that the pharmacy staff will use the tool. With Time My Meds, Ateb’s comprehensive medication synchronization solution, Ateb leverages pharmacy data and fits well into a pharmacy’s existing workflow. Medication synchronization requires pharmacies to shift from an exclusive focus on individual prescriptions to engaging patients holistically to improve health outcomes. To ease this transition, Ateb has created the Time My Meds portal to augment the capabilities of the pharmacy management system. We believe that pharmacies do not need to undergo large changes to implement a med sync program; however, pharmacies require additional tools to effectively identify and manage patients through the process. With Time My Meds, the pharmacy management system continues to function as it would normally: process refills, adjudicate, identify drug interactions and maintain prescription history. Ateb complements this process by identifying, tracking and managing patient engagement, leading the pharmacy team through the process; thereby optimizing efficiency and yielding positive clinical and economic outcomes. Further, Ateb has integrated a staff of pharmacists and pharmacy technicians into our development teams, capitalizing on their knowledge of today’s pharmacy workflow, as well as the growing clinical aspects of community pharmacy. This ensures that Ateb makes the right judgments on how to integrate our platforms with the existing pharmacy systems. We also work closely with pharmacy system vendors to continuously improve our ability to integrate our technology as seamlessly as possible with them on the pharmacy’s behalf.
DSN: What outcomes and data are available to support medication synchronization programs?
COUGHLIN: Adherence is clearly an area that could use some focused attention, and med synchronization would seem to be a way to promote adherence by making it simpler for patients to manage their refills. ... This information would be useful.
OWENS: We can all remember the early adopters of med sync using a delivery system that placed the total dosage of several medications into a visible dose-pack on a continuous roll — up to one month’s regimen. It was originally meant for caregivers and older adults. It worked great, and everyone loved it. And I’m certain it increased persistency. The downside was the complexity of the patient’s drug regimen. If a single dose changed, the entire package needed to be re-worked. A new and much improved business model appeared through the hard work and initiative of the executives at Thrifty White Pharmacy. They established an appointment-based model, or ABM, that called the patient one week prior to their visit to Thrifty White’s patient care center to see if the patient has had any adjustments to dosage or has visited a hospital or clinic over the past month. The appointment time was used for counseling on a wide range of health topics from flu shots and vaccinations to medication information and so on. Thrifty White sponsored a research project at the Virginia Commonwealth School of Pharmacy with two Ph.D. professors conducting the research to see how well their med sync program was working. The analysis fo