Problem solvers: Tech, automation makers aim to enable clinical efforts
Pharmacists finally are in the right place at the right time.
In the face of crushing DIR fees, low reimbursement and low margins, many pharmacy chains are taking giant steps to become part of the primary care offering to patients. With this transformation, comes the opportunity for pharmacists to focus more on patient outcomes, create new revenue streams for pharmacies, and reduce overall healthcare costs.
Ask pharmacy technology and automation companies to describe the state of pharmacy, and one thing is agreed upon: They are seeing more disruption in the industry than ever before. In response, these companies are ratcheting up their products and services to help pharmacies succeed.
For example, New York-based Amplicare’s CEO Matt Johnson said that pharmacies have a tremendous opportunity to provide and get paid for clinical services, but the environment is “designed to pump out prescriptions as fast as possible, particularly in chain retail pharmacy settings. Without additional staff, they’re swimming solo through unrelenting waves of chaos throughout the day.”
The consensus among executives from automation and technology companies is that their products and services are designed to help make life easier for pharmacists, while enabling better patient outcomes and store profitability.
Making It Count
Though pharmacists often are seen more frequently by patients than physicians, the time they spend with patients also can be limited. As a result, Johnson said it is important for them to have insight into patient needs and be informed about the right interventions at the right time so they can make more actionable decisions. They also need to make it easy for patients to follow through on those interventions, he said.
To that end, the company’s AmplicareAssist offers an opportunity engine that integrates with pharmacy management systems and notifies pharmacists when there is a high-
As an example, if a diabetic patient has not been prescribed a statin, the pharmacist automatically will know which drugs are covered by the patient’s insurance and what the copays are. The pharmacist will then send an electronic message to a physician all in about 30 seconds, Johnson said.
Aside from identifying when an intervention is needed, pharmacies also must ensure that their patients are adherent with their medication regimens, and many companies, such as Canada-based Synergy Medical, are focusing on adherence through packaging.
Synergy Medical manufactures and supports SynMed automation for blister packaging. The SynMed Ultra system, which the company launched more recently, is designed for retailers with central-fill sites that are dispensing very high volumes of prescriptions.
“The greatest challenge for pharmacy is ensuring a patient is adherent with their medication regimen. Weak adherence is detrimental to the health of the patient, the pharmacy’s bottom line, and the plan that is paying the cost of nonadherence,” said Mark Rinker, Synergy Medical’s vice president of sales.
Rinker said that 4 billion prescriptions were dispensed in 2019, and that every prescription dispensed is generating $131 in additional spending to account for nonoptimized medication therapy. He also said that providing blister packs can be a valuable service for patients to help keep them adherent.
Adherence also is the focus of Durham, N.C.-based Pharmacy Quality Solutions, whose EQuIPP electronic quality improvement platform is designed to help pharmacies and payers manage performance data.
“Our platform allows pharmacists to utilize the data and incorporate it into their patient care services. If we can provide simple information and data to inform the pharmacist, they can utilize the information to expand upon the conversation with patients or to focus on medication optimization with the patient — that’s the sweet spot we want to hit,” said Nick Dorich, PQS director of pharmacy relations. “We want pharmacists to understand which interventions work, which interventions need to be reviewed and to utilize that information to help them improve their patient care process.”
For pharmacists with a little more time on their hands, medication therapy management offers not just a one-on-one opportunity to discuss adherence, it offers a billable service to the pharmacy. Surescripts, based in Arlington, Va., looks to use its e-prescribing foundation to add technology into pharmacists’ workflow that offers more opportunities to provide MTM services, according to Ken Whittemore Jr., the company’s vice president of professional and regulatory affairs.
“When an e-prescription is received, the pharmacist is able to check the patient’s benefit eligibility for the medication prescribed,” Whittemore said. “This draws on Surescripts’ patient-matching technology, which enables the pharmacist to check eligibility even when the patient is not able to present their benefit card. The pharmacist can then alert the prescriber to any potential problems with insurance coverage for a prescription.”
He said that a key element of the company’s offering is making administrative duties easier to allow pharmacists more time for clinical efforts.
“We can eliminate hours spent on the phone by enabling a request to change, clarify or receive a prior authorization through RxChange,” Whittemore said. “If there are any questions, without leaving the workflow, the pharmacist can electronically communicate and coordinate with care team members.”
Jeff Key, president of Shreveport, La.-based PioneerRx also said that freeing up pharmacists’ time is an essential part of enabling better patient health.
“You are seeing pharmacy become more of the healthcare team. We help free up pharmacists’ time so they can have a closer relationship with patients,” he said. “We have messaging built into our pharmacy software system so that pharmacists can message patients within their workflow.”PioneerRx’s pharmacy system also features an e-care plan, which enables pharmacists to document and share the interactions, goals and the status of patient encounters with healthcare providers.
Convenience is King
Besides freeing pharmacists, many technology and automation companies are helping pharmacies deliver the convenient experience that consumers are demanding.
Bell and Howell, based in Durham, N.C., is making headway with QuickCollect Rx, an automated solution that simplifies the prescription pickup process. When their prescription is ready, customers receive an email or text message with a bar and pin code that allows them to retrieve and pay for their prescription at an automated kiosk. They also can request a consultation.
“While we’re speeding up the pickup process, customers can quickly pick up their prescriptions, pivot over for consultation if needed, and then be on their way,” said Brian Irish, Bell and Howell vice president of marketing.
Cincinnati-based Bavis Drive-Thru also is creating a more convenient experience for patients, as well as pharmacists.
“With our audio system and a VoIP phone system, the patient and pharmacist are connected. The pharmacist also can do a conference call with the patient’s physician. The patient can conference the pharmacist in at the pharmacy, instead of the pharmacist coming up to the drive-through window,” said Bavis president William Sieber.
Bavis’ latest product is the Drive-Thru Vittleveyor, a very large carrier that can transport prescriptions and large OTC items.
Convenience isn’t only for patients, though. Uniweb, based in Corona, Calif., has a slot system for shelving that’s meant to make the pharmacy workplace more efficient, offering flexibility for maintaining high inventories of products.
Bill Bender, Uniweb vice president of sales and marketing, said that in many pharmacies, products are stacked high because the staff doesn’t have time to unload the products, unsnap a shelf from a slot, reposition it, and put the shelving back on.
“Our slot wall system is 1 inch on center. It is a metal panel without those individual slots. It has a horizontal channel that runs across the width, and the shelves slide into those channels,” Bender said. “It’s a lot easier to adjust shelves as inventory increases.”
Tackling Logistics Hurdles
When it comes to business operations, cash flow problems can put a dent on the clinical services that pharmacies want to provide.
Libertyville, Ill.-based Pharma Logistics provides reverse pharmaceutical distribution services, including its Traditional Credit Program and Rapid Credit Program, both designed to bring a cash influx into pharmacies. The difference between the programs is the speed at which the pharmacy receives reimbursement. The pharmacy will receive cash within 14 days of the pharmaceutical products arriving at Pharma Logistics’ processing facility with the Rapid Credit Program.
“These programs are designed to accelerate credit flow from the expired pharmaceutical products that are nonviable to the retail space and turn it into working capital again,” said Jeffrey Swanson, head of retail sales. “If pharmacies receive an influx of cash from expired products, that allows them to reinvest into their pharmacy, whether that’s through technology or reinvesting back into their point-of-sale merchandising to drive customers in.”
Beyond cash flow, as pharmacies expand clinical services, they need to better manage their receivables. Lari Harding, vice president of strategy and marketing at Inmar Intelligence, based in Winston-Salem, N.C., believes that as pharmacies expand their scope of services, they must connect to the “technology ecosystem of the healthcare system” to communicate with other providers, do medical billing and facilitate contractual relationships.
Inmar Intelligence is developing technology designed to help pharmacies have a cohesive view into the financial flow of the prescriptions dispensed to a patient and the medical services they provide to them.
“There are different medical billing solutions and pharmacy dispensing systems that pharmacies are using,” Harding said. “We will integrate with whatever platform using industry-standard EDI-based billing methods they’ve chosen to run their operation, and we bring the data back for our customers so they have an accurate picture of their receivables, what they are owed, and what their activity was. They can see it in a way that helps them better manage their business.”
Pharmacies have no shortage of compliance imperatives on a day-to-day basis, and the most recent change was the USP <800> regulation, focused on the safe handling of hazardous drugs, which came into effect on Dec. 1, 2019.
Brian Sullivan, senior systems sales manager at Kennesaw, Ga.-based Knapp, said that this regulation affects all pharmacies, particularly large mail-order and central-fill pharmacies that dispense a high volume of prescriptions. Knapp offers a centralized vacuum system to control dust from medications within their automation systems and in the canister replenishment area. The system enables retailers to keep their medications in high-speed automation.
Additionally, the Drug Supply Chain Security Act has several upcoming deadlines for wholesalers and retailers, with the former needing to be compliant this year and retailer compliance set for 2023.
Knapp Vision Item Check, which wholesalers have incorporated for incoming medications, automatically reads the bar codes of serialized medications and sends that information to a database, verifying that medications are authentic.
“We are bringing variations of that technology to our central-fill, mail-order and retail customers, so that they can expedite the scanning and verification of medication and also be compliant in a cost-effective way by 2023,” Sullivan said.
Mitigating risk associated with state and federal regulations is imperative when pharmacies dispense medications, according to Craig Ford, senior vice president of pharmacy sales at Alpharetta, Ga.-based LexisNexis Risk Solutions, which offers the VerifyRx mitigation tool. VerifyRx looks at the provider information and prescriber data associated with a prescription to ensure that the information is accurate while in the workflow process.
“We help pharmacies mitigate their risk from a compliance perspective by allowing their dispensing platforms to leverage our information so that prescriptions can be filled effectively and safely, while complying to the ongoing state and federal regulations,” Ford said. “We do this in milliseconds, not impacting the dispensing process. Pharmacy chains are getting immediate real-time compliance validation checks at the point of sale. It’s cleaner, more accurate, and it addresses federal regulations,” Ford said.