McKesson Pharmacy Systems (MPS) President Stanton McComb sat down with ComputerTalk
senior editor Will Lockwood at the McKesson Pharmacy Strategies
Conference and Trade Show in Boston in July to talk about recent
changes at MPS resulting from the Per-Se Technologies acquisition, the
newest technology that MPS is offering, and the changes he sees ahead
for retail pharmacy practice.
CT: There’ve been some big changes recently at McKesson. What are you most excited about?
Stanton McComb: Two of the most exciting changes to come out of the
recent merger between Per-Se Pharmacy Systems and McKesson Pharmacy
Systems are our expanded customer base and staff.
The acquisition provides McKesson Pharmacy Systems with a far larger
customer base, which gives us access to more relationships, more
innovative ideas, and a greater understanding of what needs to be done
to improve retail pharmacy from a technology perspective. Now, as we
integrate our operations, we are especially focused on taking advantage
of these new relationships. Our top-of-mind goal is to become
exceptionally good at listening and responding to our customers, and
communicating with them on a regular basis.
The second major change brought on by the acquisition is the makeup of
our company. We now find ourselves with one of the greatest and largest
pharmacy software teams in the country. This is a team that has a
tremendous amount of experience. There are literally hundreds of MPS
employees who have been working on pharmacy software for 15 or 20
years, and some even longer than that. Now that we have so many more
resources at our disposal and so much more kNowledge inside of MPS,
it’s exciting to think about how we can leverage that talent and bring
it to bear on new opportunities for our customers.
CT: What do you see as the future of the pharmacy management system at
McKesson? How does the Internet-enabled ASP [application service
provider] model fit in?
McComb: I’ve been posed this question a few times already this week at
our McKesson Pharmacy Strategies Conference and Trade Show. Everyone’s
curious to know: Is the ASP delivery model here to stay? And is it
working? I do believe that the ASP model is the way of the future — I
really do. To be clear, when we say ASP, we are talking about a
software delivery method that allows customers on-demand access over
the Internet to their software application or solution, which is hosted
at a remote site. There are a lot of benefits associated with this ASP
delivery model. For example, it’s less expensive because it requires
less hardware inside each store. If the application includes workflow
and load balancing, a hosted system enables different stores to help
each other out during the course of business because they can be given
rights to work off of each other’s systems remotely. An ASP-enabled
system also inherently allows you to centralize data, which helps
simplify reporting and backup processes greatly. Keeping your system up
to date with the latest versions of the software is also much easier ––
as all new versions of an application can be loaded one time to one
central server. And, Will, these are only a few of the benefits. So,
yes, I am very excited about this technology in terms of what it means
for our customers and the industry.
CT: What about ASP availability and reliability?
McComb: Those have been the historical trade-offs and the source of a
lot of questions. However, we see problems with availability and
reliability fading away now. McKesson has looked closely at the
availability of high-speed connectivity, and we have found that there
are very few locations in the United States that still cannot get
access to high-speed Internet. So, as access becomes less and less of
an issue, costs will continue to come down as well.
Plus, as our first-hand experience with the reliability of
Internet-enabled applications like EnterpriseRx has demonstrated, we
are up and running 99.9% of the time. That’s a service level that
exceeds most banking ATM service levels, and we monitor uptime very
closely. On top of that, McKesson has developed a special solution —
called Down Time — that allows a pharmacy using EnterpriseRx to
continue processing scripts if, for some reason, the store loses
connectivity or the system does go down. Add to that solution
McKesson’s extensive, world-class, and fully redundant IT
infrastructure, and you have a very trustworthy solution. So, in truth,
we do not see reliability being an issue for our customers.
CT: You mentioned workload balancing and centralized reporting a moment ago. Tell us more about what’s new here.
McComb: Sure. When we think about pharmacy operations today, there’s no
question that workloads, for most, are increasing exponentially and
reimbursement for everyone is steadily decreasing. Quite simply, this
means that pharmacists and their staffs have to do more with fewer
resources. Then you have to layer on top of this dynamic the fact that
most store managers and owners struggle to find the time to run
reports, review pricing, conduct special patient and prescriber
marketing programs, and train staff. It makes life pretty tough, and
makes for very long days.
Technology can make a significant difference in this area. First of
all, the technology must be reliable, yet easy and efficient to use. At
MPS, we think our newest pharmacy system, EnterpriseRx, can even be
“fun” to use. Beyond that, we believe technology can empower and
position our customers to optimize their business by automating more
tasks that are either left undone today or that get done in a variable
fashion. We also see next-generation pharmacy systems allowing staff to
find time to do the things they want and need to do, such as spending
time with customers and balancing work across stores and resources.
A centralized system can also enable independents and groups of
independents to come together, cooperate, and potentially operate more
like chains. In the future, we envision a program whereby we can create
options for owners who say, “I want to share this data” but, “I don’t
want to share that data” with other stores in my group or area. For
example, I was just talking with somebody about pseudoephedrine who
said, “We should be able to track psuedoephedrine dispensing and
purchases across our local community and region.” This makes good
sense, and we are launching just such a service this month. But it can
be hard to do things like this when all your data is squirreled away in
a store account on a store server. There are a lot of things like this
that I think the ASP is a good solution for.
CT: Let’s talk about the new Pharmacy Navigator workflow system. What’s the history?
McComb: Eighteen months ago we sat down for an intense week-long
brainstorming session with some customers and talked about all the
things that drive them crazy and needlessly chew up their time. We
talked about all the tasks that are tedious and don’t make good
business sense. We talked about rework, the store dynamics around prior
auth, partial fills, post-it notes, ever-changing staff schedules, and
matching up different resources against variable levels of demand. We
mapped it all out and started dreaming up solutions. It was really a
great experience to think about how we wanted to solve the issues that
were causing our customers the most pain and that were affecting their
customer service and their employee satisfaction. We came up with 500
ideas and narrowed these down to 200. Then we said, “Let’s take these
new ideas and enhance and rewrite workflow.” Pharmacy Navigator came
out of that work.
CT: What can pharmacists expect from all the work that MPS did?
McComb: I’m really proud of what we have in Pharmacy Navigator. I
believe it will help pharmacies smoothly match supply and demand. What
I mean by that is this: Work comes in to the pharmacy on a variable
basis and varies by day. However, at the end of every day, you need to
deliver on the script when the patient demands it, and it’s going to be
different from one patient to another, and one script to another,
regardless of the ebb and flow of work in the pharmacy. Basic
“Operations 101” is matching your resources with your demand to make
sure that you hit particular service levels and that you are measuring
your activities, which is exactly where Pharmacy Navigator fits in. We
accentuated delivery-time-driven queues, which is not a new idea but
does allow you to have the right information at the right time. We also
added a dashboard that gives owners and managers a fresh look at what’s
going on in the store. With the dashboard, you can see how productive
individual staff members are and how profitable their work is. Today
most pharmacies have no real idea what productivity levels are and what
service levels are. Most people will claim that they fill scripts
within 12 or 15 minutes, but, in reality, they do not measure that
24/7. If they want to improve service to their customers and find more
time to offer new services, they need to truly understand their real
CT: This sounds as if you are moving workflow beyond the basic concept
of dividing tasks in the filling process along a production line, and
heading toward using it as a source for collecting and analyzing data
as well. Is this right?
McComb: Exactly. Pharmacy Navigator is first and foremost about
establishing organized operations, but it’s also now about optimization
and continuously improving that workflow. For example, if you are
monitoring your workflow you might find out that you have a bottleneck
at your verification stage. Why is that? Maybe it’s because your
pharmacist is spending too much time filling versus verifying. Or maybe
you’ll find that you have a ton of inventory at will-call that’s not
getting picked up. So perhaps to alleviate this, you could do more
customer notifications. The next generation of workflow gives you this
kind of detail. It’s more than just an image of a script and a pill on
the same screen. It’s about optimization for all your processes. I’m
genuinely excited about that, but what I’m most proud of is the major
role our customers played in designing this functionality. This is the
first time McKesson used our new staged commercialization process.
Customers had to sign off on each stage, saying, “Yes, that’s the right
set of priorities,” “Those prototypes look good,” “Those are good
quality assurance tests,” or “I liked the alpha version.” We’ve had
customer support and involvement all along the way. It’s an exciting
launch for us.
CT: What are some of the highlight features in the new workflow product?
McComb: It has biometrics and single-user sign-on, which eliminates the
need to reauthenticate users as they move from one application to
another. From a technical standpoint it uses the latest Dell server
that has a tremendous amount of memory for pill and script images. When
integrated with Pharmaserv, it has centralized reporting, so you can
now mix and match all the reporting that you get in your pharmacy
management system with what you get from workflow. In the past,
Pharmaserv and P2000 were like distant cousins who spoke to each other
by mail once in a while. Now they are two brothers living under the
same roof. It’s a much better suite. It’s worth noting that Pharmacy
Navigator can also interface with pharmacy management systems other
We also included two other exciting features that came out of our
customer brainstorming session — first, pharmacists told us that
they spend a lot of time looking for, say, one of five prescriptions
for a customer. And it’s always one little odd thing that keeps it
hidden; maybe it’s hung up in IVR or in adjudication, or maybe it’s
done, but in the refrigerator. So we created a new module called
virtual will-call that allows each store to define its own storage
locations. Call them bagged, cabinet, refrigerator, delivery — call
them whatever you want. You scan a finished prescription and associate
it with one of these predefined virtual will-call locations. When Mr.
Smith comes to the front counter, you pull up the information in the Rx
Tracker module and say, “I see three prescriptions for you in
will-call, one in the fridge, and one that’s still waiting for
authorization from your physician.” That’s a much more intelligent and
efficient conversation than giving him three scripts and then having
him go home and call you asking where the fourth and fifth are. In that
case, maybe you find the one in the fridge quickly, but then have to
call him back after tracking down the fifth, which was waiting for
authorization. You add the time that it takes to play detective and
multiply that by maybe 20 times a day, and that’s a significant drain
CT: There’s been a strong emphasis at this conference on McKesson’s
efforts to support medication therapy management [MTM] and adherence.
What are your thoughts?
McComb: We all know that differentiation around clinical care is good.
There seems to be good momentum across the industry toward MTM. It’s a
great opportunity for retail pharmacists because they know their
patients, they understand their needs, they are clinical experts, they
have a good knowledge base, and they are among the most trusted
professionals in the United States. It’s a great opportunity — if they
have the time to do it. But think again about what most pharmacists are
doing on an average day. They’re getting in early and doing the scripts
that came in overnight, or dealing with staffing issues and whatever
else is going on. They’re working hard all day, maybe taking lunch and
maybe not. At the end of the day, are they going to do pricing or any
number of other things? There’s not a whole lot of bandwidth to enable
MTM today from an operations standpoint — never mind marketing the
service to physicians or doing advertising.
CT: So what role do you see MPS playing?
McComb: From a systems standpoint, we have to find our customers the
time and the serenity to do counseling services, be it 5, 20, or 45
minutes. If Mrs. Smith is coming in at 2:30 and she’s a counseling
candidate, your system needs to identify her eligibility and then
adjust your workflow around that possible appointment. Candidates may
come in at various times and, as the pharmacist, you can’t drop
everything else. The workflow impact is going to be significant when
MTM really gets going — which may be two or three years away —
because the time in the day is not there right now. It’s going to be
interesting. You are going to have to be able to fill, say, 25% of your
scripts that come in overnight before your doors open. This bodes well
for pharmacy systems with workflow and workload balancing, and for
technology automation, central fill, and after-hours pickup.
CT: It sounds as if technology is going to continue to have a central
role in the pharmacy. Thanks for taking the time to share your thoughts
with us, Stanton.