McKesson Pharmacy Systems' (MPS) president Stanton McComb took time during the most recent McKesson Trade Show in Las Vegas to answer a series of questions from ComputerTalk's Will Lockwood about what the centrally-hosted EnterpriseRx pharmacy management product, already deployed in the chain setting, offers for independent pharmacy.

CT: Let's start out by defining what you mean when you say "independent pharmacy."

McComb: We've defined this in different ways over the years, but we've typically said an independent or community pharmacy is an organization with 25 stores or less that serves a local or regional population. Alternately, once an organization is large enough to maintain an established, IT department you start to move out of the realm of small community pharmacy. We currently have thousands of installed customers who fit the independent or community pharmacy characteristics.

CT: So what are McKesson's plans for introducing EnterpriseRx to this market?

McComb: We unveiled the very latest in pharmacy systems technology to the independent pharmacy world here at our McKesson Trade Show. Before I say more about this exciting launch, let me be very clear about something right up front: it is not our intention to sunset any of our other pharmacy systems. We're not going to push any of our independent and small chain customers off what they are using today. We know they are quite satisfied on those platforms and we recognize that a change in systems is an important event. Our goal is to attract our current customers over to EnterpriseRx when they are ready. So that's one thing, and then obviously we are interested in winning new market share. We are going to do that with two real advantages. One, by offering the very best product out there and, two, by wrapping unparalleled service around that best product. And we are very proud of the service that we have and offer to our independent customers today.

CT: Independent pharmacies come in a variety of forms, from single stores to multiple location groups. They also offer all kinds of specialties, such as long-term care, DME, and compounding. What are you doing to account for this variety?

McComb: This is an excellent question. This is one of the major challenges we've had to face with some of the other platforms. Community pharmacies often thrive and differentiate themselves when they offer specialized or higher service levels and/or when they develop niche services for their particular communities. These communities, in turn, are made up of different people - of different age groups, demographics, ethnicities, etc. - so successful pharmacies tailor their services to those niches and demographics. The pharmacy system must facilitate this differentiation and allow for this variability. Frankly, I think we struggled with that a little bit with older technologies. It is hard to try and retrofit older technologies and older architectures. They just are not as malleable as our more modern offerings. One of the things I'm most excited about with EnterpriseRx is that it is a layered technology. It is modular. And it is built entirely from the ground up on the latest programming languages. It isn't a mishmash of older technologies thrust together over 10 years. So, because it is modern and modular, we can modify the software to address this variety in the marketplace and we can make these modifications faster than ever before.

CT: Explain a little more about what you mean by layered?

McComb: Layered means that there's a rules engine, there's a presentation layer, and other layers. We can make changes to any one layer without putting the whole solution into a redesign mode. That's one key element. The second thing is that, because EnterpriseRx is built on modern technology, there are commercialization and productivity gains that we benefit from too. We are able to implement changes faster than we were previously able to. We're also able to leverage larger resource pools, whether that's in Vancouver or India. And that translates into an advantage for our customers too.

These factors allow us to pursue one of our goals, which is to launch EnterpriseRx into multiple segments. We're already in the chain segment. As I mentioned, we're here today to launch into the independent and small chain community pharmacy segment. We are actively pursuing the outpatient segment - we have several large outpatient customers who we are quite proud to have signed recently - and we're are doing a lot with our sister business unit in Atlanta called McKesson Provider Technologies that works with hospitals. One last quick thing I'll mention is that we are also launching our LTC module today. It's not a small task to handle all these requirements, but we feel that EnterpriseRx can because of its structure. And, frankly, because of the scale of McKesson, will be able to do this better than most.

CT: How do you plan to handle the transition and training?

McComb: Our implementation programs are a great example of our world-class service. Unlike other providers that only offer field training as a special program, we provide on-site training and support as standard. We augment that core offering with computer-based training, Webinars, and transition planning services. That's part of our package for independents and small chains. We can tailor it any way you want. One of our goals is to make the transition from any system to EnterpriseRx actually an enjoyable event. You talk to people and they say, "Changing systems is terrible." That's a travesty in our minds. It should be like buying a new car. The process should be something that you get excited about. You are getting this new tool, this new asset and it is going to change the way you do business. You should be excited about that. So our goal is to put together implementation programs that really work for the unique needs of each independent store and staff and make it an easy, happy event for them.

CT: You mentioned something earlier that leads into another question, about IT staff and departments. How is using this centrally-hosted model, whether we call it an ASP [application service provider] or SaaS [software as a service], going to change the IT requirements in independent pharmacy?

McComb: People probably don't fully understand how great using ASP is going to be. We know, because we see it when we map out all the versions our customers are using. Users will get caught up in a lot of different software versions if you're not careful. Suddenly a quarter of your customer base is on one version and a quarter is on another version. This happens primarily because upgrading to the latest version means users have to load a disk, run it at night, and stay late. After a long day at the store, the last thing anyone wants to do is stick around for another hour after the pharmacy closes and run some upgrade. So here's an obvious benefit from ASP. We do all that for users in the background and they are always on the latest stuff. Another is tape backups. We do that for our customers as a standard part of the partnership. Maybe the most exciting thing is data updates. Let's talk about pricing. Let's talk about new generic launches. Let's talk about Medi-Span updates and DUR updates. All that can happen as fast as we get the data. Now here's where McKesson takes it a step further. Our goal is to leverage some of our manufacturing relationships, which are many and deep, to make sure that we are working with these manufacturers so that when they launch a new drug we are prepared, we have the data, and it's loaded. The day the new drug shows up on the shelf is the day pharmacists have the pricing and the DUR information they need.

CT: Walk us through what a pharmacist will experience during a typical ASP upgrade.

McComb: Let's talk about a software upgrade or update. Maybe we have some new feature functionalities or defect fixes. For these we are going to be doing consistent service packs. We talked earlier about flexibility and the ease with which we can improve upon EnterpriseRx, right now we are averaging a service pack every other month and we'll stay on that course. Six a year is substantial. We think we'll be able to do this mostly at night. The user will come in the morning and they'll go to their home page and there, under the partner news, it will say "You received a service pack last night. Click here for the release notes." We'll tell you what changed in layman's terms. If it is a substantial change, you'll be able to click through to a computer-based training module. You won't have to look around for paperwork or worry about training your staff. Everything will be constantly updated right on the system.

CT: Is it these services packs that include pricing and other data updates?

McComb: No. Data updates will happen on a daily basis, if necessary. Updates are made available as soon as we receive them. Some are applied daily, weekly, or monthly, depending on the frequency of the data refresh. McKesson's EnterpriseRx customers can get the data they need to provide great care, without lapses or time delays.

CT: We've been talking mostly about software. But the ASP model will take some significant hardware necessities out of the pharmacy. Is that fair to say?

McComb: Yes, it is accurate to say that. However, another benefit that comes with EnterpriseRx is that it comes with fully integrated workflow package. So you may take a $10,000 server out of the equation but you may also add an $800 scanner for imaging prescriptions. You might also want to take out some old printers and put in new thermal printers. So, net-net, there's going to be to change and we would recommend that most refresh some of the equipment that they are using. But, yes, the expensive server that sits in a big cabinet and generates a lot of heat and requires maintenance is going to go away. That's pretty nice.

CT: So the hardware cycle will be similar, just without servers for the pharmacy management software and data?

McComb: Right. The peripheral recycle rate will be the same, but you won't be recycling servers. That's where the real savings are.

CT: What are we talking about when we say peripherals?

McComb: Bar-code scanners, monitors, thermal label blasters, image scanners. In fact, I think image scanners are going to be the new peripheral of choice. You want an image scanner that is high quality and high speed. That's an area that's going to be very important.

CT: Speaking of scanning, and by extension all the data that goes into a pharmacy management system, how is all this handled? It is all stored on and backed up from the outside servers?

McComb: Yes. And one of the things that we are talking a lot about is data ownership - whether it is the prescription image, the patient data, the prescriber data, or whatever a pharmacy converts into or inputs into the EnterpriseRx system. All of that data is the pharmacy's data. Our contract clearly states that this is their data. Now we'd like to have reseller rights on that data and pharmacies can participate in those value streams. But it has been an area of concern for the independents and small chains: In a centrally-hosted model, who owns the data? We make no bones about it: The pharmacy owns the data. And should they ever decide to leave MPS or if the pharmacy merges with another entity or whatever happens - it's their data and we're going to make it available to them. I also want to say that their data is going to be carefully protected and fully compliant with all the HIPAA laws when it's on our servers.

CT: What are some of the other key advantages for independents?

McComb: Well, for one thing, there's the ability to work with other Web services. A great example of this is the strategic partnership we've struck with Wolters Kluwer Health. We're very excited about this. Medi-Span is a central part of EnterpriseRx today and when you log on, there's a link on the home page that takes you right to the Medi-Span Web site. That's nice, right? But when you, the pharmacist, are actually on the verification page and you are working on a particular prescription, up in the corner there's a little button for Integrated Facts & Comparisons. If you have a clinical question and you need more information about that particular drug, you click and it takes you not only to the Medi-Span site, but it takes you to the Facts & Comparisons page for that item - right to it. So you're not leafing through a book; you're not clicking on drop down menus; you're not spending minutes trying to figure out where this information is. It's right at your fingertips, right when you need it. This is an example of providing and empowering our pharmacists with the tools they need to provide clinical services and get better outcomes. This is just one example of a benefit of Web-enabled services like EnterpriseRx.

CT: Thanks for taking time out for this, Stanton. Any final thoughts?

McComb: Thank you, Will. I would like to add that we think ComputerTalk is a great vehicle for sharing information within the pharmacy community. We learn a lot from your magazine and we appreciate your leadership on important matters. I want to thank you for everything that you and the ComputerTalk team do. It is quite impressive.