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 Pharmacist Doug Kaleugher opened Med-Fast Pharmacy 1990. Since then the business has expanded to 22 pharmacies in western Pennsylvania, with a mix of standard prescription services, retail, long-term care, and compounding. In this interview with ComputerTalk's Will Lockwood, Kaleugher talks about the big role dispensing automation has played Med-Fast's growth. He also offers strategies for introducing automation into your pharmacy and his take on the benefits of some of the newest dispensing technology out there.
CT: Give us a quick history of dispensing automation at Med-Fast Pharmacy.
Kaleugher: Our first automation was a countertop counting machine. From there we actually got into robotics, which was the first real heavy investment in automation. Then we went with what at that time was McKesson's AccuMed counting cabinet and productivity station, because they were scalable. Eventually we got our first Parata RDS. We've also used automated compliance packaging machines for our LTC business. We started with a product from one company, but have since switched to Parata PacMed because I prefer the software.
CT: That's quite a range of different automation solutions. What explains the variety?
Kaleugher: Different stores were at different growth stages. So not only were we looking for the right level of automation for each store, but we could move machines as necessary from stores where they volume had outgrown them to new stores where they would be better suited. Location is important in choosing the automation that goes in as well. Will it fit? Many of our pharmacies are in grocery stores where there isn't a lot of space. Scalability is great now. You can pick a product that will fit a location, really any location. Square footage is costly and you have to take full advantage of it.
CT: That sounds like a smart strategy. Tell us more about what scalability means to you.
Kaleugher: Scalability means that there's no reason that we can't have automation in every store. We don't have to wait until we can afford robotics. While each store has its own individual growth curve, when you get to the one-and-a-half pharmacist point you can get the automation and scale up from there. Pharmacist salaries are your biggest expense. Buy counting cabinets, for instance, and then move them down into lower volume, newer stores when you outgrow them. This is a strategy to take advantage of automation as stores evolve. Each pharmacist you hire is a big investment, so if you can make sure that they are relaxed and able to interact with customers, then that's what you want.
CT: I understand you are now installing Parata's second-generation technology. What's new?
Kaleugher: The big key is that they've spent the time proving the technology before they rolled it out. They've done a lot of testing to make sure their new products work.
It sounds obvious, but it is really important to have technology that isn't going to break. They also took a lot of time to listen to pharmacists to make sure they have a product that actually helps us. For example, one of the best things is that you don't have to shut the machine down to reload or if there's a problem. Before, when you went to reload the machine you were down for an hour plus refilling. This new generation of automation is designed to minimize downtime as well as the daily maintenance required. I think Parata has learned from their first generation.
CT: So tell us what from this second generation you're putting into your stores and why.
Kaleugher: We have both Parata Mini and Max. As I mentioned earlier we have their PacMed already, but we've also ordered a PacMed C30, which is a smaller version. This is for our pharmacies that are associated with clinics, so that they can dispense. I think this is another great niche we can serve with help from automation. We also have the APM, which is totally slick. In fact, we've wrapped it with decals that promote our pharmacy brand. It draws a lot of attention from consumers. Overall, I see some big differences from first-generation robotics, which required our staff to interact with it a lot. This second generation needed to lower touch. Our goal was to deal with these machines only once a day, in the morning, to do our maintenance routine, load it up, and go. The interfaces have also improved. With technology, you can have a great machine, but you also have to have a great interface.
It is a training issue. The machines have to be staff friendly. It is also a nice feature that the touch-screen interfaces on the Mini and Max are the same. So there's minimal retraining when we move a store from counting to robotics
CT: The APM you mentioned is a kiosk accessible to your customers that automates will call, right?
What are the advantages you've found here?
Kaleugher: It saves us staff time and offers incredible convenience to our customers. Most of our pharmacy locations are open until 7 pm, but will-call is now available 24 hours a day. Our customers are able to call in  the refills whenever they want and the APM gives them the flexibility to pick up whenever they want. The next step in this process is to have customers opt in to auto refill. Then they don't even have to call in the refill. People want things right now. They want convenience and this is perfect.
CT: How does dispensing automation help define your pharmacies in the minds of the other healthcare professionals they work with?
Kaleugher: If you can show physicians the different things that you have that other places don't, then they are going to realize, for the same copay, their patients are going to get better value from our pharmacy. For example, we've sent out tons of samples to physicians of the compliance packaging we can produce using PacMed so that they are aware of the ways we can serve their patients with multiple prescriptions who might have compliance issues. It is all about building niches and then making sure that people know you are there. You set yourself apart with the service you offer.
CT: How about in the minds of your customers? And finally, how about current and potential employees?
Kaleugher: Choosing a pharmacy isn't about the cost of the drugs from the consumer's perspective. It's about convenience. If they come into the pharmacy and there's a line three deep at the register, then it's very convenient for them to use the APM to pick up their prescriptions. Of course, it is still critical to offer the opportunity for face-to-face interactions, but for many people there's no need for this with long-term maintenance meds. They want to get in and get out.
But I think the biggest advantage is in recruiting pharmacists. This is one of the hardest things to do. Outside recruiters can charge $15,000 per pharmacist. But if I can get a few pharmacists without this cost because I impress them with the tools they'll have to work with, then the technology is paying for it self. You have to pay staff well of course, but they are going to choose the work environment that makes life easiest for them. If you give your people the best tools, like IVR and automation, where are they going to want to work? Where they have to lick, stick, and pour or where they're going to have time be pharmacists? I don't want any employee turnover either. That costs money too. Automation is one great way to keep people happy and on the job.
CT: Doug, you demonstrate a real commitment to technology, and automation in particular. What are you seeing that other community pharmacies might be missing?
Kaleugher: We are definitely committed to automation.
We had the first APM in community pharmacy and now we're the first to install these next-generation offerings, Parata Mini and Max. As far as technology goes, I'm glad it came to pharmacy and it is here to stay. People need to embrace it and know where it is going. You have to pay as much attention to that as you do to continuing pharmacy education. It is such an integral part of your success and it can make your job so much easier. Stay ahead of the curve. Don't wait until you are getting crushed. If you are maxed out right now and a new customer walks in, what kind of service are you going to give? You have to build a platform to grow and you do that with technology.
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