| Dispensing Automation Past, Present, and Future: An Interview with Kirby Lester CEO Garry Zage | | Print | |
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As Kirby Lester marks its 40th anniversary in 2011, ComputerTalk senior editor Will Lockwood caught up with CEO Garry Zage to talk about where pharmacy has been, where it's going, and the role he sees automation playing.
CT: First, let me offer my congratulations for Kirby Lester's 40 years of serving pharmacy. You are also marking six years as CEO and owner, and there've been a number of changes in the past few years. Tell me about where the company was when you took over and how you are executing your vision for it.
Zage: We're very proud of carrying the Kirby Lester name into its fifth decade. One thing that was clear when we bought the company was that it was one of the best-known and most respected brands in pharmacy technology. We looked at the success the company had with only two products and no outside sales force and saw tremendous opportunity to build the brand and expand the product portfolio. We brought in a team of executives that had experience doing just that. In fact, our team has over 100 year's of combined executive experience with pharmacy automation. Even still, it took time for people to understand that we were bringing out technology aimed at current market requirements under the Kirby Lester name. People didn't immediately understand that it wasn't your grandfather's basic pill counting machine anymore.
At left, a row of Kirby Lester counting devices, which show the development of the company's technology. Zage points out that all still function.
CT: And how do you assess your efforts so far?
Zage: When I travel and see our technology in action in a pharmacy, I feel that we've done well. For instance, I was in a pharmacy in Providence, RI recently. I was behind the counter and I felt a sense of great pride to see our KL60 robot dispensing the pharmacy's top moving medications; right next to it was our table-top counting system taking care of the balance of medications that were not being dispensed by our robot. It was the total solution, all from Kirby Lester. People there were relying on our products, which fit seamlessly into their pharmacy layout and workflow. It gives me particularly great pleasure to see our newest technology, the KL60 robot, as part of their process and to work it like it's been there for years. Everyone already knows us for our table-top counting technology and now it is gratifying to see our products in use at the highest level.
CT: Garry, tell us a little bit about yourself. How did you get to where you are today?
Zage: I'm a graduate of the University of Illinois College of Pharmacy. I have experience in dispensing in the retail and hospital settings. Out of pharmacy school, I spent a couple years at the Loyola University Medical Center in Maywood, Ill., which is a tertiary care center. Then I moved to a pharmacy management role at St. Joseph's Hospital in Chicago. After two years of pharmacy management experience, I was promoted into hospital administration in the professional services division, where I had the opportunity to build ancillary revenue programs, such as a diabetes center, a home care program, and a nutritional support service as well as manage 10 hospital departments, including pharmacy. From there I moved to American Hospital Supply, where I was involved in building a homecare company. AHS was purchased by Baxter, where I then spent 10 years in business development, corporate sales and marketing strategy, and finally assisting in the launch of a clinical nutrition company as a joint venture. I resigned from my corporate position and went out on my own with a boutique development firm that helped companies and people with products who needed help understanding how to approach the healthcare market, compete with the existing products, develop strategic plans, and secure funding.
CT: That's quite a range of experience. And was acquiring Kirby Lester the next move then?
Zage: I became aware of Kirby Lester while running my development firm. A few wholesalers were calling on the company's founder, Rod Lester at the time and asking him what his plans were for the company. I knew the company's products from my time in school and in pharmacy practice. As I mentioned earlier, it was a name everyone knew and trusted, but I could also see that they weren't developing any new products. I was eventually able to buy the company in September 2005. It was a great opportunity as I felt that I really understood the trends in automation, but I also had the experience base of developing and financing new products.
CT: And so your strategy was to build on the brand by developing new products based on the trends you were seeing?
Zage: Yes, that is correct. I wanted to take this to the next level, to the point where we can provide the most technologically advanced product, coupled with the gold standard Kirby Lester counting technology inside. We knew we wanted to stay with the tradition of offering products with a small footprint and low price point. Then we looked at what else we could do, and we realized our products needed to interface with the PMS [pharmacy management system]. When we bought the company in 2005 all of the products were standalone. So, we then integrated with each of the PMS vendors and then added inventory control, and provided tools that allowed for total quality assurance during dispensing. For example, we introduced biometrics for logging activity, advanced inventory tools, and a verification system with drug imaging. We took all this technology and built it on top of the core counting technology. Ultimately we were looking to increase efficiency, and control errors and miscounts in a way that is very cost effective.
CT: How did you decide which features, such as the PMS interface, to focus on?
Zage: One of the first things we did was develop a national advisory panel with a national chain executive, a national supermarket pharmacy executive, a representative from an innovative regional chain, and a regional grocery store pharmacy. This panel is our sounding board. Our philosophy is that we should never think that we know the pharmacy market better than the folks behind the counter. The last thing want to do is have our engineering staff develop a product that has no applicability to the market. Our advisory panel helps us understand what the needs are, where the market is going, and how we as a company can work with these trends in our development efforts without developing a "me-too" product. We look at product development as finding out what we can offer that's different, unique, and that answers many of the questions and concerns that exist in the pharmacy marketplace.
Kirby Lester's Sarah Schwoerer and Nick Tinsley with a pair of KL60s in the training and delivery prep area.
CT: So, combining your experience, the input you receive from the market itself, and the perspective afforded by your advisory panel, what are the trends and issues that pharmacies are looking to dispensing automation for now?
Zage: There's still a lot of variation in the technology that pharmacies have deployed. Some have little to no technology, no workflow software, no automation. Then there are pharmacies that have made these investments and are looking at building their future business around patient consultative services. And there's a whole continuum between these two extremes. I believe the trend that's going to become the standard of care is MTM. The opportunity to see real savings in healthcare costs from MTM, coupled with a decrease in the number of primary care physicians, means there's a real opportunity for pharmacies that can figure out how to utilize the appropriate level of technology that allows them to provide a higher level of patient care.
CT: This seems like a point where dispensing automation comes into play, right?
Zage: That's right. One reason is that automation can help free up the pharmacist, to give him or her more time. With this in mind, we ask pharmacies evaluating our technology what they are going to do with the time that our technology effectively eliminates from the dispensing process.
CT: And what kind of answers do you get? Zage: Beyond MTM, it's clear that vaccinations and immunizations are big opportunities. Also, many pharmacies look to expand their role in senior health, providing additional drug information and education sessions, or venturing into skilled nursing and assisted living pharmacy services.
Getting back to the role of automation, one approach might tell you that you need more pharmacists to provide these services. Another approach might look to central fill and remote verification: you may be able to reduce your labor needs or simply reallocate existing labor. So there are interesting dynamics right now in the profession. You have people still fulfilling the basics requirements manually and then you have people expanding the services a pharmacist can offer. We see this second group relying more and more on technology to achieve their goals.
CT: What do you see as the near-term future of clinical and patient services?
Zage: Part of my involvement with the University of Illinois National Advisory Board is curriculum development. We have been developing a set of classes that we call R-Pharm, or rural pharmacy. This is an area where there are tremendous challenges associated with access to care. In rural areas, the closest pharmacy might be 50 miles away. Your primary care resource might be one doctor. So we are developing a curriculum to prepare pharmacists to be involved as a part of the care process in rural areas.
I also am interested to see the development of practices that, for example, tie in the services a nurse practitioner with the expertise of the pharmacist at an easily accessible retail site. I believe the level of care you will receive in this setting - as well as the accessibility of this care - is very valuable for a patient.
In all these cases, the question then is, how does the pharmacist take care of the basics, like filling and verifying/checking prescriptions, and also have time to participate in a personal care offering like I just described?
CT: What's your vision for Kirby Lester's role in supporting pharmacists looking to develop innovative service models?
Zage: We will continue our efforts in developing lower-end technology requirements that support the basics of pharmacy: get the right drug to the right patient 100% of the time. Our goal at Kirby Lester is to be part of automating all aspects of dispensing, while accounting for both accuracy of drug selected and count. And we want to do this in such a way that it's affordable. We recognize that it's not a one-size-fits-all world. It's important for pharmacists to have the right piece of technology. Since late 2005, we have worked hard to develop four brand-new products that can support the pharmacy doing 75 prescriptions a day all the way up to 1,000 a day, with the national average around 225 a day. We want to keep it simple and affordable with robust functionality available for those who want it.
CT: Garry, thanks for taking time to share your thoughts. Any final comments?
Zage: My pleasure. I think when you look at the trends, they are all leading toward more involvement in healthcare by the pharmacist. I'm talking about trends toward addressing healthcare costs, the costs of non-compliance, and the current thinking about how we can better utilize the pharmacist as truly part of the healthcare team. The question is then, how do you bring pharmacists in as a provider of care that makes sense for the healthcare issues we see in the United States? How do we address non-compliance? How do we look at medication therapy management programs so that they make sense for the patient and for pharmacy as a profession? How do you factor all this in? Overall, I think pharmacy has reached a major transitional point where there are great, great opportunities. We are here to listen and continue to develop technologies that fit and support the profession and practice of pharmacy. |
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of pharmacy clinical systems for Winston Salem Healthcare Pharmacy,
brought up the topic of checklists and their potential to improve
pharmacy operations. The topic came to Moser's attention from several
sources, including reading airline captain Chesley Sullenberger's book
"Highest Duty: My Search for What Really Matters." In this interview, ComputerTalk
senior editor Will Lockwood talks with Moser to find out more about ...| Getting Out to See Technology: An Audio Slide Show |
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Pharmacist and owner Jimmy Yuen recently installed dispensing automation at his Advance Medical Pharmacy in Walnut Creek, Calif. In this audio slide show, he talks about the decision process that led him to select Kirby Lester’s new KL60 and his decision to to invite his independent colleagues for a first-hand look at this technology.| Pharmacy System Data Storage: The Case for a Standard |
by Brad Ordener With each passing year healthcare and other industries are becoming more and more reliant on technology. Pharmacy is one industry that is particularly dependent on new innovations to keep up with increasing demand. As this reliance on technology increases some unique problems are emerging that are slowing progress and making it difficult for pharmacy owners to change pharmacy systems. The technological landscape in pharmacy could be improved significantly with ... | |
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| Pharmacy Training On Demand |
 In this interview, pharmacist Jay Lalkiya talks about how he's using
a tool called myPharmacyTrainer to educate his staff at Apalachin
Pharmacy about how to improve store operations and how best to interact
with customers. This tool offers 22 modules that recreate scenarios
commonly encountered by pharmacy staff and employs an interactive,
audio/visual educational approach.
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| Technology Perspectives: Pharmacy and Healthcare Reform |
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In this podcast, McKesson Pharmacy Systems President Stanton McComb
covers a range of topics surrounding pharmacy, technology, and the
current drive for healthcare reform. He offers his take on what new
roles pharmacy may play as a result, the growing role of clinical care
in pharmacy, and what’s on the horizon for technology for the pharmacy
and for the patient. Also part of the discussion: What MTM means for
retail pharmacy right now and what it ...| The 90% Nightmare |
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For the last twelve months, many independent pharmacies have
struggled over the decision of whether to register their pharmacy under the 90% Rule, or invest in an IIAS certified point-of-sale. For one reason or another, many pharmacies opted for the 90%
Rule. It seemed like a logical
choice. No expensive
point-of-sale, no major changes, just a little complicated paperwork and it is
back to business as usual. For some,
this has worked out. For others,
FSA card declines have ...| Boost Front-End Sales with Proper Merchandise Placement |
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Pharmacies already have OTC items in their stores, and with a little
planning and proper placement, those standard items can turn into added sales
at the POS.
| Some More Thoughts on Paperless Pharmacy |
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This letter from Integra CEO Kevin Welch is in response
to the article written by Kapali Eswaran in the September/October 2009 issue of ComputerTalk
regarding "What to Look for in a Paperless System."
| Perspectives on E-Prescribing: Pharmacist and Physician |
Sponsored by Emdeon
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| E-Prescribing: An Update |
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In this interview, eRx Network's VP of Clinical Services, Rick Sage, talks to ComputerTalk senior editor Will Lockwood about where he sees ePrescribing right now and the role companies like eRx play as adoption increases. &... | |
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| Strategies for Managing Prescription Pricing and Patients’ Prescription Costs |
Sponsored by Emdeon
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| Technology and the Pharmacy School Curriculum |
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The mobile technology initiative in | A New Online Resource for Ownership Transition |
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Long-time independent pharmacist Bob Graul has made some big changes and taken a new direction recently. In this interview with ComputerTalk senior editor Will Lockwood, Graul talks about the process of selling his pharmacies and how this motivated him to get involved in his current project: | Reorganizing the Pharmacy: Learning from a Distribution Model |
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| Operating Systems: The Developer’s Perspective |
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| A Nice Side Benefit of IIAS: Easier Giving |
QS/1 user Richard Stryker, of Bayshore Pharmacy in Atlantic Highlands, N.J., anticipates that his IIAS-compliant POS system is going to help his customers help others. Here's how he tells this story.
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| Meeting the FSA Challenge with flexTRAX |
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You're probably aware that as of January 1, 2009 there will be new rules for pharmacies processing payments for items eligible for FSA/HRA spending. If you have a point-of-sale (POS) system, you'll need to make sure it is IIAS compliant and that your system has been certified. If you don't have POS, then you may be looking for another solution. In this interview, Retail Management Solutions President Brad Jones and KeyCentrix ...| Automating Front-End Tasks with POS |
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Managing a pharmacy's front-end can be a time-consuming and complex task. But there are ways to make life easier. In this interview with ComputerTalk's Maggie Lockwood, ECRS President Peter Catoe talks about how the company's Supplier Gateway can connect its Catapult point-of-sale (POS) system with supplier ordering systems to reduce the time spent on ordering, pricing, and other activities.
| Better Marketing: You Can Start Now |
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| Summer Roundup: Technology Support Services on Call |
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In this interview with ComputerTalk's Will Lockwood, DAA VP for business development Abrar Kazmi talks about the company's new OnClickTech Support offering, which offers remote PC support. This is a joint venture with Team 9 Global Serivces, and is something a little different for ...| Summer Roundup: Introducing McKesson EnterpriseRx |
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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.
| Summer Roundup: Automation and the Successful Pharmacy |
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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.
| Summer Roundup: Investing Wisely in Workflow |
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Dave Burke R.Ph, M.B.A., pictured at left in blue, owner of Dave’s Pharmacy in Marysville, Ohio, took some time out at the recent Cardinal RBC to talk with ComputerTalk's Will Lockwood about his decision to a install a workflow management system and the benefits he has seen. Dave’s Pharmacy fills an average of 400 prescriptions per day, with peaks on some ...| Summer Roundup: How to Tighten Up Your Inventory |
 Jonathan Rider, owner of Rider Pharmacy in Fairmont, W.Va., is a firm believer in perpetual inventory. He took a few minutes at the Cardinal RBC in Orlando, Fla., to talk to ComputerTalk’s Will Lockwood about Cardinal Inventory Management (CIM), how he uses Kirby Lester counting technology to speed through the daily counts that are the basis for this inventory tracking method, and the financial and operational improvements he’s seen.
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| Pharmacy Facing New Compliance Challenges |
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Joe Ross, director of business services at McKesson Pharmacy Systems, talks in this interview with ComputerTalk senior editor Will Lockwood about existing and anticipated regulations that are changing what drug sales pharmacists are required to log. State and Federal regulations that require tracking the sale of non-prescription methamphetamine precursors have contributed to a demonstrable reduction in the illegal use of these drugs. More regulation may be in store, since the FDA is currently considering a behind-the-counter class of ...| Five Questions: The Buzz Around E-Prescribing |
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Here is an overview of the big questions about e-prescribing that
pharmacists were asking Speed Script’s Heath Reynolds during the 109th
NCPA meeting in October. Reynolds, director of business development,
talks here of the nuts and bolts of taking e-prescribing from theory to
practice.
| Outbound Messaging: Expanding Your Phone’s Potential Workflow Role |
| The benefits of automating phone communications are no longer just at the front end of the prescription-filling proces. Pharmacists are now putting their phones to work managing outbound calls that help with such tasks as will-call management and opt-in automatic refill programs. | |
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| Workflow and the LTC Pharmacy |
Pharmacies serving the long-term care market are likely to have special workflow requirements. Read on for vendors' views on the key elements to maximize LTC safety and efficiency. | |
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| What's New: The Latest Workflow Features |
Workflow technology is constantly evolving. Here are some details on the latest enhancements that vendors have added to their offerings. | |
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| Beyond Claims Adjudication: Why to Expect More from Your Switching Service |
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ComputerTalk senior editor Will Lockwood caught up recently with Marc Cohen, senior director of marketing for RelayHealth, to talk about what's happening in the world of claims processing and switching services.
It turns out that there are some interesting new additions being made that build on the transactional expertise and connectivity that are the core elements of these services.
| Differentiating Independent Pharmacy: Natural Health, Loyalty Programs, and a Real Web Presence |
In this interview with ComputerTalk senior editor Will Lockwood, PharmacistsOnLine CEO David Knaggs offers his views on how independent pharmacists can improve their competitiveness by turning their attention to tested marketing tools and to product lines that have not traditionally been a big part their business. | |
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| Pharmacy Viewpoint: McKessons Stanton McComb |
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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.
| Five Questions On: Trends in Technology for the Consultant Pharmacist |
In this interview with ComputerTalk's Maggie Lockwood, the American Society of Consultant Pharmacist’s Carla Sexton, R.Ph., CGP, assistant director, policy and advocacy, along with consultant and ASCP board member Shelly Spiro, R.Ph., FASCP, talk about the ways evolving technologies, from web-based interfaces to the LTC e-prescribing pilot, are impacting the consultant pharmacist. | |
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| Parata RDS On Tour |
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Parata brought its RDS robotics directly to ComputerTalk recently, courtesy of its new mobile unit. The concept was developed over the past year as a way to reach out to busy community pharmacists.
| Trends in Dispensing Automation |
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