Cover Story: Trends in 2018

The Pharmacy Technology Forecast 

The outlook for 2018 in the clinical, operational, marketing, and financial areas of pharmacy.

2018 is just about here, and most pharmacies will have already been thinking about strategy for the coming year. What will the key trends be? Where are the best places to put investment? How can you get more out of technology investments you’ve already made? And what markets will be growing and offering new revenue opportunities? Here we take a look at what a number of pharmacy technology vendors see as the priorities for 2018.

Trends for 2018

Pressures on the traditional prescription-dispensing business will continue unabated, and pharmacies will face further constraints from restricted networks. In this setting, Tim Tannert, SoftWriters VP and COO, notes that pay for performance is a trend to keep on the radar. He points out that, while it may not be the norm in the industry right now, it’s definitely the direction healthcare as a whole seems to be headed, and pharmacies should be actively preparing by making the tools needed for a value-based provision of care a top priority. Tabula Rasa Healthcare President Orsula Knowlton also sees a need to be forward-thinking here. In Knowlton‘s view, value-based care will provide many opportunities for pharmacists that will enable them to focus on outcomes in addition to the process of pharmacy services.

Tim Tannert
SoftWriters, VP and COO

Hemal Desai
BestRx Pharmacy Software, President


Orsula Knowlton
Tabula Rasa Healthcare, President

Marty Spellman
Health Business Systems, Director of Sales
   

BestRx Pharmacy Software President Hemal Desai suggests that pharmacists will also want to make sure they are focusing on the need for a broad portfolio of enhanced services to offer their patients, ranging from immunizations to medication therapy management (MTM) consultations, to med sync, and more. And, notes Tabula Rasa Healthcare‘s Knowlton, there will be a need for pharmacies to proceed with a view toward collaborating with health plans to manage medication safety and overall medication-related outcomes.

Brian Glaves, director of sales at ScriptPro, sees a pressing need to address the continuing impact of DIR (direct and indirect remuneration) fees with tools that can identify and predict these clawbacks and empower pharmacies to address them at the point of adjudication on specific scripts rather than after the fact. It comes down to having a fine-grained understanding of where your prescription revenues and margins are, with a great deal of value to be gained from having a good grasp of which payers and customers are most valuable. This knowledge can lead pharmacies to implement patient engagement strategies that strengthen those relationships and make better-informed decisions. Pharmacies need to make every effort, notes RxMedic Marketing Coordinator William Humphries, to look for ways to generate more revenue by serving these patients better.

As an example, Mike Gross, VP of sales and marketing for Retail Management Solutions, says pharmacies can build their front-end revenues by focusing on complementary items that address areas such as nutrient depletion and that can be a way to both provide better care and increase the spend within a pharmacy. It’s even possible that pharmacies might offer further convenience by including these OTCs in the adherence packs provided to patients.

Another trend identified by Dave Bartel, senior vice president at TCGRx, and Vic Vercammen, vice president of strategy and industry relations at Supplylogix, is the rise of tools traditionally used by consumers in other retail settings to assess the value of a pharmacy. For example, patients are increasingly looking to social media for information about pharmacies and for their friends’ ratings of their experience with a business. Pharmacies should be sure to understand this dynamic so that they are seen as a recommended provider and, according to Bartel, take active steps to lead the discussion and highlight the support they are providing patients and caregivers. For example, a pharmacy may want to educate online visitors about how it supports care for aging parents through services such as med sync or adherence packaging. 

   


William Humphries
RxMedic, Marketing Coordinator
Jeremy Manchester
Liberty Software, EVP 


Brian Glaves
ScriptPro, Director of Sales
James Notaro
CSS, a Medicine-On-Time Subsidiary
President
   

Overall, don’t underestimate the significance of consumer reviews on social media and other online arenas such as Google and Yelp. There’s a real desire out there among consumers for convenience in both purchasing and interacting with the pharmacy, driven in large part by habits developed by retailers such as Amazon.

Speaking of Amazon, one vendor pointed out that, while that 800-pound gorilla has yet to enter the pharmacy space, there’s continued speculation about that, and the current big players such as CVS and Walgreens have the ability to battle it out on price and convenience. The trend at smaller pharmacies should instead be a focus on patient service and unique offerings.

An excellent example of a strategic differentiator, notes BestRx’s Hemal Desai, is participation in a performance network such as the Community Pharmacy Enhanced Services Network (CPESN), which is rolling out a model driven by the standards-based eCare plan designed to connect pharmacies with other providers in a way that we’ve talked about a lot but have yet to see come to fruition. It’s all a matter of getting connected with other providers and becoming a central part of the overall care of patients, in addition to being their choice for filling prescriptions. Micro Merchant Systems CEO Ketan Mehta also made a continuing need for data sharing his choice for a trend of primary importance in 2018, noting that a number of health information exchanges (HIEs) and regional health information organizations (RHIOs) are working actively to centralize data for access by multiple healthcare providers. Mehta points out that pharmacies will need intelligent ways to both access and contribute to this data, and that pharmacies putting their focus on overall patient care should be able to maintain their positions in networks and create opportunities to grow their practice in 2018.

At a day-to-day level, Jessica Haider, Epicor Software senior pharmacy business development representative, mentioned improved customer service as a trend to engage for 2018. Haider suggests mobile point-of-sale (POS) as service-boosting technology that should be on pharmacists’ radar, with an impact on efficiencies in signature capture and documentation of compliance for HIPAA and PSE (pseudoephedrine) sales tracking, for example. Another area of POS to monitor is strengthening payment-card security by using point-to-point encryption and ensuring card readers are using EMV (Europay, MasterCard, and Visa) chip technology.

And finally, with so many systems and vendors potentially coming into play at any given pharmacy, Kevin Welch, president of Integra LTC Solutions and CTO of J M Smith, sees the multiyear trend around systems integration fast becoming a business imperative. This is in part because it’s now reaching beyond the walls of the pharmacy, notes Welch, to include EHR vendors, HIEs, and state regulatory agencies. He suggests that pharmacists ask themselves a critical question: Are they building their future on an open systems architecture?

With these trends in mind, where do the technology vendors see a need for pharmacies to invest dollars in 2018, and where do they see opportunity for getting more out of the current systems by implementing little-used technology that’s already there?

Making the Right Investments

When it comes to making new investments in technology, Marty Spellman, Health Business Systems director of sales, sees pharmacies looking for ways to create further efficiencies in their workflow process in order to maintain prescription volumes, while also creating the time to focus on being part of a connected healthcare community, and creating strategic opportunities with inpatient care.

James Notaro, president of Medicine-on-Time subsidiary CSS, sees a similar need to focus on workflow efficiency in order to move the needle on revenue-generating opportunities. In Notaro’s view, those new opportunities will continue to have to fit around the prescription-dispensing process at most pharmacies as they gradually build in clinical work. Notaro’s advice is to invest in areas that are incremental revenue generators and that can also leverage the technician workforce for efficiency, such as technician-supported programs that identify candidates for vaccinations or implement protocols for med sync programs with adherence packaging offerings.

   

Mike Gross
Retail Management Solutions, VP of Sales and Marketing
Kevin Welch
President, Integra LTC Solutions, and CTO, J.M. Smith
 
 Kevin Minassian
Datascan, President
   

Vic Vercammen at Supplylogix enumerated three primary areas for investment that address revenue enhancement, expense control, and patient management. Pharmacists should also look for technology that will support participation in expanded clinical programs that can establish new revenue streams. For just one example, pharmacists might look to leverage the trend in wearable technology to more actively monitor patient wellness and create a data stream that helps demonstrate the pharmacy’s role in care.

For example, Vercammen sees controlling costs being addressed with investments in technology that helps analyze inventory and labor and better predicts, for example, both prescription and front-end stock needs. Managing labor cost through automation, central fill, or the workload-smoothing value of med sync can reduce the overall cost per prescription.

The Top 10 Most Important Market Factors for 2018

  1. Patient engagement and management

  2. Clinical care and documentation

  3. Data analytics/business intelligence

  4. Gaining provider status

  5. Addressing DIR fees

  6. Improving star ratings

  7. Applying mobile health technology

  8. Cybersecurity

  9. Preferred networks

  10. Specialty pharmacy

Speaking of automation, one fresh area for investment in 2018 for many pharmacies may be automated will-call management. As RxMedic’s Humphries notes, these systems allow users to manage will-call with fewer touches and greater precision, including managing by specifics such as NDC, drug name, or lot number. Also, consider the power of further leveraging automated patient engagement tools based on the data provided by automated will-call with thresholds set to automatically trigger patient messaging to encourage prescription pickup and return to stock, in the event that a prescription is in will-call too long. Humphries notes that the systems logic brought by automated will-call can standardize and automate what’s now usually a manual process and bring well-defined protocols to this area that will prevent inventory dollars from sitting in limbo.

Jessica Haider
Epicor Software, Senior Pharmacy Business Development Representative
Bob Jones
AmerisourceBergen, Director of Pharmacy Systems Solutions

Dave Bartel
TCGRx, Senior Vice President

PerceptiMed VP of sales and marketing Terry Cater sees an investment in automated will-call as a next step for pharmacies looking to improve customer service and gain labor efficiency. At the same time, notes Cater, the technology addresses the safety concerns around ensuring that all the right prescriptions get out of will-call and into the right patient’s hands, even as pharmacies manage increasing prescription volumes and a growing list of clinical tasks that put a strain on staff.

Returning to the topic of analytics, PharmSaver CIO Phil Idziak sees pharmacies making an investment in tools for purchasing efficiency getting a real return in 2018 in the face of generic deflation, which is driving down overall reimbursement dollars. Idziak points out that purchasing analytics can make a real impact on a pharmacy’s inventory costs and increase margins, for example by finding the best pricing by comparing a primary wholesaler invoice against other offers or jumping on short-date purchasing opportunities based on dispensing data. Using analytics integrated with pharmacy management systems, notes Idziak, can automate purchasing processes to save both time and money for the pharmacist. The focus here is on maximizing the value of the prescription-dispensing revenue stream by controlling cost.

When it comes to patient-oriented technologies, adherence tools such as med sync and packaging, automated patient contact and engagement tools, and platforms that provide patients with easy access to information about their care — and even scheduling time with the pharmacist — should see strong investment in 2018.

AmerisourceBergen Director of Pharmacy Systems Solutions Bob Jones and Micro Merchant’s Ketan Mehta spoke specifically of patient engagement in their responses, with Jones emphasizing the need for multichannel communications with patients, ranging from voice to apps. Look for ways to provide patients with the opportunity for self-service, recommends Jones, whether through apps, web portals, or other tools. Mehta sees a return coming from patient engagement technologies as they maximize touchpoints with patients and pharmacies employ data mining to identify needs and gaps in business opportunities and care, which can then in turn serve as the basis for targeted patient interactions and communications.

Liberty Software EVP Jeremy Manchester sees pharmacies wanting to be sure that any new technology they invest in is ready to support living in this connected healthcare world by, for example, connecting pharmacies to healthcare networks via direct secure messaging and bidirectional exchange of information about e-prescriptions and clinical interventions. Connecting pharmacists to the larger healthcare ecosystem is a necessary step toward achieving provider status, according to Manchester.

See What You’ve Got

But what about pharmacies getting more out of the investments they’ve already made?

The good news here, according to Micro Merchant’s Ketan Mehta, is that most pharmacists will find a great many tools ready at hand, including some that they may be paying extra for from an external service. For example, he recommends looking within your current pharmacy system for the tools to manage MTM opportunities, to run med sync programs, for texting and outbound calling, and even for recommending complementary medication purchases. He sees plenty of opportunity for pharmacists to use what they have to meet strategic needs and address the trends in 2018.

One theme that was clear from the responses this year is that better use of pharmacy data and business analytics can really help drive value across existing platforms and across the pharmacy enterprise. Look in your existing system for the analytics and reporting tools you have yet to really deploy.

An example comes from SoftWriters’ Tim Tannert, who sees better use of business analytics in 2018 addressing eroding margins and increasing demands on pharmacy resources. In Tannert’s view, there are many operational and financial decisions that can and should be made with data in today’s pharmacy.

   


Vic Vercammen

Supplylogix, VP of Strategy and Industry Relations

Terry Cater
PerceptiMed, VP of Sales and Marketing


Phil Idziak
PharmSaver, CIO
Justin Buckland
QS/1, Market Analyst
   

CSS’s James Notaro also sees better use of the wealth of data in prescription databases as an underused asset in most pharmacies. One suggestion: Look for tools within your pharmacy system or patient engagement platforms to address the fact that patients are generally only 70% adherent with their medications, at best. Up-to-date pharmacy platforms should be able to identify and remediate adherence gaps, for example via dashboards and adherence packaging calendars.

And, as improved patient engagement can impact adherence and boost pharmacy performance, BestRx’s Hemal Desai notes that most modern pharmacy systems have strong automated text and email support for reminders and refill notices, but that pharmacies can be slow to use these features. This despite the fact that these are tools that can easily increase the number of fills per year by a patient, and as a result improve both adherence and revenue. As Liberty Software’s Jeremy Manchester put it, patient messaging is an automation that can require very little effort to implement, while delivering outstanding results.

AmerisourceBergen’s Bob Jones notes that pre- and postedits are still not used widely enough, particularly in the independent market. Jones notes that pharmacies almost certainly have technology in place or a contract with a service that can provide these services, which can be critical for ensuring clean claims and managing reimbursements.

Marty Spellman, from Health Business Systems, notes that pharmacies should take another look at the financial reporting and inventory management capabilities in their systems, and then ask how they can use automation whenever possible to help handle the workload on the business end of things.

For example, QS/1 Market Analyst Justin Buckland recommends keying on the tools you have for inventory management, both in the pharmacy and in the front end. This insight can boost turns and make more efficient use of dollars in one of a pharmacy’s greatest cost centers.

You can find the tools for this within the reporting and analytics in your existing systems, both prescription focused and front end. For example, Retail Management Solutions’ Mike Gross points to the variety of tools in a pharmacy’s point-of-sale system that can improve front-end inventory turns, with real benefits even for pharmacies with smaller front ends. It’s by bringing a level of precision to purchasing that pharmacies prevent overbuying, while at the same time addressing revenue loss from out-of-stock situations, according to Gross. Data pulled from a POS system can also help pharmacies make more intelligent decisions about, for example, the value of promotions they run.

Looking for New Revenue? Here’s Some Advice:

  • Identify where there’s value in what you already do and look to capitalize on it.

  • Build marketing and services around wearable technologies that can help you stay abreast of patients’ well-being.

  • Research areas gaining traction for clinical services or specialty dispensing, such as dermatology, oncology, and gastroenterology.

  • Build your appointment-based services.

  • Consider curbside service and e-commerce, as well as delivery if you aren’t offering it already.

  • Give 340B another look.

  • Ask your pharmacy vendor about data collection programs.

  • Get into or expand immunizations, leveraging technology to identify eligible patients.

  • Keep an eye out for opportunities that develop out of the enhanced MTM model pilot. 

Datascan President Kevin Minassian also encourages independent pharmacies to stop ignoring OTC items while focusing on filling prescriptions. His advice? Use POS reports to see what’s moving and what’s not, dive into pharmacy customer demographics, and look for the data that can help tie more OTC sales and promotions to prescription volume.

As pharmacies better analyze their data, ScriptPro’s Brian Glaves suggests looking at a suite of tools that most pharmacies have in place — including mobile apps and other communications channels such as IVR (interactive voice response), as well as web-based advertising through Google or social media — to help ramp up marketing efforts with a focus on what the data tells you is important to your customers. TCGRx’s Dave Bartel points out that it is particularly important for a pharmacy to look for ways to leverage social media, including Facebook and Twitter, to increase consumer awareness about what it offers. Getting a good handle on what your data says about your customers is an important first step in making sure you are communicating the right messages to the right people on these platforms, by matching your demographics to the fine-grained message-targeting tools that social media platforms offer.

And don’t forget about technology to support delivery, a key service for many patients. Integra LTC Solutions’ Kevin Welch points to delivery management as an area of pharmacy operation that remains overlooked, despite the fact that potential market disruptors, such as Amazon, have homed in on delivery as being a primary competitive advantage.

Finally, Datascan’s Minassian recommends taking a good look at your existing platforms for solutions that play well in the mobile world. Minassian notes that, deployed and promoted to patients correctly, mobile can address everything that should be important for a pharmacy, including convenience for customers and the impact that greater engagement can have on building performance measures such as star ratings by driving adherence.

Watch List

What to watch for in 2018 follows on closely from the trends and areas of investment. Several vendors responded that the focus will be on the baby boomer generation, both in long-term care settings and for home care. Pharmacy should also look for ways to support caregivers, thereby creating strategic long-term relationships not just with the patient, but also with the family members or other care providers who are key allies for the pharmacy.

Other areas to watch include recently discharged patients, for whom pharmacies will want to look to provide continuity-of-care services, and patients with disease states that have special needs. In both these areas, there will be a real demand for excellent pharmacy service and disease state management.

Then there will also be a continued need to consider diversifying pharmacy services beyond the standard retail model, for example through DME (durable medical equipment), specialty, compounding, or immunizations. And then there are emerging areas, such as pharmacogenomics, point-of-care testing, and in-pharmacy basic medical care. There are relatively few resources currently available to address these areas, notes one respondent, and they are not practice models that are simply adopted in a matter of months. Instead it will require a mindset change, with measured effort to build these opportunities into a pharmacy’s protocols and workflow, and proper staffing and training.

Getting Going for 2018

Plenty to think about, and plenty to do, as always for pharmacy. A long-term view on strategy should be an ongoing aspect of every pharmacy’s operations, and it’s certainly time for getting going on goals for the coming year. These results from our 2018 forecast survey have hopefully given you a fresh view from the vendor’s perspective, and offered an opportunity to review your goals within a broader context. CT

Will Lockwood is Vice President/Senior Editor at ComputerTalk. He can be reached at will@computertalk.com.


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