Pharmacy Technology Outlook

by Will Lockwood

This year’s outlook survey found the technology vendors putting a heavy emphasis on patient management and pharmacist access. These are not new concepts in community pharmacy, and each has a great many details packed into it that see an impact from a wide range of technology. Data flows and mobile technology loom large here. And contained within this is a continued focus on adherence, driven by system features for prescription synchronization, compliance packaging to promote adherence, medication therapy and disease management tools, improvements in workflow efficiency, and technology that helps pharmacists understand their patients better and support richer pharmacist-patient interactions.

One of the most critical elements for ramping up patient management in 2015 will be deploying tools to collect and share data about care interactions. ScriptPro’s Mike Coughlin sees a need for pharmacies to focus on systems and tools to promote patient medication adherence through integration of health-system and retail pharmacy activities across the continuum of care. A significant element of this, according to Innovation’s Doyle Jensen, is that pharmacy will be looking for software that is configured with a medication therapy management (MTM) platform and a patient-level electronic health record (EHR), as well as being integrated with compliance management.

Micro Merchant Systems’ Ketan Mehta sees interfaces with MTM platforms as increasingly important for the pharmacies as well. This, Mehta notes, is where pharmacies will identify and document clinical-care opportunities that are a significant driver of performance metrics and that are in turn showing pharmacy’s contribution to payers’ star ratings.

QS/1’s Michael Ziegler offers one interestingly specific example here when he notes that pharmacies need to take an active role in high-risk medication monitoring in the elderly, using the Beers Criteria. This is the kind of clinical activity outside of the prescription transaction, along with a variety of other patient communications and interactions, that needs to be actively tracked within pharmacy data systems, notes Lagniappe Pharmacy Services’ Clarence Lea.

There’s a good existing model for this real-time flow of adherence and patient data, according to Catalyst Healthcare’s Kasumi Oda. As she points out, pharmacies that serve long-term care settings have been learning about the value of these data flows by using electronic medication administration records (eMARs) for keeping up to date with drug changes, administration records, allergy status changes, and hospitalizations. There’s a model here for how pharmacy more broadly is going to want to handle sharing real-time patient medication data with providers across the care continuum.

As this data flows, pharmacy will need to apply tools to manage and interpret it effectively. This will require an expanded use of existing reporting capabilities and business analytics within the pharmacy system, notes CarePoint’s Rachel Cupp. Pharmacies will then look to package this reporting by leveraging business intelligence products that deliver clinical dashboards and insights that are easily digested by pharmacy staff, according to SoftWriters’ Heather Martin. Data mining and reporting tools aren’t just going to be critical for clinical information, either, notes Speed Script’s Heath Reynolds, but for inventory management and marketing tools as well.

Mobile Patients, Pharmacy Access

Patient outreach is critical. In Ketan Mehta’s view, pharmacies will be looking for tools that support contact with patients through their preferred channel in a compliant manner, and support an appointment-based adherence program mode that brings pharmacist and patient face to face monthly. Mehta also makes an important aside to his comments when he notes the need for support for patient counseling and medication information in different languages to reflect the fact that, more and more, the patient’s first language is something other than English.

Pharmacy is going to need to look for ways to allow for data that flows to and from the patient as well. Here, mobile technology will continue to be paramount, according to TelePharm’s Roby Miller. This is all part of the broader consumer shift to online interactions, and more use of mobile devices. Miller sees pharmacies in 2015 having an increasing need to provide patients with ways to manage their prescriptions and communicate with the pharmacy seamlessly through both active and passive channels, such as video conferencing, text, and access to fitness tracking.
What Technologies Will Drive Pharmacy Performance in 2015?

The Vendors’ Top Five

° Adherence management tools
° Outbound messaging
° Business intelligence and reporting tools
° Workflow
° Continuity-of-care tools
Want to See the Pharmacists’ Top Five? Visit
This last item is notable, since, as Miller points out, Apple’s iOS 8 and HealthKit point to a trend in which more patients will be collecting their own healthcare data and potentially taking a much more active role in manag
ing their own health records, both of which can be key to pharmacists providing the best healthcare. Tied into the greater use of mobile devices and the push for ever-greater connectivity of data flows for pharmacy is the issue of access. In Miller’s view, patients are going to want and need greater access to pharmacy services, particularly in rural and underserved communities where community pharmacies often struggle to maintain a viable economic model. One way for pharmacies to offer this is through the broader category of telehealth.

Workflow Driving Engagement

Workflow and automation are two other areas that pharmacy will look to in the coming year to support the goal of engaging and managing patients. The pharmacies that are automating daily, repetitive tasks and investing ahead of the curve in technology that will efficiently support increasingly complex communication, business processes, and reporting needs are the ones that will come out ahead in 2015, according to SoftWriters’ Heather Martin. The widely expressed need for pharmacies to drive workflow efficiency reflects the fact that filling prescriptions is still a core activity, but one that, as Datascan’s Kevin Minassian puts it, needs to use automated processes designed to do more with fewer people. Local pharmacy-level automation can also improve workflow by eliminating the need for the pharmacists to be in the production area, notes Innovation’s Doyle Jensen. What’s interesting is that this doesn’t just mean automating pill counting. It extends, as Jensen points out, to automation that controls inventory levels, reduces expired product, eliminates diversion, secures scheduled drugs, and reduces labor.

Diversion control came up as a specific task requiring real attention within the pharmacy workflow. TCGRx’s Matt Noffsinger points out that a lack of attention to this critical area has serious business and societal consequences, with the pharmacy at risk of audit and serious penalties as states and the Drug Enforcement Administration (DEA) ramp up their attention to diversion. Considering all the other demands on pharmacy staff’s time, Noffsinger sees a real need for pharmacies to look to technology, including biometrics and software-driven access logic, to secure and track medications at risk for diversion.

Top Functionalities for Patient/Customer-Oriented Apps
° Prescription refill reminders
° Profile viewing/management
° Store location/details
° Drug and health information

Another interesting comment on the need to apply automation and logic to the dispensing workflow comes from Health Market Science’s Dan Schofield, who points to increasingly complex state and federal regulatory requirements around prescriber eligibility and prescriptive authority. This is essentially a real-time compliance requirement when submitting claims, and one that is impossible to manage effectively without a technology platform. Schofield points out that this is an area of regulation that has become even more important as third-party audits are becoming more prevalent.

With so many activities in the pharmacy demanding time and full concentration, technology-supported workflow processes and automation are significant ways for pharmacies to free up minutes, even hours, in a day for major initiatives like synchronization, MTM, or front-end rejuvenation, notes Kirby Lester’s Christopher Thomsen. He specifically sees verification technology that prevents errors as a necessary focus in 2015, whether at the point of adjudication, technician driven filling, pharmacist check, or will-call.

Front-End Considerations

The front end is an other area in pharmacy that requires attention for both operational and regulatory tasks, and that, when properly streamlined with the help of technology, can support a pharmacy’s mission of patients effectively. ECRS’s Ashlee Weatherman sees pharmacies looking to leverage point-of-sale (POS) systems to automate pseudoephedrine (PSE) tracking and reporting to the National Precursor Log Exchange (NPLEx), and to implement Web-based back-office management and analytics. Epicor’s Keith Lam also sees retail pharmacies focusing more on POS-driven analytics in 2015, with better business intelligence tools helping them to determine how to increase overall margins as the Affordable Care Act drives patient numbers up but prescription margins continue to decline. POS tools here can include market basket analysis and customer value profiling. And one important way to collect actionable customer data is through a strong loyalty program, something that Lam sees as extremely important for pharmacies in 2015 and beyond. The goal, according to Lam, is for a pharmacy to be able to out-service the competition and better compete with the big-box stores.

Adherence Drivers

Will managing patient adherence continue to be a major focus for pharmacies in 2015?

Over 85% of vendors said yes.

Adherence Drivers

Adherence will continue to be at the core of engaging patients in 2015, according to this year’s survey. This is due to the impact that adherence has on outcomes and the importance of pharmacy performance metrics, both of which continue to be top of mind across the profession. Ateb’s Frank Sheppard believes that a pharmacy’s focus on delivering differentiated services to improve medication adherence will depend on the staff having time to devote to pharmacy services and on changing the dynamic from continually reacting to patient requests to a proactive, predictable workflow. This will rely on the technology tools covered earlier, such as ready data flows and an efficient workflow that helps pharmacies effectively identify patients requiring intervention, and then engaging them to improve their health.

What Will Drive Adherence in 2015?
° Synchronized refills
° Counseling
° Continuity of care (when a patient is moving between care settings)
° Dashboard adherence metrics for pharmacists
° Compliance packaging
° Push messaging to smart devices and text messaging
° Patient calls
° Predictive modeling
Want to See the Pharmacists’ Top 10? Visit

Packaging will also come into play for promoting adherence in 2015, and not just in long-term care settings. As AmerisourceBergen Technology Group’s Sid McFadden notes, retail pharmacies should take a serious look in 2015 at capabilities that will aid adherence, such as compliance packaging, potentially as part of a program of services that will help to provide comprehensive transitional care from admission to the hospital or other institutional setting through to post-discharge follow-up and a return to the home and the community pharmacy. Pack4U’s Shane Bishop also sees easy, low-cost options for adherence packaging giving pharmacies an edge in the coming year. Compliance packaging’s impact at a given pharmacy will depend heavily on finding the right balance between cost, labor, and efficiency, notes Rx Systems’ Derek Jensen.

Star Ratings

At the far end of this chain of engagement, adherence, and outcomes is the contribution pharmacies are making to payers’ Part D star ratings.This is an area that has generated a lot of conversation and is widely recognized as an important strategic focus for pharmacies looking to demonstrate their relevance in an evolving healthcare system.

However, Rx30’s Steve Wubker is seeing a mixed bag here, with pharmacy still in the calm before the real storm. Wubker’s view is that star ratings are a priority for a certain percentage of independents, but somewhat of an unknown entity to another percentage. Continuing education is key to making independents see the ramifications and potential consequences of the star rating process.

Top Technologies to Impact Pharmacy Performance Measures

In the top tier for 2015, according to the vendors:

° Prescription synchronization
° Patient communication, including mobile
° Data management/analysis and business intelligence tools
° Dashboarded metrics/reporting of key measures
° MTM tool integration

Speed Scripts’ Heath Reynolds finds that the attention to star ratings is encouraging pharmacies to focus even more in 2015 on communications with patients, automation, and synchronized medication fulfillment. Michael Ziegler reports that QS/1 customers are spending a great deal of time educating themselves on the star ratings requirements, which is in turn leading them to learn about new tools and resources that can help them manage and counsel the right patients at the right time.

In the end, as Ateb’s Frank Sheppard puts it, while star ratings have gained a lot of attention, pharmacy has a long way to go in fully understanding the impact of the ratings and how pharmacy should be adapting to maximize its positive impact on quality measures. But the opportunity is real, according to Sheppard, since attention to as few as four or five high-impact patients daily can transform a pharmacy from simply average to a top performer over time.

The State of E-Prescribing

E-prescribing continues to present challenges, along with the benefits it brings. Replies to this year’s survey cited ongoing issues, with too many competing prescriber solution vendors resulting in a lack of accountability and standardization in prescriber practice management systems, as well as insufficient prescriber training. Several vendors also raised the issue of the cost for pharmacies that comes from repeated transaction charges when prescriber offices send the same prescription multiple times. These issues are being exacerbated by increased volumes.

Are Issues with Electronic Prescriptions...
° Decreasing? 30%
° About the same? 50%
° Increasing? 20%
Allocating Resources

What regulatory requirements are going to see the bulk of vendor development resources in 2015? Most frequently mentioned were prescription-monitoring programs, which one respondent notes continue to be dynamic. Electronic prescriptions for controlled substances (EPCS) and ICD-10 are also at the top of the list. Coming in next are implementing technology for track and trace, PCI Security Standards Council Data Security Standard (PCI DSS) compliance, EMV chip-and-PIN cards, and near field communication (NFC) payment systems.

Security for patient information and payment data is an area that technology vendors will continue to focus on, particularly in light of the continued high-profile evidence of risks from hacking. Among the improvements to look for in 2015 are role-based security enforced with a complex password policy, user tracking and intrusion detection, managed network-monitoring services, and even hardware that can perform vulnerability tests.

What Do Vendors Find Users Are Asking For?
° Expanded mobile apps, including push notifications
° Mobile payment and delivery options
° Ability to accept EMV chip-and-PIN payment cards
° A/R functionality, such as e-mailed statements
° More languages
° Enhanced packaging functionality
° Central fill
° Data analysis and process simulation
° Performance status/monitoring of compliance
° Transitional care tools
° Patient management tools that include other providers
° Patient self-management tools and patient-pharmacy communication tools
° Document management tools
° Specialty pharmacy tools

Brad Jones from Retail Management Solutions sees 2015 as a watershed year for payment transaction security. Combine the massive data breaches that continue to be in the news with new players like Google and Apple, and Jones sees some of the biggest changes coming to credit-and debit-card processing that the industry has seen in a very long time. Jones says his company has been devoting significant resources to security — rolling out point-topoint encryption and tokenization of credit-card information in 2014 with one credit-card processor — and that this will be the standard with all of Retail Management Solutions’ payment-processing partners by the end of 2015. The goal is to ensure that no credit-card data is stored on the merchant’s POS system. Unfortunately, Jones notes, this is all likely to be expensive for independent businesses.

Strategy 2015

The coming year will certainly present challenges across pharmacy operations. But amid all the change, there’s a real opportunity for pharmacies to become strategic point-of-service locations for health-care, notes Health Business Systems’ Marty Spellman, instead of being viewed as just medication points of pickup. This opportunity is made even greater because, despite the long-standing role of technology in pharmacy, most pharmacies are still using only a small percentage of the potential for clinical and operational improvement that already exists within their pharmacy management system, according to CarePoint’s Rachel Cupp.

Success in 2015 will rely on pharmacies finding what will likely be a delicate balance. As Innovation’s Doyle Jensen puts it, pharmacy has to continue to evolve into a highly sophisticated, patient-centric service driven by continually emerging technologies. And successful pharmacies will not just focus on one area, notes Datascan’s Kevin Minassian. They will use adherence, automation, and patient convenience tools to build the prescription side, while at the same time using POS-driven sales, loyalty, coupons, and reporting capabilities to build the front end.

These will be the ways in which pharmacies will survive and thrive so that they can continue to demonstrate the value of pharmacy to the healthcare system. Frank Sheppard sees this value as strong, and growing stronger every day, as the evolution continues from a prescription transaction focus to a focus on patient-centered care. This, Sheppard notes, is what will be truly transformative for the future of healthcare. For more on the 2015 outlook, visit outlook. CT

Will Lockwood is senior editor at ComputerTalk. He can be reached at

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