FEATURE: Engineering Success
Engineering Success: Pharmacies of the Great Northwest
The second installment of the author’s journey through the Northwest, visiting pharmacies that prosper in urban, suburban, and rural settings by offering a product, program, or service that extends beyond the practice of filling prescriptions.
Scroll to the end of the story to view a photo gallery of the pharmacies featured in this story.
In April of this year it was my good fortune to make a two-week road trip and visit 11 remarkable pharmacies in the American Northwest. The trip was sponsored by the Independent Pharmacy Cooperative (IPC), the large buying group headquartered in Sun Prairie, Wis. The purpose of the trip was to uncover tips, tactics, and techniques used by these remarkably successful pharmacies that might inspire ComputerTalk readers to try something new that will help them grow.
What follows are short vignettes on the things I learned while visiting the last five stores on the road trip. You can read about the first six stores in the July/August issue of ComputerTalk.
This road trip took place April 15–26, 2013, and was sponsored by the Independent Pharmacy Cooperative (IPC). The purpose of the trip was to uncover strategies successful pharmacy owners use and to share them with ComputerTalk readers. It should be noted that while IPC sponsored the trip and helped identify some of the pharmacies visited, it did so without regard to IPC membership; indeed, only five of the 11 pharmacies visited were IPC members. I wish to thank IPC for making this trip possible.
Rosauers is a regional grocery chain with 21 stores (16 with pharmacies) headquartered in Spokane, Wash. I was able to visit with Gary Glennie, R.Ph., director of pharmacy, in the home office to get a better understanding of how Rosauers views the relationship between grocery and pharmacy. Glennie then authorized a visit to the chain’s one-year-old, start-from-scratch location in Boise, Idaho.
Stephen Nadler, Pharm.D., manages the Boise pharmacy, but he understands that as a grocery store pharmacist his duties do not end at the pharmacy counter. During my visit I saw Nadler and others on his staff make several trips out front to talk with customers, help them select an OTC, or discuss a private issue of some sort.
When asked how he attracts patients to the pharmacy, Nadler started by telling me about his company’s “Blue is Better” campaign. Using guidelines from various health agencies, including the American Diabetes Association, Rosauers places a prominent blue shelf label below products with lower fat, sodium, and carbohydrates, making it easier for consumers to make healthier choices. The program also highlights whole grains, fresh fruits and vegetables, and other healthy foods. And it draws attention to the pharmacy itself, a key ingredient in the success of any supermarket pharmacy.
Another tactic Nadler successfully uses is his custom crafted Rosauers Wellness File. Here, Nadler and his staff carefully extract pertinent healthcare data from their HBS pharmacy management system and use that data in concert with his counseling of participating patients. The program provides these patients with a health record that contains information on medications being taken, immunizations received or needed, and drug allergies; there’s even room for data on selected medical conditions such as hypertension, diabetes, and BPH, and for special notes.
This is all organized on a one-page form folded to fit in a wallet or purse. Nadler says the file has proven useful in helping patients understand the meds they take and to be more compliant. And, he says, since it is often pulled out in a doctor’s office, the file has prompted doctors to suggest that others visit the pharmacy and get one, too.
Does all this work? According to Bethanie Powell, store manager, the Boise store’s pharmacy is beating its sales and prescription count projections. No one thing can account for this, but Nadler says the Wellness File card has been well received.
Robert Coulter, R.Ph., owns a remarkable pharmacy in La Grande, Ore. As the major town in this rural area, La Grande has its share of chain competitors, such as Bi-Mart, Rite Aid, and Walmart. So to succeed, Coulter has built a pharmacy hitting on all eight cylinders.
Here’s what I mean. Think of any enhanced service mentioned as a key to pharmacy success, and Coulter is doing it. He has a beautiful store on a busy intersection. Coulter takes full advantage of technology, using an Innovation robot, an Eyecon counting machine, and an Rx30 pharmacy system tied to an RMS POS to support his well-merchandised front end.
He even has a PickPoint will-call bin system where the bag holding the prescriptions being called for glows with a color-coded LED light directing the clerk to the right bag. Coulter does compounding, provides immunizations, and services LTC, assisted-living, and residential-living facilities with unit-dose packaging.
So to take his practice to the next level, Coulter has implemented an Rx-synchronization program that he says has made a positive impact on his practice. Most importantly, he says, his customers love the program; he has over 600 people enrolled.
Every day the pharmacy’s staff runs a special report created by Rx30 that prints out all the medications a participating patient is taking, along with his or her contact information and “cycle” date. Red Cross has opted for a 30-day refill cycle, meaning people come back in on the same date each month, not on the same weekday, as in a 28-day cycle.
A participating patient whose medications are due for refill then gets a personal phone call with a brief but detailed medication review to ensure all medication changes are accounted for. After the review, prescriptions are entered into the pharmacy system in a holding queue, which then pops up on the day the prescriptions are scheduled to be filled; the staff does these during slower walk-in demand times. If the medications are in the robot they will be batch filled, making it easy for all the medications for each patient to be put in a color-coded container and made ready well before the actual pickup date.
The end result, according to Coulter, is improved productivity, a higher level of customer care, better compliance, and, not to be overlooked, increased prescription sales.
Greg Armstrong, R.Ph., owner of Len’s Drug in John Day, Ore., gives a whole new meaning to the phrase “community pharmacy.” He and his wife Marla have as one of their key goals helping to build up this entire rural community, not just their drugstore.
Len’s is a large, 10,000-square-foot store, complete with HME, sporting goods, books, cards, and gifts, along with garden supplies and packaged foods. And the store accepts Supplemental Nutritional Assistance Program (SNAP) cards for these food purchases. Armstrong also owns a Subway sandwich shop and a local dollar store, and plans to open a coffee house that will serve as a place for twenty-somethings to gather other than at a local bar.
Still, at the heart of everything Armstrong does is pharmacy, and to better run that he has invested in a SuiteRx system that takes a picture of each pill and scans an image of the prescription so each prescription can be easily checked. His workflow system barcode-scans each step of the process, and he makes sure two sets of eyes review each prescription. To provide the time for this, he has a ScriptPro robot and a Kirby Lester pill counter.
Armstrong is a member of a citizens advisory board helping local government and community organizations provide a variety of health benefits and prepare for the implementation of the Affordable Care Act. Armstrong points out that Oregon is undertaking an initiative that may allow all government agencies and even many private businesses to enroll their employees in the Medicaid program, with the goal of strengthening the system, improving care, and reducing costs.
Armstrong also talks with pride of his healthy-heart class. Each month he promotes and presents a one-hour program at a local community center where he helps people understand health issues and shares recommendations on how to prevent or treat them. He says he seems to capture people’s attention as he tells them that one of his goals is to get people off as many medications as possible.
He sees the future as bright. “People will always need pharmacist is changing, but that he does not see that as a threat but an opportunity. As proof of the pharmacy’s ongoing commitment, his daughter graduates from pharmacy school this year and plans to work at Len’s Drug.
Hirons boasts two 10,000-square-foot drugstores in Eugene, Ore. Both locations are near the University of Oregon campus and, as you’d expect, find several ways to tie into the college. Steve Hirons is the grandson of the founder and serves as VP of operations, as well as a partner with his father, John Hirons, and uncle, Larry Hirons, a physician.
While not a pharmacist, Steve Hirons is passionate about pharmacy and is actively involved in finding ways to attract more patients to the pharmacy. And in true entrepreneurial style he is doing this by understanding the unique aspects of his market and taking advantage of opportunities it presents.
Perhaps the most notable is a program he is about to embark on with the University of Oregon. Any athlete prescribed a medication by the team doctor can come to Hirons and have his or her prescription filled using the family’s prescription benefit plan. Rather than charge the athlete the co-pay, Hirons will bill the athletic department each month. Hirons’ idea is that athletes are more likely to comply with medication if they don’t have to bear the cost. He has also contracted with two 340B-covered entities in Eugene.
Hirons is the most artfully and fully merchandised store I have ever seen. Merchandise of all sorts is displayed from floor to ceiling, and I do mean ceiling, as many items are hung from the ceiling — capturing your attention and providing a truly amazing shopping experience.
The store has a robust collection of college paraphernalia. It stocks an assortment of locally produced chocolates that Hirons says are a big draw. Hirons sources products from True Value and Hallmark, attends a number of trade shows, and even brings in live plants and garden supplies from four nurseries.
While walking the store it was my good fortune to meet Nicole, the front-end manager, freshening up a section in one of the aisles. While trying to take in all I was seeing I asked her, “How do you keep up with all of these items?” Her reply astounded me in its simplicity as she said, “You go through an aisle and clean it every day.” Clearly not rocket science, but it works.
One final note: I asked Hirons if he had a business philosophy he lives by. Without a moment’s hesitation he said, “If you don’t ask, you don’t get.” When pressed for more detail he explained he has learned to always ask for an extra discount, dating, free goods, etc. — a trait that has served him well.
Central Drugs is located right in the business center of Portland, Ore. This location provides some unique opportunities and challenges to partners Gary Lundgren, R.Ph., and Shelley Bailey, C.Ph.T. and M.B.A.
It is a pleasant looking and well-merchandised 3,000 square-foot store. Bailey says front-end sales are not all that good, but that an attractive front end helps communicate to their customers that this is a real drugstore and that they are there to help. “Looks matter,” she says.
To really succeed in this market they have worked aggressively to build a specialty pharmacy business, and in doing that they have done some amazing things. As to the “worked aggressively” idea, Bailey says they currently bill a state-specific AIDS assistance program only because when they were first rejected due to a mail-order-only initiative, Bailey contacted community leaders and legislators and educated them on the value of community pharmacy. Her efforts won the right to be included in the program.
About three years ago they brought in a design firm to upgrade the look of their store. In doing so they set aside prime retail space to add a 12-seat classroom right next to the pharmacy. This classroom has become the focal point of some remarkable patient care and marketing services.
Many pharmacies have found ways to engage patients in health classes, but the direction Central Drugs has taken puts a whole new twist on the idea. To help build demand for their specialty pharmacy and 340B program support, Bailey says they have developed an effective doctor-detailing program.
The educational classes provide reasons for visiting with doctor’s offices, and when calling on these offices Bailey has a professionally produced packet with her. In the packet are forms the doctors can use to provide information needed for the pharmacy to enroll patients in prescription assistance programs. Bailey says she learned early that taking this bureaucratic task out of the doctors’ hands was a great way to win their support.
But she doesn’t stop there. She has found ways to win over pharmaceutical representatives, too, and get them involved with the classes. She says the reps provide refreshments and educational materials, along with co-pay discount cards and other aids that enhance the effectiveness of the classes. And since the classes help build more-compliant patients, the reps also take Bailey’s materials to the doctors in the area and explain how Central Drugs can help patients get, pay for, and benefit from the medications the pharmaceutical representative provides.
Well, there you have it: ideas, suggestions, and examples of ways pharmacy owners are engineering success in their communities. Seeing these pharmacies prosper in urban, suburban, and rural settings convinces me that success in pharmacy is possible. That often means finding a way to provide a product, program, or service that extends your pharmacy beyond the practice of filling prescriptions. It also means realizing that your job as a professional is to help people live happier, healthier lives.
Community pharmacy faces numerous challenges, and finding ways to overcome these challenges and succeed will never be easy. And after 40 years in this industry, I can say it never was. If there is one final observation I would make, it is this: Far too many pharmacy owners spend too much time lamenting the loss of the past and fail to search for the new, better, and more profitable things to do. These can be found. How do I know? I saw 11 pharmacies doing it. CT
Bruce Kneeland is the founder of Kneeland Services, a marketing services firm dedicated to helping community pharmacy “do better.” He can be reached at BruceKneeland@kneelandservices.com.