The recent article "The Practice Management System Dilemma," by Bill G. Felkey, M.S., and Brent I. Fox, Pharm.D., Ph.D., ComputerTalk, March/April 2010, addresses the need for vendors of PMS systems to prioritize the development of new products that are desperately needed by pharmacies in order to keep their doors open. The article asks some tough questions and suggests some real needs that should be addressed. The following excerpts are from this article, with answers provided by ScriptPro regarding the capabilities of our new SP Central Pharmacy Management System to meet the requested needs.

1.     One of our committee leaders simply wants to know the actual cost that he paid for the drug product he is dispensing and to be notified whenever he is about to be reimbursed for an amount less than what he considers appropriate for the transaction.

a.     In ScriptPro’s PMS, the inventory console provides quick access to the actual cost paid on a drug. For example, a Last Order field displays the package cost paid the last time the product was purchased.

 b.     The PMS system has logic in place to detect below minimum payments and alert the user when this occurs. The user is shown their minimum payment requirements and what was paid by third party. They can then choose to accept the claim or reverse it.

2.     Are the insurance programs living up to the contracts they are negotiating? We believe inquiring minds want to know.  Does your system offer this actual cost auditing feature? If it doesn’t, would you like it to work prospectively during prescription processing, or do you want an exception report generated weekly? Do you want a report that sorts discrepancies by payor?

a.     ScriptPro has Third Party Reimbursement and Third Party Reimbursement Details reports which display pricing information related to third party claims and reimbursement. These reports are used to ensure that third party plans are paying what they indicated they would pay at the time of the insurance transaction.

b.     ScriptPro is developing a Third Party Management System which will allow users to perform electronic reconciliation of third party payments, as well as have greater insight into payment, billing, and reimbursement terms to better negotiate contracts. (in development)

3.     Another committee member wants integrated medication therapy management (MTM) messaging within his PMS. He doesn’t want to have to check his email inbox and then later find out that one of the patients who needs his MTM services just got a prescription filled an hour ago.

a.     ScriptPro is developing functionality that will allow pharmacists to track and bill MTM services. (in development)

4.     The other categories that need to be integrated into the PMS include greater Internet connectivity with the pharmacy Web site and, ultimately, with the patients being served by the pharmacy. ... Greater connectivity with electronic health records (including personal health records) and increased use of clinical decision support systems for both pharmacists and patients need to be addressed. Greater integration of medication regimen adherence support and connectivity to patient home devices should definitely be on the long-range development list.

a.     ScriptPro Interactive Voice Response (IVR) will support outbound patient communication for prescription Refill and Pickup Reminders. (in development)

b.     ScriptPro interfaces with the pharmacy website for refill requests and prescription status updates.

c.     ScriptPro interfaces with clinical patient management systems to receive updates on patient information, medical conditions and medications, as well as receive electronic prescriptions. ScriptPro PMS will also pass information back to the patient management system, such as when a prescription is dispensed to a patient.

d.     ScriptPro’s PMS achieves an integrated clinical decision support model by running comprehensive DUR processing against clinical data entered at the pharmacy, such as patient age, height/weight/BMI, smoking status, medical conditions, medications processed on-site, and medications/OTCs entered into the patient’s profile, along with information received via electronic health record interfaces.

e.     ScriptPro’s PMS also interfaces with Surescripts to receive updates on patient and prescriber information and receive electronic prescriptions. Refill authorization requests can be transmitted to the prescriber through this interface as well.