Despite the disruption the coronavirus has caused, pharmacy and its technology partners appear to have weathered this unprecedented event. Pharmacies continue to invest in technology solutions to increase the efficiency of the workplace, while invoking new approaches to not only improve patient outcomes but also increase prescription volume.
THAT SAID, WE FOUND THAT, IN THE MAIN, chains continue to add new interfaces and applications to the pharmacy systems. In one case, this involved a smartphone app to improve customer service. From an operational standpoint, we found adding automation to the filling process and packaging of prescriptions to improve medication adherence were steps taken. Ways to improve inventory management through an interface were also mentioned.
Two chains reported plans to upgrade the pharmacy system to the latest version. One reason given was to fix bugs in the software and come into compliance with legal requirements. Another was to have more interfaces. On balance, our survey indicates satisfaction with the support being received by the current vendor.
However, this was not without a wish list of what chains would like to see added. Here we found one chain that would like an easier way for two-way communication with patients and another a way to streamline medication synchronization. Adding a hybrid module to document patient encounters and bill medical insurance from the same platform was mentioned. Embracing cloud architecture made the wish list as well.
Gaining An Edge: Point-of-Sale Systems for Multi-Location Pharmacy
In this podcast with Retail Management Solutions’ Brad Jones we learn how a point-of-sale system can give your multiple location pharmacy an edge by centralizing reporting, driving front-end profits, and saving money on payment processing. Plus, how and why to think like a large retailer when you are approaching point-of-sale systems.
The technology vendors are saving pharmacies money. The med sync program at the pharmacies in Harps Food Stores is an example of this. According to Robert Acord, director of pharmacy, “this smoothes out prescription volume, which allows us to staff more efficiently.” David Cippel, president of Klingensmith’s Drug Stores, points to an inventory management program from Datarithm he installed that reduced his prescription drug inventory at his seven locations by $150,000 between January and June.
Better inventory management was noted by more than one chain as a focus because of the cash it can free up.
Receiving electronic prescriptions rather than paper prescriptions was cited by one chain as saving time, and thus money, in prescription processing.
IVR has traditionally been reported as having high impact on pharmacy productivity, and we find this the case again in this year’s survey. This phone interface avoids disruptive calls when filling prescriptions and has been attributed to reducing medication errors as a result. Saving time and labor is a big attraction of these systems. Another benefit is that IVR can be an important component of clinical care through reminder calls that prescriptions are ready for pickup. A few chains have or are planning to install a more current system from Vow.
Automation of manual tasks is also a winner. Cippel says that the installation of Eyecon units has helped his med sync program: “Pharmacists can check med sync cycles much faster than pre-Eyecon. Not having to visually check each vial doubles the speed — knowing that every barcode was scanned delivers peace of mind.” Eyecon was mentioned by another chain as improving productivity.
A central-fill program also made the list as having a positive impact on pharmacist productivity in high-volume locations.
At Evans Drugs and Kirksville Pharmacy, located in Missouri, Kevin McCullough, owner of this five-store chain, sees his pharmacy system interface to CoverMyMeds as a timesaver. “By having this link with the prescription claim, we can pull the data and send it directly to the insurance plan or provider. This allows us to get medications that need prior approvals approved much quicker than before, and this enhances the experience with our patients, staff, and medical providers,” says McCullough.
When one weaves it altogether, technology-based applications are increasing productivity and saving money.
What do chains look for before installing a new interface to the pharmacy system? Obviously, the cost factors in, and this determines the return on investment or how quickly the pharmacy can see results. But these aren’t the only considerations. We found that the company’s technical proficiency and proven track record for successful interfaces can play a role. And the positive impact it can have on workflow improvement and job satisfaction is also a consideration. Adding scope to the pharmacy practice through an interface, for example for specialty pharmacy, can factor in as well.
Curtis Pharmacy is finding that a robust IVR (interactive voice response) system is a necessity in its busy pharmacies today, handling inbound call volume and supporting clinical and loyalty programs through outbound messaging. Find out how owners Erich and Tina Cushey are benefiting from the integration of IVR and phone systems from Vow with their PioneerRx pharmacy system and RxSafe packaging automation.
We found an even split here with chains that have gone into the specialty pharmacy business and those that have not. Where chains are dispensing these high-dollar drugs, in a few cases the current pharmacy system can handle the documentation and billing requirements, with only one chain reporting the installation of a separate system. Specialty pharmacy is viewed as a new revenue opportunity for pharmacy, but not without its challenges.
IMPROVING CLINICAL CARE
Chains are taking the area of clinical care seriously. This is best illustrated by what McCullough is doing in this area. “Our newest feature is the addition of more clinical data that we are currently beta testing,”he says.“This includes the ability to add to the patient profile all diagnosis codes pulled from electronic prescriptions to build up these profiles to get more accurate DURs [drug utilization reviews] and things like the ability to apply patient weights to gather more appropriate dosing.”
This is an area that has caught on in a big way with pharmacies of all stripes. All but one chain in the survey reported having a med sync program operational. One reason is that it can increase prescription volume while benefiting patients who take their medications as directed. This was the consensus once again this year. One chain reported that it would like to see an application that would improve batch processing for med sync prescriptions.
Chains have their eye on opportunities that can increase the value of the services offered, while also bringing in new revenue. It is a mix of the clinical side and the dispensing side of the equation. See what we heard in the box on the next page.
At Klingensmith’s, Cippel says that through the robust reporting he has access to in his PioneerRx pharmacy system he can “data mine like never before.” He gives as an example identifying insulin-dependent patients with specific insurance plans to switch to more profitable pen needles, syringes, lancets, and alcohol swabs. This, he says, “delivered $10,000 to $12,000 in additional gross margin every month so far this year, versus 2019.”
New Opportunities: What We Heard in the 2020 Survey
• Clinical programs.
• Extended days’ supply for cash.
• Convert med sync patients to strip packaging to take advantage of combo contract reimbursement.
• Building the framework to get reimbursed for managing medications and eCare Plans.
As one might suspect, direct and indirect remuneration (DIR) was at the forefront of the challenges pharmacies are faced with these days. DIR fees are having a negative impact on cash flow and margins, and have pharmacies operating in the dark on reimbursement after prescription claims have been adjudicated. DIR fees go hand-in-hand with the low reimbursement for prescriptions covered by drug plans.
Not a pretty picture. But pharmacies find workarounds to keep the doors open. This is best summed up by McCullough when he talks about the automation in his pharmacy, which includes systems from ScriptPro, Synergy Medical, and Kirby Lester. “Decreased reimbursement and DIR fees have impacted pharmacies significantly compared to 10 years ago, along with the increased cost of labor. Our investment in automation and robotics hopefully allows us to be a competitor for a long time in the future,” McCullough says.
Technology-based solutions have become more important than ever to the chains. CT
Note: We do not disclose the identity of the individuals or chains they represent unless we have approval to do so. Those quoted gave approval.