Medicine-On-Time’s Rebecca Lambeth, director of product development and customer support, talks with ComputerTalk’s Maggie Lockwood about her role in the long-term care (LTC) market. Lambeth has learned she has a knack for implementing LTC workflow and adherence packaging programs that help pharmacies grow their LTC clients. Lambeth’s role at Medicine-On-Time is to coach pharmacy owners on the opportunities in long-term care.
ComputerTalk: Tell us how you got started.
Rebecca Lambeth: Long-term care was my passion. I was fortunate enough when I started in skilled nursing, my mentor was a consultant pharmacist. I learned everything that a consultant pharmacist does, whether it was in a skilled nursing, assisted living, or an Alzheimer’s unit. And I also learned that when you talk about long-term care, there are many different types of long-term care.
I would say 90% of the pharmacies that I coach don’t know there’s so much more to long-term care than skilled nursing and assisted living. There’s residential care and the department of disability and special needs — which was a huge part of what I did in South Carolina — and now medical at home.
CT: Once they have identified the opportunity, what’s next?
Lambeth: What I find is that a lot of times owners who want to add a long-term care business to their pharmacy have jumped into a contract with a long-term care provider and they are frustrated because they haven’t set their goals on what they can provide for the facility.
I educate pharmacists how to fit it into their current business model, efficiently and cost-effectively. Maybe it’s starting out with 10 at-home patients, or a 10-bed residential care facility, just so the pharmacy can get its feet wet.
CT: What are your primary recommendations?
Lambeth: First, you have to have a business plan: know what’s cost-effective and what you can do realistically. You should review your hours, staffing, the medications you carry, and your budget. It may be more cost-effective for the pharmacy to use a technician rather than a pharmacist for a lot of the work. Do your research on state pharmacy board regulations.
And it’s crucial to have everyone support the initiative. One thing I suggest is a bonus structure, which means everyone will benefit from the work that goes into making an adherence program successful.
I read recently that $265 billion will be spent in long-term care in the next three years. When you look at that number, it’s really an exciting time to be in pharmacy
Read More About The Outlook for LTC Pharmacy in 2023
CT: You took your LTC pharmacy development expertise to Medicine-On-Time. What have you focused on there?
Lambeth: One area I’m following closely is medical at home. There are limitations on how the staff can handle medications. Or they don’t have the time to package unit dose at the home. We wanted to streamline the administration process and make it as error proof as possible.
When we developed our C.A.R.E. packaging, what we had in mind was a product that anyone can easily use. Everybody knows what a multidose package is in a pharmacy now, but what can we add to that? And it is this C.A.R.E. package with a care plan that provides all the details from appointments to notes from the provider.
The packages are flexible and can be used for supplies of 28 days or 30 days or only seven days. Our software is flexible and can schedule based on what insurance will cover.
CT: Share a little about the software and how it supports adherence programs.
Lambeth: You can run motNext [Medicine-On-Time’s adherence software] as standalone software or you can interface it with your pharmacy system. You will find that motNext is very robust if you have a complicated prescription, since it takes guesswork out of medication regimens and varying dose-capacity needs. motNext also has a workflow calendar that’s designed to organize patient cycles and makes it easier to be proactive in handling volume.
That can make a difference in adherence programs. You can now manage workflow right in the software. We also offer drug forecasting, which reduces the need to keep those high-dollar drugs off the shelf until you need them. With the appointment-based model, you can see where you have an upcoming appointment and that you need to order that $10,000 drug.
CT: What are the usual frustrations around building adherence programs?
Lambeth: Last year The National Pharmacy Technicians Association had a speaker at one of its meetings who talked about medication adherence. One of the things she said really struck home to me: If a pharmacy does not start getting at least 50% of its already-established patients into a medication adherence program, the technician is going to quit.
All of our customer support staff are pharmacy technicians who have some kind of pharmacy experience, mostly long-term care. There are so many packages out there now. With us, you have a pharmacy technician who’s been behind the counter, understands the frustrations, understands how this is new for patients, and walks them through the whole process.
The truth? The number-one frustration is that the pharmacy owner or pharmacy manager is gung-ho to start a medication adherence program but hasn’t discussed it with any of the staff. Training and staff buy-in are very important so they understand it’s a good thing. And there’s the bigger picture about why this is so important for the pharmacy.
CT: It’s empowering for pharmacies to manage all kinds of patients without a cookie-cutter process.
Lambeth: The C.A.R.E. package and our software motNext are customizable with store-level features, facility-level features, and patient-level features. You can group medications and OTCs on one card while meeting state regulations. With psychotropic medications you can isolate and only have to repackage those.
CT: It’s great to hear you’re so optimistic.
Lambeth: I think the most exciting part about the C.A.R.E. package and Medicine-On-Time is the vision we have. For me, I’ve seen it be so successful with the pharmacies I worked with. Really, we need to get the word out to pharmacies that there is this huge opportunity that I think we have never seen before. CT