Tim Tannert, R.Ph., VP and COO at SoftWriters, shares his thoughts with ComputerTalk’s Maggie Lockwood on the best way to create a robust LTC business for your pharmacy.
ComputerTalk: How can pharmacists build a strong LTC (long-term care) division in their pharmacy?
Tim Tannert: What we find is pharmacists is trying to operate off a management system that is not technically designed for the long-term care space. Many pharmacy systems are developed with a retail workflow in mind.
When I think about technology that is revolutionary for long-term care, it is technology that brings enhanced services and reduces the time necessary for nurses and caregivers to access medications. It is also vital for the pharmacy to be able to handle all of the different preferences and requests between their nursing facilities accurately. When that is efficient, there is more time to spend on patient care.
To do this, think about the biggest impact by getting back to the basics — the first investment pharmacists have to make is in the pharmacy management solution for the pharmacy. If you have the right PMS, it is a productivity management solution. With an integrated solution you can move through your day with a higher degree of accuracy and have better communication with facilities.
CT: What are the innovations taking place in the LTC space?
Tannert: We have seen an increase in pharmacogenomics testing occurring. Pharmacies can intervene and say, based on a specific patient’s metabolism, if a drug therapy is effective for them or not. This results in more effective clinical outcomes. We are interfacing with companies so pharmacists have the information they need and can offer the intervention and that higher level of patient care. This fits the trend of more outcomes-based care. The clinical work by the pharmacists reduces the time around medication management on the part of the caregiver. It is a small part of the caregiver job, but it takes up a lot of time. We have seen technologies coming into play that address this. There are a number of first-dose solutions now, and the price point is coming down. The technology is improved to support communication with the facility and make it easier to access information. There’s better record keeping.
CT: What automation have you seen taking hold in the facility?
Find out what questions to ask and priorities to set when evaluating an LTC technology investment.
Tannert: There is a real adoption of automation to address first doses and STAT dose. In these situations, medications need to be accessed quickly. Using the electronic record, the dispensing information goes back to the pharmacy; it shows there is a quantity of 30 in the cabinet, and the nurse needs one. The system acknowledges that one tablet has been taken, and then the nursing staff can dispense the necessary amount. Ideally, your system has functional interfaces to accommodate the nuances right into the workflow, which eliminates errors that can occur. This leads to better service to the facility and its patients.
CT: What product has had the biggest uptake by closed-door pharmacies, and why?
Tannert: Depends on the problems the pharmacist is trying to solve. Their reimbursements are being squeezed, and buying efficiencies are no longer a luxury, but a necessity. There are tools that at one point it might have seemed nice to have — like, it would be great if we didn’t have to deal with all the paper and we had a content management solution. At what cost are they getting the prescriptions out the door without it? Efficiency is even more important today. I would advocate to anyone who is trying to enter the closed-door business or make changes in their LTC pharmacy that they evaluate their core technology and be certain they have what they need. Then evaluate what other solutions they want to integrate. What does it mean for improved customer service? How does that translate into efficiency to my pharmacy? If the system can’t talk to the EHR or eMAR, and the facility wants the pharmacy to, then that needs to be a priority. You have to make sure that you have technology that is capable.
CT: So looking holistically at the business goals is important.
Tannert: Yes. You want to ask yourself if you are building on the right foundation. Also, it’s been proven in the past that having a competitive advantage really pays off. If you walk into a facility and can’t interface with their eMAR, you can’t win the business. If you want to offer the additional technologies to gain business, like first dose or some other service, you have to know that your pharmacy management solution supports it.
You want to start with the core, then integrate the new, cool technologies — and the success is based on whether the pharmacy management system can handle it. The pharmacy management system can increase labor capacity and allow you to move through your day with a high degree of accuracy.
CT: Tell us a little about the importance of an integrated system.
Tannert: At SoftWriters, we have developed a complete solution from the minute the order comes in until it’s delivered. When all the steps in workflow are integrated, when your software is using the same business logic and accesses the same data tables simultaneously, all the pieces are working as one seamless system. For example, a refill order comes in from a facility and then they want it on the next delivery, which has a cutoff time of 12:30. The order comes in at 12:28 and it comes in through FrameworkECM [electronic content management]. The system recognizes the setup for this specific facility and that they want it on the 4 p.m. delivery. The system automatically prioritizes the order in the workflow, because it’s a refill, and it goes right into the daily production batch. The workflow is set so there’s a document associated with the order, and it processes without anyone touching it. When it’s ready to go into the totes, if the delivery person picks up the tote early and scans it, the system stops him so he won’t leave without the tote. The pharmacy can track the order in the workflow, see it’s complete, add it to the tote, and scan so the delivery driver can go. In the meantime, the facility can check the progress by signing into FrameworkLink and can see it’s on its way and what the delivery is ETA is. That’s true integration, to share that information, and all the solutions work together.
Every transaction in the pharmacy needs to be capable of offering this level of checks and balances and transparency — from content management, to data entry, to delivery solutions. The system needs to interface with eMARs [electronic medication administration records], EHRs [electronic health records], pharmacogenomics testing — it’s all helping the facility service its patients.
CT: How do you advise pharmacists to evaluate a system?
Tannert: When I think of technology, it’s critical you have the right foundation. I encourage pharmacists to evaluate all technology before they need it so they can do a thorough evaluation rather than buying something because they have a problem and have to get it solved right away. In general, pharmacists should consider the following when they talk to a vendor:
- As I grow my business, what other solutions do they have for me? Do they have everything, or am I going to be reliant on interfaces?
- Are they all on the same platform and business logic, to be able to communicate with each other?
- What markets do they service? Is it specific to what I need?
- Do they have the production management tools I need?
- Do they have the interfaces I need?
- What investments have they made in modernizing the technology? When was the last time they did a rewrite, and how did they deploy it?
- Are there specific tools or interfaces that support patient care? CT