Managing LTC Pharmacy Complexity with Process Automation

Pharmacy Forward
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An interview with Integra LTC Solutions Director of Product Management Louie Foster

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A long-term care pharmacy staff’s day is filled with multiple, detailed, and repetitive processes that require constant time and attention, and even then can be quite error prone. Add to that a constant and multidirectional flow of internal and external communications, and you’ve got quite a stressful environment. But, as we see in the May/June 2018 ComputerTalk for the Pharmacist Pharmacy Forward “Getting Things Done: Putting Process Automation to Work in LTC Pharmacy,” there’s help at hand. In that article Saliba’s Extended Care Pharmacy’s John Saliba, R.Ph., describes how he’s applying Integra LTC Solutions’ Logix process automation to the refill authorization process. In this interview with Integra LTC Solutions’ Louie Foster, we’ll learn more about how Logix process automation is being applied by pharmacies in other ways, and just what makes it such a powerful and flexible tool.

ComputerTalk: Louie, the example John gave of how he’s using Logix is a really great one for automating a specific, and common, process within the pharmacy. Where else are you seeing Logix applied?

Louie Foster: One interesting area where Logix is being applied today is providing process automation and reducing the labor associated with pharmacies having to manage communications through a growing number of channels. One facility may require the pharmacy to send them a fax, while other facilities or providers ask that the pharmacy use DIRECT messaging, secure text, or even regular email. If our clients only had to remember the method of communication to use, it would not be a terrible burden. But many facilities require that the pharmacy exchange messages with different people, depending on what is being communicated and/or even based on the floor and the room numbers of the patients. A pharmacy’s desire to win business often leads it to say yes to whatever a facility needs, and this leads to very complex processes within the pharmacy.

CT: OK, so how does Logix apply here?

Foster: The key is that Logix is extensible without requiring a developer to build an application or the customization. It can plug into a wide variety of software systems with very little work, even if we haven’t encountered the software system before. It can even pull data from the web, digest it, and pass it along as the trigger for a communication or guide the workflow process scenario. So to bring this back to all these complex messaging requirements, Logix can make it so that no matter what messaging platforms a facility or prescriber is using, messages can be exchanged and each side — the pharmacy and the other party — will receive them natively in whatever application they’re using. For example, a pharmacy may have messages coming in from external sources via fax, DIRECT messaging, or maybe even secure text messages. Logix can handle all these varieties of messaging and efficiently route them into the right queue within the pharmacy’s software platforms, such as DocuTrack. When pharmacy staff reply to the message, they do it without stepping out of the software they are using, allowing for the next step in the process to continue in applications like Salesforce, the EHR [electronic health record], or whatever they are using.

This is actually important within the pharmacy as well, since departments are often using different applications to manage their messaging. For example, one pharmacy can have different departments using different applications to manage their workflow. The pharmacists and technicians use DocuTrack, while customer service uses Salesforce. The pharmacy does not want to add Salesforce for each technician and pharmacist, due to cost as well as adding another application that staff have to monitor. Logix can be used to bridge these gaps, allowing something that may originate in Salesforce, say a coverage determination request, to move to DocuTrack for the pharmacy staff, and once completed, move the case forward in Salesforce, triggering the customer service staff to call the patient with the results. It can even send out a Slack message to the customer service group that the Salesforce case status changed.

CT: Tell us more about how this actually happens. How do you give Logix the instructions so that it knows what to do?

Foster: A pharmacy can map rules and processes in Logix to do whatever the pharmacy needs. It handles highly complex rules without compiling software or paying a developer to customize an application. The moment you put rules that vary greatly between clients into compiled software, it becomes difficult to maintain. Over time, that complexity often leads to unstable software, which is something our clients definitely cannot afford. Logix fits the bill because it allows them to manage all those rules in a way that makes them easily adjustable and flexible. With software like this, it follows the rules and gets it right every single time. One of the things we consistently hear from new Logix clients is that they were surprised at how many things were missed by staff prior to implementing the software.

CT: And does the pharmacy figure out how to set the rules in Logix, or do you help? Sounds like you’d need to know what you are doing.

Foster: Our team works with the pharmacy to map out exactly what they need in terms of process. Most people tend to think in terms of the perfect scenario: we get an in order in, we fill it, we put it in a tote, and it goes out on the truck. That perfect scenario is great, but a large percentage of time is spent managing all the exceptions that come up during that process. We have a seasoned implementation team that can quickly dive in deep so that they can get the entire process, along with all its exceptions, mapped out in Logix.

CT: What are some other good examples of tasks process automation can handle?

Foster: A common scenario that Logix can play a key role in is notifying facilities when electronic prescriptions are received. Facilities need to know what’s coming so they require the pharmacy to send them a copy of those electronic prescriptions that originate outside of the facility. Many pharmacies manually send these out after the medication has passed through a QA check. Inserting Logix into that process allows Logix to monitor incoming electronic prescriptions, and upon completion, determine if it is something that the facility needs and send it. Logix is even smart enough to know if the electronic script is on page 5 in the document and only send out page 5.

One more example for you. This one is clinical. We have a client that wants to look at each patient’s current medication regimen, and then apply an algorithm that can calculate the patient’s anticholinergic cognitive burden score and flag patients with certain values for follow-up. This is a perfect application for Logix, which can dynamically calculate scores for patients, output them, and even add them into a spreadsheet or create cases or tasks based on the scores in a CRM [customer relationship management] platform to facilitate outreach.

CT: In the end the pharmacy is getting a really hard worker here in Logix, right? And one that can handle all the drudgery without error, while the pharmacy’s people focus on the human touch.

Foster: Yes, that’s right. And the return on investment is pretty impressive; as quick as six months. Most systems can’t promise something like that. But the great thing about Logix is the numbers are what I call highly actionable and the impact is really visible. You quickly realize how many tasks you don’t have to attend to anymore. CT

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