McKesson Pharmacy Systems & Automation High Volume Solutions VP of Sales Joe Tammaro gives ComputerTalk’s Will Lockwood his perspective on what pharmacies are doing with central fill and what questions you should be asking if you are looking to get started with it.

CT: What kinds of pharmacies are looking to central fill these days?

Joe Tammaro: Really all pharmacies: retail, hospital outpatient, long term care, etc. If pharmacies are looking to increase capacity, lower cost to fill, manage inventory better, and improve quality, central fill is a viable solution.

And I think it’s also important to note that there’s really no pure central fill anymore. Instead the facilities have a more hybrid role, giving pharmacies the ability to do different things that make use of the technology and process that go well beyond filling prescriptions to return them to the store for dispensing to the patient. So, we see a lot of pharmacies doing some mail order, specialty, or some LTC out of the central site.

CT: How can a pharmacy decide what the right technology is for a central fill operations?

Tammaro: Essentially, pharmacies need to assess what they currently dispense as well a plans for future dispensing needs. The technology can be fitted to automate those processes when it makes economical sense. Technology exists that can automate all processes and the automation provider along with the customer can evaluate what is the best fit — using data, discussions on what is important to the client, and evaluation of pharmacy regulations — for today and future needs.

But even at a central site, you want to make sure that you are only automating when it makes sense. You have to look at your volume for a particular category of dispensing. It can often be the case that a manual process will continue to work very well up to a certain point and then, that’s when automation will make financial sense and you will want to look at that investment. The central-fill process and solutions are scalable, and make sense even for lower volume pharmacies.

CT: What kinds of questions should pharmacies ask prospective vendors?

Tammaro: We see savvy pharmacies looking at central-fill solutions ask “How are you the vendor going to fit your offerings to our needs?” They also want to know how we are going to support and optimize the installation, and they’re not just talking about customer service and support. They want to know how we are going to help them keep this complex system and all the parts running most effectivley for their needs over the long haul. And it’s worthwhile noting that central-site technology lasts a long time. We have systems out there that are 20 years old. You tweak the components over time, but central fill will keep going and as a pharmacy you will want to make sure that your vendor is going to remain a partner for the long haul.

Finally, implementing central fill involves many complex systems interacting seamlessly and involves risk. Prospective customers should look at the experience and track record of the solution provider. They should talk to references and see sites that are similar in size and complexity to the one that they are purchasing. Not all systems are equal and certain technology does not scale up or down well.

CT: What are the most important metrics for gauging the impact of central fill and how/where do you collect the data for them?

 At the end of the day, there are several key data elements to view the impact of central fill:

  1. Central fill pull or efficiency rate: Basically this is the number of prescriptions processed at central fill divided by the total amount of prescriptions processed by the enterprise. The higher this rate is, the better. Successful operations have achieved upwards of 50% of total prescriptions filled at central. 25% should be considered the minimum to have a positive impact.
  2. Overall net labor utilization: Most successful central fill operations look to reduce or hold net labor use across the enterprise, By taking the fulfillment activities out if the local pharmacies, labor can be reallocated and held stable while growth continues. After maturity, a pharmacies should be able to see a net overall reduction in payroll dollars per prescription filled.
  3. Inventory reduction: When you consolidate inventory at central fill, increasing turn on that inventory and reducing the need to carry extra back stock at each and every local pharmacy, your pharmacy operations should see a net reduction in overall inventory stock levels across the enterprise.
  4. Quality: Quality at central fill is much greater than at the local pharmacy level. Successful operations measure the frequency of misfills attributed to the fulfillment process — e.g., wrong product in the container, wrong label on the container, etc — and see a net reduction of incidents after implementing central fill.

CT: What are some benefits of central-fill that people unfamiliar the process might not expect?

Tammaro: A few come to mind. First, you see increased customer service and more time to implement revenue generating activities. Many operations utilizing central fill have chosen to take the labor and time savings generated and convert that into better service as measured by reduction in wait times, more time spent with customers for counseling, problem solving, etc. And then there are revenue generation activities, such as screenings, immunizations, MTM, etc

Second is a reduction in the need to remodel or expand the local pharmacy. By pulling volume out to central fill, local pharmacies can essentially process more prescriptions in their existing footprint and reduce the need to remodel or expand for higher volumes.

Next is more effective use of “technology” dollars. When budgets are tight, using technology dollars on a central site can often be done at a lower cost than having to automate all of the local pharmacies. The technology spend can be focused on making sure central fill is high capacity and capable of handing volume for many years to come, versus having to focus on incremental technology at many sites where it may not make sense. We see successful pharmacies being smart about this and realizing that central fill can make better use of their resources and let them be more selective about broader automation deployment. CT

To learn more about McKesson Pharmacy Systems & Automation, visit the company’s ComputerTalk Buyers Guide profile page.