There’s a lot going on in the cloud, and you’re probably there yourself pretty much every day whether you realize it or not. From cloud services like Gmail and Dropbox to on-demand computing power like Amazon Web Services, the cloud is where major players such as Google, Amazon, Microsoft, and IBM are making their bets these days. The endgame is to move from delivering hardware and software to customers, be they businesses or individuals, to providing these resources as flexible, even on-demand, services. This model isn’t new in the pharmacy world, but it may be time to take another look at the ways cloud-hosted services can benefit your operations, such as streamlined deployment and maintenance, data security and access, support for business continuity, and scalability.
VP of Operations
Regional chain headquartered in Holliston, Mass. Offers a mix of retail and specialized long-term care services.
Eaton Apothecary’s route to the cloud came through experience. Some years ago, according to John Lynch, Eaton Apothecary’s management decided interactive voice response (IVR) would make a positive impact on efficiency at one particularly high-volume location. At the time, long enough ago that the cloud wasn’t the option it is now, Eaton Apothecary installed the TeleManagerCentral IVR System at that location, which was filling about 23,000 scripts a month. This was a store-based system that needed to connect pharmacy phones through a PC, and in the case of this location in a medical building, the IVR needed to integrate with the building’s phone system. Lynch says it took a lot of work. Once it was up and running, it was a great addition, but Eaton Apothecary also learned something: “As we got more high-volume stores that we knew could use IVR,” says Lynch, “we remembered that it was a difficult process to get the hardware and configuration done.”
Then about five years ago, at the time when Eaton Apothecary was evaluating installing IVR in more stores, TeleManager Technologies was just rolling out its cloud model, iRefill Voice. “It effectively wrapped up all the benefits of the on-site product but eliminated all the headache of the setup,” Lynch says.
Total Remedy & Prescription Center has been a long-time user of voiceTech’s IVR. The pharmacy is also using a voiceTech product that calls selected patients to let them know that their prescriptions are ready for pickup. As recently as six months ago, the pharmacy still had a physical server running the technology on-site. That’s when Total Remedy & Prescription Center made a move to a voice over Internet protocol (VoIP) phone system that in turn led the pharmacy to choose the cloud to host its IVR. As Ruby Portillo tells it, she was on the phone with voiceTech working out some details of the switch in phone systems when her contact there asked, “Would you be interested in having us host the IVR on our end?” Portillo was indeed interested, and it’s turned out to be a very good decision. “voiceTech coordinated with our phone provider to get the systems working together,” says Portillo. “I didn’t have to be involved in it. I just connected them, they set up the connections between the VoIP and the cloud IVR and tested it, they tested it with me on it, and then I approved it. The only problem is you are at the mercy of an Internet connection, which at times can be frustrating in itself.”
The cloud has become a resource for Guardian Pharmacy because of the growing need to support long-term care (LTC) facilities with electronic medication administration record (eMAR) systems. “More and more communities are wanting to use electronic medical records,” says Matt Hopp. “That being said, there are a lot of companies that offer them, and often facilities will come to us with a system in place or an idea of what they want to use.” So Guardian Pharmacy has to be flexible and support a number of eMARs for facilities. Among these is a cloud-based eMAR from Yardi, which offers an example of how pharmacy can offer a product to customers that’s flexible and quick to roll out because it resides in the cloud.
Roadmap to Innovation
Read an interview with VUCA Health CEO David Medvedeff to learn more about
how a company develops a solution leveraging the cloud.
You Don’t Have to Do It Yourself
Many pharmacies don’t have in-house IT resources. That’s the case for Terri Dyches, who looks to her vendor, QS/1, for technical support. But even with reliable help when it’s needed, Dyches was reluctant to upgrade to the company’s NRx Windows-based system. First of all, she and her staff were used to using keyboard commands, and then she was also wary of potential IT headaches that might come with the transition. “We’re not tech savvy here,” Dyches says.
Guardian Pharmacy of Atlanta
Part of 28-location long-term care pharmacy group that serves skilled-nursing, assisted-living, and other communities in 19 states.
However, last year, when QS/1 approached her about its new system, SharpRx, she was intrigued in part because of its flexible user interface. “You can use keyboard commands or a touch screen, or you can use a mouse,” she says. “I thought it was good because anyone could use it.” But then Dyches also found out that Wagener Drug Company could use the system as a cloud-based service. That meant she didn’t have to worry about the IT side of upgrading. The benefits of moving to a cloud-based pharmacy system don’t stop there, she notes.
First, training on the new system was easy, since the staff of five at Wagener could easily work on the new system without the need for any changes in-store. Everyone got familiar with the new software for two weeks before QS/1 staff uploaded the pharmacy’s data to the cloud. Then the transition was as easy as flipping the proverbial switch: When Wagener went live on May 24, Dyches says the staff had closed the store on the legacy system the night before, came in that morning, and was up and running on SharpRx when they turned the lights on. “The training paid off,” says Dyches, “our staff were comfortable with SharpRx, and the change wasn’t overwhelming to us when we began using it in a live environment.”
But even if you can manage the IT demands of a product install or upgrade, that doesn’t mean you have to or should. John Lynch says Eaton Apothecary has been able to install the entire iRefill Voice IVR system remotely. “There was no need for someone to go on-site to splice a single wire,” says Lynch. That makes for a much more efficient use of the pharmacy’s resources, and it has a big impact on costs. “TeleManager is able to install and activate iRefill Voice all through the hosted service,” says Lynch, “making the cost to implement the system go down to nothing.”
The cloud can be an important tool for making the best use of limited IT resources in other ways as well. For example, it helps move troubleshooting problems out of the pharmacy and back to the vendor that’s hosting the solution. It also makes managing backups a thing of the past, supports a more robust business continuity plan, and can help pharmacies and customers easily access technology across a range of devices and from many different locations.
Is Now a Good Time?
First, let’s talk about when things break. When’s your ideal time to have a system go down? How much time do you like to spend fixing your technology? The answers to these questions are most likely: never and none.
Director of Operations
Total Remedy & Prescription Center
Los Angeles-based retail pharmacy operating for over 20 years.
John Lynch says that the lack of hardware maintenance is a real benefit of cloud-based systems. “There is nothing that needs to be tended to, it’s always on and operational, and everything is handled within their data center,” he says, “You get redundancy, and the ongoing cost to support the system is minimal.”
That’s certainly a benefit, in the opinion of Ruby Portillo and Total Remedy & Prescription Center, too. “When we’re busy,” says Portillo, “the last thing we want to have to do is go to a server and look for which light is on and which is not, or which light is blinking, and figure out why.” For example, Portillo relates an incident where there was an issue with the phones at the pharmacy. Rather than having to stop and work through the problem, Portillo instead got in touch with voiceTech, which was then able to coordinate with two other vendors to figure out what was happening. It turned out the security system was the root of the problem. “The nice thing,” explains Portillo, “is that we were able to get this solved without any on-site IT help. I don’t even have to be on the call with our vendors. I let them know there’s a problem and then it’s ‘Okay, you guys deal with it, let me know what we’re going to do and how it’s going to affect me.’”
Keep Your Data and Your Software Safe
Next, what about creating and maintaining a plan for business-critical data backup? Not only is an effective data backup process a good idea, but having the right plans and procedures in place is a legal and regulatory requirement in many cases as well. Terri Dyches, for one, sees an improvement from her cloud-based system and the secure data backup it provides. “No more daily backups stored in a fireproof box,” says Dyches.
It’s also important to note that a cloud solution isn’t just another way to back up your data off-site. Sure, it’s checking off the boxes on your list: off-site, secure, redundant, and automated data storage. But there’s an even bigger benefit when it comes to the very reason why you back up: continuity in case of disaster. “If something were to happen overnight,” explains Dyches, “I could go to any remote location and run off another computer. You can just plug in and go.” That’s because both the data and the software are off-site.
Cloud-Based Systems — A Vehicle to Create Opportunities
“Although still in its infancy in pharmacy, the cloud is the greatest technological innovation for pharmacy owners since computers replaced typewriters. Once fully developed, the cloud will afford pharmacies the ability to have virtual relationships. Innovative cloud-based services such as offered by PharmSaver are already changing how pharmacies analyze opportunities and purchase drugs, by providing the pharmacies with increased choices, more competitive pricing, and prospective reimbursement analysis so that pharmacies can make better and more informed decisions. For the first time the cloud provides pharmacies the ability to both police and manage their vendor relationships. The advantages of cloud-based systems are that the pharmacist can have access from anywhere and even use their cell phone. Another advantage is data is updated real-time. We see that training is one of the most significant impediments for pharmacies taking advantage of what these services offer. This is the reason we provide extensive free training and customer support. Other barriers include the pressures of time constraints and operational responsibilities. The squeeze on reimbursement has forced more and more small pharmacy owners to work longer and harder. Once they invest the time they will find cloud-based systems to be a vehicle to both save time and create new opportunities.”
That easy accessibility of data and solutions is also very important for Guardian Pharmacy, according to Matt Hopp. Guardian Pharmacy works with several different eMAR solutions to support facilities’ needs — something that’s simply a fact of life in the LTC space, where the pharmacy doesn’t always have a chance to advise on solutions that facilities choose. Hopp sees certain clear benefits from plugging into the cloud. For example, Hopp says that being able to access data on the cloud for multiple long-term care facilities, particularly for emergency situations, is very valuable. “You see the flooding that happened in Louisiana recently,” he says, “and it really highlights why the protection of your data and the safety of your data is very key. We like knowing that our patient and prescription data are backed up using cloud services, and that certainly is a benefit of the Yardi eMAR.” Hopp also makes the excellent point that, with a localized backup, you have not only to hope that it’s accessible, but that it’s working as well. A robust cloud platform will have your data backed up not just on one server in one location, but in redundant copies at other sites as well.
Cloud Apps and Web Apps: What’s the Difference?
Brian Cole, director of development and data services at Net-Rx, An MHA Solution,
offers this definition:
“Web apps are generally on private servers that you access over the Internet via a Web browser, whereas a cloud app could be hosted on a shared server, with multiple vendors running multiple applications all in the same environment.”
Effortless Updates, Systems That Scale
The fact that it’s not just your data that’s in the cloud, with the resulting benefits to access and backup, but your software as well, means that you can add software maintenance to the list of things you won’t do anymore. Plus, you can respond rapidly to increased demand for a service. For example, because Wagener Drug Company’s SharpRx is hosted in the cloud, Terri Dyches says updates and store-requested enhancements happen overnight without any work on her staff’s part. “I’ll call QS/1 and let them know I need a fax form to transfer prescriptions, for example,” she says, “or fields to customize their labels. They go to work and get it done while we’re still able to focus on the pharmacy and our patients. Changes can happen almost immediately, in fact.” If an upgrade happens overnight, Dyches and her staff will come in the morning and see a message letting them know to restart the system, or they’ll see the screen is different and they know there has been a change. The important thing is that these updates and changes don’t affect the workflow.
Terri Dyches, R.Ph.
Wagener Drug Company
A small, independent community pharmacy in rural Wagener, S.C., 45 miles south of Columbia, that also offers basic over-the-counter items and a small gift section.
Then there’s scale. The data centers that host the cloud are bringing large-scale and flexible computing power that would otherwise be impractical and cost prohibitive for most users to maintain on-site. For example, the cloud-based Yardi eMAR means that Guardian Pharmacy can quickly roll out the service for a client with multiple facilities and readily scale it to that client’s needs. “Do they need to access data from multiple states and for multiple communities?” asks Matt Hopp. “If that’s the case, then if it weren’t a cloud-based solution, what kind of a server and how many are you going to need to get that done, and where does it go?”
Scalability has made a positive impact at Eaton Apothecary as well. Since its locations are all different, notes John Lynch, with volumes ranging from 2,000 to 50,000 prescriptions a month, a cloud-based solution’s flexibility is an advantage both to the pharmacy and to its technology partners. For example, Lynch reports that the pharmacy has enabled TeleManager’s IVR service on demand, with a resulting cost structure that has helped the pharmacy be flexible in how it uses the services. “One of the big questions independent pharmacy asks is ‘What about our customers who don’t want to use IVR — they want to talk to us?’ With a cloud-based system, you can set it up to fit what you need,” he says. Eaton Apothecary gives out a separate number for the IVR, and customers who don’t mind using it call that number, while all customers get the IVR after hours. Over time, says Lynch, at least 20% of Eaton Apothecary’s customers who call in with refills choose the IVR, and that can go as high as 33%. “You have to ask yourself, if you can turn something on and get 33% of the calls to go right into your system, the tool is flexible enough that you can allow your customers to choose the experience, and you haven’t hindered your staff’s workflow at all — the advantages stack up pretty quickly,” says Lynch.
Spurring Innovation, Creating Choice
There’s another interesting aspect to all the power and flexibility of the cloud, according to John Lynch: a lower barrier to switching vendors if you find a better product. “New cloud services can integrate using the same backbone to communicate with our KeyCentrix pharmacy system,” he explains. “This gives us as pharmacy owners more options when we’re ready to grow the business and bring new offerings to customers, because the vendors are aware of this, and it drives them to continually maintain and improve the product. Every pharmacy has experienced buying a product and then being unable to get the vendor to support it once the sale concludes. In the cloud environment the vendor never stops selling you product, so they are motivated to support your use of the service and improve functionality.”
Cloud Communications Changes the Game
In this interview with Val Gurovich, president and CTO of TeleManager Technologies, Inc., he explains how cloud-based products present pharmacies with a remarkable value proposition: innovative technology for communicating with patients in a cost-effective way.
ComputerTalk: Are there any communication challenges facing pharmacies today?
Val Gurovich: Pharmacies are facing a big shift in the communications landscape, and that shift is moving to another gear in terms of “cloud” and IP-based communications. As the Wall Street Journal stated, “At decade’s end, the trusty copper-wired landline telephone could be nothing more than a memory.” For instance, AT&T and other large telecoms are not even replacing old technology when it fails. They are just switching those landlines to fiber-optic or wireless ones. That’s a big shift, and pharmacies need to make sure that their network and communications technology are ready to move over to the cloud. TeleManager, which has been offering cloud-based IVR solutions to its customers for over 15 years, has witnessed firsthand an accelerating migration to cloud communications in the last year. There is a clear change in the pharmacy’s approach to cloud technology.
CT: How is TeleManager evolving its product line to help pharmacies stay on top of these challenges?
Gurovich: TeleManager started providing hosted/cloud IVR solutions in 2000 — way before it was such a mainstream technology and even before it was called a cloud. TeleManager has the experience, expertise, and infrastructure necessary to provide such technology to pharmacies. TeleManager offers one of the most comprehensive cloud communications portfolios for pharmacy.
CT: Why cloud pharmacy solutions from TeleManager?
Gurovich: Let’s face it: Good communication is critical to a pharmacy’s success. But today it can be really confusing. Cloud-based phone and IVR solutions are virtually hardware-less and do not require any wiring or changes in a pharmacy network or telecom infrastructure. As with any cloud-based technology, these systems provide built-in disaster recovery and failover capabilities, which are very important to the pharmacy profession And last, but not least, are savings on telecom infrastructure maintenance and support. That’s unified communications in the cloud, and it’s our number-one mission now.
Lynch’s point is a good one, and it drives home just how the cloud can support innovation by both pharmacies and technology vendors. When massive computing power is readily available on demand, vendors can develop products more quickly and with less expense, and even imagine services that are so storage and processing intensive that they might not be practical in a world where IT resources are distributed and local. Then, when pharmacies see something that looks interesting, they can simply plug into the new service without the need to add hardware or manage new software resources in-house. That should lead to a greater willingness to try something new and find out how it really works at a pharmacy. In the end, the cloud has great promise for bringing new and more efficient technology to pharmacies of all kinds. Keep your eyes to the sky and look for what’s next. CT
Will Lockwood is VP and a senior editor at ComputerTalk. He can be reached at firstname.lastname@example.org.