Cover Story │ The Outlook
There’s a never-ending need to think several moves ahead when it comes to pharmacy’s opportunities for growth. What will your patients need in the coming year? What are the trends you should have your eye on? How will you overcome challenges, expected and unexpected? And what technology will position you to take not just your next move, but set the board for continued success?
Our look at the year ahead attempts to give you some new ideas or encourage you to run with some that have been on the back burner. We find out from a range of technology vendors what they see as the top technologies driving pharmacy success in 2017, and what key trends you should be sure to watch.
Driving Workflow and Efficiency
First and foremost, the message continues to be that the pharmacy model is changing — and has to change. You can’t rely on prescription dispensing to carry you into the future, but most pharmacies are also not in a position to let up on the volume. In order to balance the demands, there’s more of a need than ever to shift prescription-dispensing efforts onto technology solutions. This will remain a priority in 2017.
As a result, there will be a strong focus on continuing improvements to workflow that standardize and streamline pharmacy operations, as Hemal Desai, president of BestRx, puts it. GSL Solutions’ CEO Shelton Louie sees pharmacies looking to add technology in the coming year that can provide labor savings, efficiency, accuracy, and improved customer service. “They are going to be looking for technology that allows the right person to do the right job,” says Louie.
Trends to Track
Matt Noffsinger, senior vice president of business development and sales for TCGRx, sees new inventory management tools being implemented to lower the cost of filling a script — one way he sees for combating the continuing pressures on prescription margins. This is an area where CarePoint’s Director of Client Services Rachel Cupp sees pharmacies with a need to better apply the technology they already have. “Inventory management continues to be one of the more underutilized modules in many pharmacies,” says Cupp. “Not taking advantages of inventory also very much limits the opportunities for effective business analytics and improved financial performance.”
Overall, the focus will be on what drives efficiency, notes Mike Gross, Retail Management Solutions’ vice president of sales and marketing. “Pharmacy owners are looking to put dollars into technology that can make them more profitable, or improve their service level,” says Gross. “As margins on prescriptions get tighter, they will be looking for ways to make themselves more efficient while staying competitive in their local marketplace.”
This reliance on technology for driving the dispensing process will support a clear and continuing trend toward patient services. Services, such as medication therapy management (MTM) and adherence programs, are placing a real premium on pharmacists’ time, according to William Humphries, marketing coordinator for RxMedic. This is in turn going to drive investment in 2017 in technology that will allow them to perform these duties while still maintaining the dispensing volume that sustains a pharmacy. “Investing in automation from full-blown robotics to tabletop counters will free up time behind the counter to help pharmacists get in front of the customer,” says Humphries.
Opportunity in Specialty
There will also be opportunity in the burgeoning area of specialty pharmacy, where excellence in medication dispensing and patient support intersect, but also where the demands on pharmacy for the right balance of time and effort really ramp up. “The first, and easiest, step here is to free up staff to perform in this area through implementation of robotic dispensing,” says ScriptPro’s President and CEO Mike Coughlin. “The next step is to implement efficient workflow systems, again to free up time.”
Coughlin foresees a growing interest in adding to clinical documentation and case management capabilities. “Ultimately, more powerful, integrated pharmacy management systems are required to participate at higher levels in the specialty pharmacy space,” he says. “This power will be required to manage the cases and provide the documentation and reporting required by manufacturers and payers to enable access to specialty medications.”
It’s an area that has quite a few pharmacies looking to position themselves for success, according to BestRx’s Desai. He reports seeing more clients investing in technology to support specialty dispensing, and taking a strategic view of the large upfront cost of getting into the specialty market. “Once they pass the initial hurdles, the rewards are there due to the high margins on specialty drugs,” says Desai.
The Old and the New
What tools will be most critical for attaining the right balance of dispensing volume and patient-focused care opportunities? There are quite a few, and the good news is that some are already part of modern pharmacy technology offerings; others are easily accessible through the growth of cloud-based services, and no matter what there’s a great array of choice out there in the current technology market, with competition driving innovation.
Trends to Track in 2017
• Telepharmacy will support remote-dispensing sites and off-site consultations by disease-state-trained pharmacists.
As mentioned earlier, one instance of a long-standing technology that can have a strong workflow benefit is dispensing automation. “If you can verify count quantity, easily recall that data in the future, and ensure that there are absolutely no over- or under-counts happening by mistake,” says Kirby Lester’s Senior Marketing Manager Mike Stotz, “then this has a real impact on improving your workflow by making sure you are dispensing correctly the first time.”
For something newer, there are offerings that take advantage of the rise of the web and the cloud as ways for pharmacies to access software. Mike Sosnowik, president of PharmSaver, sees great promise in the efficiency drivers that can be delivered to pharmacy this way. For example, he points to generic pharmaceuticals, the focus of a great deal of attention in recent years and no small amount of angst as prices jumped all over the place. While the generic market has calmed down, Sosnowik’s opinion is that it will continue to be the most important market segment and that it’s the pharmacies that use tools to ensure generic profitability that will thrive. “Though in their infancy, pharmacy analytics, purchasing comparison systems, relationship management tools, and prospective reimbursement tools are keys to success in this environment,” says Sosnowik.
And once you’ve got the inventory purchased at the best price, TCGRx’s Matt Noffsinger points to inventory management systems as an important way for pharmacies to track what’s in stock down to the pill. “This is data that really drives proper filling and billing,” says Noffsinger.
Pharmacies should also look at automation that has an impact on will-call, an area that hasn’t seen much change in most pharmacies over the years. There are innovations out there, though. For example, inventory systems such as those using a pick-to-light process can make sure the correct prescriptions get into the correct patient’s hands.
These are gaining popularity, according to RxMedic’s William Humphries. “In many pharmacies there may be common patient names such as Mary Smith,” he explains, “so automated will-call systems ensure the correct Mary Smith receives her medication. This can be an affordable piece of technology that allows pharmacies to gain time and efficiency.”
The systems can also be an important component for keeping an eye on your controlled substances, according to GSL’s Shelton Louie. He emphasizes that inventory and will-call systems need to work together to ensure you have proper storage, tracking, and staff accountability for controlled substances from the time medications are delivered to the pharmacy by the wholesaler until they are safely in the correct patient’s hands. “Fully automated will-call systems bring technology to the last 10 feet of pharmacy prescription dispensing and improve accuracy, accountability, efficiency, and customer service,” says Louie.
Adherence and Performance
The trends around patient adherence and pharmacy star rating performance will continue to hold center stage in 2017. Our survey results suggest that several technologies, including patient messaging and engagement tools, as well as med sync, MTM, and packaging, will be foundational for pharmacies’ efforts to position themselves for achievement here.
Trends to Track in 2017
• Health and wellness, coupled with big data, will move pharmacies away from being dispensers of commoditized prescriptions toward a “health and wellness center” model grounded in clinical services and patient education/empowerment.
Jeanne Van Dyke, voiceTech’s director of marketing and business development, sees communication as a relevant focus for the pharmacy profession overall, and driving patient engagement will be vital for determining how pharmacies fare with the star rating requirements. And if you haven’t really gotten going here yet, BestRx’s Desai suggests keeping it simple to start with: “Text and email reminders for refills and prescription pickup are simple ways for pharmacies to increase adherence as well as volume,” he says, “which in turn leads to increased profits.”
Bob Jones, director of pharmacy systems solutions for AmerisourceBergen, is anticipating continued investment in this area. “For example,” says Jones, “our PSAO partners with PrescribeWellness to provide our members with these types of solutions through our Patient Engagement Center. They also have additional options like personalized outbound patient messaging, medication synchronization, and a Medicare Part D plan selection tool.”
And don’t forget the impact that packaging can have on adherence, especially in the retail setting, where it’s still not a common practice. “With the continued focus on adherence, pharmacy owners should consider investing in some type of adherence packaging to attract new patients and support their synchronization efforts while ultimately improving patient outcomes,” says Jones. “Based on pharmacy size it could be a semi-manual filling solution or a totally automated robotics solution, such as pouch packaging.” And, notes Jones, providing adherence packaging promotes customer loyalty, too, since once your patients get a look at the convenience and benefits of packaging, they are less likely to go elsewhere.
Better Patient Care, Better Pharmacy Business
Improved adherence has a significant positive financial impact for pharmacies, too, for example by generating more fills over the course of a patient’s therapy and affording more opportunities for providing additional services such as MTM, immunizations, or Part D plan selection help. Jon Bell, lead retail market analyst for QS/1, emphasizes that the financial advantages for pharmacies embracing an outcomes-oriented model are all rooted in having a positive impact on patients. “A greater focus on outcomes leads to better patient care and more loyal patients,” notes Bell. “And, as we’ve seen with the CMS five star ratings, physicians will often seek out pharmacies that can help the physician improve quality.”
Bell recommends that pharmacies keep an eye on one topic in particular that he sees driving everything around pharmacy performance: outcome-based payments. “This is what’s driving adherence and the healthcare information technology needed to improve and document outcomes,” says Bell. In his view, pharmacy management systems will become more important than ever as pharmacists look to technology to aid the pillars of performance — med sync, patient education, and patient reminders and communications — while also creating the documentation payers require.
Ranking the Top Issues and Market Factors
will be most critical for 2017?
Patient engagement/clinical management
PBM cost transparency
Retail data analytics
Clinical data analytics
Mobile health technology
Another important trend in 2017 will be the leverage to build a better organized, appointment-based service model. This is something for which your pharmacy may already have laid the groundwork, according to Ateb’s President and CEO Frank Sheppard. He sees that the key to providing value-based care and increasing patient engagement is to transition to the appointment-based model (ABM) using medication synchronization programs that smooth and organize workflow and afford pharmacies with structured and scheduled opportunities to engage patients.
Taking all this into consideration, Datascan’s President Kevin Minassian offers some sound advice: Pharmacies should not expect to make do with their existing technology. Minassian emphasizes that pharmacists should be taking a close look at the market in order to update older technology and ensure they have the latest tools at their disposal.
The transition to a service-based model will require that pharmacies learn to tell their story to patients and prescribers effectively, something technology can help with as well, according to Robert Terrell, product manager for PocketRx. “The first step for pharmacies is marketing their services and educating customers,” says Terrell. In conjunction with this, Terrell notes that there’s also a growing emphasis on technology that helps pharmacies deliver and manage their enhanced service offerings. “It’s evolving into utilizing more interactive technology to help deliver these solutions,” he says.
Data and Analytics
As the need grows to engage more effectively with patients, and as pharmacy practice grows ever more complex, the depth of insight into operations and patient populations via pharmacy data will be a key piece for success in 2017.
Ateb’s Frank Sheppard sees a critical need for pharmacies to analyze their existing data. “Pharmacies can better understand their current patient population,” says Sheppard. “They can identify any lapsed patients and develop appropriate strategies to retain their patients. They can identify patients that require interventions and proactively drive engagement to improve adherence in an affordable manner.” Leveraging big data and predictive analytics will empower pharmacies to practice a more proactive workflow, in Sheppard’s view.
SoftWriters’ Heather Martin, vice president of sales and marketing, makes the point that how you consume your data and timely access to insights are critical areas pharmacies will want to look to in 2017. “Fully integrated data analytics tools allow for easy distribution and consumption of information,” says Martin. “Real-time dashboards and historical reporting features are essential for operators striving to identify patients in need of additional services and for identifying opportunities to improve operational efficiencies and financial performance.” These are the same tools that can be used to reinforce customer service commitments and value, notes Martin.
But don’t just look to your pharmacy management and clinical systems for data, advises Mike Gross, Retail Management Solutions vice president of sales and marketing. He notes that point-of-sale (POS) systems are powerful data collection and analysis tools for pharmacy. They can help identify areas with strong margins and give the pharmacy a competitive advantage by offering a higher level of customer service than what the competition may offer. “POS gives insight into how the store is performing,” says Gross. “You can learn who the best customers are, and where to invest in goods and services, or more importantly, where not to invest. It can give insight into staffing levels, employee performance, and even help determine store hours, but only if used correctly.”
Loyalty programs are another area that should be on pharmacies’ radar for 2017. Epicor’s Senior Product Marketing Manager Keith Lam notes that these programs are also driven by POS data and analytics. “Every retail pharmacy should be using POS data to find their best customers and determine how to continue to provide the higher-class service and the unique products independents can offer,” says Lam. Loyalty analytics will amplify the already powerful sales and product movement data coming from a POS system by providing insight into not just what’s moving, but which customers are buying what. Your next move is then identifying other, complementary products you can sell, including wellness and alternative medicine products, according to Lam.
And the impact is significant, according to Retail Management Solutions’ Mike Gross. “Rewarding your best customers and offering an attractive loyalty program is a very popular trend,” says Gross, “because it not only drives incremental revenue, but increases customer visit frequency beyond what may be typical with 90-day refills.”
Get Secure, Get Mobile
There are several other POS and front-end trends to keep an eye on. One is Europay, MasterCard, and Visa (EMV) and payment security, according to Epicor’s Lam. “Independent pharmacies are lagging behind in getting EMV implemented to protect their patients’ credit card information,” says Lam. “As they implement EMV, they may also invest in other payment security features, like point-to-point encryption and tokenization that encrypts all bankcard information at point of insertion/swipe, so no useful bankcard information can be stolen from the pharmacy’s retail system.”
Then there’s mobile POS, which may be growing to be a competitive necessity these days but which Lam reports seeing only sparing use of so far. Still, he expects growth here as retail pharmacies look to the technology for deliveries and health-system pharmacies for bedside checkout.
Retail Management Solutions’ Mike Gross sees a real strategic benefit for pharmacies willing to invest in a newer technology like mobile POS. “Typically, pharmacies wait for customers to come to the counter to make a purchase,” says Gross. “Retailing today means you have to be everywhere your customer is, including the counter, in the aisle, at curbside, or even at their front door. By leveraging mobile POS technology, a pharmacy can improve its customer service by getting out to assist where its patient base is.”
Finally, you should not forget the revenue and profit opportunities available in a pharmacy’s front end, according to Datascan’s Kevin Minassian. “Independents’ revenues are still 90% prescription and only 10% front end,” says Minassian. “Building adherence in the back is great, but finding ways to promote and sell more in the front end will really build revenue streams and diversify profits.”
Building prowess in your front-end business creates a real opportunity. As you solidify your operational strengths and learn more about your patients’ needs, you can then leverage that knowledge into being a smart pharmacy where you have just the things your patients want and need just in time for each visit they make to your store.
Keeping It Simple
You may be wondering where to start, however. There are a lot of powerful tools out there and some big concepts to approach, such as adherence and performance. But don’t feel overwhelmed and just step away. Educate yourself about what your current systems can do, and start with small steps there. For example, Liberty Software’s Jeremy Manchester points out that workflow features have been available in pharmacy software for years. “But we still see established, high-volume pharmacies not using workflow,” he says. “They aren’t using RPh1 check and final product check, for example. These busy stores are the ones that have the most efficiency to gain from these type of workflow features. Change is always hard, but workflow can really improve a pharmacy’s organization and productivity.”
Datascan’s Kevin Minassian has similar advice. “It amazes me how much technology is built right into so many pharmacy management software products,” he says, “and yet our clients don’t know about the advanced features and technology within.” According to Minassian, a review of your current software is likely to turn up many of the tools that drive adherence, as well as ways to automate tasks. “Use all the technology in your software,” advises Minassian. “Especially when so many of us are including it at no additional cost. You’re basically already paying for it.”
Sharing, Liking, Tagging
Another area that likely gives many pharmacies pause is social media. Maybe you aren’t so excited about it, or maybe you don’t even really know what it is and how it works. But it’s a key area in which to put your message out there and educate patients, current and potential, about the levels of service and attention they can expect. Indeed, voiceTech’s Jeanne Van Dyke says that social media is typically overlooked by pharmacies as a valid vehicle for reaching out to their patients. That’s something that needs to change in 2017, according to TeleManager Technologies’ Paul Kobylevsky, who sees a big need for patient-oriented digital and social media with a cloud-based connectivity.
But there’s a real chicken-or-egg problem here. “These services are widely used by large chains, but not so much by independent pharmacies,” says Kobylevsky. “It is a Catch-22 situation. Independent pharmacies don’t have the time and ability to maintain and promote these services and apps. As a result, patients don’t use them to the fullest extent, and pharmacies in turn don’t see a reason to invest further time and resources in them, since they do not see enough return on investment.” This is completely wrong, in Kobylevsky’s view, because these social apps and other digital media technology are the strong preference for many patients for receiving communications that can impact critical areas such as adherence.
The Hot Markets
What about the market areas where pharmacies can apply their efforts to the best effect in 2017? We got a range of responses from the technology vendors, suggesting that there’s good opportunity for pharmacies looking for growth.
In line with the highlighted trends, a strong focus on the patient and providing services that are competitive differentiators will continue to be a key to success. This may take the form of an emphasis on outstanding customer service; on pharmacist consultations that afford opportunities for providing therapies and clinical interactions at the pharmacy; or on opportunities such as expanding product offerings in the growing alternative health-and-wellness market.
High-growth areas such as specialty pharmacy and 340B will also continue to rapidly evolve, with opportunity for those pharmacies prepared to comply with the specialized demands of these market segments. There should also be reason to see investment by traditional retail pharmacies in long-term care (LTC) services, while the definition of LTC will continue to evolve to include more patient settings, such as home care, a market that is large and growing. Finally, continuity of care will see attention from retail, long-term care, and hospital pharmacies.
Making Your Move
There’s never a good time to be at a loss for your next move in pharmacy, and 2017 will be no exception. It may be the time to rev up your services, getting med sync or immunizations going. Or you may decide to revamp the workflow in your pharmacy, add automation, or move into specialty. It will take a good strategy and a firm grasp of the technology pieces available for you to make these moves successfully. The good news is that the board is full of options, and the biggest job is deciding just which move to make. CT
Will Lockwood is VP and a senior editor at ComputerTalk. He can be reached at email@example.com.