QR Codes: An Avenue for Digital PMI

A small change is promising to make a big difference in efforts at Hobbs Pharmacy to make sure its patients have the medication information they need. What’s new? A QR, or quick response code.

Eric Russo, R.Ph., Director, Clinical Services, Hobbs Pharmacy, Merritt Island, Fla.
Eric Russo, R.Ph., Director, Clinical Services, Hobbs Pharmacy, Merritt Island, Fla.

Hobbs Pharmacy is closing in on its 50th year in business, reports pharmacy manager Eric Russo, Pharm.D. It offers retail and closed-door long-term care dispensing, home infusion, and compounding. “We offer a full selection of pharmacy services,” says Russo, “but we also see ourselves as a very traditional pharmacy in that we promote high-touch customer service.” So Russo and his colleagues are always on the lookout for technology that’s better for the patient while also helping the pharmacy further this patient-centered approach. It’s not surprising then that the Merritt Island, Fla., pharmacy jumped at the opportunity to be the first Rx30 pharmacy to go live with a new QR-code-driven digital medication information resource from VUCAHealth, called MedsOnCue.

Point and Scan

Here’s how it works: A patient uses the camera and a free app on his or her smartphone to scan the two-dimensional QR barcode, and this links to video and text-based medication information. This affords Hobbs Pharmacy’s patients with a sophisticated multimedia resource that Russo and his colleagues see as a supplement to paper patient medication information (PMI) efforts. “The reality is that a lot of patients don’t read the paper PMI they receive,” he says. “The paper gets thrown away when the patient gets home and then, a few days later, when they are experiencing something they think may be a side effect of the medication, they don’t have the information they need.” The patient may then call the pharmacy or, even more likely, may go online, where it can be hard to tell if the medication information is from a trusted source. “But if they have access via our QR code, they get a trusted source of information that’s branded through Hobbs Pharmacy,” says Russo. “And with video, text, and the option to contact the pharmacy, we can also cater to the different ways a person may want to learn about medications.”

QR Codes for Pharmacy

Creating a QR code isn’t difficult. They are in common use these days, and you can even use various resources online to generate one that links through to a URL, an email address, or other locations. Of course, it’s never going to be quite that simple when you are trying to add the code to a prescription vial label in order to convey something as crucial as PMI.

First, there’s the matter of finding space on the label. Russo reports no major issues here, with Rx30 doing all the work to reorganize the Hobbs Pharmacy label. “They showed us a few options, and we picked one,” he says.

Next, there’s the need to have the right information to connect to in the first place. VUCAHealth comes into play here by providing the video information and offering a selection of text-based drug information resources for pharmacy users to choose from.

And then Russo points to another important detail, which is making sure that the code connects patients to direction-specific PMI. “Rx30’s programmers worked hard to extract the patient-specific directions from the pharmacy system and connect them to the right video via the QR code,” he says. “It really impressed me that they could make this intelligent connection.”

Finally, there’s the important detail of the pharmacy-specific branding that Russo mentioned. “This resource is an extension of our brand and of our pharmacist into the patient’s home,” he explains. “For us as an independent, it’s a huge technology boost that gives a presence we’ve never had before. Maybe a large chain has a drug information site, but we wouldn’t have the resources to do this without the support from Rx30 or VUCAHealth.”

A New Standard

Hobbs Pharmacy is printing the QR code on every vial label, and making this new resource part of the counseling conversation. “When the patient is at the counter and we are counseling him about what to expect from the medication and how to best use it,” Russo explains, “we are able to end the conversation by letting the him know that we’re also giving him easy access to reinforcement of what he’s just heard. And it’s all just behind this QR code that we show him.”

Giving patients access to on-demand information helps an independent pharmacy address a couple of big issues. First, notes Russo, a lot of people don’t take medications properly because they don’t know what to expect from them or what the benefits are. The video and text information in MedsOnCue addresses this. And then, Russo points out, there’s the issue of patients who do not want to continue a medication when the generic source, and therefore the look of the pill, changes. “They don’t trust it when it looks different,” he says.

“We actually get a lot of calls at the pharmacy about this.” This issue is addressed by the NDC-specific pill image that’s part of the medication information. The tool even provides patients with a method for remembering to take their medications

via a “remind me” tab. A patient can create an account with one of VUCAHealth’s partners, according to Russo, and then the system will drop in the drug and the directions. “You can then choose an email or text alert for either a daily reminder at a specific time of day or a simple refill reminder,” he says. “Adherence is a big objective these days, and this gives people another option to fit their needs.”

Patients Respond

Since this QR code is new at Hobbs Pharmacy, there are ongoing efforts to educate not only patients but staff as well. “I don’t assume this will be the solution for everyone,” says Russo, “but if it improves care for a subset of our patients then we’ve done our job.” And the immediate response has been positive, even among groups of the pharmacy’s patients that you might not expect to be enthusiastic. “I think we can underestimate our population’s level of interest in a new technology tool like this,” says Russo. “I explained the service to our delivery driver recently and showed him how the QR code works, in case he got any questions. He said, ‘Yeah, but most of the people I deliver to are older and I don’t think they have this kind of technology.’” When the driver returned from his delivery rounds he was quick to admit that he’d misjudged the situation. “The first person he delivered to was a 94-year-old who had always wondered what a QR code was, and was so happy to know what it was and was excited to scan it,” Russo says.

Of course, it’s going to help to be able to take small steps with some patients, for example by scanning the code in the pharmacy and emailing the link at the patient’s request. “We just had a case the other day when we were telling a woman about the QR code, and she said she didn’t have a smartphone to scan it,” explains Russo. “She thought she’d be able to get her niece to access the information and play the video for her. But when we said we could email the link instead, her eyes lit up and she asked us to please email her links to information for all her meds. She was about 85 years old, and she was comfortable and even excited about getting these links.” Overall, Russo expects an adoption curve similar to the one that Hobbs Pharmacy’s patients followed when the pharmacy introduced another barcode technology, scanning for refills. “It turns out that even some of our older patients are really putting this other technology to use,” he says.

Looking to the Future

And while this QR code for delivering medication information is currently just an addition to printed PMI, Russo sees it as one step forward to a day when pharmacy won’t be asked to print 15 pages that’s going to get thrown away. “If patients were allowed to opt in to a program that provides PMI electronically,” says Russo, “and a technology like this serves that purpose, you’d get a real return on the investment from using less paper and toner, and you’d be greener. It would reduce the burden on the pharmacy while still getting the information to the patient.”

Whatever the future of delivering medication information, Russo expects to see real value from these QR codes as another way to deliver the service that keeps patients coming to Hobbs Pharmacy. “We didn’t want to lose patients when other pharmacies started to offer the ability to scan the prescription barcode for refills,” he says. “Now when there’s the opportunity to provide these new QR codes that allow us to be there whenever a patient needs us,

we want to do that too.” Time will tell just how valuable these codes prove for Hobbs Pharmacy, but Russo’s already happy to be on the cutting edge. “I had one lady say that she was proud of us for having something so innovative,” he says. And building and keeping a reputation as an innovator is a very valuable thing for a pharmacy. CT