The

2015
Pharmacy Technology Outlook

by
Will Lockwood

This
year’s outlook survey found the technology vendors putting a heavy
emphasis on patient management and pharmacist access. These are not new
concepts in community pharmacy, and each has a great many details packed
into it that see an impact from a wide range of technology. Data flows
and mobile technology loom large here. And contained within this is a
continued focus on adherence, driven by system features for prescription
synchronization, compliance packaging to promote adherence, medication
therapy and disease management tools, improvements in workflow
efficiency, and technology that helps pharmacists understand their
patients better and support richer pharmacist-patient interactions.

One
of the most critical elements for ramping up patient management in
2015 will be deploy
ing
tools to collect and share data about care interactions. ScriptPro’s
Mike Coughlin sees a need for pharmacies to focus on systems and
tools to promote patient medication adherence through integration of
health-system and retail pharmacy activities across the continuum of
care. A significant element of this, ac
cording
to Innovation’s Doyle Jensen, is that pharmacy will be looking for
software that is configured with a medication therapy management
(MTM) platform and a patient-level electronic health record (EHR),
as well as being integrated with compliance management.

Micro
Merchant Systems’ Ketan Mehta sees interfaces with MTM platforms as
increasingly important for the pharmacies as well. This, Mehta
notes, is where pharma
cies
will identify and document clinical-care opportuni
ties
that are a significant driver of performance metrics and that are in
turn showing pharmacy’s contribution to payers’ star ratings.

QS/1’s
Michael Ziegler offers one interestingly specific example here when
he notes that pharmacies need to take an active role in high-risk
medication monitoring in the elderly, using the Beers Criteria. This
is the kind of clinical activity outside of the prescription
transaction, along with a variety of other patient communications
and interactions, that needs to be actively tracked within pharmacy
data systems, notes Lagniappe Pharmacy Ser
vices’
Clarence Lea.

There’s
a good existing model for this real-time flow of adherence and patient
data, according to Catalyst Healthcare’s Kasumi Oda. As she points
out, pharma
cies
that serve long-term care settings have been learning about the value
of these data flows by using electronic medication administration
records (eMARs) for keeping up to date with drug changes,
administration records, allergy status changes, and hospitalizations.
There’s a model here for how pharmacy more broadly is going to want to
handle sharing real-time patient medication data with providers across
the care continuum.

As
this data flows, pharmacy will need to apply tools to manage and
interpret it effectively. This will require an expanded use of
existing reporting capabilities and business analytics within the
pharmacy system, notes CarePoint’s Rachel Cupp. Pharmacies will then
look to package this reporting by leveraging business intelligence
products that deliver clinical dashboards and insights that are easily
digested by pharmacy staff, according to SoftWriters’ Heather Martin.
Data mining and reporting tools aren’t just going to be critical for
clinical information, either, notes Speed Script’s Heath Reynolds, but
for inventory management and marketing tools as well.

Mobile
Patients, Pharmacy Access

Patient
outreach is critical. In Ketan Mehta’s view, pharmacies will be
looking for tools that support contact with patients through their
preferred channel
in a compliant manner, and support an appointment-based adherence
program mode that brings pharmacist and patient face to face monthly.
Mehta also makes an
important
aside to his comments when he notes the need for support for patient
counseling and medication information
in different languages to reflect the fact that, more and more, the
patient’s first language is something other than English.

Pharmacy
is going to need to look for ways to allow for data that flows to
and from the patient as well. Here, mo
bile
technology will continue to be paramount, according to TelePharm’s
Roby Miller. This is all part of the broader consumer shift to
online interactions, and more use of mobile devices. Miller sees
pharmacies in 2015 having an increasing need to provide patients
with ways to manage their prescriptions and communicate with the
pharmacy seamlessly through both active and passive channels, such
as video conferencing, text, and access to fitness track
ing.
What Technologies Will Drive
Pharmacy Performance in 2015?

The Vendors’ Top Five
° Adherence management tools
° Outbound messaging
° Business intelligence and reporting tools
° Workflow
° Continuity-of-care tools
Want to See the Pharmacists’ Top
Five? Visit www.computertalk.com/outlookRPh

This last item is notable, since, as Miller points out, Apple’s iOS
8 and HealthKit point to a trend in which more patients will be
collecting their own healthcare data and potentially taking a much
more active role in manag

ing
their own health records, both of which can be key to pharmacists
providing the best healthcare. Tied into the greater use of mobile
devices and the push for ever-greater connectivity of data flows for
pharmacy is the issue of access. In Miller’s view, patients are
going to want and need greater access to pharmacy services,
particularly in rural and underserved communities where community
pharmacies often struggle to maintain a viable economic model. One
way for pharmacies to offer this is through the broader category of
telehealth.

Workflow
Driving Engagement

Workflow
and automation are two other areas that pharmacy will look to in the
coming year to support the goal of engaging and managing patients.
The pharmacies that are automating daily, repeti
tive
tasks and investing ahead of the curve in technology that will
efficiently support increasingly complex com
munication,
business processes, and reporting needs are the ones that will come
out ahead in 2015, according to SoftWriters’ Heather Martin. The
widely expressed need for pharmacies to drive workflow efficiency
reflects the fact that filling prescriptions is still a core
activity, but one that, as Datascan’s Kevin Minassian puts it, needs
to use automated processes designed to do more with fewer people.
Local pharmacy-level automation can also improve workflow by
eliminating the need for the pharmacists to be in the production
area, notes Innovation’s Doyle Jensen. What’s interesting is that
this doesn’t just mean automat
ing
pill counting. It extends, as Jensen points out, to automation that
controls inventory levels, reduces expired product, eliminates
diversion, secures scheduled drugs, and reduces labor.

Diversion
control came up as a specific task requiring real attention
within the pharmacy workflow. TCGRx’s Matt Noffsinger points out
that a lack of attention to this criti
cal
area has serious business and societal consequences, with the
pharmacy at risk of audit and serious penalties as states and
the Drug Enforcement Administration (DEA) ramp up their
attention to diversion. Considering all the other demands on
pharmacy staff’s time, Noffsinger sees a real need for
pharmacies to look to technology, including biometrics and
software-driven access logic, to secure and track medications at
risk for diversion.

Top Functionalities for Patient/Customer-Oriented Apps
° Prescription refill
reminders
° Profile viewing/management
° Store location/details
° Drug and health information

Another
interesting comment on the need to apply auto
mation
and logic to the dispensing workflow comes from Health Market
Science’s Dan Schofield, who points to increasingly complex state
and federal regulatory require
ments
around prescriber eligibility and prescriptive author
ity.
This is essentially a real-time compliance requirement when
submitting claims, and one that is impossible to manage effectively
without a technology platform. Scho
field
points out that this is an area of regulation that has become even
more important as third-party audits are becoming more prevalent.

With
so many activities in the pharmacy demanding time and full
concentration, technology-supported workflow processes and
automation are significant ways for pharmacies to free up minutes,
even hours, in a day for major initiatives like synchronization,
MTM, or front-end rejuvenation, notes Kirby Lester’s Christopher
Thomsen. He specifically sees verification technology that prevents
errors as a necessary focus in 2015, whether at the point of
adjudication, technician driven filling, pharmacist check, or
will-call.

Front-End
Considerations


The front end is an other area in pharmacy that requires attention
for both operational and regulatory tasks, and that, when properly
streamlined with the help of technology, can support a pharmacy’s
mission of
patients effectively. ECRS’s Ashlee Weatherman
sees pharmacies looking to leverage point-of-sale (POS) systems to
automate pseudoephedrine (PSE) tracking and reporting to the National
Precursor Log Exchange (NPLEx), and to implement Web-based back-office
management and analytics. Epicor’s Keith Lam also sees retail
pharmacies focusing more on POS-driven analytics in 2015, with better
business intelligence tools helping them to determine how to increase
overall margins as the Affordable Care Act drives patient numbers up
but prescription margins continue to decline. POS tools here can
include market basket analysis and customer value profiling. And one
important way to collect actionable customer data is through a strong
loyalty program, something that Lam sees as extremely important for
pharmacies in 2015 and beyond. The goal, according to Lam, is for a
pharmacy to be able to out-service the competition and better
compete with the big-box stores.

Adherence Drivers
Will managing patient adherence continue to be a major focus for pharmacies in 2015?


Over 85% of vendors said yes.

Adherence
Driver
s

Adherence
will continue to be at the core of engaging patients in 2015,
according to this year’s survey. This is due to the impact that
adherence has on outcomes and the importance of pharmacy performance
metrics, both of which continue to be top of mind across the
profession. Ateb’s Frank Sheppard believes that a pharmacy’s focus
on delivering differentiated services to improve medication
adherence will depend on the staff having time to devote to pharmacy
services and on changing the dynamic from continually reacting to
patient requests to a proactive, predictable workflow. This will
rely on the technology tools covered earlier, such as ready data
flows and an efficient workflow that helps pharmacies effectively
identify patients requiring intervention, and then engaging them to
improve their health.

What Will Drive Adherence in 2015?
° Synchronized refills
° Counseling
° Continuity of care (when a patient is moving between care settings)
° Dashboard adherence metrics for pharmacists
° Compliance packaging
° Push messaging to smart devices and text messaging
° Patient calls
° Predictive modeling
Want to See the Pharmacists’ Top 10? Visit www.computertalk.com/outlookRPh


Packaging
will also come into play for promoting adher
ence
in 2015, and not just in long-term care settings. As
AmerisourceBergen Technology Group’s Sid McFadden notes, retail
pharmacies should take a serious look in 2015 at capabilities that
will aid adherence, such as compliance packaging, potentially as
part of a program of services that will help to provide
comprehensive transitional care from admission to the hospital or
other institutional setting through to post-discharge follow-up
and a return to the home and the community pharmacy. Pack4U’s
Shane Bishop also sees easy, low-cost options for adherence
packaging giving pharmacies an edge in the coming year. Compliance
packaging’s impact at a given pharmacy will depend heavily on
finding the right balance between cost, labor, and efficiency,
notes Rx Systems’ Derek Jensen.

Star
Ratings

At
the far end of this chain of engagement, adherence, and outcomes
is the contribution pharmacies are making to payers’ Part D star
ratings.This is an area that has generated a lot of conversation
and is widely recognized as an important strategic focus for
pharmacies looking to demonstrate their relevance in an evolving
healthcare system.

However,
Rx30’s Steve Wubker is seeing a mixed bag here, with pharmacy
still in the calm before the real storm. Wubker’s view is that
star ratings are a priority for a certain percentage of
independents, but somewhat of an unknown entity to another
percentage. Continuing education is key to making independents
see the ramifi
cations
and potential consequences of the star rating process.

Top Technologies to Impact Pharmacy Performance
Measures
In the top tier for 2015, according to the vendors:
° Prescription
synchronization
° Patient communication, including mobile
° Data management/analysis and business intelligence tools
° Dashboarded metrics/reporting of key measures
° MTM tool integration


Speed
Scripts’ Heath Reynolds finds that the attention to star ratings
is encouraging pharmacies to focus even more in 2015 on
communica
tions
with patients, automation, and synchronized medication
fulfillment. Michael Ziegler reports that QS/1 customers are
spending a great deal of time educating themselves on the star
ratings requirements, which is in turn leading them to learn
about new tools and resources that can help them manage and
counsel the right patients at the right time.

In
the end, as Ateb’s Frank Sheppard puts it, while star ratings
have gained a lot of attention, pharmacy has a long way to go in
fully understand
ing
the impact of the ratings and how pharmacy should be adapting to
maximize its positive impact on quality measures. But the
opportu
nity
is real, according to Sheppard, since attention to as few as
four or five high-impact patients daily can transform a pharmacy
from simply average to a top performer over time.

The
State of E-Prescribing

E-prescribing
continues to present challenges, along with the benefits it
brings. Replies to this year’s survey cited ongoing issues, with
too many competing prescriber solution vendors resulting

in a lack of accountability and standardization in pre
scriber
practice management systems, as well as insuf
ficient
prescriber training. Several vendors also raised the issue of
the cost for pharmacies that comes from repeated transaction
charges when prescriber offices send the same prescription
multiple times. These issues are being exacerbated by increased
volumes.

Are Issues with Electronic Prescriptions…
° Decreasing? 30%
° About the same? 50%
° Increasing? 20%
Allocating
Resources

What
regulatory requirements are going to see the bulk of vendor
development resources in 2015? Most frequently mentioned were
prescription-monitoring programs, which one respon
dent
notes continue to be dynamic. Electronic prescrip
tions
for controlled substances (EPCS) and ICD-10 are also at the top of
the list. Coming in next are imple
menting
technology for track and trace, PCI Security Standards Council
Data Security Standard (PCI DSS) compliance, EMV chip-and-PIN
cards, and near field communication (NFC) payment systems.

Security
for patient information and payment data is

an area that technology vendors will continue to focus on,
particularly in light of the continued high-profile evidence of
risks from hacking. Among the improvements to look for in 2015 are
role-based security enforced with a complex password policy, user
tracking and intrusion de
tection,
managed network-monitoring services, and even hardware that can
perform vulnerability tests.

What Do Vendors Find Users Are Asking For?
° Expanded mobile apps,
including push notifications
° Mobile payment and delivery options
° Ability to accept EMV chip-and-PIN payment cards
° A/R functionality, such as e-mailed statements
° More languages
° Enhanced packaging functionality
° Central fill
° Data analysis and process simulation
° Performance status/monitoring of compliance
° Transitional care tools
° Patient management tools that include other providers
° Patient self-management tools and patient-pharmacy
communication tools
° Document management tools
° Specialty pharmacy tools

Brad
Jones from Retail Management Solutions sees 2015 as a watershed
year for payment transaction security. Combine the massive data
breaches that continue to be in the news with new players like
Google and Apple, and Jones sees some of the biggest changes
coming to credit-and debit-card processing that the industry has
seen in a very long time. Jones says his company has been
devoting significant resources to security — rolling out
point-to
point
encryption and tokenization of credit-card informa
tion
in 2014 with one credit-card processor — and that this will be
the standard with all of Retail Management Solutions’
payment-processing partners by the end of 2015. The goal is to
ensure that no credit-card data is stored on the merchant’s POS
system. Unfortunately, Jones notes, this is all likely to be
expensive for indepen
dent businesses.

Strategy
2015

The
coming year will certainly present challenges across pharmacy
operations. But amid all the change, there’s a real opportunity
for pharmacies to become strategic point-of-service locations
for health-care, notes Health Business Systems’ Marty Spellman,
in
stead
of being viewed as just medication points of pickup. This
opportunity is made even greater because, despite the
long-standing role of technology in pharmacy, most pharmacies
are still using only a small percentage of the potential for
clinical and operational improvement that already exists within
their pharmacy management system, according to CarePoint’s
Rachel Cupp.

Success
in 2015 will rely on pharmacies finding what will likely be a
delicate balance. As Innovation’s Doyle Jensen puts it, pharmacy
has to continue to evolve into a highly sophisticated,
patient-centric service driven by continually emerging
technologies. And successful pharmacies will not just focus on one
area, notes Datascan’s Kevin Minas
sian.
They will use adherence, automation, and patient 
convenience
tools to build the prescription side, while at the same time
using POS-driven sales, loyalty, coupons, and reporting
capabilities to build the front end.

These
will be the ways in which pharmacies will survive and thrive so
that they can continue to dem
onstrate
the value of pharmacy to the healthcare system. Frank Sheppard
sees this value as strong, and growing stronger every day, as
the evolution continues from a prescription transaction focus to
a focus on patient-centered care. This, Sheppard notes, is what
will be truly transformative for the future of healthcare.
For
more on the 2015 outlook, visit www.computertalk.com/ outlook
.
CT

Will
Lockwood

is senior editor at
ComputerTalk.
He can be reached at will@computertalk.com.