A.J. Oben, Pharm.D.

GoldStar Pharmacy, located in College Station, Texas, focuses primarily on partnering with different healthcare providers, long-term care (LTC) facilities, accountable care organizations (ACOs), and patients directly to serve seniors by helping them manage their medications, according to owner A.J. Oben, Pharm.D. “We’re trying to improve outcomes and reduce the cost of care,” says Oben. He looks to invest in technology that ensures his pharmacy is getting the right medication to the right patient at the right time. “This is the critical element of what we do as a pharmacy,” he says. “We are always looking for technology that gives us the most efficient way to be the medication safety experts.”

PATRICK DEVEREUX, PHARM.D. FMS Pharmacy
Patrick Devereux, Pharm.D.

PATRICK DEVEREUX, PHARM.D., serves a large Medicare and Medicaid population at FMS Pharmacy in Bessemer, Ala., outside of Birmingham. Adherence packaging is central to the services Devereux offers, and while he does serve several group homes, the majority of his patients using packaging are living independently at home. “We find that when patients can get their meds packaged, they are able to keep living independently longer,” says Devereux. Tom Mullaney, R.Ph., is a third-generation pharmacist. Mullaney’s Pharmacy + Medical Supply, a Guardian Pharmacy, has been in business for over 86 years in Cincinnati, Ohio.

Tom Mullaney, R.Ph.
Tom Mullaney, R.Ph.

“We’ve been pretty early adopters of technology,” notes Mullaney. “My dad bought our first pharmacy management software from QS/1 in 1977 and we’ve been staying on the cutting edge ever since to ensure we are as efficient and accurate as possible.” Mullaney’s largest area of service is LTC, and the pharmacy partnered with Guardian two years ago. After a major acquisition a year ago, his pharmacy now serves 5,000 patients all over Ohio, as well as in parts of Kentucky, Indiana, and West Virginia.

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CORE LTC WORKFLOWS

Patrick Devereux has been using Medicine-On-Time (MOT) for over eight years. He sought them out as a way to scale blister card packaging capabilities and create the capacity to serve more facilities. Devereux relies on the motNext software to run key packaging workflow steps, including managing patient profiles and tracking cycle dates. “We can run a lot of different reports out of motNext very easily,” says Devereux, “and print medication administration records or export them to PDFs. motNext has really helped us streamline a lot of those functions.” Devereux also points to the calendar within motNext as an important feature. “We can quickly use the calendar to see which patients and facilities changes to dosing time, color coding on the packages, and more. “It’s all pretty easy to customize however a facility needs it inside of motNext,” says Devereux. It’s also easy to use, he says. “If we have an intern coming in for five weeks,” says Devereux, “they generally pick it up within the first day.” At GoldStar Pharmacy, Oben looks to Meditab IPS Elite pharmacy management software to ensure efficiency in moving orders from facilities through the dispensing process and into the packaging automation he runs. The packaging is central to patient adherence and smooth medication passes at facilities, of course, but it’s also a major efficiency driver within the pharmacy. “We’ve made a big investment in packaging,” says Oben, “But we aren’t able to use it with peak efficiency without being certain that we are sending the right filling data over with as few manual steps as possible.” This is where IPS Elite shines, according to Oben, by automating steps and checks that the staff had to work through manually when using a previous system. For Tom Mullaney, being able to manage the flow of documents and communications efficiently — whether via fax, e-prescribing, or otherwise — is a core element of workflow. For this he has been relying on Integra DocuTrack and PrimeCare for over 15 years. “DocuTrack really drives the workflow,” says Mullaney. “Every new and refill prescription is routed through DocuTrack, as are all our communications with facilities, prescribers, and patients. Then staff are using this data flowing in from DocuTrack to manage areas such as cycle fills and patient records in PrimeCare.” The two systems are closely integrated. For example, facilities that are coming due and plan ahead,” he says. It’s one example of the bird’s-eye view Devereux gets from the software. Another is the ability to easily pull up all patient records at a facility or make use the on-demand model rather than cycle fills can order refills by faxing sheets of barcode labels peeled off prescriptions. DocuTrack receives these faxes, reads the barcodes, and automatically loads the refill orders into PrimeCare, where they’re processed. The staff has visibility into the various work queues from both PrimeCare and DocuTrack, and they can sort the queues by a variety of criteria, such as alphabetically, building, sender’s fax number, or delivery time.

ELIMINATING MANUAL LTC PROCESSES

DocuTrack is valuable across Mullaney’s business lines, not just for LTC. He uses it to manage durable medical equipment (DME) processes, for example. And it even applies within his retail operations. “We route retail e-scripts through DocuTrack,” he says, “and we scan any paper prescriptions into it as well. From there we can easily tag the prescriptions, for instance as ‘waiting’ or ‘on file for delivery,’ and this means that we are managing everything in one place and ensuring that the right staff are able to access the right information when they need it.” “It makes us so much more efficient to have one central place that our staff uses to know what’s going on and to answer questions,” says Mullaney. “When anyone calls to check on a prescription, staff just type the name into DocuTrack and get an immediate overview of everything that’s going on.” For prescribers, the staff can simply pull up everything that has come in from a prescriber or facility’s fax number. Not just that, but DocuTrack logs who scanned items in and who has worked on them, which makes a big difference in accountability and coordinating work across shifts. Patrick Devereux is managing the packaging details for patients within motNext; he had been using a different packaging product before that, but it lacked this software component, which meant that there was no good way to automate tracking key data such as due dates. “Add to this the fact that the MOT packaging is much sharper than what we used before,” says Devereux, “and it is clear that we made a great decision. Devereux is now implementing MOT’s C.A.R.E. Package product, which also leverages motNext for workflow. This packaging has a host of important patient care and adherence features, according to Devereux, including calendar layout with weekly and monthly options, removable dose cups, color coding, and an optional patient C.A.R.E. plan attachment. “All this gives us so many tools that really increase the level of care we are offering patients through packaging,” he says. Interestingly, most of Devereux’s patients who receive adherence packaged medications are living independently at home. “Medication mismanagement is one of the biggest barriers to independent living,” he says. “So it’s very important that we’re able to help our patients with that through the MOT adherence packaging.” Cycle fills are one of the most critical areas that Oben is automating with IPS Elite software. “IPS Elite is reviewing a cycle batch and looking for differences between last month’s and this month’s fills,” he explains. “For example, a number of the facilities we serve get multidose packs. The first thing we need to know is: Are we sending the same 10 medications this month? Then we need to know things such as, are there prescriptions that are not verified, that are expired, that have had the refill denied, that have a different NDC in the robot, or that we don’t have sufficient quantity on hand for?” These were all manual checks before. But once IPS Elite has reviewed the prescriptions according to established rules, the staff sees a simple green check mark next to all the prescriptions hat are ready to go in the cycle-fill queue. The automated application of these rules is so important, notes Oben, because it is a highly efficient way to ensure that GoldStar Pharmacy’s packaging automation gets clean and accurate filling instructions for the cycle. “We end up saving about an hour every day using these automated checks,” he says. “And we are ensuring that we have all the right medications in the packs that the automation is producing.” Oben also appreciates the way in which the IPS Elite web portal and app can be applied to minimize manual tasks. “The web portal gives facilities, patients, and caregivers a real-time view of what’s going on in the pharmacy,” he says. “We have a lot of residents in facilities here, but the son or daughter lives in another state. The web portal makes it very easy for them to manage their parent’s care. They don’t have to pick up the phone.”This visibility extends to items en route for delivery. The app, called MyDoses, allows patients and caregivers to receive alerts when it’s time to take a medication, record that they took it, and receive missed-dose alerts, according to Oben. Among other features, patients can also view their profile, message the pharmacy securely, and order refills.

LTC RELIES ON TECHNOLOGY

“Our investments in technology have been primarily driven by patient safety,” says Oben. “Having the right technology has also helped us retain our talent in a tight labor market and ensures we are providing facilities with the highest levels of service, too. We want to be the medication safety experts and ensure that facility staff have everything they need for the systems we have to make everyone’s job easier and less stressful. It gives me peace of mind.” Patrick Devereux finds great value in technology that gives him a bird’s-eye view of what’s going on in the pharmacy. “I love a dashboard,” says Devereux. “I want to know what we need to prioritize and what’s in the packaging queue this week.”This ability to see what’s happening at a glance is a central aspect of providing the highest levels of service at FMS Pharmacy. Making things as easy as possible for facilities is central for Tom Mullaney. “Facilities are getting hit really badly by the labor shortage,” says Mullaney. “A lot of nurses retired during COVID. We try to do everything we can to make their life simpler, to speed up med passes. And patients have a choice of pharmacy too. That’s another reason why we invest in technology.” CT