John Frady joined QS/1 in 1990, he was first introduced to QS/1 when the pharmacy owner where he worked purchased a system from the company. Charles Garner joined in 2005, and became an expert on the web/mobile applications, Point-of-Sale (POS) and IVR. Both retired this summer, and in this interview with ComputerTalk’s Maggie Lockwood, they share stories and memories about working at QS/1 and how the pharmacy industry has changed with improved hardware and connectivity.
How did you start out at QS/1?
John Frady (left): I was working at an independent, a small retail pharmacy with a soda fountain, in Spartanburg, S.C., where I had worked since pharmacy school. I moved to a pharmacy that was part of a rural health network with four pharmacies. While I was there, the owner purchased a QS/1 system and we were using it in all four locations. We had a manual system until 1986. The real reason the owner got a computer was his technician threatened to quit if he had to do another universal claim form by hand. When we brought QS/1 into my store, I trained everyone. In late 1989, QS/1 asked me if I’d help manage the clinical side of their system and I said yes.
Charles Garner (right): I started with QS/1 in 2005. I came in with a background of 25 years in consulting in healthcare and governmental affairs without a specific pharmacy background. But my experience applied to the products QS/1 had me working on: interfaces with different systems, IVR, as well as starting WebRx, their product for Internet refills. From there I focused on POS and the newer things, like the Web and wireless products.
When you started out, what were the systems like and what were pharmacists looking for?
JF: When I started, OBRA ’90 was hot on the agenda. What was required for OBRA meant pharmacists were looking for more automated ways of clinical checking. When I first went to work, automated clinical checking didn’t exist. When a new drug came out, I would check with the pharmacy staff at the University of South Carolina and develop an interaction profile. I would put together a guidebook listing the side effects. We were still looking at how to integrate monographs. We worked in conjunction with First DataBank. In 1993, I wrote an article on “Look How Far We’ve Come with a Computer” and what I talked about were the things that were meant to be helpful with OBRA ’90. I would explain how the system could do drug-drug and drug-allergy checks without walking away from the computer. Within the system, you could check a profile before a refill.
What was the biggest disruptive change that took the systems in a new direction?
CG: In my experience it was the move to window-based systems. QS/1 was just coming out with NRx, and there were still a lot of customers on the character-based, DOS RxCare Plus system. As we were moving forward with the new system, we were trying to see what were the barriers for pharmacists to get past the older system. The older systems were big and owners need to have space for them in the limited space of a pharmacy.
JF: And they were expensive.
CG: And they weren’t that fast. As the technology improved, pharmacists started to accept that the systems were getting better and they could do more things with them. There were more options available. Pharmacists started to see how being computerized enabled them to look things up more quickly.
JF: Cost was an issue as the initial systems were $50,000. And then there was the computer literacybarrier. Pharmacists didn’t know anything about computers. The uncertainly is what stopped them – will it last? Will it be useful?
CG: John just mentioned that change is hard – it’s still hard to change things. One of the big hurdles to accept is that change is going to be for the better.
What was a memorable project that you felt increased the value of the system to pharmacists
JF: NRx. We still had a lot of people who loved the character-based system. It was hard to learn but easy to use once they got used to the function keys. With NRx as a windows-based product, it was easier to learn and use, and the other thing was all the different functionality that they could add.
Another project that added value was integrated workflow. When we first did the workflow system many of the other systems offered workflow but it wasn’t integrated, it was a module and you’d have to have two systems. More recently, there is the addition of medication therapy management, and I’m happy with the tools we’ve added to the system. These required a lot of work from everyone at QS/1.
CG: One of the big things that affected POS were the SIGIS standards and the need to have a POS system to process FSA cards [to pay for items on the SIGIS eligible product list]. At that time, the smaller pharmacies that didn’t have a POS system had to figure out what they were going to do, how were they going to check if the items were on the approved list. This meant small pharmacies had to get a POS system and it was a big thing for them. For QS/1 as we had to order the systems and get them installed, it was a disruptive period with a specific deadline.
Another thing that came along that influenced the POS side of the pharmacy was when pharmacies started looking at the capabilities of doing things wirelessly. POS is going to smaller devices, away from the counter cash register. There is a need to find a way to be mobile, to allow staff to move around the store. Some clients said they wanted curb service if they didn’t have a drive-through window — they wanted to be able to go out to the car. And for delivery services, there was a need for mobile devices, too. We wanted to offer options. You’ve got to give the customer options, and that is what QS/1 has done. They know there are multiple ways of doing things. To me it’s a good thing. I would prefer to have options.
What would you single out as the most significant catalyst that moved the technology forward?
JF: I would say when it became too hard to use a manual process to fill out claim forms. Really, I think the third-party influence was what really made technology common place. Pharmacists had to find a way to automate third-party reimbursement and computers were getting to a price point where they were affordable. If you find a pharmacy now without a computer, you’re digging in the weeds. Being computerized became the standard of practice. Pharmacists cannot do business without it.
CG: And now every time you turn around there is some new requirement that has to be automated. It’s no longer possible to do things by hand. Data has to be transferred at the time of the transaction or overnight. It’s gotten to the point where a pharmacist has to be automated to stay in business.
JF: I spent a ton of time over the last 10 years addressing what each state required such as collecting controlled substance data and billing for immunizations.
What are your favorite memories of your careers at QS/1?
JF: For me it’s the people I worked with and the customers. You need to have a place where you like to go to work. I had the privilege of working with neat people who I learned a lot from. I had a good relationship with the customers. I’ve done a lot of speaking and my customers will know my legacy as a speaker is not what I was going to say about the system, but the jokes I would tell. It’s been good and rewarding to see the projects I’ve worked on make significant changes in the market. It’s my friends at work and the customers we have that are the most important memories to me.
CG: I echo what John said. The best memories I have are with my fellow coworkers at QS/1 and everything we worked on. Also, building the relationships with the customers, and the trust they have in you. They use the product you’ve worked on and they can see the things the systems can do for them.
JF: The customer conferences have been the most fun for me. I had a little group from Texas and some other folks, and we’d get together and share war stories, some from years ago. I always looked forward to seeing them each year. I’m going to miss seeing those folks at the conference. Customer conferences are a lot of work for the staff, it’s a 24/7 job, but having those people you knew at the conference, it’s a really good relationship and I’ll miss that part.
CG: You see some customers over and over again at the conference or at trade shows. I remember this one customer who every time he saw me, he’d talk to me about IVR and he was always afraid of losing the personal touch of customer service. This went on for four years. When he finally bit the bullet and installed the IVR, he said to me, ‘I should have listened to you. It’s worked all around for all us. We should have done it years ago.’
JF: Once they make the change, the pharmacists will say they should have done it before.
What will you do now that you’re retired?
JF: I’m looking forward to spending a lot time with my grandson. And I’ve got a list of outdoor chores, outside work to do at the house.
CG: We plan to spend more time with family, too. I’m doing some consulting work for QS/1 and going out and talking to customers, which I dearly love to do. I will visit with long-term customers who are very loyal to us and I will see what they are doing. I’ll be enjoying a little bit of both. CT