The role of technology in the efficient operation of pharmacies has never been more critical.
The pandemic has brought pharmacists to the fore as essential providers in a health care system under duress. The role of technology in the efficient operation of pharmacies has never been more critical. In this virtual roundtable, retailers and suppliers discuss what COVID-19 has meant for pharmacy technology thus far, and what the future may bring.
Q: What has been the impact of the pandemic on technology’s role in pharmacy?
MENNEN: The COVID-19 pandemic has validated the importance of elevating the role of the pharmacist. In addition to consulting on and filling prescriptions, we’ve seen pharmacists step up to administer COVID-19 diagnostic testing — and soon they’ll play a critical role in vaccination, too. Technology is ever more critical in the pharmacy, from convenient testing and vaccination scheduling, to seamless pickup or delivery of prescriptions for customers, to robust automation of manual steps to free up pharmacists as they take on this elevated role. A great recent example is our technology that allows for easy online/mobile scheduling — and results delivery — of COVID-19 tests.
CAULFIELD: Technology can help in several areas as it pertains to the pandemic. Pharmacies are tasked with managing the health and well-being of their customers as well as their employees, so managing traffic in the store is critical. Technology solutions can help manage occupancy and help efficiently navigate customers through the store — ensuring there is enough space between customers. This may seem like a simple task, but it needs to be orchestrated so there are not droves of people waiting in the same area. Store managers can navigate these situations through locationing technology so the pharmacist can focus on taking care of the patents.
Additionally, contactless payment and checkout engagements have increased and been embraced by both shoppers and store associates so that people aren’t interacting at close distances with one another. According to Zebra’s “Global Shopper Study,” over half of surveyed shoppers (59%) reported that they prefer shopping at stores that offer contactless payment options. Retailers will need to prioritize experiences that focus on expediency and cleanliness to meet shopper needs.
FARAH: The role of the pharmacist continues to transform from simply dispensing medications to a greater responsibility for patient care. This has never been more important than today, during COVID-19. Pharmacists in all settings continue to transform their practices to provide safe and efficient care during the pandemic.
With pharmacies serving important roles on the front lines during this time, Health Mart, Health Mart Atlas and McKesson are proud to help them through these times. We want to be a strong partner, no matter what challenge you may face.
The pharmacy technology solutions our customers rely on expand past workflow software, giving pharmacies tools to help reduce costs, evaluate pharmacy quality with tools like the Electronic Quality Improvement Platform for Plans & Pharmacies (EQuIPP), and better manage the behind-the-scenes functions such as reimbursements and risk management. Supporting the prescription claim lifecycle are solutions like our ProviderPay reconciliation solution. During the pandemic, these technology solutions have helped make it possible for them to stay open and continue serving their patients with confidence.
RICHARDSON: Over the past 10 years, community pharmacy has emerged as a leading provider of immunizations and vaccinations. Ranging from seasonal flu and pneumonia vaccines to shingles, travel and more, pharmacists have leveraged their expertise, convenient access and patient trust to provide these valuable services, and this has never been more apparent than in 2020.
We believe the pandemic has acted as a catalyst for pharmacy transformation, and that pharmacy has a great opportunity to be transformed and move to being “health care’s front door.” For this to happen, pharmacy providers are going to need to move dispensing work out of the stores to give pharmacists time for patient-facing care. To support demand and an increase in services, pharmacy automation solutions from iA will be central to moving dispensing work out of a retail pharmacy setting to ensure pharmacists have the time to deliver impactful patient care that goes beyond vaccinations. Remember that the new COVID-19 vaccine is hitting the market currently, and the number of immunizations will triple in 2021, given the primary and booster sequencing for the COVID-19 vaccine.
STUTZ: The response across the U.S. health care system to COVID-19 has highlighted the lack of connectivity between community pharmacies, providers and payers. During the pandemic, we have seen obstacles sharing data between hospitals, physicians, and state and local public health agencies, which has unfortunately hindered our ability to quickly respond to a rapidly changing health crisis. In response, several initiatives have recently formed to address the gaps in interoperability and information exchange. Moving forward, we can expect that there will be continued emphasis on improving connectivity across health care. Pharmacies are an important part of the ecosystem of health care stakeholders, and the interactions they have with patients must be recorded and shared as part of the patient’s medical record. Therefore, pharmacies will need to ensure they have the right technology infrastructure and tools in place to share details on patient interactions with the other members of a patient’s care team. This will be particularly important as pharmacies begin administering COVID-19 vaccinations.
Additionally, we have seen that COVID-19 has disproportionally affected racial and ethnic minorities, patients with existing chronic illnesses such as hypertension, diabetes and respiratory disease, and patients who live and work in densely populated areas, magnifying disparities in care quality and access. Artificial intelligence (AI) and predictive analytics can help providers analyze patient data and identify social and environmental factors that may put some patients at higher risk. In the near future, community pharmacies will be able to act on insights obtained from AI to better target the patients most at risk and pinpoint those who may be in need of intervention, driving better patient outcomes and lowering costs.
HOUSTON: When the pandemic hit, the natural direction for consumers was to leverage the internet and technology for anything they need — online shopping and grocery curbside pickup are prime examples. But these trends also spilled over into health care and the practice of pharmacy. Many independent community pharmacists, in particular, went from connecting to their patients in-person to meeting with them remotely through phone or other telemedicine applications. This was critical, as they still sought to provide that same level of personalized care patients came to expect. In addition, due to lockdown orders across the country early in the pandemic, many patients were stocking up on their prescriptions. As a result, early in the pandemic, pharmacies were filling more 90-day fills, as opposed to 30-day, into that short period of time. To ensure patients were continuing their treatment regimens, pharmacies had to adjust their operations to possibly close their doors and establish delivery services, curbside pickup, or drive-thru operations.
Within the Good Neighbor Pharmacy Network, we saw our customers and their patients benefit from our digital media platforms and the My GNP mobile app. We saw 20,000 social posts related to COVID-19 shared by pharmacies between March and June 2020, reaching more than 2.2 million social media users. During that initial period of the pandemic, we saw an 18% average monthly increase in prescription refills through MyGNP.com compared to February. A 32% increase in refills through the My GNP mobile app. And a 58% increase in local delivery selection in the app.
We’ve also continued to emphasize digital marketing for stores in our network. So far this year, Google has earned 290 million impressions for our stores. When we combine all our digital marketing efforts, they account for nearly 4.4 million phone calls received by our stores. That averages out to roughly 175 calls per month per store coming from our marketing channels. That’s in addition to 1.9 million landing page visits and 329,600 prescription refills — all driven by digital marketing. During a pandemic, when pharmacists couldn’t necessarily meet with customers face-to-face, these touchpoints were absolutely critical.
COUGHLIN: Almost overnight, the pandemic forced most of us who work in the pharmacy industry to rely on technology to carry on with our jobs. It quickly aligned the efforts of medical professionals, business executives, frontline support personnel, and technology experts to solve problems that could not wait. Our collective creativity and determination came shining through. This will have a lasting impact on how we view change and work together to adapt.
WYSONG: Pharmacy technology was already in the ramping-up process, as pharmacy was forced to contend with the rapidly evolving digital transformations occurring across retail and health care. The COVID-19 virus only served to highlight the importance of the timeliness of that transition. With the elderly and immune-compromised patients looking for easier and safer ways to obtain their medications, it became self-evident that pharmacy would have to do a better job of accommodating for people not leaving their homes. This means a refinement of online prescription refill services, better telehealth platforms, and better on-time delivery services.
RINKER: Pharmacies that have relied on manual Rx fulfillment have been exposed operationally by the pandemic like no other time. Amidst the massive vaccine effort now under way, there likely will be a sustained boom in automation as the industry builds operational redundancy and enables capacity to meaningfully provide these services to their patient community.
The last few years have seen a shift toward multidose dispensing. The pandemic has accelerated this trend for several reasons; Multidose dispensing, utilizing automation, mitigates infection by limiting the touches during Rx preparation, and when dispensing, particularly in LTC settings. Syncing prescriptions and dispensing on a regular cycle utilizing blister packaging results in efficient and predictable work flow for the pharmacy, and better medication adherence for the patient. Certainly, Amazon has contributed too, and many pharmacies are now offering the multidose service to retain their own patients. The majority, it seems, are electing to compete with Amazon using multidose blister packaging versus pouch, though the SynMed Technology will allow pharmacies to elect either, and scale the service with ease.
SOMANI: The COVID-19 pandemic has had a major impact on technology and the pharmacy. With many health care institutions being temporarily closed or having to reduce services due to stay-at-home orders, it became critical for the industry to have a digital presence and digital commerce capabilities.
Some key areas where we’ve seen consumers change behaviors and adapt quickly:
• Digital. As patients seek care and medicines from home, Walgreens moved quickly to expand our digital health platform, Walgreens Find Care, which connects patients to in-person and virtual doctor visits as well as solutions to help manage their chronic conditions, all from the comfort of their home. Our Walgreens Find Care platform has grown significantly since the start of the pandemic. In the first quarter, traffic to this site increased 13 times versus last year to over 18.9 million visits. During stay-at-home orders, we also saw an increase in usage of another tool we offer, Pharmacy Chat, which helps patients have confidential, secure chats 24/7 with a pharmacy expert as well as access online delivery and shopping options, also from the comfort and safety of their homes.
• Expanded role of pharmacists. Community-driven care continues to be critical as we navigate the pandemic. Pharmacists and pharmacy technicians are playing an even bigger role as part of our patients’ care teams — from addressing medication concerns through tools like Pharmacy Chat, available 24/7 online and through the Walgreens app, to overseeing COVID-19 testing and now the administration of COVID-19 vaccines.
• Convenience. As part of our new myWalgreens customer loyalty program, we recently rolled out pickup service so consumers can shop from a full-store assortment of more than 27,000 items, including everyday health and wellness and O-T-C essentials as well as photos, with choice of convenient same day pickup options — in-store, curbside or drive-thru — in as little as 30 minutes.
SULLIVAN: The COVID-19 pandemic cast a spotlight on the pharmacies and essential workers, most especially their very visible and important role in delivering health care services. Correspondingly the pandemic placed a strain on both human resources and existing processes, highlighting the need to offer alternative delivery methods for patient care using new digital and touchless technologies.
We have seen this firsthand as pharmacies have accelerated adoption of KNAPP Apostore in-store robotic systems, marrying digital medication order processing with touchless dispensing of medications and automated 24-7 dispensing kiosks to accommodate off-hour pickups and deliveries.
Q: How do you expect technology to come into play as retailers gear up to administer the COVID-19 vaccine?
SOMANI: The technology and data infrastructure that Walgreens has today will be critical to supporting the administration of COVID-19 vaccines, especially those that require two doses and require tracking and patient follow-up. Walgreens already supports and reports state registry data and will meet any additional reporting requirements. We have extensive experience administering series-based vaccinations and will take the learnings and tools from our current immunization processes to apply to COVID-19 vaccinations, which includes dose reminders, email reminders and more.
FARAH: Providing better care to their patients and the community is paramount, and vaccines only exemplify that fact. With everything from the annual flu vaccine to travel-related vaccinations and the future COVID-19 vaccines, these programs represent a big opportunity for pharmacies to engage with patients in a way they may not have done before.
Having the right technology in place makes it possible to deliver these vaccines safely and efficiently by eliminating many of the nonessential steps and streamlining things such as data entry to help them serve as many patients as possible. Workflow tools like those provided in McKesson’s EnterpriseRx pharmacy management system can be used to add alerts right into the daily work flow, letting the pharmacist know when a patient may have additional clinical opportunities available such as a vaccination, and allow the pharmacy to create patient facing portals that help capture pre-visit information to accelerate compliance with state reporting requirements. This is important when billing for services that can be processed either through the pharmacy or medical claims systems.
Expanding these services can help position the pharmacy/pharmacist as a clinician and be a gateway to offering additional services.
RICHARDSON: With COVID-19 vaccinations being a global health priority, more patients are going to be visiting their retail pharmacy — and soon.
Accelerated centralization and automation of pharmacy fulfillment is needed to free up valuable pharmacist time to take on this added role. Pharmacy automation in a retail setting or in a centralized fulfillment location creates the time pharmacists need to step into this opportunity to do what we were all trained to do — take care of the patient.
That’s why iA has recommitted itself to giving pharmacy providers an accelerated approach to realizing software-driven pharmacy automation solutions that are customized for any pharmacy environment.
This is pharmacy’s time, and the time for centralization is now.
MENNEN: Technology is integral to the success of vaccinating a large population in short order. In addition to the importance of accurate customer data capture and scheduling, the COVID-19 vaccine will come in the form of a two-shot series, which will require a great deal of coordination and communication to customers to ensure they not only schedule an appointment for the initial shot, but come back to receive their second shot. While there is a great deal yet to be determined when the vaccine becomes available for the general population, we do know pharmacists will play an integral role as certified immunizers. Providing the technology to enable the pharmacy to operationally administer the vaccine at scale is critical. We’re ready and up for the task.
STUTZ: Both COVID-19 vaccines approved by the FDA are multi-series vaccines requiring two doses. Studies of previous multi-series vaccines have shown that adherence rates for completing the final dose are low. Therefore, patient education and engagement will be critical to ensuring the success of vaccine administration efforts. Patient engagement technology solutions can provide simple, convenient and persuasive touchpoints for staying in contact with patients, whether they prefer text, email or phone calls to remind them about their next dosage. These tools can also drive efficiency and streamline the pharmacy work flow, freeing up the pharmacist to focus on more important clinical tasks instead of making follow-up phone calls.
The sheer volume of patients in need of a COVID-19 vaccine also means that a sizable number of new patients will be visiting community pharmacies. This is an outstanding opportunity for pharmacies to demonstrate the additional level of personalized care they can provide and having the right patient engagement tools will help pharmacies effectively leverage this opportunity by creating a convenient, high-touch patient experience.
CAULFIELD: Retailers will be looking for technology to help manage the vaccine from the time it’s dispensed to the time a patient receives the vaccine. Manufacturers need technology to manage the complex supply chains so that those administering and receiving the vaccine are confident that all the handling procedures have been observed. Temperature sensing labels will be an important part to ensure the vaccine has been handled appropriately prior to administration but additional tracking technologies will play a huge role as the shipments go through the traditional supply chain process. Since there will be situations where a shipment is damaged, technology will play a role in the seamless return process that will be critical for expediting new vaccines to the affected location. The return process will inherently have a higher level of complexity, especially with limited supplies of a high-profile vaccine and the need for safe management of disposal.
There are two ways the vaccine can be administered from a retail perspective — either inside the pharmacy or outside the pharmacy via remote locations. As it pertains to the pharmacy, technology will be required to ensure the vaccine has been handled appropriately and can be administered. Tracking the vial temperature will be an important piece of the process for pharmacists. Positive Patient ID (PPID) will also be an area that pharmacies will need to pay special attention to and there are several mobile computing technologies that can help with that process.
HOUSTON: In early November, AmerisourceBergen reached an agreement with the CDC to include Good Neighbor Pharmacy and the Elevate Provider Network in the Federal Pharmacy Partnership Strategy for COVID-19 Vaccination. This means that independent community pharmacies in our network will be able to get access to vaccines during Phase 2 of distribution, when there’s enough supply to vaccinate the general public after prioritized populations. There are two key areas where technology will come into play during this time.
The first is around patient education. Pharmacies will need to leverage a multifaceted digital engagement approach to dispel misinformation, quell concerns among patients, and provide reassurance around the safety and efficacy of the vaccine. The second area is around post-immunization follow-up and reporting. At Good Neighbor Pharmacy, we’re working with our technology providers to support our customers’ ability to notify patients about the need for a second dose and remind them when to come back for that dose. At the same time, we’re working with pharmacies to strengthen their capabilities to report vaccination information back to their states, which will enable better tracking overall.
SULLIVAN: Retailers are already reacting to adapt to the latest market forces; the need for testing, administration of vaccine, and a new competitive dynamic is forcing changes to the retail store configuration, driving more space- and labor-efficient automation, and staffing models.
COUGHLIN: I think there will be many twists, turns and things to learn regarding variations and short- and long-term management of the disease. In addition to administering the vaccine, pharmacies need to adopt a new breed of technologies to collect and effectively share real-time population-specific information regarding lessons learned and outcomes achieved.
RINKER: Pharmacies that elect to administer the vaccine will have to create time to offer the service, which, in effect, leaves them with four choices: (1) hire additional staff, (2) cut other services, (3) automate Rx dispensing to the fullest extent possible, and (4) utilize a third-party central fill service to prepare prescriptions on a more substantial basis.
On the first point, many pharmacies have made a standard practice out of keeping certain groups of team members together during assigned shifts. The extra hands are needed, but care still needs to be taken to prevent the extra socialization among new hires. Most staffing models now call for greater usage of automated technologies in terms of compounding and other areas. We’re seeing workflow systems that are up to the challenge, but pharmacies may want to consider enhancing safety measures at every touchpoint.
Given the financial numbers, there is understandably a downward pressure on cutting hours or shifts to make the productivity benchmarks look rosier than they actually are. On this score, it’s clear that some inventive thinking will be required to address the way pharmacies measure the productivity of their employees. Any change made in haste has the potential of creating unintended, unwanted and entirely preventable consequences.
The pandemic-driven shortfalls in manual dispensing have already laid bare those concerns in the bigger picture. As such, the trend toward automation that was already in process has only picked up the pace in recent weeks, providing some reinforcements for current supply chain challenges. Many experts suggest the overall framework needs to be strengthened, and Synergy Medical has a part to play there as well.
WYSONG: When I consider the logistical and operational complexity of shipping and tracking millions of doses of vaccines across the country and ensuring that the integrity of those vaccines has not been compromised, I realize how dynamic a situation this is. I am not sure we have experienced an event like this in history requiring all stakeholders to work together in ensuring the safe delivery and administration of a life-saving vaccine. Between the tracking services, the temperature monitoring requirements, and the need to communicate in real time with patients, these technologies will evolve quickly and will be necessary for caregivers to participate in and provide the proper care as Operation Warp Speed rolls continues to roll out.
Q: With pharmacists’ stature enhanced as vaccine providers, how can technology reinforce their elevated place in health care?
STUTZ: The value that community pharmacists can deliver through accessible, personalized patient care has been thrust into the spotlight during the COVID-19 pandemic, and it will be further heightened within the health care community as pharmacists administer the vital vaccinations needed to bring the pandemic to its eventual end. With the right technology solutions at their disposal, pharmacists will be better equipped to practice to their full capacity. And for these tools to be most effective in driving improved patient outcomes, they will need to be part of an interconnected solution. Many pharmacies are currently working with several disconnected systems, which are not only inefficient, but also hindering them from playing an elevated role as a central connector between patients, payers and providers. Greater connectivity between technology solutions will also help pharmacies more easily identify opportunities for clinical intervention, which ultimately drive better outcomes and lower overall costs.
WYSONG: The COVID-19 pandemic reminds all of us of the important role that pharmacy plays in health care. As the backbone of care, the local pharmacy and pharmacists could be the only medical professionals that people have seen since the pandemic started. Despite the pandemic and its resulting challenges, pharmacies continue to look for new ways to expand their services in the pursuit of improving patient outcomes. This only serves to bring a heightened sense of awareness about the critical role pharmacy can play in identifying and treating the most vulnerable of patients. Technology must be flexible in accommodating for this expansion. Telemedicine will continue to be a relevant tool in maintaining patient standards and reaching those who oppose in-person visits. We will likely see an expansion of care across state lines and more focus placed on identifying and treating chronic disease, which increases susceptibility to adverse results with the virus and increasing costs for payers and consumers long term.
HOUSTON: Throughout the pandemic, pharmacies have proven that they are an accessible, but largely untapped, health care destination for patients — particularly in rural areas that lack convenient access to other health care providers. Pharmacies have a broader reach than ever before, creating opportunities to provide more point-of-care testing and further expand their clinical services to support patients with chronic diseases.
While HHS has authorized pharmacies to vaccinate under a state of emergency, prescribing authority varies from state to state. Pharmacies have the technology to play a greater role in patient health, but we need consistent, sensible laws to ensure pharmacies can have the biggest impact possible.
RINKER: In the COVID-19 era, Pharmacists that embrace technology are perceived as pragmatic, having taken steps to ensure accuracy, efficiency, redundancy and, importantly, infection transmission mitigation. As the scope of the vaccine effort widens, their heightened role is coming into focus, as teams of CVS employees are already heading into long-term-care facilities across Texas.
As of December 28, 2020, CVS will be expanding its influence in 36 additional states, in a dramatic offensive push to make a difference in the lives of our most vulnerable. And it’s not just CVS. Walgreens and others are joining together to help administer the coronavirus vaccine in nursing homes and assisted living facilities of every stripe.
So far, more than 275,000 Texans have been inoculated. That does a lot to raise the profile of the pharmacy profession. But so does having the technological capabilities to keep the vaccine refrigerated and distributed safely. In time, administration will become as routine as the average flu shot, which should go a long way in building trust with skeptics.
RICHARDSON: Technology and centralization are going to play a significant role in retail pharmacy now and in the coming years. Centralized fulfillment has the ability to remove dispensing work from retail pharmacies, freeing up pharmacists’ time to focus on patient services. Without this reduction in dispensing work and phone calls with providers, we cannot expect our nation’s pharmacists to continue to play such an important role.
At iA, we have invented and developed a suite of leading-edge, software-driven pharmacy automation solutions. The majority of prescriptions written are for chronic conditions, which allows for them to be electronically routed from the pharmacy to a centralized fulfillment facility and back, freeing up valuable time for pharmacists to provide these additional services.
We know we’re going to see an increase in immunizations this year and throughout 2021. But we have been able to free up pharmacists’ time to focus on patient care — now you can think about MTM, adherence — a fundamental expansion and transformation of a pharmacist’s time to deliver patient care.
SOMANI: Over time, pharmacies have embraced technology advances such as automation to handle medications, from point of order entry to the final delivery of a prescription. By automating these processes, it allows pharmacists to concentrate on providing more essential health care services to patients. Pharmacists can now spend the time that was previously taken up by having to perform a repetitive and monotonous task on consulting and educating patients regarding their medications and check if they’re up to date on their immunizations, as well as consulting physicians around their patients’ care.
COUGHLIN: In the past, pharmacists have exhibited leadership in technology-based health care solutions for an ambulatory population such as real-time claims adjudication and effective systems for drug utilization analysis and screening. Today, pharmacists should be expanding on these skills to guide the health care system towards the most effective ways to manage the current pandemic, and the variations that will certainly follow, for ambulatory patients. I have mentioned the term “ambulatory” twice here because the key is to provide the care patients need without bringing them into the hospital.
SULLIVAN: Pharmacists’ role as preferred health care providers is resulting in completely redesigned stores that are focused around clinical solutions — and enhanced patient care.
This change in demand has highlighted the need for two distinct approaches:
• Centralized dispensing, verification and packaging of patient orders: Allowing pharmacies to reallocate resources formerly used for order filling to more higher-level clinical and therapeutic functions, the pharmacy can provide added health care services without additional staff. Additionally, inventory is centralized for maintenance medications, opening up space within the store for value-added and profitable functions.
• In-store Apostore systems: These automated storage and retrieval systems use dynamic storage to reduce the space required for back counter prescription medications. O-T-C medications can also be staged in these space-efficient units. Adding digital Aposcreen technologies to display a broad inventory without having to maintain floor inventory is both space efficient and “performance efficient” — with the potential to automate upsell and cross-sell processes — while meeting customer needs for more detailed advice.
CAULFIELD: Pharmacies will feel more regulated and high-tech, as the pandemic has convinced stores that technology is critical to ensuring a healthy experience. The new technology will enhance their capabilities to ensure a safe experience for both customers and staff as well as administration of the vaccine. The increased level of technology will enable pharmacies to be more efficient and standardize many processes. Given the complexity of mass distribution of the vaccine, it is important everyone is handling the process similarly.
MENNEN: We’ve seen throughout the pandemic that pharmacists are ready and willing to take on a bigger role in health care. We’re particularly interested in finding ways for pharmacists to do less routine work and spend more time advising patients, consulting with care teams and administering vaccinations. To make that happen, we are applying the Lean methodology to our operations, while leveraging technology to make routine tasks as easy or automated as possible. The more time we can free up for the pharmacist to spend with patients, the better. Technology and customer data management is also critical to provide the pharmacist with the data insights they need to help advise the customer in the moment.
Q: When the pandemic ends, to what extent will technology be part of irrevocable changes in pharmacy that were brought on by the crisis?
COUGHLIN: The technology genie is fully out of the bottle and is not going back in. We have seen how much can be done from a safe distance with robotics and telehealth. It’s not only safe, it’s efficient and it enables more personalized focus between pharmacist and patient. So, the lessons learned will be expanded upon and certainly not reversed.
RINKER: As mentioned prior, COVID-19 has exposed reliance on manual Rx preparation. A number of pharmacies have automated in the midst of the ongoing pandemic to release production bottlenecks due to absenteeism. An equal number of pharmacies are waiting to automate after COVID-19 substantially is under control. There will certainly be a period of reflection and examination to insulate operations to better weather the future, but waiting it out isn’t an option.
Identifying disruptions before they take hold is now a routine part of mitigating risk. Telehealth and app-based devices are also finding larger audiences than originally predicted. Global sourcing is now a thing that impacts people on a local level. In large part, the pandemic has been the perfect, imperfect storm of circumstances that have pushed many pharmacists to reinvent themselves, particularly in terms of quality control and compounding.
The one-to-one relationship remains paramount, but the interaction in a more virtual world has yet to emerge in a new, fully formed shape. With any luck, technology will make the new normal feel and look more like the old normal than anyone can predict at this point. That’s the best-case scenario, and one we’re prepared to support to the fullest on the automated side of the ledger.
HOUSTON: Patients have grown accustomed to the convenience that technology provides, and that will remain after the pandemic ends. We expect that patients will continue to leverage mobile apps to refill prescriptions, opting for telehealth appointments where possible, and seeking out digital resources to answer personal health-related questions.
MENNEN: While COVID-19 has, by necessity, accelerated the shift toward things like appointments, online ordering and telehealth, these changes were already on the horizon before the pandemic struck. That’s why we were ready to adapt to meet the challenge of COVID-19 head on. While we knew that these changes were coming, the pandemic certainly brought forward rapid acceleration in customer adoption and technology innovation in the space. Even something as simple as home delivery of health care essentials and O-T-C products has been critical to keeping people healthy when they can’t leave home. We’ve taken steps to bolster our prescription delivery options, in addition to adding convenience options, like Pay n Go, for preordering and seamless pickup of prescriptions. We will continue to focus on changes that enhance the customer experience with a unified approach digitally and in-person.
FARAH: Pharmacy will never be the same. The shift we’ve seen is — and I’ll use the word of the year — unprecedented. But the exciting news is that this change has forced us to evolve quicker than we may have ever anticipated. Our profession is now further on our road map, and we’re continuing to be seen and recognized for the integral role we play in health care.
The pharmacy of the “here and now” should be part digital and part physical. If your approach to patients is one-way, on one channel, then you’re at risk of being left behind. We need all pharmacists to think through their very own omnichannel approach and build a network of health and wellness offerings in-store and online. You think digital and e-commerce capabilities were important before? They are vital now.
CAULFIELD: Now that mass adoption of tracking and tracing as well as locationing technologies have been deployed, it will be part of the fabric of the pharmacy, less of a differentiator. You will continue to see the regulated handling of vaccines as well as contactless approaches whether its payment or pickup of prescriptions. The return on investment has been proven for many of these technologies, and keeping customers and staff safe will remain paramount for pharmacists and retailers.
SULLIVAN: The pandemic has undoubtedly created new opportunities — including order delivery approaches, and off-hour dispensing, but most industry analysts are projecting that the pandemic has accelerated technology adoption to a “new normal.”
In other cases, existing challenges facing pharmacies were amplified. Shortages of technicians, unpredictable DIR and GER fees all pointed to the need for automation. Our customers have simply accelerated the time lines for these solutions, and they expect that the demand for technology adoption and more efficient processes will only increase as they move forward in a post-COVID world.
RICHARDSON: At iA, we believe there is a great opportunity to unburden pharmacists while providing choice to patients for how they would like to receive their prescriptions. This trend will only continue after the pandemic. We believe that in order for pharmacy providers to continue to be able to provide additional services, including an increase in all vaccinations, and to provide enhanced patient choice, it all starts with moving pharmacists’ redundant work out of the stores and into a centralized process. Centralized fulfillment allows pharmacy providers to provide patient choice, and it also creates time for pharmacists to deliver impactful patient care that goes beyond vaccinations.
The move to centralization holds limitless possibilities, and iA is passionately committed to the optimum use and expansion of our software and technology. Working together with our customers, we can transform the industry — to help improve the health and well-being of patients across the country and around the world.
SOMANI: Responses to the COVID-19 pandemic have sped up the adoption of digital technologies by several years — you’ve probably heard it said that the pandemic has accelerated 10 years’ worth of technology advances in 10 weeks — and for us, many of these changes are here to stay.
For some time, Walgreens has talked about our work to accelerate the digitalization of our company. Initially, much of this work was going on behind the scenes: Moving to a more cloud-based data structure and putting in place the systems and structures to use this data more effectively. Now, as consumers have embraced online channels to access their retail and health care needs they are experiencing greater personalization and ability to keep their appointments via telehealth. For example, our new myWalgreens customer loyalty program is heavily focused on health and well-being with content, services and offers specifically curated to each member. And given the demand for telehealth, we’ve more than doubled the number of providers and offerings available via Walgreens Find Care to more than 40 providers that together offer more than 60 services and treat more than 100 conditions.
WYSONG: COVID-19 only highlighted the necessity for a technology like telemedicine to be used as a permanent tool in improving patient standards and outcomes. As we continue to experience changes in payer models and insurance coverage, those that desire an alternative to face-to-face visits will likely gravitate to this platform. Aside from the gentle reminder of the important role pharmacists and pharmacies play every day in safeguarding the general health of the nation, this will be a lasting change to our industry. Additionally, the virus once again reminds us that pharmacies can be useful in identifying the most vulnerable patients in the communities that we serve, and we must be focused on filling in the health care gaps for these people to improve outcomes. Without the right technologies deployed, this will be a difficult task to accomplish.
Q: How has the pandemic changed the potential for greater use of telepharmacy/telehealth, and how can technology enhance its prospects?
HOUSTON: The pandemic ushered in a significant increase in telemedicine and has demonstrated that not all health care services have to be face to face. For example, many health plans had previously required comprehensive medication reviews to be conducted in person, but made temporary modifications, due to the pandemic, to allow for other means of connecting to offer this valuable benefit to patients. Pharmacies have proven they can engage with patients remotely, without sacrificing the quality of care.
SOMANI: The COVID-19 pandemic has led to an increase in telehealth use as never seen before as people seek care from home. Telemedicine is also being integrated into the daily operations of various health systems more than ever before as the Centers for Disease Control and Prevention (CDC) recommends the use of telehealth to help address medical needs while supporting social distancing during the pandemic.
As a digital resource already in place, Walgreens Find Care can easily flex and expand to meet emerging and current societal and health issues. With the COVID-19 pandemic, some new features we added to our platform include:
• Helping people connect with Walgreens COVID testing sites.
• A COVID-19 risk assessment tool, powered by Microsoft, to help users assess their risk for having COVID-19 based on CDC guidelines and to help ease the burden on the health care system during the pandemic.
• The Find My Clinical Trial program to help individuals identify relevant COVID clinical trials in their area.
• Added and expanded relationships with partners to help meet the increasing demand for telehealth during stay-at-home orders.
As many people, patients and providers become more familiar and comfortable using digital health care solutions, we anticipate that they will continue to use telehealth beyond COVID-19 as an important tool to help manage their health care. A combined physical-digital offering will be a key driver in enabling the best possible health outcomes, experience and costs.
RICHARDSON: The pandemic has introduced patients to new ways of care and potentially new delivery options. We believe that telepharmacy and telehealth are going to remain essential parts of the patient choice conversation. To continue these offerings and to continue to be able to offer patient choice, pharmacies are going to need a solution for offloading repetitive dispensing work. Centralized fulfillment will continue to play an important role in how pharmacy providers continue to meet patient needs and choice.
WYSONG: Telehealth offers the promise of a more convenient and potentially low-cost platform that can be more easily accessed by patients and care givers. Additionally, with the right advancements, telehealth could serve as the conduit for enabling stakeholders to better engage with patients to create more tailored solutions and better treatment plans. By improving patient engagement with better communication and more touchpoints between and after visits, telehealth could be a viable tool in heading off adverse issues before they arise. This technology could also be used to improve patient compliance and adherence by ensuring that the proper medications are being taken at the proper time. Incorporating more meaningful interactions will likely ensure that a customer’s experiences match their expectations, which is favorable when trying to increase patient engagement and have them be advocates in their own treatment plans.
CAULFIELD: Pharmacies had been deploying virtual pharmacy and health capabilities prior to the pandemic. The pandemic has accelerated consumer acceptance and level of comfort to embrace and use these technologies more readily. Technology providers are enhancing their capabilities to provide scalable solutions that allow pharmacies to provide high-level consumer engagement. Consumers’ willingness to engage the pharmacy from their home has only increased the depth by which pharmacies are creating deeper roots with their customers.
MENNEN: The pandemic has accelerated the trend toward telehealth — this was something that was on our radar in envisioning the future of pharmacy through our RxEvolution strategy. In fact, our new Store of the Future concepts include telehealth rooms where patients and pharmacists can facilitate better connections with the patient’s broader care team. We believe pharmacists — as some of the most accessible health care providers — are the glue that holds together the care team, and technology will make that role even more impactful.
COUGHLIN: Instead of being cumbersome and difficult to work with, telehealth has been seen to be effective, quick and easy to use. It provides accessibility, saves time and money for both patients and providers, and makes sense from the standpoint of avoiding unnecessary exposure and risk. Having been forced into it, the question would now be, “What’s not to like about it?” I think it’s here to stay in situations where it has been shown to be effective.
FARAH: With the onset of the pandemic, telehealth and telepharmacy rapidly expanded. According to research from Frost & Sullivan, telehealth visits surged by 50% in March 2020, and 80% of patients are likely to have another virtual visit, even post COVID-19, based on results of a recent Deloitte study. While the technology existed previously to support it, telehealth was often underutilized, as providers and patients held fast to traditional in-person visits.
However, virtual face-to-face visits between provider and patient have offered a way for care to continue during shelter-in-place orders issued by many states at the pandemic’s height. Moving forward, telehealth clearly has a place in today’s patient-centered model of care. Convenience, speed and safety top the list of benefits.
RINKER: As the country continues to experience dramatic spikes in coronavirus outbreaks and increasing rates of hospitalization, there comes the unfortunate, but familiar refrain on steps to “flatten the curve.” In that regard, telehealth and telemedicine remain on the front lines — virtually — in giving hope to those dealing with the worst outcomes imaginable.
Never more than at the present moment, the news of rationing care in response to dwindling ICU space is more than a cause for concern, it’s a cause for alarm. What gets missed, of course, is practicing traditional medicine in traditional ways. For now, that’s just not possible in any widespread application. The consequences are building, but telemedicine may be the strongest form of a workable strategy in response.
Medication management services are now typically delivered via telehealth. Simple checkups are now being performed via smartphone, in turn, becoming standard practice for older Americans who might have previously been reluctant to do so. Telepharmacy offers pharmacists the ability to oversee operations, watch for symptoms and triage patients from remote locations.
Moreover, the CDC is encouraging the use of telepharmacy, particularly in combination with home testing for COVID-19, but also for chronic disease management, as well as for other concerns that don’t require face-to-face meetings. Many states are following suit, calling for remote prescription processing and dispensing, drug utilization reviews, and insurance processing.
SULLIVAN: Knapp’s 24-7 dispensing technology was driven by market demand for touchless and off-hours solutions for O-T-C meds and will-call prescription orders, both capable of integration with telepharmacy/telehealth technology to answer questions about and order, or about a specific medication.
Whether using the telepharmacy interface at the unit or calling the number when items are delivered to the patient’s home, we expect this approach will be essential as patients increase their use of touchless prescription delivery.
STUTZ: While community pharmacies will have a tremendous opportunity as a central destination for administration of the COVID-19 vaccine, balancing an already full workload on top of this critical need will be a logistical challenge. Even prior to the COVID-19 vaccine, many pharmacies were already struggling to find time to counsel patients on medication or perform clinical tasks. Telepharmacy can help solve these challenges as a workload balancing tool. By creating a cloud-based workflow queue, telepharmacy can help to delegate prescriptions to another location if pharmacists are busy immunizing patients. Using a virtual queue can also provide greater visibility into where pharmacists may be performing lower-value tasks, so that resources can be reallocated and their time can be spent on more clinical activities. The end result is more focus on patient care, an optimized work flow and the ability to serve their community to a greater capacity