PP_1170x120_10-25-21

Virtual Tech Roundtable —Technology: Indispensable for handling obstacles

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The pandemic and resultant staff shortages continue to heighten challenges for pharmacists, making them ever more dependent on technological advances. In this virtual roundtable, retailers and suppliers probe the implications of COVID-19 for pharmacy technology at this juncture. They also ponder what the future may hold, whether there is a return to normal or not.


Q: Broadly speaking, what are the implications of the pandemic’s persistence for pharmacy technology?

Mike Coughlin

Mike Coughlin
President, CEO, CFO
ScriptPro

COUGHLIN: It is very clear that pharmacists will always need to be on the front line in dealing with situations like this. They need the best automation and software technologies we can provide to help them cope with their jobs.

LASHIER: Pharmacists were pushed onto the front line of our nation’s response to the pandemic. As one of the most accessible and trusted health care professionals, patients turned to pharmacists for guidance. Patients expressed sincere gratitude to their community pharmacists for their compassion, professionalism and expertise. Pharmacists earned respect from patients and the health care community in recent years as they established themselves as leading providers of immunizations and vaccinations. So it was natural for the country to turn to these valued professionals once the COVID-19 vaccines were approved.

Alecia Lashier

Alecia Lashier
Chief Automation Officer
iA

As the pandemic has persisted, these health care heroes have been faced with increasing prescription volume, more populations receiving approval for the vaccines, the need for booster shots, and workforce shortages including pharmacists and technicians. Leading chain and independent pharmacies responded to the needs of their dedicated, but struggling, team members through shortened hours, pay incentives and aggressive recruiting efforts.

However, the most effective solutions to this crisis are technology driven. iA offers leading-edge software-enabled pharmacy fulfillment solutions that address these pandemic complications while helping to drive down the cost to fill, simultaneously addressing the challenge of shrinking margins. iA is partnering with pharmacies in a range of sizes, from independents to the large chains. Our modular software and robotic systems are designed to grow and scale as demand grows. Together with our pharmacy customers, we are unleashing the full potential of pharmacy.

SULLIVAN: Consumers have changed their habits from the way they buy groceries to filling prescriptions. Patients now prefer convenience and easy access. The ongoing pandemic is putting a strain on the workforce and, in many respects, automation is a safety valve for retail or central pharmacies to offset this risk. The successful pharmacy today will require an omnichannel offering including core technology to enable this type of operation. Some of the core automation technologies, like Apostore, lower staffing requirements and free additional space for clinical services. These services are both in high demand and elevate customer brand preference by providing a differentiated suite of patient amenities.

Brent_Stutz

Brent Stutz
SVP/GM
Outcomes

STUTZ: The pandemic has accelerated the issues pharmacies were already experiencing. What we’ve learned from the pandemic is that pharmacy technology and automation are no longer a nice-to-have — they’re a necessity to keep the pharmacy running and to get patients the medications and care they need. Current pharmacy workflows are manual and inefficient, leaving the pharmacist little time to spend on patient-centered clinical activities, such as administering vaccines. By digitizing the prescription workflow, you can eliminate bottlenecks and untether the pharmacist from the manual fulfillment process, allowing the pharmacist to spend more time with the patient.

MikeWysong

Mike Wysong
CEO
CARE Pharmacies

WYSONG: The ongoing pandemic has clearly highlighted the benefits of remote-based care and telehealth. Pharmacists can now connect with (and take care of) patients virtually anywhere. As there continues to be a natural expansion of pharmacy-based programs and services, which includes diagnostic testing and an expansion of vaccine-related services, it is self-evident that technology will have to take on a similar trajectory. All of this was well highlighted in retail pharmacies’ quick response in dealing with the COVID-19 pandemic.

SWORDS: The COVID-19 pandemic continues to have a major impact on the health care and retail pharmacy industries. As a result, Walgreens accelerated the implementation of technology and tools to better address common pain points and remove barriers to care for patients, while driving efficiencies in our pharmacies that allows pharmacists to establish an even more meaningful connection with patients and providers.

For example, our micro-fulfillment facilities help to fill routine prescriptions, and centralized services operations redirect work to be centrally performed outside of the stores. Our natural language technology allows us to triage calls away from our pharmacies to our customer care center, and automated technology enables us to quickly and efficiently resolve issues with a patient’s insurance. These tools together automate routine and administrative tasks so our pharmacists can focus on providing better patient care.

Phyllis-Houston

Phyllis Houston
VP of Program Development and Market Intelligence
AmerisourceBergen

HOUSTON: There’s an increased desire from patients to access care in a more flexible manner and in a variety of settings. As such, we need tech to help meet patients where they are.

For example, My GNP mobile app is a free resource available to Good Neighbor Pharmacy patients. A few benefits it provides to patients include easy prescription refills, medication reminders and seamless prescription transfers.

In fact, in the initial months of the pandemic, we saw an average monthly increase of 18% in prescription refills through MyGNP.com, a 32% increase in refills via My GNP mobile app, and a 58% increase in local delivery selection in the app compared to February of 2020.

We also see patients turning to search engines like Google to find a COVID-19 vaccination site. In 2021, Good Neighbor Pharmacy members reached over 3 million people on Google search with advertisements for COVID-19 vaccines. These advertisements drove more than 200,000 clicks, and resulted in nearly 12,000 in-person visits to the pharmacy. This is the new way of reaching patients. More so than ever before, online activity is driving in-store health care and purchasing decisions.

Q: What new prospects for technology could emerge if pharmacies become empowered to prescribe antivirals to treat COVID?

LASHIER: Empowering pharmacists as providers is an important issue the industry has been fighting for and iA supports. Pharmacists have clearly demonstrated value through their critically important role during the pandemic including vaccinations, counseling and accessibility. Provider status is a logical next step given the significant impact on patients’ health outcomes, overall health and reduced health care costs evidenced throughout the pandemic.

Although provider status would align reimbursement with the services pharmacists are trained to provide, it would exacerbate the overworked, “burned out” situation retail pharmacists are facing due to short staffing and the increased demand for immunizations. In order to free up pharmacists’ time and provide patient focused care, the non-value-added tasks of filling must be executed more ­efficiently.

Pharmacy Fulfillment by iA is a comprehensive solution that enables pharmacy fulfillment efficiencies and enhanced inventory management for pharmacies of various volumes and market segments. The solution utilizes pharmacy automation technologies run by iA’s intelligent enterprise pharmacy fulfillment software platform, NEXiA. This leading-edge software solution manages prescription fulfillment centrally, freeing up pharmacists to focus on patient-facing care. NEXiA manages iA’s SmartPod, a next-generation robot that delivers innovative scale in a central fill pharmacy environment. SmartPod features a breakthrough auto-fill unit with built-in modularity, allowing pharmacy providers to adjust and scale their centralized fulfillment solutions to meet demand.

Provider status legislation would allow pharmacists in underserved areas to bill Medicare Part 11 for services within pharmacists’ state scope of practice delivered to Medicare beneficiaries. iA’s NEXiA software and modular SmartPod robotic solutions would enable efficiencies to unleash pharmacists to care for these vulnerable populations.

HOUSTON: Broader access to point-of-care testing at pharmacies or at home along with the ability for pharmacists to access and prescribe antivirals allows patients to receive care more quickly. It streamlines care for patients because they receive complete care in one place, which is the goal for any provider, especially when a patient is not feeling well. Also, in the case of antivirals, nirmatrelvir/ritonavir significantly reduced the risk of hospitalization or death by 88% when administered to a non-hospitalized, high-risk adult, according to recent data from Pfizer. Time is of the essence, so streamlining testing, prescribing and dispensing to one location will support the overall treatment experience.

With pharmacies playing an even greater role in providing clinical services, there’s a need for pharmacy management systems to be able to capture information that’s submitted for clinical services, such as a COVID-19 test or an assessment of a patient.

Adam Woodard

Adam Woodard
Commercial Project Manager
Outcomes

WOODARD: Prescribing antivirals is just the latest milestone in the shift toward providing more clinical services. As more clinical services emerge, the technology needed to support these new workflows will need to be ready. This will include decision support, billing support, scheduling, longitudinal patient records and a whole bevy of other supporting technologies. It all adds up to an EMR (electronic medical record) for pharmacy. This is great news for both pharmacies and patients. Pharmacies will be able to diversify their revenue streams and practice at the top of their license, and patients will be able to access high-quality and convenient care.

COUGHLIN: Pharmacies need their own, dedicated EHR (electronic health record) systems to manage and document prescribing processes and outcomes. Pharmacy EHR systems need to be patient- and pharmacy-centric applications that are basically extensions of the pharmacy dispensing system. Pharmacy EHR systems need to exchange data with the large hospital-based EHR systems, but they should not require frontline retail pharmacists to learn and navigate these comprehensive EHR platforms to serve patients on the front line.

WYSONG: While access to COVID-19 antiviral treatments is still being ironed out, the current situation clearly underscores the fragmentation that exists today within our health care technology infrastructure. These challenges include access to effective testing, access to treatments and access to affordable care. Technology will continue to play a pivotal role in addressing the integration of these important elements to ensure that the most high-risk patients and high-risk populations are adequately served.

Q: How is technology helping pharmacies cope with the labor shortages that have hit the practice along with other sectors of the economy?

Rex Swords

Rex Swords
Group VP of Centralized Services, Operations and Planning
Walgreens

SWORDS: Never before have pharmacists been more essential to the health and well-being of our communities. But, like many other companies in retail and health care, we are not immune to the labor shortages that have plagued much of the country. Our pharmacy of the future vision has helped build the foundation to address today’s complex and hectic environment through tech-enabled solutions. This has been part of our strategy for years, and we continue to steadily progress it. For example, through our microfulfillment centers, routine prescriptions are filled at a central location and sent back to patients’ local Walgreens stores for pickup at the pharmacy counter. We also use cutting-edge automation technology from iA, a company we made a majority investment in, and our existing AmerisourceBergen distribution network, to efficiently fill prescriptions and quickly get them to our pharmacies through these microfulfillment facilities. By automating routine prescriptions, we enable Walgreens pharmacists to provide more value-added health services that can improve health outcomes. In 2021, we opened two microfulfillment centers that now support Walgreens pharmacies, with plans to open an additional nine centers by the end of 2022 and 22 sites by the end of fiscal year 2024. In addition, we leverage technology like data entry automation, third-party reject automation and refill automation to centrally process prescription data, resolve insurance issues and ensure patients get routine medications on time. These developments automate routine tasks and further free our pharmacists’ capacity to provide personalized care and additional health services to patients. This is critical because we know that health care is best when it’s local and, even as a national company, the power is in our pharmacists — embedded in their communities — who have a deep understanding of the neighborhoods they’re in and the patients they support.

Brian Sullivan

Brian Sullivan
Senior Systems Sales Manager for Healthcare Solutions, U.S. and Canada
KNAPP

SULLIVAN: Pharmacies are moving to a centralized prescription fulfillment model, whether mail or central fill, micro fulfillment centers, or nano fulfillment. Traditional supply chains are being reengineered to a more flexible and efficient hub-and-spoke model. By automating the prescription fulfillment operations, it allows technicians and pharmacists that are on site to elevate their activities and perform at the top of their license. As a result, employee satisfaction increases, which is linked to employee retention rates. Hub-and-spoke models can provide enhanced service levels, while at the same time leveraging partnering arrangements for last-mile pickup and delivery.

COUGHLIN: Robotics has become an affordable necessity for a retail pharmacy at any volume level. Twenty-four/seven real-time support is required to make it easy and reliable for pharmacies to use robotics without interruption.

WYSONG: The labor shortage now negatively impacting pharmacy is clearly part of the larger issue plaguing most retailers across the country. It is now difficult to fill open technician and support staff positions or employees that have been reluctant to return to work during the pandemic. Compounding this issue is the declining reimbursement, increasing DIRs, and increasing wages. Technology offers hope and a solution to assist existing staff by automating labor-intensive tasks, freeing up pharmacy technicians to focus more on patient-engaging activities, and better integration of pharmacy workflow to produce better health outcomes for patients.

Roby Miller

Roby Miller
Director
Telepharm, A Cardinal Health Company

MILLER: Throughout the pandemic, staffing shortages have hit the pharmacy industry hard and have led to a greater need for automation. Virtual verification software can help pharmacies cope with this in a couple ways. The first is by enabling the technician to elevate their role by increasing their responsibility in the prescription fulfillment process, while also allowing the pharmacist to perform additional clinical activities. Secondly, it increases efficiency across an organization as lower-volume pharmacies are able to assist those with higher volumes, where regulations allow, sharing the workload across multiple pharmacies.

HOUSTON: The industry has a constant focus on talent retention, and keeping high performers comes down to how a pharmacy maximizes efficiencies among its staff.

One way to address shortages is through technology that helps staff work efficiently and not feel overwhelmed. Automated processes — such as medication synchronization, dispense automation, text refill reminders — can help save time.

Streamlining pharmacy visits is another way to boost efficiencies, because a patient is only coming in once a month versus two or three times. Any tech-enabled communications to minimize the number of phone calls is a relief for pharmacy staff and time saver for patients.

One last piece to address retention is employee development. Continuously looking for ways to develop a team professionally, whether it’s training or continued education, is critical for maintaining healthy team morale.

LASHIER: Pharmacist and technician labor shortages are dramatically impacting the pharmacy industry, with the retail sector getting hit particularly hard. Coverage of this dire situation has spread beyond pharmacy trade publications to mainstream and general business media outlets. Swift response to this challenge is critical to patient safety, pharmacists’ well-being and financial performance.

Pharmacy Fulfillment by iA can help remove labor intensive, repetitive dispensing work from individual stores, by shifting this work to a central location. iA’s intelligent enterprise pharmacy fulfillment software platform, NEXiA, manages the fulfillment process including iA’s SmartPod robotics. This model enhances patient safety and aids in elevating efficiency through significant reductions in labor and inventory. Ultimately, the pharmacist-patient relationship is transformed. iA’s SmartPod robotics feature the ability to self-diagnose with industry 4.0 standards and implement solutions often before an event occurs, saving on-site service technician time and helping to decrease system downtime. iA works with pharmacy providers to help understand their unique circumstances and develop an appropriate approach to their specific central fill needs and capitalize on new configurations available with the iA SmartPod. These new configurations feature a variety of cabinet and canister options. iA’s advancements in dispensing technology are empowering pharmacy providers to take advantage of the benefits of centralized fulfillment with the ability to scale as demand increases.

iA has partnered with progressive chains on a Quick Start approach to central-fill solutions. These chains capitalize on efficiencies and working capital reductions through centralization of high-cost inventory quickly, perhaps leveraging a “dark” or closed location, utilizing manual resources with minimal capital expenditure in advance of a planned automated solution buildout. These efficiencies include inventory savings on high-value, low-volume NDCs and workflow optimization through our innovative NEXiA software platform. This Quick Start approach accelerates return on investment capture and helps fund the overall central-fill solution.

Q: Discuss the latest advances in pharmacy software and possible breakthroughs on the horizon.

WYSONG: The recent advancements seen in pharmacy technology and software development are impressive to say the least. The emerging telehealth platform offers the promise of receiving better coordination of care without ever having to leave the confines of your house. That coupled with medication therapy management, live video counseling, drug treatment monitoring, integration of diagnostic test results, and up-to-date compliance and adherence factors, makes it possible to integrate these facets into a single comprehensive patient care solution. This is a critical development in adequately addressing the unsustainable costs of our current system.

HOUSTON: We’re constantly looking at how we can maximize pharmacy visits for both patients and pharmacy staff. For instance, when a patient walks through the door, we can have a full picture of that specific patient’s needs to enable the pharmacist to proactively ask the following questions: what refills do they need; are they up to date on their immunizations; are they comfortable with the medications they’re taking; is there any point-of-care testing we could provide? The ability to have curated care for a patient is, in large part, due to intelligent software and recent tech breakthroughs.

Adding on to that, the ability to capture that health information at the pharmacy and share it with other providers across the patient care team and health plan creates a more holistic view of a patient’s health, producing deeper and more beneficial conversations between a pharmacist, a physician team and a patient. Not to mention that the patient can bundle multiple health care needs at the pharmacy, making it a true health care destination that can provide countless services and help reinforce health care.

SWORDS: We are implementing one of the largest transformations in the history of Walgreens with Pharmacy Renewal — an adaptive platform that will grow and evolve with us into the future. We are creating a new, modern platform using the latest software technology to support our pharmacy teams. Our current platform fills more than 1 billion prescriptions each year while providing life-saving immunizations, testing and high-touch care to specialty patients. Pharmacy Renewal will significantly improve the day-to-day work experience for our pharmacy team members by making it easier to fill prescriptions, manage inventory and provide additional clinical ­interactions.

MILLER: The recent emergence of image-based virtual verification workflow software has enabled pharmacists to focus on clinical activities. In the next 12 months, we’re predicting most pharmacies will be using computer vision to improve workflow efficiency, accuracy and safety. Further into the future, we predict pharmacists will be readily available in every aisle, patient’s home or travel destination via a simple scan of a QR code while having a consistent patient experience regardless of location.

LASHIER: NEXiA, iA’s proprietary, industry-leading suite of intelligent pharmacy operations and fulfillment software helps to increase safety, speed and efficiency to the pharmacy fulfillment process. Utilizing elastic demand workflow, NEXiA processes prescription orders in real time, evaluates constraints and prepares inventory to intelligently manage the fulfillment process and helps prescriptions reach patients with optimal speed and efficiency.

NEXiA has been continually redefined and developed, and it includes unique safety and tracking features across all aspects of a central fill or mail order operation. NEXiA tracks major events related to the filling of a prescription and delivers comprehensive Rx tracking and real-time problem management, helping to reduce errors and provide detailed customer support. Users of the NEXiA system have an extraordinary view into the status of every prescription and subsystem. Our system is highly configurable, with 700 configuration parameters and 70 existing bidirectional interfaces, NEXiA integrates with many pharmacy systems and hardware technologies currently in the market. We have designed our system to grow with our pharmacy partners and to allow full scalability consistent with customers’ operational capacity. NEXiA’s system management functionality includes front-end logistics, intelligent demand management, patented dynamic prioritization, work queue management, and system oversight. At its core, NEXiA’s detailed analytics module allows for a vast set of built-in standard reports along with custom data analysis compatible with business intelligence subsystems. NEXiA’s interface engine includes over 80 robust interfaces to third-party software systems and automation technologies.

COUGHLIN: Integrated patient- and pharmacy-specific EHR systems allow pharmacies to document basic prescribing and dispensing functions and also support the more complicated specialty pharmacy functions. These should be structured as extensions of the pharmacy management and dispensing system rather than as another system to be used for these encounters.

SULLIVAN: There’s been a major increase in the demand for Smart Software platforms that leverage artificial intelligence as well as predictive modeling and analytics. Delivering enhanced data like intelligence and insights to pharmacies to better manage operations and resources is more important than ever. For example, KNAPP’s KiSoft One Pharmacy Suite supports full WMS functionality like managing inventory/stock management of all drugs in the system. Integral to this software suite are KiSoft Analytics, providing historic system data and forecasts. KiSoft redPILOT is a sophisticated but easy-to-use staffing tool to view operator performance data and provide guidance for allocation of assets.

Q: To what extent is technology helping boost medication adherence and countering the massive costs of noncompliance?

COUGHLIN: Pharmacies can now offer the full range of compliance packaging (vials, pouch packages, blister packs) via robotics integrated with their dispensing system.

HOUSTON: It all comes back to medication synchronization, which is often tech-enabled through a pharmacy management system. For example, at Good Neighbor Pharmacy our Patient Engagement Center is a hub that provides data related to adherence, helping pharmacists focus efforts on patients who are not taking their medications as prescribed. We also have text reminders that proactively remind patients that a refill is due. This helps boost adherence and allows for better care because patients won’t discontinue their medication.

Another area is compliance packaging. There are solutions for multidose packaging, and that contributes to better adherence, especially for complex therapies where a patient is taking multiple medications throughout the day. It makes for safer care overall, and patients have confidence as to when to take a medication or whether they’ve taken it already.

Also, there are even apps and programs now where providers or caregivers can track — in real time — whether a patient has taken their medicine and, if not, outreach to the patient to take the dose will be triggered.

LASHIER: Medication nonadherence contributes to an increase in chronic disease complications and places a significant cost burden on health care systems. Estimates from multiple news sources report the cost of medication nonadherence exceeds $200 billion a year. Compliance packaging helps to increase compliance, improve health outcomes and reduce costs to the health care system. However, these solutions can be labor or capital intensive.

iA offers a therapy management solution for pharmacy providers looking for options for multiple medication dispensing methods outside of the traditional bottle or vial methods, utilizing the BD Rowa Pouch Packaging Solution. iA’s intelligent pharmacy operations software, NEXiA, and partner hardware, enable pharmacy providers to customize a patient’s medications in easy-to-open adherence pouch packs. This service can be brought together in a centralized fulfillment location. A central-fill strategy allows chains to leverage their investment across multiple stores, which can result in reduced labor costs and lower cost to fill. iA’s medication adherence solutions also allow pharmacists to synchronize the medication regimen, ensure capture of 100% of patient requirements, increase refill rates and allow for scheduled medication therapy counseling. Chains embracing this model enhance patient compliance and satisfaction. Our software and partner hardware enable us to get a patient’s medications all in one pack, all in one place from a central-fill location, freeing up pharmacists to collaborate with patients.

WYSONG: There are several reasons that contribute to medication noncompliance and nonadherence. These factors include self-diagnosis, nonfulfillment and medication misuse. Collectively these culprits drive the unsustainable costs of health care often association with costly hospital readmissions and lingering chronic disease conditions. Technology advancements in e-prescribing, EHRs, mobile app’s, and telemedicine will undoubtedly improve patient connectivity and continuity of care. The net result will be better patient outcomes and more affordable health care for everyone.

STUTZ: It’s all about engaging patients at the right time, with the right message through a multichannel approach. Using modern techniques such as AI and machine learning, we are not only able to find nonadherent patients but also patients at high risk for becoming nonadherent. We can then stratify these patients and create a personalized communications approach leveraging digital and human outreach. A pharmacist’s time is so valuable that it’s important to optimize an adherence campaign to be as efficient as possible. Lessons learned in other industries, such as e-commerce and digital marketing, are easily adaptable for pharmacy. However, in the case of pharmacy, you just may save someone’s life.

SWORDS: We use many tools to automate refills and drive greater adherence, including Save a Trip Refills; auto-fill; and automated app, text and phone notifications. We have sent more than 500 million proactive notifications to pharmacy customers informing them of their prescription status or offering self-service to process a refill. This is a completely automated activity requiring no store intervention, enabled by technology. Patients experience these tools as yet another resource to make management of their health care simpler. Through Walgreens.com and the Walgreens app, patients can opt in to numerous tools like 90-day refill, pill reminders and 24/7 pharmacy chat to make it easier to manage their routine medications. All of this helps support adherence to medications and, as a result, drive better health outcomes. In fact, 79.4% of patients using digital prescription tools are adherent. (Digital prescription tools to manage and refill prescriptions; compared to those who did not receive reminders.)

Those using Walgreens refill reminders increase adherence by 2.6 percentage points. (Impact of email refill reminders on medication adherence among patients with chronic diseases in a retail community pharmacy; 2015.) But sometimes patients need high-touch care to remain adherent. For these patients, we offer Health Outcomes Pharmacists. These pharmacists supplement the work that our pharmacy teams do every day as they engage with patients to improve adherence and provide better health outcomes. This unique model of proactive patient outreach influences patient behavior and complements the work of the local pharmacy team to identify gaps in care and barriers to adherence. Despite advancements in technology, human interaction remains critically important when managing people’s health and well-being. Health care is local, and our power is in our experienced pharmacy teams who live and work in the communities they support. With our new strategy, we will fully harness the accessibility of our pharmacists and the right technology and tools to fulfill our company vision: To be the leading partner in reimagining local health care and well-being for all.

Q: How effective is tele­pharmacy proving to be, and how much more widespread can it become?

MILLER: Telepharmacy locations have increased by 279% over the last five years, and 28 states practice retail remote dispensing. Telepharmacy can be found in urban and rural retail, as well as in high-volume, outpatient and grocery store pharmacies. New forms of telepharmacy, like virtual verification, are becoming more prevalent, and are being utilized in settings from the largest chains to small ­independents.

WYSONG: Telepharmacy continues to refine its strengths, and there is compounding evidence that the technology has cost benefits over traditional dispensing models. One pharmacist can now cover a much wider area with more sites than currently being serviced with a traditional retail pharmacy. There is also better accessibility for patients in remote communities, and the platform offers an alternative solution for patients who are elderly or who cannot travel to pick up their medications or see their care providers. It is likely the platform will continue to see significant growth (especially in the near term) as the supporting technology, IT infrastructure and WiFi/internet bandwidth grows.

COUGHLIN: There are various methods readily available for face-to-face pharmacist-patient communications and counseling. These are constantly evolving and can be adopted and used quickly without strict integration with the dispensing system. The essential focus of telepharmacy within the dispensing function should be to enable efficient remote verification of prescriptions along with enforced documentation of verification and approval activities. This process needs to be tightly integrated within the dispensing system so it is efficient and reliable. Once this is in place, telepharmacy workflow can proceed at a rapid pace, and pharmacists can communicate with patients through the most effective means — which may vary from patient to patient.

SULLIVAN: At KNAPP we see growth in the demand for telepharmacy and telehealth expanding. Drivers for this increase are similar to those affecting grocery and retail. Today’s consumer expects a convenient, frictionless experience to customer service, communications and therefore virtually every part of their pharmacy experience. For instance, today we are incorporating telepharmacy into our 24-7 terminal solution for retail pharmacies. Our expectation is that it will become a broadly adopted service enhancement in the relatively short term.

HOUSTON: Telepharmacy is a rapidly emerging field that has the potential to transform and improve the delivery of pharmacy services. Telepharmacy has many recognizable benefits, such as easy access to health care services in remote and rural locations, greater patient satisfaction, cost savings, effective patient counseling and improved patient adherence, and it helps maximize pharmacy efficiencies.

Telepharmacy is expanding the reach of the pharmacist further into the community for purposes of extending care, which can be either consultative or for dispensing medications. This is critical for boosting medication adherence, especially as we see pharmacy closures in some rural areas, which creates pharmacy deserts, or in urban areas where transportation may be a barrier. With recent tech adoption, pharmacists can now do a remote consultation, fill a script, and then add in delivery. That’s the definition of caring for patients where they are.

LASHIER: The pandemic opened the door for patients to consider alternative means of health care delivery. Telehealth utilization, in general, exploded during the early stages of the pandemic. Although utilization declined as traditional points of care reopened, the world has changed, and pharmacy leaders must be prepared to meet patients expectations including telepharmacy and omnichannel delivery options. We believe that telepharmacy and telehealth are going to remain essential parts of the patient choice conversation. To further develop these offerings and provide patient choice, pharmacies will require a solution for offloading repetitive dispensing work. Centralized fulfillment will play an increasingly important role in how pharmacy providers evolve to meet patient needs and choice.

Q: To what extent has technology helped retail pharmacy thwart Amazon pharmacy’s inroads?

SULLIVAN: Our pharmacy customers, like our customers in food and retail, have used technology to differentiate their brand in a way that is more difficult for Amazon to compete. A centralized pharmacy that reduces costs also opens space in the retail pharmacy that can provide value added services for their customers — today. Amazon does not have that brick-and-mortar presence to interact one on one with their patients. We expect to see more of these investments focused on delivering superior patient care, enhanced convenience and a differentiated consumer experience.

LASHIER: The pandemic has accelerated the idea of ordering groceries and household goods online and having them delivered to the home or picking them up at the store. Consumers are demanding omnichannel solutions, and pharmacy is no exception. Pharmacy operators across sectors including retail, specialty, online and health systems must adopt omnichannel pharmacy fulfillment in order to remain relevant and competitive. Consumerism is requiring the ability to deliver pharmaceutical purchases the same day or in two days to the house, to the store or perhaps to a secure kiosk at the place of employment. The economic pressures of health care are driving pharmacies to find lower-cost, higher-touch strategies to capture additional market share, and ultimately increase patient satisfaction. iA is partnering with innovative pharmacy providers, helping drive their strategic road map and execute on implementation as they journey to unleash the full potential of pharmacy.

COUGHLIN: I think personal interaction between patient and pharmacist is more important than ever. The pandemic has brought health issues to a high level of concern, and people value the advice of medical professionals more than ever. Pharmacists are often the ones they look to for advice. As long as we can deliver and support technologies to help pharmacists avoid being overwhelmed with the demands of their job, they have nothing to fear from the purveyors of mail order medical advice and drugs.

WOODARD: So far, Amazon has failed to deliver on the most important component of any pharmacy: a knowledgeable, knowable and compassionate pharmacist. However, retail pharmacy cannot be complacent. Fortunately, we’ve seen Amazon’s playbook over and over again and we know how to respond. A great e-commerce and delivery strategy is table stakes for any pharmacy hoping to compete in the next 10 years. Pharmacies will need to leverage technology to track customer journeys in the real and digital worlds in order to reach patients where they are. One of those places is social media. Pharmacists, in some ways, are the original “influencers.” Well before TikTok, the local pharmacist was that trusted and accessible member of the community you could count on to give you great advice. Technology allows a local pharmacist to scale that influence up by several orders of magnitude. Pharmacists that embrace e-commerce and social media will be the ones most likely to positively impact patient health and will, therefore, be poised for success in the coming years.


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