At the Precipice of Retail Pharmacy Transformation

Episode Highlights

Q: In your view, how has the business and practice of retail pharmacy changed since COVID-19?

Duane Jones: The pandemic opened many doors, generating a tremendous amount of awareness about the value of community pharmacies, and the impact on healthcare and patient outcomes.

But as it was happening, COVID was all-encompassing. Some independent pharmacies working in a manual environment tried to do everything at the same time. It just got to be too much. They couldn’t handle the stress. Some ended up selling their businesses.

At Harps, COVID forced us to look at the demands of our time and think about how we could transform our pharmacy practice in a pragmatic and efficient way. We turned to technologies to help workflow our time more efficiently, so we can take better care of patients.

Q: How can independents avoid pharmacy burnout?

David Kirkus: There are documented shortages of both pharmacists and pharmacy technicians. At the same time, the workload challenges for pharmacies are at an all-time high. It’s always been an industry where you have to do more with less. That really has come into focus recently, and it's caused a lot of people to leave the workforce. The remaining staff is forced to do even more with even less. 

The major responses we see include an increased reliance on pharmacy technicians. Pharmacy technicians are stepping into more prominent roles, such as administering immunizations, so pharmacists can more directly engage in patient care.

Another response is an increased reliance on technology. This is an area where we see immense opportunity. Streamlining workflow and improving efficiencies is just the nature of operating in retail pharmacy. Driving a better workflow experience for the pharmacist is ultimately going to lead to a superior patient experience and improved health care for patients.

Duane Jones: David, I couldn't agree with you more. With the pandemic, we’ve seen much greater awareness of the community pharmacist’s ability to meet challenging situations and provide organizational structure. If not for community pharmacists stepping up and managing local vaccine programs, we could have been facing a national catastrophe. 

That’s where we are today. More public health officials, healthcare leaders, insurance plan administrators, and more, realize community pharmacists need to be used more. We’re accessible, talented, extremely knowledgeable, and have the ability to positively impact patient care. 

We’ve talked about practice transformation for many years. We’re now at the precipice of change, of getting provider status for pharmacists, either through private payers or Centers for Medicare and Medicaid Services (CMS). 

We need to prepare for this change every day. We need to delegate non-clinical responsibilities to technicians. We need to use technology to automate tasks such as scheduling, medication synchronization programs, and more. So, we can be more efficient and free up time for pharmacists to focus on clinical duties.

Q: What practice transformation changes are occurring now in your region? 

Duane Jones: Under Arkansas Medicaid, pharmacists are able to do point-of-care COVID tests and treatments. We schedule testing and boosters in several Harps pharmacies, along with strep, flu, and other immunizations. We even are scheduling comprehensive medication reviews because we think it’s really important for our pharmacists to do that at the store level.

All Harps pharmacists are credentialed with Arkansas Blue Cross Blue Shield as providers. We currently are providing point-of-care testing and billing for those services.

We’ve seen two major benefits. First, our pharmacists are gratified to have enhanced interactions with patients. Second, we’re able to bill as a normal provider does. This is going to mean a radical transformation of pharmacist workflow. As they make that transformation, with the support of programs and technology, their work-life is going to be so much more fulfilling.

Q: What foundational technology do you recommend starting with? 

Duane Jones: Medication synchronization programs. We thought we could do med sync manually, but after three or four weeks, we got frustrated and gave up. It was just too much to manage.

Then we found the Medication Synchronization Platform and rolled it out very deliberately, in a fashion to get the pharmacies comfortable using them, and to get patients comfortable receiving the refill reminder communications. Then we rolled out immunization reminders. 

The med sync programs have been a tremendous asset for our company. It generates more consistent adherence by our patients, more consistent refills, and allows us to proactively manage our workflow throughout the month as opposed to having everybody come in at one time. 

To be honest, I was shocked at the success of our refill reminder program. I was expecting a lot of patient pushback, just from the reminder calls. But we achieved a 70 percent refill rate; people are saying yes, thank you. It’s a personalized technology that allows us to reach so many more people than we otherwise would. 

That’s the foundational technology. Then we built off that to include scheduling software. I’ve said many times, that CareScheduler was our salvation during COVID. It allows patients to access the system to schedule their immunization and choose their pharmacy location. It also provided valuable information to us about the patient. This helped us to be very methodical. We gave well over 20,000 vaccines and it did not tsunami our operations.

David Kirkus: Building on Duane’s point, personalization, is in every aspect of a consumer’s life. Technology is getting smarter and more personalized.

Recently, I filled a couple of prescriptions at a local pharmacy. I got two phone calls from two different employees telling me my prescriptions were ready for pickup. How much wasted time and effort is in that type of workflow?

Automated solutions are available to send me a text message. These are core blocking and tackling personalization communications that are readily available. And they can be done in a personalized, proactive way because we have the data and knowledge of what the patient needs. 

Q: What other technology is available to solve workflow and patient care challenges? 

David Kirkus: We anticipate that community pharmacists are looking forward to fully participating in the transformation of pharmacy practice. The only way transformation is going to be successful is by using technology to improve efficiencies and workflow.

And, let’s be honest, reimbursement gets worse every year. If you’re relying on filling prescriptions to keep the pharmacy lights on, you’re going to have difficult times ahead. These new, advanced clinical opportunities offer future protection against the erosion of reimbursements in pharmacy. 

In addition to the tools Duane mentioned, other consumer-centric technology includes the very basic to the more complex, such as:

• Personal communications solution. Using intelligent technology and interactive response, it validates the caller’s identity, anticipates the probable reasons for the call, proactively answers the caller’s questions, and provides appropriate directions, such as obtaining a due prescription refill. This frees the pharmacy staff from answering routine questions, and allows them more time to perform other duties. 

• Medicare Match plan selection tool. This puts pharmacy in a position to be a central player in the healthcare hub. Discussing Medicare Part D plans can be a complex conversation for patients and pharmacists, the automated workflow simplifies drug lookup and data entry, making it easier to select the best plan for the beneficiary. 

• MedBill technology. I love what Duane is doing, scheduling point of care testing and other services. To actually bill Medicaid, BlueCross BlueShield, or other plans, there are solutions to enable that type of billing.

DISCLAIMER

The Future of Pharmacy Podcast is produced and distributed by Pharmacy Podcast Network. The views and opinions expressed in this podcast are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.