Pharmacies turn to automation as workloads, data needs rise

Retail pharmacy is being squeezed.

Even as an aging population and expanded insurance coverage under Obamacare propel rising dispensing rates and add to pharmacists’ workloads, they’re being called on to practice “at the top of their license” by filling an ever-expanding role as front-line patient-care specialists and fully engaged members of collaborative care provider networks.

With “the healthcare landscape … undergoing its most rapid transformation in a century,” to quote the National Association of Chain Drug Stores Foundation, chain and independent pharmacies are facing an existential challenge. How do pharmacists — no matter how highly trained and motivated they are — juggle rising prescription counts with expanding clinical and such preventive-care services as medication therapy management, diagnostic screenings, immunizations, medication adherence programs, appointment-based patient counseling sessions, and chronic disease monitoring and management? And how do they link those efforts to a broader, more holistic model of patient care in collaboration with doctors and health systems?

Technology firms say their solutions will enable community pharmacy to keep pace with the explosive changes occurring in health care. In an era of collaborative and accountable care, outcomes-based reimbursement models, rising prescription volumes, a shrinking pool of primary care physicians and urgent cost-cutting imperatives, pharmacy retailers and their technology vendors are more closely linked than ever. And automation is more critical than ever — both as a labor-saving tool and as a means of capturing, sharing and applying prescription data on behalf of healthier patients and lower health costs.

Some pharmacists might argue that those labor-saving tools aren’t being applied fast enough to keep up with the added burdens of clinical care. But massive investments in robotic dispensing systems and other tools are clearly shifting some of the dispensing workload away from pharmacists and onto more highly trained technicians — and into high-volume, highly automated central-fill facilities.

‘Amazing transition’

At the same time, systems to mine, measure and analyze patient data are advancing rapidly, giving pharmacists more powerful decision-making tools to support patient interventions and connect more seamlessly with the broader health network.

“We’ve seen this amazing transition taking place in community pharmacy with it becoming more clinical in nature,” said Brian Glaves, director of sales for ScriptPro. “Today’s incoming pharmacists are chomping at the bit to be a healthcare provider to their customers —developing those personalized relationships and helping set up prescribed medication therapies.”

For its part, “ScriptPro is keeping abreast — developing new technologies that enable pharmacists and their teams to stay connected across their network and with their patients and prescribers,” Glaves said.

Glaves called robotic dispensing systems “a game changer” that “go a long way to streamlining workflow, saving time and improving accuracy.”

“Now you can seamlessly integrate all these new technologies that keep patients and their pharmacies connected,” he added, citing ScriptPro’s own RefillPro and PharmacyPro mobile point of sale systems. Within “our industry’s growing collaborative care mindset, the retail setting is facing a huge need for organized case management and treatment plans for patients undergoing chronic disease, pain management and specialty drug therapies,” Glaves told DSN.

It’s about applying technology and patients’ electronic health records “to integrate pharmacy care from the payer to the provider to the patient,” CVS Health president and CEO Larry Merlo noted earlier this year. The company’s “truly integrated assets,” he added, give CVS “a full view of each patient and a single patient record for prescriptions and care regardless of the CVS Health channel used.” And it allows the broad-based retail pharmacy and pharmacy benefit management giant “to offer innovative services and to deliver additional value to [other healthcare] stakeholders.”

Supporting health provider status

The American Pharmacists Association calls health IT “an effective vehicle for exchanging information between practitioners, patients and pharmacists.” To that end, “Pharmacists need access to pertinent clinical information about their patients, and in turn should contribute information to the health care team in order to improve patient outcomes,” APhA noted.

“Information technology plays a major role in monitoring any adherence program. That’s especially true when it comes to tracking outcomes,” said Sandy Canally, founder and CEO of the Compliance Team, the first certified, woman-owned healthcare accreditation organization to hold “deeming authority” from the Center for Medicare and Medicaid Services.

“In this day and age, nearly every pharmacy uses some type of software program that enables them to submit data to payers and referral sources,” Canally added. “The best use of IT is utilized in the patient monitoring follow-up. Careful documentation is key to providing proof of a positive patient outcome.”

For that and other reasons, she told DSN, “Obtaining a complete medication history is critical in assessing the appropriateness of the prescribed medication therapy, and to create a reconciled medication list and care plan for the patient. Equally important is the coordination of care by the pharmacy with a patient’s prescribers.”

Automation experts agreed. “Technology, integration and interfaces are the way of the future,” said Crystal Ratliff, market analyst for technology provider QS/1. “As pharmacy’s role in the patient care team expands, technology is becoming a greater factor in removing barriers between the pharmacy and a patient’s other healthcare providers. This expanded team provides a more collaborative, efficient process to improve patient outcomes.

“Pharmacists’ ability to substantiate their value in improving patient outcomes will be crucial to their recognition as healthcare providers,” Ratliff pointed out. “Pharmacists are already providing services beyond filling prescriptions, but this work must be documented and shared with the healthcare community for the pharmacist's value to be realized.”

As for QS/1, she said, its role “is to provide pharmacies with the tools necessary to adapt to this rapidly changing market and to give them a substantial competitive advantage. We provide the technology to speed workflow and track compliance and reimbursement, thereby increasing the time available for important counseling opportunities.”

Another critical benefit community pharmacies can bring to the new health paradigm is their proven ability to improve patients’ adherence to medication therapies — a key core competency that can lead to reduced hospital readmissions and healthier patients long-term. The installation of unit-dose or multi-dose packaging systems within the pharmacy can be a powerful tool for improving adherence rates, said Mark Rinker, senior director of sales for Synergy Medical.

“We continue to strongly … advocate the use of packaging to improve patient outcomes,” Rinker told DSN. “The FAME (Federal Study of Adherence to Medications in the Elderly) study and others cl