Strength in numbers: Advocacy in focus at Cardinal Health RBC 2018
At the Cardinal Health RBC 2018 Opening Session in San Diego, pharmacy owners heard about the ways they can work together to bring change to the current reimbursement model.
Doug Hoey, president and CEO of the National Community Pharmacists Association, and Ritesh Shah, owner of Drug$mart Pharmacy in Keansburg, N.J., spoke to Steve Lawrence, Cardinal Health senior vice president of independent sales, about how independent pharmacies’ strength lies in their numbers when it comes to changing policy.
Hoey noted that progress has been made in bringing to light the reimbursement issues that community pharmacies have with pharmacy benefit managers. He highlighted recent stories from “60 Minutes” and The Wall Street Journal that shined a light on the issue and noted that even President Donald Trump has taken notice of PBMs.
“We can’t let up — we’re reinventing pharmacy and redefining how we get paid,” Hoey said, noting that NCPA members are bringing some of their legislators to tour their pharmacies and educate them about the reimbursement system.
This direct approach is one way that pharmacies can help effect change on an individual effort, and Shah highlighted ways that pharmacists can do so on a larger level.
Shah, who chairs the New Jersey Pharmacists Association Political Action Committee, said that lawmakers in his state, after listening to a coalition of community pharmacy groups, recently passed legislation focused on maximum allowable cost, or MAC, transparency, as well as legislation that subjects PBMs to state regulation and allows pharmacists to dispute with PBMs through the state, allowing them to enforce contracting standards.
Hoey noted that changing the current payment model, while a victory in itself, cannot be where pharmacy advocacy ends.
“It’s really important not only that we succeed in disrupting this current payment model, but that we also offer a solution that redefines how pharmacies get paid,” he said. “That solution is the Community Pharmacy Enhanced Services Network.”
CPESN USA is made up of local, largely state-based pharmacy networks that work together to negotiate contracts with payers as a clinically integrated network. Hoey noted that doing so helps elevate pharmacies to the same level as health plans and other healthcare providers in negotiation, which complements legislative efforts.
“When you put CPESN and the advocacy efforts together, that’s how we’re going to change how pharmacies are paid,” he said.
Shah said that pharmacies in New Jersey recently banded together to get a Jersey City independent pharmacy re-added to a network by telling legislators the new hurdles for Jersey City patients who might have to travel farther just to pick up their prescriptions.
“We fought hard, our numbers worked and we were able to get the pharmacy back into the contracts,” Shah said. “When you work together, united, it works. The numbers make an impact, but we have to stay focused and organized.”
Hoey noted that in addition to pharmacies being engaged, recent coverage and focus on pharmacy-related issues also is mobilizing patients, who he said can be a key voice to add to those of pharmacists.
“There’s no question staying organized and moving as one unified front makes for a very powerful force,” Lawrence said as he closed the panel. “Change just doesn’t happen — we have to get involved to cause change.”
AR you ready?
Augmented reality could break down patient care barriers
Even people who haven’t heard of augmented reality are probably familiar with its application in their daily lives. If they’ve played with Snapchat or Instagram filters, participated in the Pokémon GO craze or used digital tools from beauty companies to try before buying, they’ve used some form of AR. Fuse by Cardinal Health, the company’s innovation center, is exploring the role AR can play in patient care and showcased a prototype on the show floor at Cardinal Health RBC 2018.
“At Fuse by Cardinal Health, our explorations always start with the needs of the patient or user. Pharmacists are looking for tools that help them teach and coach patients about medication adherence,” Keith Gasper, principal engineer at Fuse by Cardinal Health, said.
According to an article on Essential Insights, an online publication sharing healthcare industry expertise from Cardinal Health, 51% of those 65 years and older take at least five prescription drugs regularly, and 63% of them say they forget their meds. Improving adherence should be a goal for all pharmacists, as adherence can lead to patients experiencing better outcomes, and nonadherence can result in revenue loss when prescriptions go unfilled.
“Augmented reality can be a powerful teaching tool for caregivers. Patients can understand complex topics related to their care through augmented reality aids that are visual, non-textual, three-dimensional and compelling,” Gasper continued.
At Cardinal Health RBC, Gasper and his team demonstrated how AR could be useful when taking medication. If patients had an AR-enabled tablet inside their medicine cabinet that could read medication labels, superimposing easy-to-understand 3-D graphics above the pill bottles with AR, it could help reinforce information that pharmacists want the patient to remember. This also could show auxiliary labels and medication schedule info, as well as warn against taking expired medication or highlight any potential interactions.
Gasper noted that this could be especially helpful in care transition situations when a patient gets home from a hospital visit overwhelmed with information and possible new treatment plans. These situations are the most fruitful for the nature of AR, he said. “Explaining how medications help your heart by using a visual, 3-D beating heart is more illustrative than using a drawing or pamphlet and is likely to be more memorable,” Gasper said.
On the show floor, the Fuse team was also interested in hearing from pharmacists about the potential uses they saw for AR in their pharmacies as a patient tool. Gasper said that they were particularly keen on its ability to bridge gaps in communication, possibly due to language barriers, in the pharmacy. Many suggested an in-store AR kiosk that would help patients find out more about products or the medication they’re taking.
With no requirement for specialized equipment, Gasper said, he sees a lot of potential in AR in a more straightforward way than other altered reality tools. “We are energized by AR because we can create powerful interactive experiences without the high barrier of entry that virtual reality or mixed reality require,” he said.
As technology continues to improve, Gasper said pharmacy tasks that can be manual or repetitive will become more commonly automated, leaving pharmacists better able to provide additional patient care services. As part of that, connectivity — integrating patient data from various sources and keeping it in one place — will be key for pharmacists and patients. Additionally, he said, home devices will be more connected. That leaves AR essentially at the intersection of connectivity and patient-facing tools.
“By taking familiar home devices and improving them through better connectivity and usability, we can help caregivers and families stay up-to-date on the status and health of their loved one,” Gasper said.
Leveling the playing field by engaging patients digitally
Increasingly, digital tools have become vital to attracting and retaining patients. Phil LaFoy, pharmacist and co-owner of Blount Discount Pharmacies, which has locations in Alcoa and Maryville, Tenn., said that digital tools — a website that allows for prescription refills and a mobile app with similar capabilities — are one of the main ways independent retail pharmacies can stay competitive.
“I’m always looking for something that’s going to help set me apart or level the playing field,” LaFoy said. “With technology such as it is today, there’s an expectation of web presence, of phone apps, texts when your medicine is ready — all that stuff the chains are doing.”
In an effort to better deliver these options to his patients, LaFoy joined a pilot program of Cardinal Health Pharmacy Marketing Advantage. Though he already had a website in place, the Pharmacy Marketing Advantage suite of tools, which is offered in partnership with Digital Pharmacist, brought new functionality to the Blount website, as well as a mobile app for patients looking for a more convenient way to fill prescriptions.
Besides offering patients information about the pharmacy and its services, which include point-of-care testing, immunizations and various wellness classes for diabetes management and smoking cessation, the Blount Pharmacy website also allows patients to request refills on maintenance medication and create a profile with their prescription information, as well as their entire family’s medication needs. LaFoy noted that the website and the app both store a patient’s medication information to make ordering refills easy. These tools have drawn high patient engagement, he said.
“As the use of the app and website starts to move upward, I’m seeing more and more refills coming in from the app,” LaFoy said. In the past roughly three months, he said, refill requests from the app have grown to make up about 40% of the electronic refill requests, with the rest coming from the website.
The website and app offer a round-the-clock option for ordering refills, which LaFoy said is a capability that helps put his pharmacies on par with larger competitors.
“If the community perceives I don’t have a service because we can’t afford it or we’re just not strong enough, that can cloud the deal a lot of the times,” he said. “Once we adjusted to that 24/7 mindset where customers can call in their refills online anytime so they’re ready when they get to the store, we created an opportunity for more face-to-face engagement to build stronger relationships with our patients.”
Also through Pharmacy Marketing Advantage, LaFoy sends out a weekly e-newsletter with product promotions and health information that can help build patient engagement and encourage use of the website and app. Benefits of this engagement include the ability to cross-promote the app on the site and to offer additional services — including flu shots — to patients. Knowing patient information such as birth date can also help LaFoy target patients who might be on Medicare Part D plans and benefit from adherence counseling. These benefits, LaFoy said, help better serve patients in the ways they expect to be served, making independents competitive with their larger national counterparts.
“Give me tools like this, and I’m competing head-to-head,” LaFoy said. “Once you level the technology playing field, I know who’s going to win because the people I’ve got in place and the service we bring is second to none.”
Click here to learn more about how this solution can help you digitally connect to your patients. If you’re attending Cardinal Health RBC 2018, you can visit the Pharmacy Marketing Advantage booth on the show floor.