pharmacy technology
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Automation, tech companies aim to reduce lick, stick and pour duties

BY Sandra Levy

No doubt about it. There has been a cosmic shift in pharmacists’ role in health care, from a dispensary position behind the counter to one that involves engaging and interacting face-to-face with patients.

From medication therapy management and therapy-based point-of-care testing to immunizations and health screenings — and even including prescribing — it is clear that pharmacists have more opportunities than ever before to use their clinical expertise.

Pharmacists must address the question of how they can build and nurture patient relationships in the current healthcare landscape that require them to fill an increased volume of prescriptions in a shorter period of time.

That is where pharmacy technology and automation come in. Pharmacy software systems are able to help pharmacists streamline the process of identifying opportunities for engagement with patients, while automation and time-saving technology are meant to free them from licking, sticking and pouring so they have the time to spend with patients.

Identifying opportunities
Mountain View, Calif.-based Omnicell, for example, is helping pharmacists better identify and resolve medication-related problems with its Patient Engagement Platform.

“Technology equips pharmacists to identify and resolve gaps in therapy and other medication-related problems,” said Omnicell director of clinical healthcare strategy Rebecca Chater. “Enhancing their ability to manage medication use of populations is essential, and it’s important to make it as efficient as possible.”

With the Omnicell Patient Engagement platform, Chater said pharmacists can identify needs that exist within that patient population they serve to demonstrate their value in driving better health, better care and lower costs. In particular, she said that the platform can help identify patients who might require pharmacist engagement.

“Effective medication management is the centerpiece of value-based care,” she said. “Value-based care is not about simply identifying and resolving problems as you find them in the course of reacting to patient requests to fill prescriptions. It requires pharmacists to manage medication use related to chronic health conditions at the population level. Technology-assisted medication management is the future of pharmacy practice.”

New York-based Amplicare offers a workflow platform aimed at improving both patient outcomes and opportunities for intervention. Amplicare Connect helps pharmacies set up automated phone call campaigns, and Amplicare Restore helps identify patients whose prescription regimens might result in a nutrient deficiency.

“Patient care intervention notifications show up in-workflow as pharmacy staff is working within the pharmacy system,” said Matt Johnson, the company’s CEO. “This process ensures that pharmacies have the information they need, exactly when they need it.”

Freeing up pharmacists
A key component of medication management is actually dispensing the medication — a process that can take valuable time from pharmacists without a technological assist. From in-store automation that can help count pills to behind-the-counter robots that can create blister cards aimed at improving adherence, pharmacies increasingly are looking for new ways to free up time for pharmacists to spend on counseling patients.

Among the companies on the forefront of automation is Mission, Kan.-based ScriptPro, which offers six robots to help pharmacies increase their efficiency. ScriptPro’s director of industry data resources, Chris Fitzmaurice, sees automation as a key partner in the expansion of pharmacists’ role in patient’s lives that he said is on the horizon.

“We stand on the precipice of a new golden age of pharmacy. As health care grows in complexity and more services are guided to outpatient and retail pharmacies, technologies need to evolve along with the pharmacist’s expanding role,” he said. “Advanced tools like those developed at ScriptPro balance clinical decision-making with flexibility, supporting pharmacists with a foundation of evidence, while allowing them to tailor care to the individual needs of their patients.”

Canada-based Synergy Medical also is taking the lead in automation, designing and manufacturing robotic technology to fill single-dose and multidose blister packs.

“Blister pack automation reduces the labor required to fill packs and dispense, and frees up time so that there can be more emphasis on consultations and revenue-generating services,” said Synergy Medical marketing director Samantha Cockburn.

Pointing out that as Synergy Medical celebrates its 10th year and has installed 115 robots in the United States, Cockburn said that automation isn’t just a time-saving tool — it also can assist in adherence.

“Blister packaging is a key component to an adherence strategy,” she said. “As you get to a certain number of patients, however, the manual process of filling these packs starts to get onerous, it requires more labor, and it’s prone to error when you are doing a lot quickly. That’s where the precision and efficiency of automation comes in.

Noting that about 30% of oral medications are packaged in blister packs in Canada, compared with 2% in the United States, Cockburn said, “More studies show that organizing a patient’s medication by day and time of administration in multidose blister packaging is beneficial for patient adherence and outcomes. It synchronizes their prescriptions so they will refill more regularly. This is better for the patient and also provides more consistent revenue for the pharmacy.”

Cockburn touted the company’s SynMed XF robot, which is tailored to independent pharmacies. “A pharmacy that is operating at a nice steady flow is going to put out between 30 and 50 multidose cards per hour with one FTE, or about 1,000 cards per week, assuming an average of eight prescriptions per patient,” she said.

SynMed ULTRA, launched last year, is a high-capacity robot designed for high-volume facilities, where there is a need for a high volume of single-dose cards. “The robot has two picking units. It’s not much bigger than the original robot, but it is three times faster and can produce close to 200 single-dose cards per hour,” Cockburn said.

Beyond its software offerings, Omnicell also is looking to help relieve pharmacists from the burden of repetitive behind-the-counter tasks. The company offers several scalable adherence-packaging solutions for the pharmacy, which includes the VBM 200F Multimed Automation.

Omnicell executive vice president and chief commercialization officer Scott Seidelmann said that the VBM 200F fills and checks the company’s SureMed blister cards, “creating a seamless active workflow and freeing up the pharmacist for patient-focused activities.”

The company also recently introduced its digitized Autonomous Pharmacy, which Seidelmann said combines automation, predictive intelligence and expert services that serve as an extension of the pharmacy to support improved efficiency and regulatory compliance, as well as outcomes.

Noting that 20%-to-30% of prescriptions are never filled, and 30% of patients don’t take medications after pickup, Seidelmann said Omnicell envisions a care delivery model where the pharmacist is no longer sorting, picking, checking, reconciling and transporting medications.
“Formulary updates are made with the click of the button, and predictive intelligence offers inventory visibility to better plan for drug shortages and manage costs,” he said. “The bottom line is we are enabling the pharmacist to practice at the top of their license to transform the pharmacy care delivery model.”

Not all of the ways that pharmacists’ time is saved are automated, though — something that reverse distribution services firm Pharma Logistics realized. The company developed a solution for the human resources that are behind the pharmacy counter — pharmacy technicians.

“Pharma Logistics has created a 16-page Pharmacy Technician Handbook to educate pharmacy technicians on inventory management and the pharmaceutical return process, roles that many technicians are now responsible for as pharmacies seek to free pharmacists so they can provide counseling and other patient services,” said Daniela Weiszhar, the company’s head of marketing and communications.

Reaching customers/convenience
Beyond helping patients manage their treatment and finding the solutions that exist to find time to do so, pharmacists also are tasked with making the pharmacy experience easier for patients.
One crucial element to improving the experience is helping patients understand their medication. Palmetto, Fla.-based En-Vision America manufactures labels that help patients better understand their treatment regimen.

The latest addition to the company’s ScriptAbility offerings — which include ScripTalk, technology that reads a prescription label aloud for patients; label translations in 17 languages; ScriptView large-print labels; and BRL braille labels — is the Controlled Substance Safety Labels, or CSSLs. The labels distinguish Schedule II medications and help to reinforce the need for caution when taking the medication.

“Our new CSSLs help pharmacists effectively counsel their patients when taking Schedule II drugs. The booklet-style label reinforces the need for caution by providing both instructions and warnings in an easy-to-read 16-point font,” said En-Vision America vice president and chief technical officer David Raistrick. “In addition, by scanning a QR code on the label, patients instantly see a safety video showing the drug’s patient education details.”

In addition to helping diversify how patients can learn about their medication, companies are looking to help pharmacies with such patient-facing tasks as will call and drive-through.

Johnson City, N.Y.-based Innovation’s PharmASSIST Light-Way — in addition to offering potential as an inventory-management system — can be used as a will-call system. The product uses bottom-lit shelves that guide pharmacy staff to the bag they need after scanning a barcode.

For pharmacies with drive-through windows — through which roughly 60%-to-70% of their prescription volume flows — there also are needs for an improved experience that Cincinnati-based Bavis Drive-Thru is looking to help meet.

The company’s Bavis Enhanced Audio Module, or BEAM, filters up to 90% of environmental noise, eliminating miscommunication and potential conflict when patients come to the drive-through hoping to consult with their pharmacist and discuss medications.

“Many patients are looking to their pharmacist for more advanced information about the medications their doctors have prescribed, and they are also looking for over-the-counter solutions,” said Bavis president Bill Sieber. “Our goal is to create systems that allow pharmacists to consult easily with patients and to provide advice. We believe counseling at the drive-through is more confidential and secure than counseling in the store, and it is very convenient, especially for elderly patients and mothers with their children in tow.”

Manufacturers agreed that all of their solutions ultimately are aimed at empowering pharmacists’ clinical skills as a way to bring about better patient outcomes.

“They are specifically trained to tailor the right medication therapy to a patient this includes detection and resolution of medication therapy problems, as well as reduced medical costs that result from optimized medication use,” Omnicell’s Chater said.

ScriptPro’s Fitzmaurice said, “Individualized care requires a higher level of specificity and commitment. To successfully set out into this new era, pharmacists should embrace both their roles in the new clinical landscape, as well as support platforms designed specifically with them in mind.”

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