Pharmacy software, tech focus on outcomes, clinical interventions
With pharmacies continuing to focus on outcomes that are tied to reimbursement, they are feeling more pressure than ever to boost pharmacists’ interaction and engagement with patients.
Yet, it’s a daunting task. Faced with ever-growing prescription volume, pharmacists must juggle their time dispensing a higher volume of prescriptions, while also ensuring they are taken as prescribed. A recent study in the Annals of Internal Medicine found nonadherence contributes to nearly 125,000 deaths and 10% of hospitalizations — and it costs the healthcare system between $100 billion and $289 billion a year.
Many technology companies have taken notice of the myriad challenges that pharmacies are facing. They are cranking out innovative technologies and improving functionalities to streamline workflow and increase efficiency, thereby freeing pharmacists from having to perform mundane tasks so they can focus on counseling patients.
The innovative technologies also are allowing pharmacies to provide more convenience to patients, thereby helping pharmacies to differentiate themselves from their competitors.
Efficiency and engagement
With increased patient care offering an opportunity for better patient outcomes and additional revenue streams, one of the main tools pharmacies deploy to do more during the same operating hours is their software choice. Companies offering pharmacy software are variously focused on workflow improvements, and making it easier for pharmacists to check the work of pharmacy technicians, whose responsibilities behind the counter also are increasing.
“A lot of pharmacies are moving toward having a pharmacy technician enter a prescription and fill it, leaving the pharmacist to conduct the final check, which frees them to focus more on clinical outcomes and counseling,” said John Bell, assistant product manager at Spartanburg, S.C.-based QS/1. The company’s software features a customizable workflow feature that includes multiple workflow queues, allowing pharmacists to verify multiple prescriptions, and a dashboard that allows them to monitor the queues. “Our workflow model allows pharmacists more time counseling patients rather than spending the majority of their day entering data into the system, printing labels and getting prescriptions out the door,” he said.
Alongside efficiency, pharmacies increasingly require patient engagement tools from their software, as more touchpoints offer an opportunity to impact adherence or provide reimbursable services. New York-based Amplicare also offers a workflow platform aimed at improving both patient outcomes and opportunities for further intervention.
Amplicare Connect helps pharmacies set up automated phone call campaigns — freeing up pharmacy staff — and Amplicare Restore helps identify patients whose prescription regimens might result in a nutrient deficiency, which can drive nonadherence. Amplicare CEO Matt Johnson said that Restore also could help increase OTC supplement sales. The important part is knowing when to reach out, he said.
“Patient care intervention notifications show up in-workflow as pharmacy staff is working within the pharmacy system,” Johnson said. “This process ensures that pharmacies have the information they need, exactly when they need it.”
QS/1’s refill reminder program, dubbed Health-minder, enables pharmacists to run a list of prescriptions that are due in the next 2-to-3 days, so they can be filled and ready for pickup when patients come into the pharmacy. The company’s software also can highlight which patients would benefit from medication synchronization.
“We have features built into the software that allow pharmacists to pull up a patient’s medication profile, and if they are taking five medications every day, the pharmacist can look at the last date it was filled and determine a possible synchronization date,” Bell said.
As important as knowing when to reach out is knowing which patients require additional attention from the pharmacist. Rebecca Chater, director of clinical healthcare strategy at Mountain View, Calif.-based Omnicell, said that a good portion of the patients — some pharmacies serve as many as 5,000 patients — require an intervention of some sort. Chater said that in the past, pharmacy software has been solely focused on making dispensing more efficient, rather than identifying patient care opportunities.
“Today’s direction of value-based health care signals a change, and will require pharmacists to practice to the full extent of their clinical knowledge and training,” she said. Omnicell recently unveiled the Omnicell Patient Engagement platform and analytics offering, which can track and guide patient interactions. A cornerstone service of pharmacies’ enhanced services, medication therapy management, is a key area where software providers are focused on making it easier to identify patients who might benefit from it. For example, QS/1 has an interface with two companies whose Medicare data informs pharmacists where MTM opportunities exist.
With clinical interventions, software providers are building out the analytics capabilities of their offerings to make suggestions that will be valuable for patients — both with regard to MTM and beyond, including such services as vaccinations.
San Francisco-based McKesson’s clinical solutions include the ability to identify possible opportunities for clinical intervention.
“We analyze patient history to understand how adherent they are, and help the pharmacist create a plan to make sure they are taking the medication as prescribed. We’re also looking at whether they are due for different vaccinations, so they can be administered when they pick up their medications,” said Heather Cusick, McKesson’s director of product management for clinical services. She noted that the company’s tools alert pharmacists about engagement opportunities when they’re working on a patient prescription.
In the case of immunizations, technology also can assist in potentially time-consuming reporting requirements in various states.
QS/1 offers pharmacies that provide immunizations the ability to enter data for transmitting to state registries when required, reducing pharmacists’ effort, Bell said. “It’s a time-consuming process for a pharmacist to go back into the system and manually put the information in.”
Like administering vaccines, filling specialty prescriptions also comes with such nonclinical tasks as prior authorizations and documenting a patient’s drug regimen. QS/1 can interface with other vendors to get these done quickly, Bell said. “Within our system, they can scan documents in the patient record, and we have interfaces that focus on that to help them with the workflow,” he said.
Improving the patient experience
Pharmacy technology companies also are helping pharmacies enhance the way they communicate with patients when they call the pharmacy.
Chater said Omnicell recently enhanced its Interactive Voice Recognition software solution to add functionality at a reduced cost to improve patients’ experiences. “It’s a lot easier for pharmacies to implement because, instead of having IVR hardware in each pharmacy, it is hosted,” she said. “They no longer have to make the investment in that equipment. It allows them to streamline their workflow and improve patient engagement.”
For patients looking for the convenience of a drive-through, Maineville, Ohio-based Bavis Drive-Thru offers a host of technologies that enable its customers — some of whom see between 60% and 80% of their volume pass through the drive-through window — to operate more efficiently, while offering safety and convenience for patients.
The company’s Captive Carrier TransTrax system enables pharmacies to deliver prescriptions to remote lanes at either car or truck height, making the experience easy for the drive-through’s most common patients — women with children and elderly patients.
“Our Captive Carrier TransTrax opens the doors immediately upon arrival,” Bavis president Bill Sieber said. “By delivering products to a height that’s convenient for whatever kind of vehicle the patient is driving, and opening the doors automatically — all the patient has to do is simply retrieve the medication. They don’t have to manipulate the equipment like doors or lids, or anything else.”
The company’s Bavis Enhanced Audio Module, or BEAM, eliminates as much as 90% of environmental noise to make communication easier. “Misunderstandings in audio communications, concerning patient medications and information, can be dangerous, Sieber said. “BEAM is so powerful that I can be speaking right next to a diesel truck and be heard clearly.”
When it comes to convenience, another factor is making payment easy with drive-through credit card technology. The company’s first-lane Transaction Drawer is big enough to allow for portable credit card equipment to be placed inside for patient use. It also offers credit card processing equipment for the Captive Carrier TransTrax to allow for quick payment.
Managing and monitoring stock
Irving, Texas-based Supplylogix is making headway in helping pharmacies operate more efficiently and profitably with various software offerings in regard to their stock, including Pinpoint Transfer, which identifies dead and overstock inventory products in one chain’s location that aren’t selling, as well as other locations in the chain that need the product transferred to them.
They identify dead medication as product that hasn’t moved for the last 120 days, and overstock inventory as product that has greater than 120 days of supply on hand. If the store doesn’t have use for this inventory, the products will eventually expire, and when they are returned, the pharmacy may receive partial credit, or no credit.
“For pharmacies using Pinpoint Transfer software, 85%-to-90% of product will sell within 90 days of it being transferred,” said Brad Dayton, Supplylogix senior account manager. “In today’s healthcare environment, pharmacists are taking on additional roles in patient care. We can help that pharmacist make sure they have enough product to dispense and are not needlessly losing money as inventory expires, and, ultimately, are better positioned to meet their patients’ healthcare needs.”
Supplylogix also offers a replenishment solution, Pinpoint Order, which enables users to analyze their pharmacy data to better determine inventory purchases and dispense history so they can set informed reorder points on their medications.
For example, if a pharmacy needs to keep 100 tablets in stock of a certain drug to meet its customer’s normal needs, Supplylogix will recommend it set that reorder point so that any time it drops below 100, another bottle will be ordered.
“We feed the reorder points to their pharmacy system, which creates an order that either goes to the pharmacy wholesaler or to their own warehouse, for replenishment. We inform pharmacies how much inventory they need in stock and how much they should be buying of individual products,” Dayton said, noting that Supplylogix’s Product Linking helps with the cost of goods, offering a daily update of wholesalers’ preferred products and generic prices. “The bottom line for pharmacies is they are able to improve their margins when they buy the least expensive product available to them.”
Once products are in stock, it is important to keep them there, and Dayton said Supplylogix’s Pinpoint Audit solution allows for pharmacies to focus on loss prevention and potential opioid diversion.
The tool looks at the purchases and dispensing of individual pharmacies and identifies situations where it appears they are either dispensing more product than they are purchasing or purchasing more product than they are dispensing.
Additionally, Supplylogix’s Point Monitor looks for suspicious ordering habits of controlled substances.
“Our tool helps to monitor purchasing, compares each instance against all others in the system, and evaluates purchase frequency against the industry,” Dayton said. “If one pharmacy is buying an excessive amount of a drug, it alerts their corporate office of the anomaly. There can be legitimate reasons for the purchase, but you can also have negative occurrences of ‘prescription mills.’ Our system helps the pharmacy follow the DEA’s laws.”
The future appears ripe for more innovations in pharmacy technology, and much like today’s pharmacists, pharmacy technology companies likely are to play a greater role as consultants.
Looking ahead, pharmacists also will have more technological tools at their disposal to document patient care.
QS/1 took part in an electronic care plan pilot program with the Community Pharmacy Enhanced Services Network and the National Community Pharmacists Association. The pharmacy-focused software enables pharmacists to document patient care in a comment format that other healthcare providers can read and share across different platforms.
“If the pharmacy can prove they’re taking better care of patients, it leads to higher reimbursement from payers,” Bell noted. “We have pharmacies using the software, and data is being submitted to CPESN, which is helping those pharmacies improve their value.”
Overall, McKesson’s Cusick said, it is imperative that companies be ready with solutions for pharmacies.
“With the changing landscape for our pharmacies as they are looking at additional revenue opportunities, and as pharmacists are becoming more valued for their additional touchpoints with the patient, driving a lot of the services for our providers and payers, we need to provide solutions,” she said.
Updox launches secure text and messenger
Customer relationship management platform Updox is unveiling its latest offering — Updox Secure Text and Updox Messenger.
Using the Updox platform, where users manage prior authorizations, lab results and orders, healthcare staff can now immediately and securely text message a patient or post a message to an internal coordination group or channel to support real-time communication and collaboration.
Updox Secure Text does not require a password or separate application. It relies on verification based on a patient’s birthday, unique URLs and end-to-end encryption for security, the company said.
Patient responses arrive in the Updox inbox with the full thread of conversation, allowing messages to be archived and added directly to a patient’s chart, so conversations are not lost and can be easily referenced.
The patient-facing, HIPAA-compliant text solution is aimed at providers who require a high level of regular interaction with pharmacists, primary care physicians, pediatricians, OB/GYNs, dentists and dermatologists.
Updox Messenger gives practices greater visibility into how healthcare teams coordinate care. Whole conversation threads can be viewed at a glance to see when messages were sent and received so that providers can ensure messages get delivered when they need to be delivered.
“Like other businesses, hospitals use collaboration tools to improve internal coordination and communication, and create inter-office chat channels to keep people updated in real time, post questions, share videos, etc. Updox brings that to out-of-hospital providers,” Updox CEO Michael Morgan said. “Technology only works if it eases frustrations, not adds to them. That’s the core of what we offer providers. Communicate more efficiently so that care can be delivered more effectively — for the benefit of providers, staff and patients.”
FDA approves Gamifant for ultra-rare illness
Sobi, an international biopharmaceutical company dedicated to rare diseases, and Novimmune, a Swiss biotech company, have received the green light from the Food and Drug Administration for Gamifan (emapalumab-lzsg), an interferon gamma, blocking antibody for the treatment of pediatric — newborn and older — and adult patients with primary hemophagocytic lymphohistiocytosis, or HLH, with refractory, recurrent or progressive disease or intolerance to conventional HLH therapy.
Primary HLH is an ultra-rare syndrome of hyper-inflammation with high morbidity and mortality, and for which there was previously no approved drug. Gamifant represents a major advance in the treatment of these patients through a targeted mode of action.
“Today’s landmark approval of Gamifant will allow Sobi to bring the first and only FDA-approved treatment for primary HLH to a rare disease community that has faced high mortality without much improvement in care for the past 24 years,” Sobi North America president Rami Levin said.
Gamifant is expected to be available for administration in treatment centers in the first quarter of 2019.