Using Candy to Fuel Delivery

Why E-Prescribing Makes Sense for Community Pharmacies

Technology That Helps You Implement Medication Adherence Services

The Hiring Advantages of Community Pharmacies

Strengthening the Pharmacist/Patient Relationship

Helping independent pharmacies play a more integrated role in patient care is the reason I joined McKesson five years ago. This focus continues to drive everything I do at the company.

After spending several years at McKesson working on a variety of technology-based projects, including a solution that supports pharmacists in delivering medication therapy management to patients, I recently joined the Health Mart group as Vice President of Health Mart Retail Technology. In this role, I am supporting the deployment of technology solutions with the goal of creating a technology foundation upon which to build solutions for independent pharmacists to maximize their business and help address their customers’ unique needs.

There are many ways that technology and technology companies claim to help independent pharmacists. However, identifying which technologies to invest in and implement can be a daunting challenge for even the most tech-savvy professional. In this issue of Independent Advisor, we offer insights on two areas — medication adherence and e-prescribing — where independent pharmacies are realizing great benefits from technology.

In this issue, we also discuss the competitive advantages that community pharmacies have in hiring great people and we profile a successful promotional program that has helped one community pharmacy strengthen its relationship with its community.

As you contemplate potential technology investments, we hope the ideas shared in this issue spark thoughts that not only help you improve your business, but also strengthen your relationships with your community and your patients. I look forward to hearing from you on how technology can best support independent pharmacies.

Nancy Chung
VP of Health Mart Retail Technology
McKesson

Using Candy to Fuel Delivery

Call it sweet success.

For the 36 years that Craig Kueltzo has owned Lombard Health Mart in Lombard, Illinois, the pharmacy has offered free prescription delivery to customers, many of whom are elderly and would have difficulty getting to the store. With 30 to 40 deliveries each day, delivery is an important part of Lombard’s business.

A few years ago, as gas prices continued to climb, Craig wondered whether Lombard would be able to continue delivering for free, or if he would have to impose a charge to offset his increased delivery costs.

Then, when driving by a nearby candy outlet store, he had an idea: Lombard could purchase candy bars from this outlet (for as little as $0.13 each), and offer them to customers in exchange for a $1 donation. These donations would be used to offset the costs of gas and maintenance, allowing Lombard to continue to make thousands of free deliveries each year.

To test the idea, Craig bought 50 candy bars and put a collection bucket and a sign in front of his register, explaining that donations of $1 would enable Lombard to continue making free deliveries. The result: those 50 candy bars were gone in the very first weekend. Now, two years later, Craig buys 1,000 candy bars at a time and goes through about 400 per month. Lombard’s staff all know about the candy bars, and they make sure that customers are aware.

Craig shows samples of candy bars that are given in exchange for donations.

Some people feel so strongly that they donate without even taking a candy bar. Also, during the Christmas season Craig has found $20 bills and checks for $50 in the bucket. Many customers who receive free delivery also donate. (They do this with a very different attitude than if they were required to pay.)

While Craig’s initial intent was merely to help cover gas costs, what has resulted is much more. This simple activity has become a way that Lombard and its customers help give back to the community. It has generated press coverage for Lombard, built trust with customers, increased Lombard’s status, and strengthened Lombard’s reputation as a value-added community resource.

Who knew that candy could be the secret to fueling delivery.

Why E-Prescribing Makes Sense for Community Pharmacies

The concept of electronic prescriptions isn’t new, but adoption (at about 62% for independent pharmacies) is picking up steam as new studies demonstrate the many benefits.

What Research Shows
One recent study of a pilot by Medco Health Solutions and the California Public Employees Retirement System (CalPERS) showed significant results. During the 18-month pilot project, the number of doctors using e-prescribing jumped 79%, prescription renewals were up 104%, and 50% of participating physicians changed at least one prescription after receiving a safety alert through the e-prescribing system. The project also led to lower prescription costs through an 11% increase in generic dispensing rates among doctors who converted to e-prescribing.

Benefits to Independent Pharmacies
In addition to the boost in productivity and safety that e-prescribing supports, pharmacies that haven’t yet switched should consider the following benefits of e-prescribing:

• Fewer errors and increased patient safety through delivery of “clean” prescriptions.
• Fewer rejected claims due to easier access to prescription coverage information.
• Less paperwork and re-keying of data, which reduces staff time.
• Increase patient compliance since 100% of e-prescriptions arrive at your pharmacy.
• E-prescribing physicians prefer to do business with e-prescribing enabled pharmacies.

Tips for Promoting e-Prescribing to Physicians
The key to maximizing the benefits of e-prescribing is letting your prescribers know that your pharmacy accepts e-prescriptions. A few tips include:

• Educate your staff about how e-prescribing works and the benefits of the service.
• Identify one staff member as your e-prescription expert and have them interact directly with physicians in your area to inform them you now accept e-prescriptions.
• Have this staff member contact (via email, phone calls, or in-person visits) the largest physician offices and prescribers in your area to make them aware of your e-prescribing capabilities.
• Take advantage of managing renewal authorization requests electronically. This helps strengthen physician relationships because it reduces their time managing prescription renewals.

Technology That Helps You Implement Medication Adherence Services

America’s Other Drug Problem
Medication non-adherence has long been acknowledged as a serious problem for the American healthcare system, costing $106 billion annually and resulting in the premature death of an estimated 125,000 Americans each year.

Studies indicate that for every 100 prescriptions doctors write, only 50–65% are actually filled. Of those prescriptions that are filled, only 25–30% are taken by patients as directed and only 15–20% are refilled. According to The Express Scripts 2009 Drug Trend Report, procrastination is a primary factor in why 80–85% of prescriptions are never refilled by patients.

Pharmacists Are Part of the Solution
Increasingly, the healthcare industry is looking to pharmacists, particularly community pharmacists, to play a key role in solving the medication adherence problem.

New business models are emerging and reimbursement for medication therapy management (MTM) is getting more attention. A recent article in Drug Topics (“Is MTM Ready for Prime Time?” January 15, 2011) asserted that “Medication therapy management is looking like the next new career opportunity for pharmacists as the Patient Protection and Affordable Care Act, health plans, and employers press for its adoption.”

Pharmacists are interested in taking steps to improve medication adherence because doing so represents an opportunity to improve patient health outcomes, tap new revenue streams, and strengthen customer relationships.

Technology is a Prerequisite
Before pharmacists can implement medication compliance programs, they must find ways to replace their current daily tasks, reorganize their pharmacy, and implement technology that enables them to efficiently and profitably offer clinical services.

Ways that community pharmacists can use technology to improve medication adherence and increase revenues include:

• Implementing a pharmacy management system. Pharmacy management systems can decrease the amount of time spent on administrative tasks, freeing up a pharmacist to spend more time with patients and on value-added clinical services.

• Accessing electronic health records (EHRs). The Drug Topics article indicated that having organized patient information is an important prerequisite in a pharmacist’s MTM review, and is not something pharmacists want to invest significant time in. Pharmacists need to be able to quickly and efficiently access patient information and EHRs.
  
  Pharmacy management systems that are HL7 enabled have the ability to support interoperability between pharmacies and other clinical systems. When pharmacists can electronically access their patients’ medical records, patients receive more holistic care from each member of their healthcare team.

• Automating refills. Today’s leading pharmacy management systems, like McKesson’s EnterpriseRx, simplify the refill process for both the pharmacy and the patient by tasking the system, rather than the patient, with initiating the refill.
  
  In some systems, Enhanced Refill Processing (ERP) will automatically refill patient prescriptions for maintenance medications as they come due. If a patient is out of refills for a prescription, the system will electronically transmit or fax a refill authorization request to an eligible prescriber long before the medication is needed by the patient. Once the authorization is electronically sent back to the pharmacy, the software will automatically move the prescription back into workflow so a technician can proceed with dispensing. This automated process adds efficiency and saves time in the pharmacy. It also simplifies the process for the patient and improves compliance since it eliminates the need for the patient to request a refill or contact their doctor.

• Utilizing IVR. Outbound IVR calling is another technology that can enhance medication adherence. An adherence-focused IVR system will automatically phone a patient when a prescription is ready to be picked up. Some IVR systems will also automatically follow up with patients if they haven’t picked up their medication after a certain number of days. Pharmacies using these IVR features have seen a measurable decrease in the number of prescriptions not picked up by patients.

Each of these advances in technology helps pharmacists take the lead as medication adherence advisors to their patients. Yet, there is still plenty of work ahead in both technology development and operational changes behind the counter. As the role of the pharmacist continues to evolve, McKesson will focus on providing innovative technologies to help pharmacists serve more patients, offer more services, and drive better results

The Hiring Advantages of Community Pharmacies

Even with today’s high unemployment rates, most businesses are still experiencing challenges hiring good people. Community pharmacies are no different. Independent pharmacies are constantly competing with chains in hiring pharmacists and technicians, and are competing with other local businesses for hourly employees. Chains have strong brand names and opportunities for advancement, and often offer compelling salaries and benefits.

But, like other small businesses, community pharmacies have significant competitive advantages. It is important for owners of independent pharmacies to understand and leverage these advantages during the hiring process. Important advantages include:

• Greater flexibility. A distinct advantage of community pharmacies and other small businesses is the ability to offer employees greater flexibility, which some surveys indicate is what many employees most want from an employer. Flexibility might entail flexible hours, job diversity, or a flexible career path. In contrast to large companies, community pharmacies can tailor a job, benefits, and hours to meet a person’s specific needs.

• The ability to make a difference. Community pharmacies have less bureaucracy than a large organization. A result is that each person can have a direct relationship with the owner and everyone’s ideas can be heard and acted on. Most people want independence and freedom; they want to be creative and share ideas that can make a difference. In a community pharmacy, each person has the opportunity to make a tangible difference to customers and to the business. Having a sense of purpose and feeling like a valued contributor is often lost in large organizations.

• Job breadth. In large organizations, people often have very narrowly defined jobs. But in smaller businesses and community pharmacies, people can wear many hats, work in many roles, and learn a diversity of skills. For many people, this is far more appealing.

• Customer interaction. High levels of service and personal relationships with customers from the community are what typically distinguish a community pharmacy. For individuals who enjoy interacting with customers, particularly to help improve their health, working at a community pharmacy can be a great fit.

• A family-like culture. Many community pharmacies have very low turnover rates and long-tenured employees because the owner creates a culture that feels like a family. Employees feel like they belong and are cared about. They love being part of the organization.

Pharmacy owners need to be aware of these competitive advantages and leverage them when attracting new employees. Appealing to individuals’ desire for flexibility, job variety, and an inclusive culture can counter the advantages of large organizations and can attract great people into community pharmacies.

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