By Robert Dudzinski
While pharmacists spend years training to be experts on drug formulation, dosing and how to prevent adverse interactions between medications, it’s probably not their favorite part of the job. Many instead relish the one-on-one interactions with longtime customers throughout different seasons of their lives.
This is a key moment for pharmacists to cement their role as a health care provider with a 360-degree view of the patient. Post Affordable Care Act, the wait for doctors’ appointments is rising, and pharmacies prepared to provide patients with a growing array of primary care services will flourish. Pharmacists can be the eyes and ears of the health care ecosystem, because patients visit the pharmacy once a month — at least — versus the once-yearly visit to their primary care physician. In a recent survey by PwC’s Health Research Institute, three-quarters of consumers surveyed said they were open to “extenders,” such as nurse practitioners and pharmacists, performing health services.
Relationships at risk
But these important relationships are in jeopardy as pharmacies, too, see their volumes rise. U.S. pharmacy sales crossed the $225 billion mark in 2014, and they continue to climb due to patients newly insured through the ACA and recent Medicaid expansion of drug coverage. Pharmacists are also stretched thin by population health initiatives that demand new pharmacy services such as large-scale medication adherence and chronic disease management programs. So at many drug store chains these days, long waits on the phone and in person may threaten to derail both customer loyalty and pharmacist morale.
It may seem counterintuitive, but the best chance the retail pharmacy industry has to preserve and enhance patient engagement is to automate and offload routine tasks so that pharmacists can focus on what they do best, counseling and advising patients to improve medication adherence outcomes. The time is now to free up pharmacist capacity so drug store chains can take advantage of the current opportunity to expand the role of pharmacists as a key hub in the patient journey.
Forward-thinking pharmacy chains are looking to technology to automate prescription filling, maximize work flow, monitor performance and track medication adherence. The first step in modernizing a retail pharmacy engagement strategy is to enable self-service for those consumers who want it. Collapsed phone menus, guided by IVR, can provide end-to-end service for customers with simple queries.
For those customers with more complex or ongoing needs, a combination of automation and the pharmacist touch can help patients to stay engaged as they initiate, titrate, and transition among medications. By creating new touch points in the channel of the customer’s choice, pharmacists can help them work through any challenges with their medication, keeping them on therapy and boosting both outcomes and the bottom line.
When it comes to customer channel preference, technology can help by alerting pharmacy staff to which consumers are calling from smartphones. Pharmacists can then proactively reach out to see if customers would prefer to receive text refill reminders or medication adherence education, versus phone calls.
Here’s an example of how some pharmacies are using a combination of automation and pharmacist touch to optimize patient engagement throughout an episode of care:
Meet Jim, a 60-year-old man with diabetes. The pharmacist first sends Jim an “order ready” notification. Since this medication is new, the pharmacist activates a customized communications solution geared towards a specific type of medication — in this case, diabetes drugs. Jim has indicated that he prefers text message, so within 24 hours of drug pickup, the pharmacist sends him an order ready text message. Five days later, the pharmacist sends an automated IVR asking him to take a short survey to reveal any side effects or other hurdles to medication adherence. If Jim is found to be noncompliant, the platform will alert the pharmacist to follow up, via text or phone call, using survey information to customize reminders — such as advice to take a pill with food to avoid nausea, for instance. If the survey shows Jim is compliant, no follow-up is needed. Jim will receive an automated message at 25 days to reassess his compliance and remind him to refill his medication.
This type of integrated, customized engagement strategy helps to free up capacity by automating communications for compliant patients, while offering additional support to noncompliant patients. In this way, pharmacies can drive more insightful programs around medication adherence at scale, capacity and lower cost.
The most cutting-edge drug store chains are also using advanced analytics to drive continuous learning and improvement. These tools can help detect customers most at risk for medication nonadherence, track outcomes over time, and report data back to physicians and health insurers.
For instance, Costco, with pharmacies in 459 of its warehouse stores, is preparing to implement a technology tool for outcomes management, with a focus on the Centers for Medicare and Medicaid Services’ Star Ratings. It will enable Costco to identify at-risk and nonadherent patients.
The Health Mart chain recently launched an online platform that gives health plans and community pharmacy organization members access to their performance data and industry
benchmarks to help identify areas to improve.
Drug store chains of the future will have to rethink that outdated conflict between automation and the personal touch. Today’s health care landscape demands that pharmacies leverage technology to scale their businesses and free up pharmacist capacity to preserve and enhance patient relationships — drug store chains’ greatest differentiator.
Robert Dudzinski, Pharm.D., is executive vice president at West Corp.
This article previously appeared in the September 26, 2016 edition of Chain Drug Review.