Will mAdherence and mHealth Virtualization Trends Advance Pharmacy ROI?

Category: Pharmacy Advances Written by Dr. Charles Shively / November 5, 2014

Is What We Knew Last Month Now History?

Who reading here believes that what we thought we knew last month is now history? In our environ of rapid, almost immediate (if not daily) national healthcare “thinkings”, how will these challenges cause our customer service and patient-oriented adherence activities to change? What to do?

Being successful as a pharmacy owner or outpatient hospital pharmacy director today demands constant awareness of the proposed national mandates or newest agendas…and more importantly…immediate understanding of the impact on the pharmacy’s ROI (return on investment). Knowing which low-level profitable pharmacy workflow activities demand the most time to complete can allow pharmacy workflow adjustments so less time is spent on these human resource consuming efforts. These understandings can be used to improve ROI success…even though unique to each and every pharmacy. Will this knowledge support establishment of more available time that can be used in the high-level profitable areas? It can when selected pharmacy workflow functions are re-assigned and enhanced patient education occurs. A major result is enhanced medication adherence by patients.

Challenges to ROI Come From Everywhere

Today, challenges to pharmacy ROI are more frequent with many a result of the virtualization trends that are occurring. What do you know about mAdherence (mobile adherence) and mHealth (mobile health) and how they can impact ROI? Toss in the more frequent use of Server Hosted Virtual Desktops (SHVD), Server Based Computing (SBC) or cloud-based applications (CBA) with poorly written electronic prescriptions, pharmacists can unknowingly be lead to the bottom of the profit chain through time challenges alone. Understand where we are headed here?

It’s well known that the solution to any problem lies at the base of the problem. With this in mind, why not accelerate implementation of mAdherence and mHealth efforts to support awareness of the high-level profitable pharmacy workflow activities? Which elements or steps of pharmacy workflow and patient education for medication and therapy adherence can be categorized low-level profitable or high-level profitable? No doubt the categorization will be unique to each pharmacy operation, yet there are some similarities.

Defining the Time-Takers, Time-Savers and Money-Makers

Rather than abruptly considering Time-Takers as “aliens invading our pharmacy workflow planet”, most pharmacists understand several time-taker type activities fall into two categories: pharmacy workflow and secondly, patient education/medication and therapy adherence activities completed by the pharmacist and staff. Within traditional pharmacy workflow, simple casual observation suggests the selection/counting/filling/verification and prescription adjudication areas are the largest Time-Takers. It is also easy to consider the effort (and time) needed to complete patient education and adherence activities as another Time-Taker

But which Time-Savers are available to challenge these “alien” Time-Takers? How might the Time-Savers convert Time-Takers into Money-Makers? The Time-Taker activity of selection/counting/filling/verification activity can be easily and quickly converted. The answer: Automated Pharmacy Dispensing. Numerous systems for automated counting and automated dispensing are available in today’s automation environ. Only certain of these systems however can eliminate as many as 7-9 of the necessary steps involved in the selection/counting/filling/verification sequence. Prescription adjudication, insurance problem solving and therapy management adjustments by the pharmacist…on the other hand… can also often be (actually it is…) another time-consuming effort (opportunity?).

Some independent pharmacies and select hospital outpatient pharmacies (due to the Pay for Performance ”P4P” opportunities now offered by the government) dedicate senior pharmacy technicians to solve potential adjudication issues or care transition needs in advance of the dispensing and education/adherence process. Upcoming fills for any individual can be pre-screened early for possible insurance issues, combination with other forthcoming refills, pre-authorization of payments for medication therapy management and other health-supporting activities (immunizations, body mass, etc.). Working through whether or not a patient has an insurance payer that will support medication therapy management efforts (Humana is today’s largest supporter) before any discussion with the patient saves considerable discussion time later, allows them to understand the complexity of the activity and defuses patient aggravation.

Are Pharmacy Case Managers An Answer?

The concept of pharmacy-completed, patient-specific, healthcare “case management” approaches are new to the profession. With support from full-time (as opposed to part-time)senior certified and registered pharmacy technicians responsible for specific patients, these technicians can work with the patient/customer supporting the advance of the patient’s “I’m Helping Myself®” approach to healthcare improvement. These approaches are not unlike those being using by outpatient hospital pharmacies in their care transition efforts for released patients.

Incorporation of mAdherence(mobile adherence) and mHealth(mobile health) through the use of specifically designed (and available) cell phone apps (applications) with this case manager approach converts the Time-Takers into Time-Savers enlarging Money-Maker opportunities. Often times not valued is that these new approaches cause patients and pharmacy personnel to co-join. The patients subsequently feel they are a family member of the “pharmacy” and have a pharmacy medication/therapy home.

Although it would first appear most Time-Takers might never been be considered Money-Makers, the use of adjustments in approach to effecting traditional pharmacy workflow and patient adherence activities can actually elevate these Time-Takers into Time-Savers and Money-Makers.

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