Only A Matter of Time Till Automated Pharmacy Dispensing Supports Success

Category: Pharmacy Success Written by Dr. Charles Shively / November 10, 2014

Located at 139 East Main Street, between South Powell and Mill streets, exists a pharmacy that started in 1920. Smith's Drugs and its companion businesses (Smith's Vital Biocare and Smith's Medical Equipment Supplies) occupy nearly a full block in downtown Forest City, North Carolina. To area residents, Smith's Drugs is a landmark.

Initially established in 1920 as part of the J M Smith Company, it was sold to its then current manager in 1939 and opened as an independent pharmacy. Now in its 94th year of success, current pharmacist-owner John Higgins has continually added new healthcare options for area residents...including automated pharmacy dispensing.

This pharmacy provides prescription medications (including specialty compounded medications), medical equipment and supplies and in-home IV infusion for medications and enteral feeding to its patient-customers including area long term care and assisted living facilities. Medical equipment and supplies including in-home infusion by a registered pharmacist are delivered in thirteen (13) northwestern North Carolina counties and two (2) northwestern South Carolina counties (Spartanburg and Cherokee).

Today's Challenges to Pharmacy ROI (return on investment)

The number of different challenges to pharmacy ROI (return on investment) John and his pharmacy has experienced through the years you might imagine...significant. Today Smith's Drugs fills as many as 800 prescriptions a day with Rexxie, the RxMedic Automated Dispensing System that stands front and center behind the customer dropoff area. During our discussions about what areas had changed the most during the past few years, John shared: "We couldn't do what we do, with all of the insurance-adjusting activities we now perform for our customers, without Rexxie. Rexxie is a human-like resource for us...and never makes a mistake. The RxMedic ADS allows us the necessary time to provide medication counseling, medication adherence and offer medication therapy management (MTM) options to our customers...while it completes many of the necessary pharmacy workflow steps we previously completed manually. Our prescription pharmacy business represents a large percentage of of our total gross for Smith's Drugs and the RxMedic ADS has greatly supported our growth in this area of our business."

Wide Array of Challenges Forthcoming

John then asked: "Charles, what challenges have the other pharmacy owners with whom you have recently visited, as part of your RxMedic Customer Appreciation Tour, offered as their primary impactors on pharmacy ROI today? I offered: "Owners tell me that today the customer insurance adjustments are far more challenging and time consuming even than when Medicare Plans began in 2006. One pharmacy owner told me he felt he was now more of an insurance-adjuster than pharmacist. Another offered that he choice of the PBM (pharmacy benefit manager) the pharmacy uses to adjudicate prescription payment claims can really impact ROI. With generic medication supply costs regularly increasing, pharmacies are losing money on each prescription they fill if the PBM doesn't adjust their reimbursement levels quickly to the generic medication supply cost. Some PBM's take 4-6 weeks to reflect the new generic medication pricing while pharmacies dispense at a loss. They do this to ensure medication adherence for the patient-customer."

Can Cellphones and Patient Portals Help Improve Success?

In response to a question regarding the potential use of mobile cellphones, tablets and the apps for linking patient-customers and their pharmacy, John offered that it may take until 2020 for these new technologies to truly impact and improve business growth for him. When asked why, John shared: "These new technologies work well with younger clientele who can afford the communication costs (monthly service fees) associated with and including hardware purchase. Probably 60-70% of my customers cannot even afford these types of interactive approaches to improving their healthcare...and the resulting linkage with us here in the pharmacy. It would be great if these technologies would allow a linked-portal approach for any individual consumer to read –only their medical and medication records available from their physician's office, last hospital visit and pharmacy records. Clearly this is a tremendous opportunity to help individuals improve their health. Unfortunately, most folks in this area just don't have the money to own the technology that will someday be put in place. I am aware that some of the larger hospitals in our area offer the patient an ability to access their on-file information. To my knowledge, there is no effort to build interoperability linkages between physician offices, hospitals and pharmacies. Here in North Carolina we have just implemented controlled substances use records through prescription fills (monitoring) via internet but it takes a great deal of time to access and confirm necessary information with the current software. Any linkages between physicians, hospitals and pharmacies is clearly in the future."

Smith's Drugs in Forest City, North Carolina---A Local Landmark

Smith's Drugs in Forest City, North Carolina has a total of 5 pharmacists (4 in the prescription area and 1 in the Biocare area (home infusion) and up to 8-9 technicians depending upon the number of pharmacists "behind the counter". Upon completing discussions with John, I returned upfront to have lunch in the old-fashioned fountain area favorite for the quality and choices of food offerings. The Livermush was outstanding...even though it had an unhealthy 30 grams of fat in my one serving. Livermush is a Western North Carolina favorite you know... Telephone: 828-245-4591

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