Realize med sync’s full efficiency, performance and revenue potential
- Testing elements of your med sync system allows fine-tuning it for greater gains.
- Increasing refills is only part of the revenue potential from offering med sync.
Shrivers Pharmacy had an effective autofill program in place for several years, but the leadership team recognized it wouldn’t be enough in the long run. “We knew we were going to be in or out of networks [based on quality measures],” said Greg Paisley, vice president and chief operating officer of five Shrivers Pharmacies in Ohio.
Starting in 2014, the team took thoughtful steps to implement a more comprehensive medication synchronization program with the goals of improving Star Ratings measures (particularly adherence, measured by the proportion of days covered), increasing refills, decreasing dispensing costs, and finding new ways to serve customers.
Shrivers Pharmacy Results
Since Shrivers Pharmacy began implementing med sync with one pilot location in March 2014, it has seen significant, measurable results at all five retail pharmacies:
- 20 to 30% of eligible patients at each pharmacy enrolled in med sync. In November 2015, that was 2,812 patients with about 16,000 medications.
- 450 prescriptions filled in 3.5 hours before opening at two locations.
- Double-digit increases in prescription volume in all stores.
- Decreased cost of dispensing.
With the PrescribeWellness dashboard Shrivers can see the impact med sync is having. “We’re killing it when it comes to PDC,” Paisley said, exceeding the levels needed to be in the top 20% of pharmacies on Star Ratings. The five stores have seen an average of 35% improvement in PDC.
- Test and expand. Shrivers Pharmacy started med sync in late March 2014 at one pharmacy with a goal of enrolling 10 patients per month, focusing on patients taking two or more maintenance medications. The pharmacy also put its delivery customers on med sync unless they opted out. After the pharmacist in charge signed up 15 patients per day for two weeks, the goal was revised to 10 patients per day.In July 2014, Shrivers Pharmacy expanded med sync to three more locations, including two that were much busier than the initial location. Staff from those stores had worked in the pilot store to learn the med sync program and worked directly with the technician champion in the lead store. Shrivers acquired a fifth pharmacy in February 2015 and started med sync there by May.
- Focus staff on performance. To keep staff focused on med sync, Shrivers added a med sync measure to its monthly performance scorecard. This meant that stores’ performance scorecards now include the percentage of patients enrolled in med sync out of the total number who are eligible. By the end of November 2015, locations had 20 to 30% of eligible patients enrolled in med sync. Each month, employees at the top-performing location receive a reward, with the top-performing pharmacy for the year receiving an additional reward.
- Capture efficiency. In November 2015, one of the busiest Shrivers Pharmacy locations began focusing on med sync two mornings each week, before the store opens. It expanded the early fill to a second location in 2016. As Paisley points out, a pharmacy doesn’t just own or rent its building for the hours it is open; it makes financial sense to use it during off hours, too.The evening before morning refills, the pharmacy staff prepares for the morning fills. “You’d better have a workflow process in place,” Paisley said, so the staff doesn’t show up and then take 20 minutes setting up to work.
On Mondays and Thursdays, a pharmacist and three technicians arrive at 5 a.m. and fill prescriptions with no interruptions until the store opens at 8:30 a.m. With the radio cranked up and no phones to answer, “the efficiency is insane,” said Paisley. They fill about 450 prescriptions in 3.5 hours.
Studies have shown that even brief interruptions such as answering a question if a medication is ready can account for up to six hours a day of lost productivity in a pharmacy, noted Crystal Lennartz, Health Mart’s director of clinical development.
A few uninterrupted morning hours filling med sync prescriptions makes the rest of the day easier, Paisley said. Pharmacists have time to do CMRs and vaccines during store hours, and staff can work on inventory control. Staff morale has gone up as efficiency has increased. Although staff members start work early on the refill days, they leave work at noon and are off the following day.
One busy store that required hours for 2.5 pharmacists now requires only 2, so Shrivers can better allocate staff among its locations. Deliveries are more efficient too, saving driver time and fuel costs. Prescription deliveries that previously took 2.5 drivers all day now take one driver only five hours.
- Find a niche in community. One niche Shrivers has found is with injectable antipsychotic medications. In three Ohio counties, Shrivers Pharmacy is able to drop off drugs at doctors’ offices so patients can receive injections during their appointments.Shrivers also shows doctors the impact that the med sync program can make on adherence using data from their patients who are Shrivers customers.
Next step: maximizing appointment value
Now Paisley is thinking about how to best use the monthly appointment time with each customer.
Through med sync, Shrivers Pharmacy has learned something important about its patients on respiratory medications. “So many patients were using their maintenance inhalers as rescue inhalers,” Paisley said. During a CMR, the pharmacy can review how to use an inhaler properly, and in Ohio a pharmacy can be reimbursed for that counseling.
- In addition to checking in with the patient, “the appointment is about expanding your sources of revenue,” Lennartz said. Think about what type of campaign you can run each month or season: In the fall, for example, take care of their flu shot when they come in for their medications, and your staff can have all the paperwork complete before customers come in.
- During Medicare Open Enrollment, ask whether a patient would like to talk about which plan may be best based on their medications.
- In the spring you might focus on diabetic shoes.
- In the summer talk about OTC supplements that help with side effects of common prescriptions.
Paisley hopes to build an expectation among customers that when they pick up their prescriptions each month, they talk with the pharmacist about their health. That can build rapport with patients, increase customer loyalty and improve health outcomes. “We’re trying to redefine what retail pharmacy is,” he said.