Digital tools, automation streamline Rx process

BY Richard Monks

As health care in the United States continues to shift from a system based on services to one where providers are rewarded for driving outcomes, an efficient pharmacy operation and the ability for pharmacists to spend time with patients is more critical than ever.

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To meet these goals, pharmacies large and small are turning to sophisticated technologies that can streamline the prescription-filling process, maximize workflow and ultimately free up pharmacists to counsel their patients. A report released in May by the forecasting firm Markets and Research estimated that the North American pharmacy information system market will increase by slightly more than 8% a year through 2019.

“The changing healthcare landscape requires pharmacy to adapt to a new model that not only focuses on filling prescriptions, but also places a premium on what happens to the patient using those medications,” said Frank Sheppard, president and CEO at Ateb, a provider of pharmacy-based patient care solutions.

“Pharmacy already has the data and resources to address this model,” he said. “It simply must adopt incremental changes to better leverage its existing relationships with payers, physicians, health systems and patients to improve patient health outcomes.”

Ateb’s Patient Management Access Portal, for instance, allows pharmacies to identify patients who can benefit from improved pharmacy engagement and communication, while its Time My Meds medication synchronization solution helps drive medication compliance and adherence.

Other technology suppliers have taken their offerings in a similar direction, offering a variety of tools to pharmacies and their patients, including systems that can improve workflow, enhance medication therapy management programs and streamline the prescription-filling process.

“We believe that automation, mobile technology and interfaces will allow our customers to be more efficient, while improving patient experience by decreasing wait times and allowing more personal service,” QS/1 market analyst Jon Bell said.

For instance, he noted, the company’s unique InstantFill automatically queues interactive voice response (IVR) and Web refills, and prints labels; its Health-Minder automatically fills routine prescriptions and can call, text or e-mail pickup reminders to patients; and its RetrieveRx will-call bin management and point-of-sale systems help pharmacies minimize waits at checkout.

For MTM programs, QS/1’s Patient Chart and Patient Outcome records can document changes to a patient’s medication history and record the results of an intervention.

Technology providers say that because pharmacies have access to so much patient data, they are in the ideal position to take on a greater role in patient care.

“Pharmacies have a tremendous amount of data that can be mined to provide a virtual road map for viewing which patients are at risk and which strategies the pharmacy can implement to help these targeted patients.” Ateb’s Sheppard said. “By converting their pharmacy practices to a proactive workflow, pharmacies are able to predict when patients on chronic medications will visit the pharmacy for their prescription refills, thereby allowing pharmacies to manage their inventory better, and prepare in advance for a productive patient encounter.”

Those who offer pharmacy technology say that nothing is more important to meeting the demands of the evolving healthcare system than an efficient workflow. Better workflow, they say, results in increased patient engagement and improved outcomes.

“In the past 20 years, we’ve gone from workflow not even being a term used in pharmacy to a very important part of the process of any pharmacy,” said ScriptPro president and CEO Mike Coughlin, whose company has supplied pharmacies with robotics and other pharmacy technologies since the mid-1990s. “One of the greatest factors in improving that workflow has been pharmacists’ confidence in the technologies they are using.”

With many pharmacists and pharmacy executives today having spent their entire careers working in computerized pharmacies, the comfort level has never been higher, he said. As a result, community pharmacy operators have become more open to these systems and are adding them to their stores.

“The people who have been on the sidelines are now starting to see the benefits and saying they should have done it sooner,” Coughlin said, noting that a robot to automate the prescription process has been shown to provide significant savings in the long term. While the upfront cost of such a device can be substantial, he said, on average, robots handle between 40% and 60% of a pharmacy’s prescriptions and cost just $25 a day to operate.

As the role of the community pharmacist continues to change, so do the types of drugs they are being required to dispense. Technology providers say the growing use of specialty drugs is leading to new software to ensure these drugs are prescribed correctly and used safely.

“Drugs today can do tremendous things,” Coughlin said. “But now more than ever, they need to be used correctly. It’s not good enough any more to give the patient the right drug. They have to ensure they are used properly or there could be dire consequences.”

Because of that, he noted, using a pharmacy system that scans the pill or tablet and lets the pharmacist or technician view a prescription at every step of the dispensing process is critical. Just as important, those in the industry say, is a detailed drug utilization review function.

Going forward, technology will continue be a vital part of America’s pharmacies, taking on new roles and being applied to other areas of the business. Coughlin, for instance, said the day is not far off when robotic automation could be applied to will-call and other pharmacy-related areas.

Others echo that sentiment, saying that while technology has enabled pharmacy to adapt to the changing dynamics of the country’s healthcare system, it must continue to evolve to meet the challenges that lie ahead.

“Pharmacy is in the right place at the right time with the right resources available to be a major contributor to addressing the challenges of delivering effective, affordable health care,” Ateb’s Sheppard noted. “We have developed the tools, data models, intellectual property and business processes to allow pharmacy to capitalize on this opportunity to be a leader in patient engagement and patient care delivery.”

However, he stressed, community pharmacy is only one cog in the wheel. A comprehensive team of healthcare providers all employing sophisticated systems to drive patient outcomes is the future of American health care.

“Pharmacy will not replace the network of skilled physicians that patients rely on for their care,” Sheppard said. “However, pharmacy should develop the capabilities to integrate into the existing healthcare system by leveraging its unique opportunity: the ability to engage patients regularly about their healthcare concerns and outcomes.”


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J&J completes Novira Therapeutics acquisition

BY David Salazar

NEW BRUNSWICK, N.J. — Johnson & Johnson on Friday announced that it had completed its acquisition of clinical biopharma company Novira Therapeutics. The terms of the transaction, which was announced Nov. 4, were not disclosed. 
Novira, which develops innovative treatments for chronic hepatitis B, will now be part of Janssen Pharmaceuticals’ Infectious Diseases and Vaccines Therapeutic Area. The lead candidate among Novira’s portfolio is NVR 3-778. 
“We are exploring several approaches in pursuit of a functional cure for this insidious disease,” Janssen’s global head of research and development William Hait said. “Bringing together NVR 3-778 with our own internal discoveries we will leverage our vast experience in viral diseases to develop potentially transformational medicines for HBV patients.”

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CDC: Only half of patients eligible for statin therapy actually taking a statin

BY Michael Johnsen

ATLANTA — More than a third of American adults are eligible to take cholesterol-lowering medications under the current guidelines or were already taking them – but nearly half of them are not, according to a report by Centers for Disease Control and Prevention researchers published in last week's Morbidity and Mortality Weekly Report. Blacks and Mexican Americans are less likely than whites to be taking cholesterol-lowering medications, the report noted.
“Nearly 800,000 people die in the U.S. each year from cardiovascular diseases – that’s one in every three deaths – and high cholesterol continues to be a major risk factor,” stated Carla Mercado, a scientist in CDC’s Division for Heart Disease and Stroke Prevention. “This study reveals opportunities to reduce existing disparities through targeted patient education and cholesterol management programs.”
CDC researchers examined data from the 2005-2012 National Health and Nutrition Examination Surveys. Overall, 36.7% of U.S. adults – 78.1 million people age 21 or older – were eligible for cholesterol-lowering medication or already taking it. Within this group, 55.5% were currently taking cholesterol-lowering medication and 46.6% reported making lifestyle changes; 37.1% reported making lifestyle modifications and taking medication, and 35.5% reported doing neither.
Gender, race, and ethnicity made a difference. Of:
  • 40.8% of men eligible for or already on medication, 52.9% were taking medications;
  • 32.9% of women eligible for or already on medication, 58.6% were taking medications;
  • 24.2% of Mexican-Americans eligible for or already on medication, 47.1% were taking medications;
  • 39.5% of blacks eligible for or already on medication, 46% were taking medications; and
  • 38.4% of whites eligible for or already on medication, 58% were taking medications.
Blacks who did not have a routine place for health care had the lowest rate (5.7%) of taking recommended cholesterol-lowering medication. People who said they already had adopted a heart-healthy lifestyle (about 80%) were the group most likely to be taking cholesterol-lowering medication.
While the study included people taking all forms of cholesterol-lowering medication, nearly 90% of those receiving medication were taking a statin drug.
Data from 2007 through 2014 show a decline in the number of Americans with high blood levels of cholesterol. There also has been a recent increase in the use of cholesterol-lowering medications. But a high blood level of LDL cholesterol – also known as “bad” cholesterol – remains a major risk factor for heart disease and stroke in the United States.
Getting 65% of Americans to manage their high levels of LDL cholesterol by 2017 is one of the major targets of the U.S. Department of Health and Human Services’ Million Hearts initiative to prevent one million heart attacks and strokes.
As many as 78.1 million Americans were already taking or are eligible for cholesterol-lowering medication. 
The American College of Cardiology and the American Heart Association recommend cholesterol-lowering medication for four groups of adults:
  • People with heart disease, a prior heart attack or some types of stroke, or angina;
  • People with LDL cholesterol levels of 190 mg/dL or more;
  • People ages 40 to 75 with diabetes and LDL cholesterol levels of 70-189 mg/dL; and
  • People ages 40-75 with LDL cholesterol levels of 70-189 mg/dL and an estimated 10-year risk of heart disease of 7.5% or more.

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