THE RX TECHNOLOGY PUZZLE

STEPHANIE LOUGHRAN

Pharmacists are looking toward the future to help solve the workflow inefficiency puzzle of today.

The ongoing pharmacist shortage, the aging population demographics and shrinking margins are contributing to the steady adoption of interactive voice response systems (IVR), pharmacy workflow management software, automated counting machines and refill orders over the Internet, among other technological advances, said retailers and analysts.

"Pharmacies in general are looking for any way to increase efficiency and produce manpower," said Curtis Hartin, director of professional services, Schnuck Markets, St. Louis. "I'm faced with the challenge of integrating several pieces [scanners, workflow software, IVR] to make a smooth flow for pharmacists."

The retailer utilizes IVR in all 92 of its pharmacies to enable patients to call in and voice their prescription refill requests, thus saving the pharmacy staff time on the phone. In addition, Schnucks uses two robots to ease the dispensing crunch.

The continuing pharmacist shortage, which resulted in 7,744 unfilled positions in the United States last year, coupled with the projection that the volume of prescriptions will reach 4 billion annually by 2004, is driving the need for technology, according to the National Association of Chain Drug Stores, Alexandria, Va.

IVR systems are increasingly popular among retailers, with a saturation rate approaching 50% to 60% among supermarket pharmacies, said Debbie Sheppard, vice president, sales, ateb, Inc., Raleigh, N.C., a producer of IVR and workflow software.

"IVR has been a major tool in assisting pharmacy productivity and allowing pharmacists to better control their time," said Doug Berry, vice president, pharmacy, Farmer Jack Supermarkets, Detroit, a division of A&P, Montvale, N.J. The retailer upgraded its IVR system with an automated fax-back component to communicate with doctors on prescription refills in all 82 Farmer Jack locations with pharmacies late last year.

"It's been a nice additive to [the system], and we've been very pleased," Berry said.

IVR has become an essential for retailers trying to keep up with the pharmacy across the street. "IVR is extremely important," said Joseph Friedman, pharmacy manager, Topco Associates, Skokie, Ill. "If you don't have it, you're giving up something to the competition."

Pharmacy technology will play a crucial role as April 14, 2003, looms. That is when the Health Insurance Portability and Accountability Act (HIPAA) regulating patient privacy goes into effect. The ability to capture patients' signatures electronically is another important tool to help pharmacists comply with the strict regulatory enforcement.

"Technology will help us be more compliant with HIPAA," Hartin said. "Signature capture will certainly help with the documentation portion."

HIPAA has changed technology for pharmacists, said Kenny Hill, chief operating officer, PDX-NHIN, a Fort Worth, Texas-based technology company that provides electronic signature capture for retailers. The company also provides supermarkets like Hannaford Bros., Scarborough, Maine; Publix, Lakeland, Fla.; and Safeway, Pleasanton, Calif., with workflow software that directs tasks to specific people behind the pharmacy counter. "We're electronically capturing that signature at the pharmacy so we can keep an electronic record, rather than have pharmacists keep filing cabinets full of multiple forms they've had patients sign," Hill said.

Other retailers disagreed that the HIPAA mandate will alter pharmacists' relationship with technology. The mandate would require pharmacists to have written prior consent from patients before treatment and payment, although modifications to the regulation are currently under proposal.

"As far as technology goes, not too much will change for HIPAA [compliance]," said John Fegan, vice president, pharmacy, Stop & Shop Supermarket Co., Quincy, Mass. "It's how we use the technology. We have to be more cautious in our approach with it" by following proper patient privacy compliance training, he said.

HIPAA slowed down some technological innovations, like e-prescribing, where doctors can send prescriptions from their handheld digital assistants, said Karen Silverblatt, vice president, business development, creehan, mchenry, Pittsburgh, a healthcare and technology consulting firm.

Pharmacists are taking "one extra look at crossing the t's and dotting the i's to make sure that confidentiality isn't breached," she said. "They're a little more cautious about making sure that all of the security that needs to be in place is in place."

The integration of technological components across other sections of the supermarket has given supermarket pharmacies the opportunity to be front-runners in technology, said Silverblatt.

"Supermarkets are very forward-thinkers, and they utilize technology to automate other departments in the store," she said.

Efficient solutions to pharmacist and physician communications, workflow management and organization take a backseat to customer service, however.

"Technology has to have benefits that don't take away from personalized patient care," said Berry of Farmer Jack.

A worthwhile return-on-investment is another crucial factor in the decision to implement technologically advanced tools, said Silverblatt.

"Supermarkets have to take a step back with any technology and make sure they do a thorough ROI," she said. "The last thing you want to do is implement technology that doesn't end up supporting your business or that is not scalable as your business evolves, changes and grows."

After a failed test with a workflow automation device (because "it created a need for more help instead of less help," according to Fegan), Stop & Shop will test a similar device by a new supplier starting later this month at a New Bedford, Mass., store.