POINT OF CONTACT

Stephanie Loughran

PHILADELPHIA -- Supermarkets are going to the next level in pharmacy technology.

As the industry gears up for the National Association of Chain Drug Stores' Pharmacy & Technology Conference here this week, retailers, manufacturers and analysts polled by SN said retail pharmacies are continuing to expand technological tools such as electronic prescribing, robotics and automated counters.

The new technologies streamline in-store workflow efficiencies, reduce errors, and increase the amount of time pharmacists can spend with customers, which boosts sales and increases shopper loyalty, said industry observers. Because of heightened competition, the pharmacist shortage and regulations like the Health Insurance Portability and Accountability Act, this move to technology becomes critical.

Schnuck Markets, St. Louis, plans to expand its use of robotic solutions by ScriptPro, Mission, Kan., and its use of pill-counting machines by Kirby Lester, Stamford, Conn., said Curtis Hartin, director of professional services for the retailer.

"We're looking forward to seeing something new and different [at the NACDS conference] to maximize efficiencies," he told SN. While he does not expect any "earth-shattering" new pharmacy technologies, Hartin said he anticipates technological tools will be "fine-tuned to take up less space or make them easier to use."

ScriptPro plans to debut two new control centers for automating the handling of prescription vials filled by robots at the NACDS conference, according to spokeswoman Leslie Bayer. The robots can now be equipped with the Automated Control Center and the Collating Control Center. The Automated Control Center uses a second-stage robotic arm to pick up the filled and labeled vials and place them into storage slots, assembling multiple vials for the same patient in a single slot. This add-on fixture uses an electronic display that flashes to visually direct the pharmacist to a prescription of a particular customer waiting for pickup, said Mike Coughlin, president and chief executive officer of ScriptPro. The Collating Control Center routes filled and labeled vials onto a series of staging conveyors, which can be configured to collate the prescriptions in various ways.

These new systems, which are designed to fit all ScriptPro robotic systems already in the field, run $10,000 to $20,000, he said.

"Full robotics is the direction that pharmacy will be going, which includes filling, labeling, handling bar codes and verification of prescriptions," Coughlin said. "Robotics is here to stay, and is growing rapidly." Hy-Vee, West Des Moines, Iowa; Price Chopper, Schenectady, N.Y.; and Safeway, Pleasanton, Calif., also use ScriptPro systems in their pharmacies, according to Bayer.

Other retailers find the cost of maintaining robotics difficult to legitimize if the prescription volume does not warrant the use of the system, said Bob Killoran, director of pharmacy services, Kash n' Karry, Tampa, Fla. "We're all hoping manufacturers can come up with development of better robotic technology," he said. "If you're not filling 3,500 to 4,000 prescriptions a week, it's difficult to justify the need for robotics

Stop & Shop Supermarket Co., Quincy, Mass., a division of Ahold USA, Chantilly, Va., and Haggen Food and Pharmacy, Bellingham, Wash., operate Kirby Lester automated dispensing systems that simplify the dispensing process without the high cost of robotics, said Marc Hampton, vice president of sales, Kirby Lester. The company makes tablet-counting machines. The KLipc dispensing system displays the image of the drug each time the pharmacist scans the drug, and it counts and dispenses the correct medication, he said. "It provides 80% of robotic features for only 10% of the cost," Hampton said. "Not every pharmacy can afford $200,000 for robotics."

Stop & Shop is "testing automation," said John Fegan, corporate vice president of pharmacy, Ahold USA. "We're looking at the pharmacy workflow and looking to automate the pharmacy workflow environment, so there's no stone unturned at this point," he said. "We know we have to help the pharmacists somehow, and take the pressure off of them."

Electronic prescribing is also becoming more widespread in supermarket pharmacies, according to the recently published 2003 Supermarket Pharmacy Survey by Food Marketing Institute, Washington. Nearly 20% of supermarket pharmacies are set up to receive e-prescriptions, and more than half plan to have this capability by the end of the year, according to the report.

Giant Food Stores, Landover, Md., another division of Ahold USA, has been a leader in e-prescribing, said Fegan. "We're really pleased at what's going on at Giant Landover, and it's about to embark upon our other operating companies," he said. Ahold USA's recent venture to centralize its pharmacy operations will "allow our other operating companies to take advantage of [e-prescribing] as it moves forward."

Supermarkets have been among the first retail channels to use e-prescribing, said Kurt Proctor, senior vice president of pharmacy operations, NACDS, Alexandria, Va. "Everyone is getting their systems up and running to build platforms for pharmacist-physician connectivity," he said.

SureScripts, Alexandria, Va., founded by NACDS and National Community Pharmacists Association, also located in Alexandria, Va., recently completed a test of its e-prescribing solution in CVS, Brooks Pharmacy and Walgreens drug stores in Rhode Island. The company works with health care technology vendors to provide pharmacies with a gateway for e-prescribing connectivity. This network provides a paperless connectivity that allows physicians and pharmacists to communicate in an electronic format and cut down on phone time, said Tammy Lewis, executive vice president of marketing communications, SureScripts. The company is ready for a national rollout, she said.

Albertsons, Boise, Idaho; Kroger Co., Cincinnati; and Ahold USA will be connected to the SureScripts network by the end of the year, said Lewis. "For e-prescribing to take hold and be adopted, the majority of pharmacies in a geographical area need to be connected to the same network, so a physician doesn't need to have one workflow for one pharmacy and a different workflow for another," she said.

Technology has become an integral part in the maintenance of privacy policies in relation to HIPAA. More than a third of the survey participants from the 2003 FMI Supermarket Pharmacy Survey use electronic signature capture for consent and acknowledgement of the new privacy regulations.

"Pharmacists were tickled pink with the electronic signature capture for HIPAA; it was a big plus," Fegan said. "Our pharmacists handled it very well, and the tech support and planning that went into it made the pharmacists' jobs easy."

Pharmacy technology is also playing a role in the growing specialty pharmaceuticals business, said Scott Creehan, president of creehan, mchenry, a Canonsburg, Pa.-based technology consulting service. This segment includes providing "biotech" drugs and customized services for patients with chronic diseases like HIV, cancer and multiple sclerosis, which require special care. The labor-intensive pharmacy model requires the right tools, specialized software for advanced clinical reimbursement services and clinical specialists to deliver the care, and supermarkets have yet to play a big role in this arena, he said.

"The opportunity is there, and [supermarkets] have to start to play the game," he said.

Eckerd, Clearwater, Fla., joined the specialty pharmacy care business when it began its Specialty Pharmacy Services by Eckerd earlier this year to provide customized care to patients with special needs. Other major drug chains are also entering the fray, like CVS, Woonsocket, R.I., which operates 44 Pro Care specialty pharmacies near major hospitals that deal with large numbers of special-need patients. Supermarkets are taking a much more cautious approach to specialty pharmacy care, said retailers.

"The direction that our company is going is pharmacy care management, as opposed to specialty pharmacy," said Hartin of Schnuck Markets. "The demand is there, but it's easily met by one or two locations in a metropolitan area, because [the business] is so specialized."

Whatever technological advancement comes to fruition, proper staff training is essential to maximize the technological tool, said Killoran. "There are some tremendous workflow tools, but a lot of companies that have spent money on technology have not followed through with training," he said. "With high turnover and the pharmacist shortage, we must make the best use of the tools available."