Rx TECH MEANS SERVICE

WENDY TOTH

Time is more than money in community pharmacy.

It is the currency that enables the pharmacist and pharmacy staff to connect with patients, and establish relationships that help define a store's service level.

This is especially important at Buehler's Food Markets, Wooster, Ohio, where a premium is placed on service, whether in its food departments, or in specialized nonfood areas like pharmacy, gift shops and even its five in-store Ace Hardware operations.

“We need to free up our most valuable asset, and our most valuable asset is our employees,” said Verne Mounts, director of pharmacy. He was speaking about all store employees, but Mounts — who writes a weekly “Your Hometown Pharmacist” newspaper column (see story, Page 40) — has a passion and a vision for making greater use of the highly educated in-store pharmacist.

“We've got to get them out of being stuck in the redundancy and production process, whatever it might be in their job. If we can use technology to leverage time, and free them up to offer exceptional, palpable and compelling customer service, we will have that word-of-mouth advertising, which is going to grow our business.”

The realization that many of its pharmacy systems were out of date led Buehler's to a massive technology upgrade that is designed to save the company money, but more importantly, gain time for the pharmacists.

So far most of the changes, while far-reaching, involve a pharmacy management system that mainly affects software, and are invisible to anyone curious enough to check out what equipment is over the counter. That will be different soon, according to the vision Mounts has for the future of the supermarket chain's pharmacy operation, including automated prescription pickup kiosks and technology-based space-saving fixtures.

“At Buehler's, where positioning is based on more personal attention and more attention to detail, customers are likely to expect a high level of customer service,” said Bruce Kneeland, president of PharmacyConnections, a consultancy in Royersford, Pa.

Mounts' goal is a “palpable” level of customer service. “We want to compel people to go out and tell others about what a fantastic experience they just had.”

Pharmacy customers at Buehler's prompted the chainwide technology upgrade last year.

While other chains allowed pharmacy customers to pick up prescriptions at any of their locations, Buehler's shoppers still were limited to choosing just one store for drop-offs and pick-ups.

“It became too obvious that we weren't current,” said Mounts, director of pharmacy for the then nine out of 13 Buehler's stores with pharmacies. “The customers would make comments to us like, ‘Everybody else can do that.’”

At the time the supermarket was using nine independent computer systems to track pharmacy orders, one for each store. Minimal central management was outsourced to health care services company NDCHealth in Birmingham, Ala. Since then NDCHealth has been purchased by another health care services company, McKesson Corp., San Francisco. “They would keep pricing and all of our files updated,” he said.

CENTRAL CONTROL

What Mounts made plans for instead was central control. “I wanted all of our information centralized and I was looking for a system that could interface with as much other technology as possible.”

This was a wise decision, said Kneeland. “Pharmacy management and marketing teams will too commonly look at the most valued service by consumers and concentrate on providing it. But the smartest move for the future is identifying all of the services consumers will respond to and integrate providing as many as possible so you have a wider spectrum of service capabilities.”

Choosing a system with such robust capabilities proved daunting so Mounts engaged the help of Christopher Thomsen, president of the Thomsen Group, a Kansas City, Mo.-based technology consultancy. Thomsen listened to the retailer's list of requirements and narrowed the market down to seven systems.

From there Mounts choose the Etreby Pharmacy Management System from Cerner, Kansas City, Mo. “It gave us central operations control for everything from pricing to patient records so customer data can now easily be accessed at any of our locations. It is a lot more seamless,” Mounts said.

Rollout began in May 2006 and ended almost a year later, slightly longer than expected. However, the chain also added two new pharmacies — in two new stores — in that time, bringing its total number of in-store pharmacies to 11. “All 11 pharmacies are connected to the new platform.”

From previous experience running a relief pharmacist agency, Mounts learned to be sensitive to employee issues when new technology was being introduced. “One of the things that kept me busiest when I was doing relief work was companies changing software. Usually employees will just abandon ship because the experience is so horrific and they just aren't given enough training.”

To avoid any such occurrences at Buehler's, he hired a doctor of pharmacy and a certified pharmacy technician to travel to each store to train the employees, and test and refine the system. “I am proud to say that through this entire rollout, we took our time. We trained, we retrained, we did hands-on training and we did not lose one pharmacist or tech in this whole process.” The dedicated training staff is still traveling between stores offering assistance, he added.

One of the basic functions of the new system is its ability to interface with another new system at Buehler's, an interactive voice response, or IVR, phone system from TeleManager, Newark, N.J. When patients call for refills, the data is converted to electronic messages that show up on a computer screen hooked to the pharmacy management system. From there the pharmacist can begin processing the refill.

If the patient leaves a detailed message, an alert comes up on the computer and the pharmacist can plug headphones into the pharmacy's computer unit to listen to the message confidentially.

The system is also able to receive prescriptions sent in electronically by doctors' offices, but currently those come in as faxes. The next thing on Mount's agenda is to allow electronic prescriptions to be sent directly into their management system. “We want to see e-prescribing happen right away because there are doctors in our area that want us to use it. Then the information can populate our software directly.”

Similarly, Mounts hopes soon to use the management system software to start a compliance program. With it, the retailer will agree to automatically refill common recurring prescriptions for customers. “The system will recognize how much time has elapsed since the last refill, process the prescription and have it ready.”

To take it one step further, Mounts would like to connect the compliance function to the IVR so that it can put a call out to the customer and let them know their medication is ready for pick up. “It's critical to me that once I scan the product and put it in our will-call area, the system dials out to inform our customer that we have their prescription ready for them. Some pharmacies try to call customers manually but that is pretty high-touch and it might just be better to leverage technology in this situation.”

The final task in the prescription process — billing — is made easier by the management system as well, Mounts said. When pharmacists receive a prescription, the computer software allows them to choose the disease state of the patient, which will pull up an automatic billing code that is then sent out to the insurance company responsible for the reimbursement.

The end result is a combination of saved money for the chain and saved time for the pharmacist, Mounts said.
Additional reporting: Dan Alaimo

Automated Medicine

In the midst of a chainwide pharmacy management system implementation, Verne Mounts, director of pharmacy for Buehler's Food Markets, Wooster, Ohio, recently gained approval for two Automated Pharmacy Machines from Distributed Delivery Networks, San Marcos, Calif.

“They are self-serve will-call devices, like ATM machines,” Mounts said. “We wouldn't use these for new prescriptions but they make sense for refills.”

Half of the retailer's prescription volume is refills, Mounts said. The machines can decrease the lines in front of the pharmacy, which are usually largely made up of people waiting to pick up refills, he said.

“The patient can come up and enter their own pin code number, pay by credit or debit, select the prescription or prescriptions that are appropriate, take that medication and just walk away.”

To gain funding approval from management, Mounts, with the help of his pharmacy interns, did store-specific research to prove the value of the machines. “I started working on the research in October of 2005. I had students go to the stores and time how long different functions took so we could compare that to the machine's functions. We looked at every aspect of pharmacy that I thought could be influenced by this device.”

Once finished, Mounts concluded that one machine could pay for itself in two years. “With that, management approval was a no-brainer,” he said. “Talking concepts and visions doesn't cut it; you have to put it down on paper and have some numbers behind it.”

One machine will go into each of the retailer's two busiest pharmacies at some point in the next few months, he said.
— W.T.

'Your Hometown Pharmacist'

For many years, Verne Mounts, director of pharmacy, Buehler's Food Markets, Wooster, Ohio, has found a weekly newspaper column he writes — “Your Hometown Pharmacist” — to be a source of credibility, loyalty and patient interaction for the pharmacies he supervises.

With an upgraded technology platform installed for all stores, and other technical enhancements on the way, Buehler's pharmacy staffs will have more time to devote to the customers who come in with questions and concerns raised by Mounts' writing.

Among his recent articles: “Pink Eye,” “Age-Related Macular Degeneration,” “Prostate Cancer Testing” and “West Nile Virus.” An archive is available on the company's website. The column is published in daily newspapers in Buehler's trading areas of Wayne, Ashland, Coshocton, Delaware and Muskingum counties in Ohio.

He began writing his first column in 1987 at a time when he was starting his own independent pharmacy and he perceived a general lack of knowledge of the pharmacist's extensive education, among both the public and other health care professionals. “I wanted to distinguish my vision of pharmacy from count, pour, lick and stick.”

He gained immediate credibility with customers that to a degree, “trickled over to the pharmacy profession as a whole,” he said. “I remember writing a column early on called, ‘What It Takes to Become a Pharmacist.’ Nearly every pharmacist in the community then heard comments like, ‘I had no idea,’ and ‘Why didn't you go on to medical school?’”

He began writing the column related to Buehler's in 2002. It focuses on health care topics but occasionally touches on technology, he said. “In my grand vision, I am striving to utilize technology and upgrade the skills of the technical staff, drive distribution and thus free up the pharmacist to share their education with the public and other health care professionals.”
— W.T.