The New Vision: The Next Big Thing

Vendors and pharmacists share their thoughts on what innovative pharmacies, technology vendors, and pharmacy organizations see as the biggest and best moves for 2020. story begins on page 13.

Podcasts for Clinical Services Out The Patient 26 Pharmacists 28 of Necessity? 30 Satisfaction Factor A New Way What’s Ahead Interventions: Key to of Catching Up in 2020 Higher Satisfaction

NCPA 2019 Convention Coverage november/december 2019 computertalk 35 Be like Miral- Save valuable time without losing valuable space.

Do you need affordable and reliable tabletop counting technology but lack counter space? The RM1™ is a compact, vision-based tabletop counting system perfect for growing or space-limited pharmacies. The RM1 quickly and accurately counts solid oral medications, has an easy-to-clean surface and saves you valuable time without taking up scarce counter space. Less than 8 inches tall and lightweight at RQO\VL[SRXQGVWKH50SDFNVHIͤFLHQF\DQGDIIRUGDELOLW\LQWRRQHSRZHUIXODQG portable automated counting system.

See the future of pharmacy automation and what it can do for you. Visit rxmedic.com or call 800.882.3819.

³,WGH¿QLWHO\LPSURYHVRXUZRUNÀRZHI¿FLHQF\DQGLW¶VYHU\HDV\WRXVH:H¶YHWULHGRWKHUFRXQWHUVLQ WKHSDVWDQGWKH\GLGQ¶WZRUNZHOOIRUXV7KH50ZRUNVDQGLW¶VDJUHDWYDOXH :HKDYHVHYHQRQHIRUHDFKRIRXUORFDWLRQV´

Miral Patel, RPh – Owner, Curlew Pharmacies, Clearwater, FL

34 november/december 2019 computertalk © 201 RxMedic Systems, Inc. RxMedic is a registered trademark and RM1 is a trademark of RxMedic Systems, Inc. RxMedic Systems, Inc. is a subsidiary of the J M Smith Corporation. softwriters.com 412-492-9841 [email protected]

Reach new heights with the power of FrameworkLTC®, in the palm of your hand.

With FrameworkFlow, your team can easily connect to FrameworkLTC from anywhere in the pharmacy, and across their favorite iOS and Android supported devices. Improve RSHUDWLRQDOHIĆFLHQFLHVWKURXJKRXWWKHIXOĆOOPHQWSURFHVVOLNH

Inventory Packaging 0DNHLQYHQWRU\PDQDJHPHQWVWUHDPOLQHG 6WUHDPOLQHTXDOLW\FKHFNVXWLOL]LQJ ćH[LEOHDQGHIĆFLHQWE\HDVLO\VFDQQLQJ EDUFRGHHQDEOHGVFDQQLQJWRHDVLO\ products from anywhere in the the YHULI\WKDWWKHGUXJODEHOVEHLQJ SKDUPDF\ZKLOHDXWRPDWLFDOO\V\QFLQJ\RXU SDFNDJHGPDWFKWKHGUXJRQWKH data with FrameworkLTC. SUHVFULSWLRQODEHO

Review Toting Wirelessly capture pharmacist or (DVLO\WUDFNPDQDJHDQGVWUHDPOLQH technician ID and timestamps for each \RXURUGHUVZLWKEXLOWLQQRWLĆFDWLRQV SKDVHRIWKHIXOĆOOPHQWSURFHVVLQFOXGLQJ that verify accuracy. ĆQDOUHYLHZ

Start transforming your pharmacy today with FrameworkFlow. 9LVLWVRIWZULWHUVFRPIUDPHZRUNćRZIRUPRUHLQIRUPDWLRQ 1

© 2019 SoftWriters ® Nov | Dec 2019 The intersection of technology and management.

departments 4 Publisher’s Window Accessing PDMP Data 6 Industry News 7 PharmacyPlusTechnology: Online Content 26 Technology Corner The Podcasts for Pharmacists New Vision: 28 Viewpoints 2020: Clinical Services Out of Necessity? The Next Big Thing 30 Catalyst Corner Patient Satisfaction Better with by Bill Lockwood Pharmacist Discussion e went out and asked pharmacy owners and technology companies 31 Index of Advertisers W to share what they see as having an impact on the future of 32 Conference Circuit pharmacy. We report here what we learned. story begins on page 13. NCPA 2019 Annual Convention & Expo Plus… Solutions for the Pharmacy of the Future, pg. 16 pharmacy forward Connecting for Care, pg. 18 23 You and Your Primary Pharmacy Software Underutilized, pg. 20 Wholesaler* Beyond Dispensing, pg. 22 The relationship between pharmacies and their primary wholesaler has dramatically features evolved over the past 30-plus years. Mike Sosnowik, president 8 Passion and Technology: 10 “Yes, We Can Do That”: at PharmSaver, gives the tools The Foundation at White’s A Pharmacy That‘s Patient available to pharmacists to Pharmacy Focused manage wholesaler agreements, KFGPVKH[UKIPKƂECPVEQUVUCXKPIU by Maggie Lockwood by Maggie Lockwood and avoid ever-growing reim- Pharmacy owner Lucas Smith, owner of Buena Vista bursement pressures. Alexandra White Drug, is a typical pharmacist in 25 Customer Service as looks to carry many ways: running a pharmacy Pharmacy Development on the family in a small community. But he also Incubator pharmacy business represents the pharmacist of and honor her VJGHWVWTGCUJGFKXGTUKƂGUVJG Community pharmacists rely on grandfather’s pharmacy’s offerings through customer support departments VQUQNXGRTQDNGOUCPFƂGNFKFGCU legacy at White’s new clinical services and stocking to improve their systems. Here’s Pharmacy. While technology may medical equipment in response an insider’s look at how to best have changed since the pharmacy to patients’ requests, and using take advantage of that time on ƂTUVKPUVCNNGFKVURJCTOCE[U[UVGO his pharmacy system to document the phone. ComputerTalk’s in 1978, the core philosophy at and manage patient records. Maggie Lockwood shares in- White’s remains the same: treat the sights from Adam Engel, director customer like family. of client services at Liberty Software. *Sponsored Content

2 november/december 2019 computertalk 2345

november/december 2019 computertalk 3 publisher’s window www.computertalk.com Volume 39, No. 6 nov/dec 2019 Bill Lockwood STAFF Chairman | Publisher William A. Lockwood, Jr. Bill can be reached at Chairman/Publisher [email protected] Maggie Lockwood Vice President/Director of Production Accessing PDMP Data Will Lockwood As more and more states require pharmacists to check their prescription drug Vice President/Senior Editor monitoring program (PDMP) before dispensing an opioid, the quality of the data reported Toni Molinaro to the PDMPs will have a bearing on getting a “match” on the person of interest. Administrative Assistant This is where it is important to recognize that what’s reported to a PDMP is going to Mary R. Gilman determine to a large degree how often you are going to find the person you are looking Editorial Consultant for when checking the PDMP data. ComputerTalk (ISSN 0736-3893) is published bimonthly by Computer- Data elements that are used to identify the individual are the patient’s full name, address Talk Associates, Inc. Please address (including ZIP code), date of birth, gender, and phone number. These are the data fields all correspondence to ComputerTalk that must contain accurate and consistent information when reporting prescriptions Associates, Inc., 492 Norristown dispensed to your state’s PDMP. Gender and phone number increase the probability of a Road, Suite 160, Blue Bell, PA match, but not all PDMPs require reporting these data elements. 19422-2339. Phone: 610/825-7686. Fax: 610/825-7641. The American Society for Automation in Pharmacy (ASAP) developed a standard designed Copyright© 2019 ComputerTalk to allow queries of PDMP data from within the workflow of your pharmacy system rather Associates, Inc. All rights reserved. than through a web portal supported by the PDMP. It is called the ASAP Web Services Re pro duc tion in whole or in part standard to differentiate it from the ASAP standard used to report controlled substances without written permission from dispensed. the publisher is prohibited. Annu al subscription in U.S. and terri tories, The standard allows selecting a date range and then multiple states in a single query. $50; in Canada, $75; overseas, $95. The standard also supports a “pick list.” This is where the state would send back a list Buyers Guide issue only: $25 Print- of probable matches with a weighting indicating the confidence level that the person ed by Times Printing LLC. matches your criteria. A reference number is assigned to each person, and that number is General Disclaimer used to access the prescription history on the person you select. Opinions expressed in bylined ar- Appriss Health, which provides the gateway to NABP’s (National Association of Boards of ̈ViÃ`œ˜œÌ˜iViÃÃ>ÀˆÞÀiyiVÌÌ i opinion of the publisher or Com- Pharmacy) PMP InterConnect program, supports the ASAP standard. The standard can also puterTalk. The mention of product display the risk scores that Appriss would send back on the person selected. or service trade names in editorial Another feature of the standard is that it is designed to automatically check with the material or advertise ments is not in- PDMP to see if anyone has reached the state’s threshold for sending out an alert to a tended as an en dorsement of those products or services by the publish- prescriber and pharmacy. er or ComputerTalk. In no manner If you do not have the functionality in your pharmacy system to query PDMP data directly should any such data be deemed from your system, then I suggest you talk to your system vendor about incorporating the complete or otherwise represent an entire compilation of available data. ASAP standard. Of course, it all depends on your state allowing access to its data directly from your pharmacy system. A starting point would be to check with your PDMP. Member ASAP The ASAP Web Services standard is available by going to asapnet.org and clicking on CT 2019 publications.

4 november/december 2019 computertalk From our family to your pharmacy

A different way to do business. Strong foundation, successful future

As a family owned and operated company, we know the value of a hard day’s work and believe good business UVCTVUYKVJRCTVPGTUJKRUPQVRTQƂVU

Since 1985, BestRx has served the needs of independent pharmacies with innovative solutions to streamline business, increase revenue, and enhance the care you provide to patients. With BestRx, you can rest assured knowing our product isn’t a one and done deal - it’s an ongoing relationship to grow businesses and strengthen communities. Let’s talk. 1200 Jorie Blvd Suite 310 Oak Brook, IL 60523 1-877-777-5758 november/december 2019 computertalk [email protected] 5 industry news

BestRx Pharmacy Software Angeles, it allows us to keep adding include experts whom pharmacists announced the opening of its first talented members to the BestRx team may call and ask about buying, selling, branch office on the West Coast in and continue our mission to help and marketing, pharmacists are also en- Irwindale, Calif. In addition to the West independent pharmacies serve their couraged to familiarize themselves with Coast office, BestRx is also doubling its patients and communities.” local, state, and federal laws governing headquarters by occupying additional the sale of CBD products. space in its Oak Brook, Ill., headquarters. The National Community Pharmacists Association Indy Health Incorporated, The West Coast office is BestRx’s latest (NCPA) announced that it has the nation’s first Medicare Part D plan step in expanding its geographical teamed up with PRS Pharmacy wholly owned by independent phar- footprint to accommodate its rapidly Services to launch the NCPA CBD macies and independent pharmacy growing customer base. BestRx has had Source, a first-of-its-kind online re- organizations, introduced its executive staff working in the Los Angeles area source for community pharmacies that team at a by-invitation meeting at the for the past several years, but until now features cannabidiol products as well as 2019 National Community Pharmacists they had been working remotely from general information about the CBD in- Association Annual Convention & Expo their homes. The opening of the branch dustry. The NCPA CBD Source will serve in San Diego, Calif. office will bring the company’s staff to- as an easy-to-navigate website pro- “We couldn’t be more excited to intro- gether for improved collaboration and viding pharmacies with answers they duce this new leadership team,” says facilitate greater teamwork. Along with may need to make educated decisions Laura Atkinson, CEO and co-founder of the current staff moving into the office, about the growing CBD marketplace. Indy Health Solutions LLC, the par- BestRx will be rapidly hiring over the ent company. “We were fortunate to next few months to add significantly to “Many pharmacies are deciding to sell find these individuals, each of whom its West Coast operations. CBD products because of the patient demand and because, as the medi- embodies the values and commitment “The new office opens up opportu- cation expert, they can serve as the Indy Health brings to the Medicare Part nities for adding new support staff to source of truth,” says NCPA CEO Doug D marketplace. Together they bring a meet demand,” says Bart Rogacewicz, Hoey. “Pharmacy owners want to be bold combination of spirit, commit- senior operations manager of BestRx. able to answer their patients’ questions ment to care, and a fierce desire to pro- “With this location, we’ll be able to and recommend products where they vide much-needed transparency, which provide the support that our current can check their certificate of analy- some PBMs have failed to do, resulting customers have grown accustomed sis. The new CBD Source goes a step in high drug costs for consumers over to throughout the entire business day, further and will be sending product the last many years.” regardless of time zone.” samples to an independent lab to verify The executive team consists of Amanda The additional space at BestRx’s Illinois strength and product integrity.” Peterson, Pharm.D., CEO; Alynn Purdum, headquarters will create room for new Pharm.D., COO; and Eugene Samuels, The NCPA CBD Source, powered by PRS, hires and will also include space dedi- J.D., M.B.A., chief legal and compliance will function much like any other online cated to improving the overall well-be- officer. shopping site but with resources for ing of its staff. pharmacist CBD education and market- “Indy Health’s intention is to return Hemal Desai, president of BestRx, says: ing tools and with products researched transparency and fairness to the phar- “We have been fortunate to have been by NCPA and PRS. Samples of products macy industry that has been missing growing at an incredible pace over the on the site will be tested for concentra- with the current model, as well as to past few years, both in terms of our tions of all cannabinoids, including CBD rein in the soaring cost of drugs, ben- staff and our client base. By expanding and THC, by an independent third-par- efiting both consumers and indepen- our offices in both Chicago and Los ty lab. While the NCPA CBD Source will dent pharmacies,” says Atkinson.

6 november/december 2019 computertalk industry news

Mutual Drug, a member-owned network of over 550 independent phar- PharmacyPlusTechnology: Online Content macies in the Southeast, has entered into a strategic alliance with Percep- Pharmacy voices and trends at www.computertalk.com tiMed to introduce the scripClip pick- to-light will-call system to pharmacies. New to www.computertalk.com, guest blogs from subject matter experts and pharmacists using technology to make their pharmacy According to Meredith Lauderdale, VP better. Learn more and share your thoughts. Right now you can of sales for Mutual Drug, the agreement access these articles: will allow Mutual Drug members to more efficiently serve their patients. The Are You Ready for CPESN? Five Key Services* scripClip system uses proprietary soft- By Emily Smith, Marketing Coordinator, QS/1 ware to support a system of LED-em- Community Pharmacy Enhanced Services Networks offer a promis- bedded clear plastic hanging prescrip- ing way to differentiate yourself with both pa- tion bags, as well as plastic clips that tients and payers. CPESN member pharmacies can be affixed to paper bags and large come together to improve patient outcomes with optimal medication use. They agree to containers. The system speeds up the provide enhanced services that go beyond process of placing prescriptions in the dispensing and basic patient education. Take will-call area without alphabetizing pre- a minute to evaluate your pharmacy against some of what CPESN scriptions. With scripClip, prescriptions encourages. can be quickly retrieved by pharmacy staff simply by looking for the bag(s) HHS Final Drug Pricing Rule Fails to Address Pharmacy with the flashing, color-coded LED. DIR Fees* Contributed by Micro Merchant Systems “We are excited to be working with Despite strong support from leading pharmacy associations, pa- PerceptiMed to bring this new technol- tient advocacy groups, senior citizen groups, ogy to our members,” says Lauderdale. and members of the U.S. Congress, in May “One of our important goals is to help 2019 the U.S. Department of Health and our pharmacies provide better clinical *WOCP5GTXKEGU **5 KUUWGFCƂPCNFTWI services to their patients. PerceptiMed pricing rule for Medicare and Medicaid that streamlines their workflow so the phar- failed to address the serious issue of phar- macy direct and indirect remuneration (DIR) fees. macist can deliver enhanced services to their patients, including immunizations The Next Big Thing: Independently Owned and Operated and diabetes education.” An interview with Diana Lischin, R.Ph., owner, Coats Pharmacy and Frank Starn, CEO of PerceptiMed, says Angier Family Pharmacy that working with Mutual Drug is both In this interview Lischin shares the way ScriptPro an honor and an opportunity: “Mutual VGEJPQNQI[JCUJGNRGFJGTTGFGƂPGJGTRJCTOCE[ Drug, being a cooperatively owned to best serve her patient population, and gives her view on the technologies she sees changing distributor, has extremely close relation- the pharmacy of the future. ships with the pharmacies they serve. We feel that by working together we’ll Sign up for our weekly be able to bring the customer service eNewsletter at benefits of scripClip to hundreds of www.computertalk.com/enews-signup/ more pharmacies than we could on our own.” CT * Sponsored Content

november/december 2019 computertalk 7 feature: pharmacy innovators

Passion and Technology: The by Maggie Lockwood Foundation at White’s Pharmacy VP, Director of Production

Alexandra White, Pharm.D., looks to carry on the pharmacy business and honor her grandfather’s legacy at White’s Pharmacy Inc. in Wiggins, Miss.

At eight years old, Alexandra “Alex” honoring the family-owned pharmacy for make their medications affordable and calls White would work Saturdays in her 40 years as a customer. Alex accepted the their doctors to check on prior authoriza- grandfather’s shop, White’s Pharmacy. Each award on behalf of her beloved grandfather, tions, refills, and medication history. Many week, she would who passed away this past March. of her patients are elderly, with multiple help customers find John White installed one of the first 200 disease states — diabetes, cholesterol, and items and help the QS/1 systems in the country. “John saw the high blood pressure. “Pharmacists play an cashiers with their benefits and gave us recommendations on important role here,” says Alex, who has chores. She remem- benefits to make the system better,” says the store registered to provide diabetes bers the way her QS/1 sales representative Dennis Antici. “He education and bill Medicare for that specific grandfather, John was not only a customer but a partner. He service; it is called DMSE (Diabetes Self Milton White, R.Ph., was extremely proud of having a computer Management Education). helped customers and having a QS/1 system.” “I’m excited. The main thing is I want my Alex White who might need White was one of those people who saw grandfather’s legacy to live on,” she says. a store credit because they were on hard the benefit in the investment, not just the times, or the way he’d run a promotion to cost, says Antici. He was so sure of the ROI THE NEXT GENERATION bring customers in — in particular, the time (return on investment), he would hang out While systems have changed, and the na- he raffled off a pony. And she remembers at the QS/1 booth during trade shows and ture of pharmacy is slowly shifting from bill- his dedication to the pharmacy profession. give demos. “He would reach out to peers ing for prescriptions to billing for services, “Papa was the type, he was always in the to come over and take a look,” recalls Antici. the core philosophy at White’s remains the back room on the phone, talking to phar- “He wanted to share the success story of same: treat the customer like family. That macy colleagues to see what everyone was using the system himself.” family feeling starts with the staff, which doing,” says Alex. “And he was always trying Anytime QS/1 offered a new product or is multigenerational and includes siblings to see in which direction healthcare was feature, like point of sale and IVR (interactive working side by side. Alex’s mother and headed.” voice response), John White asked when he co-owner, Rebecca “Becky” White Pipkins, Clearly, he saw the impact that technology could install it. Alex shares her grandfather’s has worked in the pharmacy since she was was going to have on healthcare. In 1978, progressive approach to technology. “Alex is a teenager. Alex’s father, also a pharmacist, John White installed the first QS/1 system ready to move the pharmacy forward,” says works there too. Antici. “She is also looking to be a partner in the state of Mississippi, “which was his The store is half a gift shop, with candles, with her system vendor.” claim to fame,” says Alex. John White’s cards, jewelry, and a large bridal registry. commitment to QS/1 was recognized at Like her grandfather, Alex is passionate The gift shop was for years in Alex’s grand- a recent customer conference, when Alex about her customers in this rural commu- parents’ antebellum home across the street was presented with a bouquet of flowers nity of 18,000. She looks for coupons to from the pharmacy. In 2009, Becky moved

8 november/december 2019 computertalk the gift shop and pharmacy to its current location, which is about 3,000 square feet. Carrying on the family legacy of using tech- nology (Becky installed a ScriptPro robot in 2009), Alex relies on a suite of interfaces to support her clinical programs through Amplicare, PrescribeWellness, Mirixa, OutcomesMTM, and StrandRx. Alex says she likes Amplicare’s customer support chat feature and its support of Medicare Part D plan enrollment, as well as its checking on the pharmacy’s performance rates, which helps minimize DIR (direct and indirect re- muneration) fees. She wants her customers to understand the relationship between lifestyle and healthcare. “There are more drugs, more disease states, more people,” she says. “Before, you might get a medication for an acute illness, but now we are treating disease states. We are now seeing our patients more often than Papa did. We can see our patients three days a week or more.” Times haven’t changed, though, when it comes to the White’s combination of personal connection backed by technology. Alex says she hopes the pharmacy systems give her more access to data shared with doctors and hospitals. She has gotten involved with CPESN (Community Pharma- cy Enhanced Services Network) and sees the benefits of collaborative relationships The history of an independent. From top, clockwise: The staff at White's carries on the with hospitals. “I would hope we are more independent tradition; John White celebrat- integrated with healthcare. That’s what ing the store’s 50 years; Alex and QS/1’s CPESN wants. Then we can call a patient Dennis Antici; press coverage from the and say ‘Hey, you got out of the hospital. archives. daughter, “It takes someone with comput- Let’s go over what happened — what are er-savvy skills to keep up with the latest in To succeed, Alex says, it comes down to your medications, and can we help set up pharmacy technology.” CT an appointment with your primary care family: “My mom is behind me 100%. And physician?’” she says. “I’m optimistic about she’s giving me the reins to do what I think Maggie Lockwood is VP, director of produc- the future of pharmacy. It’s not about mak- we need to make the store run better tion at ComputerTalk. She likes sharing the ing a profit on filling a prescription; it’s for and to help our patients live a longer, stories of pharmacist entrepreneurs who use billing for our services, what we can provide healthier life.” technology to find success. You can reach her to our patients.” As the next generation, Becky says of her at [email protected].

november/december 2019 computertalk 9 feature: expanding services

“Yes, We Can Do That”: by Maggie Lockwood A Pharmacy That‘s Patient Focused VP, Director of Production

Lucas Smith, Pharm.D., owner at Buena Vista Drug, has diversified clinical services and responded to patients’ requests, building a relationship with his community and generating new revenue, thanks to an increase in cash payments.

Like many community pharmacists, Colorado to be accredited by the American Lucas Smith found a small community, Association of Diabetes Educators to offer Buena Vista, Colo., where he wanted to diabetic self-management education, and work as a pharmacist, and has set down can bill Medicare for 10 hours of diabetic roots. He has moved from pharmacist to education. Those patients whose insurance owner at Buena Vista Drug, and is now doesn’t cover the education sessions pay expanding the business, opening another out of pocket. Currently, Smith is trying location 30 minutes away. to build a diabetic prevention program to show effective outcomes and receive Smith is also an example of the pharmacist accreditation for that as well. Customers of the future, as he looks to clinical services can take advantage of Medicare Part D and products to augment his prescription “I’m enjoying expanding consultation and compounding services. business. He has forged collaborative rela- our business and offering “We’re trying to offer a lot more unique tionships with area providers in this town clinical services to help us grow,” says Smith. of 3,000, two and a half hours southwest these services. I’m a young “The challenge is we can’t bill insurance. of Denver. Since Smith arrived at Buena pharmacist, and I’m glad But people do pay cash for the services.” Vista five and a half years ago, and he and his wife took on ownership two and a half that I can expand the “WE CAN DO THAT” ago, his goal has been to expand access to business to use the skills services. Buena Vista Drug is 4,000 square feet, I learned in school, more The pharmacy’s med sync program now and includes a large gift department and has 400 patients enrolled. Smith has taken than just dispensing over-the-counter selection. Where Smith advantage of Colorado protocols that allow medication.” has found opportunity is around renting for counseling in contraception and smok- oxygen concentrators, wheelchairs, and ing cession; point-of-care testing for A1C, – Lucas Smith, knee scooters. Another unique item the cholesterol, and high blood pressure; rapid Pharm.D. pharmacy rents is the biliblanket, used to flu and strep testing; diabetes education treat neonatal jaundice. This rental is bill- between August and December 2018, hit and prevention; and nutrient depletion able to Medicaid, but the rest are invoiced that mark in October this year. counseling. The pharmacy’s flu vaccine pro- to the patient. gram, which administered 1,000 vaccines Buena Vista Drug was the first pharmacy in Since it’s a small community, Smith knows

10 november/december 2019 computertalk the providers well — running and rock climbing with some — giving him the opportunity to explain what the pharmacy can offer. He joins a quarterly provider meeting that includes four doctors and five mid-level practitioners, and gives an update on what the pharmacy is offering. To promote these services, Smith uses traditional radio advertising during sporting events, as well as Facebook posts. “I love the services we offer, because they fill the needs of our com- munity,” says Smith. “Both the biliblanket and the oxygen concen- trators came about because a provider asked if we could do it. I did the research and said that, yes, we could.“ Buena Vista Drug, in a small mountain community in VALUE OF FLEXIBILITY Colorado, provides a clinical hub for its patients. At left, Smith, along with the other full-time pharmacist and two techni- the DME (durable cians at Buena Vista Drug, uses the PioneerRx system to document medical equipment) clinical encounters. Smith has found he can document his clinical inventory responds to the programs using features available in his system. When he installed needs and requests of the the system about a year ago, he felt overwhelmed by all he could pharmacy‘s customers. do with it. But, he says, by working through the screens, using the on-demand training modules, and calling the support desk, he has pressure medications. Smith has built a care plan in the system come to value the system’s flexibility. that prompts the staff to ask patients if they would like to have “When we first got it,” he says, “I thought ‘Oh, this is cool, but how their blood pressure taken at the store, or if they take it at home, do you build it out to what you want it to do?’ Once you learn have the store record the data in the care plan. By tracking a health about what’s available, you can customize the system to what measure like blood pressure, Buena Vista Drug staff are able to alert works best for you to document almost any clinical thing you’d patients of any trends, such as several months of an elevated blood want to do.” pressure. Smith says that the staff will ask patients if they want to share the information with their doctor, or if patients would like The on-demand training was particularly helpful, since it explains Buena Vista Drug to contact the doctor. “It’s another touch point how to develop clinical programs. This helped Smith to understand where we’re talking to our patients and offering more than just a the best workflow for his pharmacy. For example, with his med prescription,” says Smith. sync program, he plans to use PioneerRx’s new care plan module to document phone calls. “I’m excited to use the prebuilt docu- The pharmacy was nominated for Health Mart’s Clinical Innovation mentation program for our med sync,” he says. Award by its McKesson sales rep. Smith says it was an honor to receive the award. “I was surprised,” he says. “I’m enjoying expand- Smith has customized the system through prompts based on clini- ing our business and offering these services. I’m a young pharma- cal offerings that are triggered during the dispensing process or at cist, and I’m glad that I can expand the business to use the skills I the point of sale. One prompt indicates to the staff that a patient learned in school, more than just dispensing medication.” CT is on a medication that causes nutrient depletion. This gives the pharmacy staff an opportunity to counsel the patient and explain Maggie Lockwood is VP, director of production at ComputerTalk. She the benefits of a nutritional supplement. likes sharing the stories of pharmacist entrepreneurs who use technolo- Another trigger Smith plans to use is counseling around blood gy to find success. You can reach her at [email protected].

november/december 2019 computertalk 11 12 november/december 2019 computertalk The New Vision: The Next Big Thing

by Bill Lockwood Chairman, Publisher e went out and asked pharmacy [email protected] W owners and technology companies to share what they see as having an impact on the future of pharmacy. We report here what we learned.

continued on next page >

november/december 2019 computertalk 13 cover story: next big thing continued from previous page

OVER THE YEARS PHARMACY HAS BEEN RESILIENT in addressing adversity. This has been prov- taking care of the whole patient over time,” the patient, so it en time and time again. Now the adversity says Schwartz. However, she adds, “Scalable will be important comes in the form of lower margins on pharmacy practice transformation requires to understand generics; DIR (direct and indirect remu- changes to workflow, care processes, and the staffing and neration) fees, thus clawing back dollars business models in repeatable, consis- expenses required from adjudicated claims well after the fact; tent, and achievable increments.” This is a for each service preferred networks; and other aggressive change that system vendors must recog- and which of moves by the pharmacy benefit managers nize and address to help pharmacists move Jason Turner these are having a to squeeze out more profits from prescrip- in this direction. beneficial outcome tion drugs dispensed, at the expense of for the patient and pharmacy. Paul Baldwin, from the Baldwin Health pharmacy margins. Even the major chains Policy Group, sums He projects that pharmacies will continue are not immune from these new pressures. it up this way: “The to innovate with new technologies and That said, what must happen for pharmacy, dispensing function services, including patient communication particularly the community pharmacy, to will become in- tools, medication synchronization, and survive? Clearly, pharmacy must take steps creasingly automat- medication adherence packaging, with to reinvent itself. Specialty pharmacy is ed, but cognitive more focus on immunizations, nutrient one avenue, but this presents its own set service oppor- depletion, and therapy optimization. of challenges in handling the high-priced Paul Baldwin tunities abound. At Osborn Drugs in Miami, Okla., Bill Os- drugs involved. Pharmacists will born, president, has engage in places they never imagined and clinical services on An NCPA (National Community Pharma- will be able to pave new roads into direct his agenda moving cists Association) recent survey of its mem- consumer interactions, even without any forward. Osborn bers found that 58% stated that they are official designation as providers under the says he is starting somewhat likely or very likely to close their Medicare program.” doors in the next two years if things do not to see patient improve. That’s a scary finding. Yet pharma- Along those lines, Jason Turner, owner of acceptance of ad- cy is not resting on its oars. The Commu- Moundsville Pharmacy in Moundsville, W.V., Bill Osborn herence packaging nity Pharmacy Foundation launched a feels that pharmacies need to develop op- and is working on flip-the-pharmacy campaign to change portunities to ensure they are maximizing ways to improve clinical services and qual- the focus of pharmacy to clinical-based the outcomes for patients — to be focused ity outcomes; he also notes the expansion services with care plans and documenta- on providing those services consistently at of NCPA’s CPESN (Community Pharmacy tion. Lisa Schwartz, who is senior director the highest level for every patient. “This will Enhanced Services Network) program. of professional affairs at NCPA, reports that require pharmacy owners and managers Indeed, Synergy Medical is finding pharmacists across the country are part of to develop processes for the services being steady growth in adherence packaging. the flip-the-pharmacy initiative. “This seeks offered and training for the pharmacy staff,” Its research has found that in 2015 less to refine the scalable models for phar- he says. He recognizes that many of the macists practicing in the community and services are being offered at no charge to continued on page 18

14 november/december 2019 computertalk Ready to Elevate the Role of Pharmacists?

Equip your pharmacists with proprietary tools to provide advanced clinical services. Tabula Rasa HealthCare’s innovative technology solutions improve workflow and enable pharmacists to deliver personalized medication therapy.

Medication risk management Disease management Patient relationship management solutions

Pharmacists bridge the gap to improve outcomes

Medication decision support tools that help detect, resolve, and prevent adverse drug events

Multi-channel communication tool allows pharmacies to engage with patients

Med synchronization tool makes it easy to enroll and sustain patients in a program

Customizable software that identifies and provides solutions for medication and other health-related problems

Backed by Science. Proven Outcomes. Documented Savings. Tabula Rasa HealthCare (TRHC) (NASDAQ:TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations and consumers to optimize performance, including medication regimens to improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk.

Tabula Rasa HealthCare® | 228 Strawbridgenovember/december Drive, Moorestown, 2019 NJcomputer I 866-648-2767talk I [email protected] I trhc.com 15 cover story: next big thing

spotlight: Solutions for the Pharmacy of the Future Kevin Welch, president of Smith Technologies, CT: And what will pharmacy parent company of QS/1, and chief technology look like? officer of J M Smith Corporation, was asked to share his thoughts on where pharmacy is Welch: Dispensing will continue to heading. Here is what he had to say. be more automated, with increased technician involvement — allowing ComputerTalk: Kevin, please share pharmacists to focus heavily on patient your vision for pharmacy and how engagement and clinical outcomes. technology will power it. Appointment-based medication man- Kevin Welch: Expertise, love of commu- agement will combine synchronized medication delivery with clinical-based nity, and easy access make pharmacists “Healthcare is becoming an essential part of the patient care pharmacist counseling. Enhanced team. As pharmacists’ role continues to more focused on patient clinical services as part of, or indepen- evolve and expand beyond dispensing, health outcomes, and dent of, collaborative agreements will provide revenue streams from the they will likely become the initial health- pharmacy is in an ideal care provider for an increasing number medical-billing side of healthcare reim- of patients. position to impact bursement. Healthcare is becoming more focused results.” CT: How is technology going to let on patient health outcomes, and pharmacists redefine themselves pharmacy is in an ideal position to – Kevin Welch and become a bigger part of the impact results. Pharmacy can show its fabric of the industry and their value by optimizing medication therapy communities? management — engaging patients Precision medicine also has the poten- Welch: Pharmacy management sys- while monitoring clinical impact, tial to enhance the patient experience. tems are increasingly providing work- recommending necessary adjustments, Through a combination of pharma- flow models with integrated quality and communicating plans and progress cogenomics and collaboration with control measures that both support en- to other members of the patients’ prescribers, pharmacists can better hanced technician roles in the dispens- healthcare team. predict treatment and prevention for ing process and reassure the dispensing Advanced technology will enable more chronic conditions, which improves pharmacist of prescription accuracy and efficient workflow that frees up phar- health outcomes. accountability. With technicians focused macists to be more clinically engaged Pharmacies have access to so much on dispensing, pharmacists will have and patient facing. data. Intelligent analytics are essential to more time to engage patients in clinical discussions that optimize outcomes. CT: When you think about the solu- ensure ongoing business success and Enhanced clinical screening will also tions available now, which ones do help with identifying areas of growth further enhance the accuracy and effi- you think will change how pharmacy and objectively viewing weaknesses; ciency of medication assessment with will look in the future? monitoring trends; looking at contracts and services with negative margins; and appropriate documentation and then Welch: The Pharmacist eCare Plan analyzing inventory management. With communication with other members initiative has opened the door for phar- decreasing prescription reimbursement of the healthcare team. Secure commu- macists to communicate with other margins, pharmacies must operate at nication options will improve patient providers in a universal language. The maximum efficiency to maintain posi- engagement while ensuring privacy eCare Plan provides data for outcomes tive cash flow. Business analytics enable and data security. CT analytics as well as patient status report- decision makers to make informed ing in a standardized format. business decisions.

16 november/december 2019 computertalk NRx® gives community pharmacists the power to be more. As a community pharmacist, we know you have many responsibilities. You deserve a pharmacy management system that’s ready for whatever you need. No other system comes close to NRx’s comprehensiveness, hundreds of interfaces, 24/7 emergency support, or ability to adapt to your evolving needs. We know community pharmacy, and we build NRx to help you become everything you want to be.

november/december 2019 computertalk 17 Go for NRx. / qs1.com/NRx/Go / 800.231.7776 cover story: next big thing continued from page 14

than .5% of all U.S. prescriptions were dispensed in ad- spotlight: Connecting for Care herence packaging. Today’s usage is Josh Howland, VP with other healthcare providers, providing at 2%. “Given the of clinical strategy point-of-care testing, and providing medica- activity we see with at PioneerRx, offers tion management services. PioneerRx phar- his thoughts on macists are able to better understand their Mark Rinker pharmacy chains what pharmacies patients' needs by using reports to segment and independents, will need to do to and identify gaps in and potential oppor- it is not a stretch to think adherence better connect and tunities for services. These services should packaging will represent 4% of all retail care for patients. be provided in a way that the patient wants prescriptions dispensed in 2021,” says Mark Josh Howland Community phar- and can be within the pharmacy, via an app, Rinker, the company’s VP of sales for North macy must leverage technology to connect or even through the use of telemedicine America. He finds that for most pharmacies with patients and be a key part of the platforms — or preferably by using all three there can be a period of indigestion as healthcare team by facilitating interactions in a way that feels seamless. CT new workflows and processes related to

18 november/december 2019 computertalk adherence packaging are absorbed. “Often with emerging markets, to the smart watches that monitor our physical health. One theme exponential growth is initially disguised as modest linear growth,” that weaves throughout our findings is how the pharmacist serves Rinker says. “It is inspiring to see pharmacies endure this period as the medication specialist and needs to leverage this position knowing that, on the other side, this new service will lead to better through deployment of virtual health technology. “Healthcare patient outcomes, customer retention, and new business oppor- no longer has to measure only snapshots of our health when we tunities.” come in for a visit, but our health can be tracked instantaneously,” notes Thai. VIRTUAL HEALTH DISRUPTIVE TECHNOLOGY Virtual health is something we are going to hear more and more of as a way of staying connected with the patient. Pharma “The next big thing for pharmacy will companies are already moving in this direction. It makes sense for be a disruption to the current business pharmacists to jump on board as well. through the use of new technology tools,” says Orsula Knowlton, president of Tabula Among the emerging technologies that can benefit pharmacy Rasa HealthCare. Specifically, she is talking in this manner are secure text messaging and video chat. That’s about the company’s MedWise program. what Cathy Kuhn, director of strategy for UpDox, sees as the future. MedWise takes a completely different “These tools can help pharmacists engage existing patients by Orsula Knowlton meeting them where they are,” she says. continued on next page “Patients want to receive text and email reminders about refills or the need to follow up with their prescribers or being informed about immunizations.” Having this connec- Cathy Kuhn tion should happen PHARMACYPHARMACYMACY MANAGEMENT within the workflow of the pharmacy, which SYSTEMS & SERVICES Kuhn sees as a way to improve clinical ser- vices and revenue, but just as importantly, enabling pharmacists to expand their role as “healthcare’s most accessible provider.”

Digital healthcare is also what Ken Thai, PRM LTC POS All-inclusive software Enhancing the Integrating point of sale co-founder and CEO of 986 Pharmacy in and services, letting communication between directly into the work San Marino, Calif., software and technology long term care facilities flow of the pharmacy; help manage patients and the dispensing giving even the most feels will be the new and letting pharmacists pharmacy; streamlining demanding pharmacies wave “that will affect and employees manage and improving point-of- the tools that are required patient’s health. care performance. for successful growth. how pharmacy re- invents itself to start the new decade.” CALL US TODAY 800-569-1175 Thai points out that www.speedscript.com • [email protected] it’s all around us, Ken Thai from analytical data

november/december 2019 computertalk 19 cover story: next big thing continued from previous page

approach to managing a person’s drug growing emphasis on clinical services. therapy, particularly when multiple drugs are taken. It allows the pharmacist to TAPPING THE MEDICAL spotlight: personalize the medication regimen. “This BENEFIT Pharmacy Software improves medication safety and wellness,” Helping to move pharmacy into new says Knowlton. MedWise goes a step Underutilized revenue streams is what Mike Coughlin, further than the traditional drug interaction Kevin Minassian, president of Datascan, a ScriptPro CEO, checking that pharmacists have relied on in pharmacy software developer located in envisions as the their pharmacy systems. MedWise identifies Bohemia, N.Y., finds that pharmacists are next big thing. underutilizing areas of the software that risk for dangerous cumulative side effects, Here he is talking can benefit them. unintentional overdose, and ineffective about integration of He says, “Independent pharmacy owners medication regimens, and presents ac- medical billing into need to tionable opportunities using the MedWise pharmacy manage- harness the Risk Score for risk mitigation. This includes technology al- Mike Coughlin ment systems: “This precision dosing systems. MedWise is ready built into will allow specialty pharmacy and ambula- an indication of where we are headed in their existing tory infusion reimbursement to be received providing pharmacists with a new decision systems and support tool that dovetails nicely with the continued on page 22 put it to work.” Minassian finds Kevin Minassian that the large majority of independent owners tell him Does it feel like your software vendor they don’t have the time, or they are afraid to automate certain processes. “This leaves is abandoning you? them overstaffed and with declining reim- bursement; this is something they cannot Did your software vendor sell out to a huge corporation, afford to do,” he says. and now you're lost? “I do not feel that pharmacists are taking advantage of the functionality we offer that can improve their profit margins,” says Minassian. Specifically, he points to the underutilization of the adherence dash- board in the system to build medication adherence and star ratings, and of course increase revenue from higher refills. The dashboard can also be used to organize requests sent to doctors that require follow-up, and is a timesaver. Another Call Datascan, the Independently feature that he finds lacking use is a profit optimizer to help choose an equivalent Owned Pharmacy Software lower-cost drug to dispense. “We are giving pharmacists the tools to help improve their margins, and it is frustrating to see the lack (877) 222-RXRX of uptake,” he says. [email protected] Minassian suggests that pharmacists dig into their software to find out how they datascanpharmacy.com can put the technology they have to better Free Demo • Pain-Free Conversions use. CT

20 november/december 2019 computertalk Be like Eric - Change how you do business with automated will-call.

The RxMedic® Automated Retrieval System (ARS®) is an electronic will-call system that helps you more effectively store, organize, retrieve and return prescriptions to stock. Utilizing unique hanging bags with LED lights, the ARS helps you easily identify prescriptions for pick-up and allows you to keep same- KRXVHKROGSUHVFULSWLRQVWRJHWKHU(YHQEHWWHUWKLVVLPSOLͤHGV\VWHPZRUNVZLWK most pharmacy management systems.

See the future of pharmacy automation and what it can do for you. Visit rxmedic.com or call 800 .882 .3819.

“RxMedic’s ARS provides peace of mind regarding patient safety not found in other will call systems. It has helped us utilize the tools in our pharmacy management system better. It’s also the kind of technology that gets patients’ attention.”

Eric Russo – Director of Clinical Services at Hobbs Pharmacy in Merritt Island, FL

© 2017 RxMedic Systems, Inc. RxMedic and ARS are registered trademarks of RxMedic Systems, Inc. november/december 2019 computertalk 21 RxMedic Systems, Inc. is a subsidiary of the J M Smith Corporation. cover story: next big thing continued from page 20

from either the pharmacy benefit or medical benefit coverage.” spotlight: Beyond Dispensing BestRx is another company that sees Here, Michael Muniz, owner of Muniz Rio Grande deficient in from only what they are eating. opportunity here. An optional medical Pharmacy in Harlingen, Texas, offers his perspec- billing component was recently added tive on the next big thing. It has to be more than In Texas, pharmacists will be included as provid- to its software to ers and be able to bill insurance companies for dispensing product. allow pharmacies the services they provide come January 2020. to submit claims Pharmacy has been This billing will be done through the PioneerRx system. I am working with them to get the for professional all about volume and, superbilling software in place. In the meantime services, medical to a certain extent, quality. This has been patients are paying cash for the service. The supplies, drugs, the case for many encounters are documented in the Practice and immuniza- years, especially Better system I use, which is web based. I like Stephen Barnes tions covered as reimbursement this because it can travel with me. I then upload under the patient’s medical benefit. for a product has my notes to the PioneerRx system. Michael Muniz Stephen Barnes, director of sales and decreased. The only These services and payment for these services marketing for the company, encourag- way to be profitable in that side of the business are the next big thing. Pharmacists will no es pharmacists to pursue the medical is to have the volume to sustain your business. longer need to be tied to a product. A product benefit in their growth strategy for the In the future you have to offer more and be will be dispensed at a pharmacy, but pharma- more. I completed a Fellowship in Metabolic pharmacy. This is revenue that can offset cists will be able to go out and partner with & Nutritional Medicine with A4M in 2016, and what is being lost on traditional prescrip- physicians and be a point of reference for their that has been one of the best things I have tion drug billing. patients. This increases the practice setting for a invested in. With this training I am able to treat pharmacist. the patient holistically rather than with a com- MOVING FORWARD partmental treatment approach. We try to find Don’t get me wrong: We still need to be the the root cause of the issue. Much of this starts ones dispensing the medications and mak- There you have it. While the current with what our patients are consuming. I have ing sure that the patient is not at risk for drug environment may be considered bleak, a program where I sit with patients weekly for interactions. there is opportunity for pharmacy to a month, then for two more visits at two-week My advice: Never stop learning, and continue move the needle in its favor. The use intervals. Here we get them to eat better and to to be part of the healthcare team. Many of my of technology-based products and see how foods affect them. This is the nutrition colleagues only want to dispense a medication part of healing and different from just diet. We services will continue to play an and not further their education or specialization, take it to where it is a true lifestyle change. With important role in the survival of which is the same route taken by those pharma- this we are able to get patients to decrease their community pharmacy. CT cists who are now closing their pharmacies. We medications, and often they are completely can provide amazing care when we are allowed Share your “Next Big Thing” at taken off medications. They will sometimes use to be a part of the medical team. CT wp.me/p9LtTd-2sF. nutritional supplements to get what they are

Frustrated with your Primary Wholesaler? Take The Pharmsaver Challenge! -Reimbursement Alerts -Compliance Parameters -VAWD Wholesalers Compare Your Pricing Against 14 Wholesalers Instantly -Purchase Order Uploads! E M VisitVisit wwww.Pharmsaver.net/CTww.Pharmsaveraavveveer.net/CT ttoo EEnternNter A I L 22 november/december 2019 computertalk pharmacy forward SPONSORED CONTENT

You and Your Primary Wholesaler The relationship between pharmacies and their primary wholesaler has dramatically evolved over the past 30-plus years — from a true partnership in the ‘70s and the early ‘80s, to today’s often-mined landscape, where any and every misstep can, at the minimum, be costly.

Let’s begin by the same. So, to evaluate a solution, let’s look and use technology? A common trap verifying a fact and at some specific areas to address. with systems is perceived benefits at the dispelling a myth. You need to identify the structure of your pri- cost of more time than you have. Fact: Every pharmacy mary vendor agreement (PVA). Technology R Access: Can my chosen solution provide must have a primary that can’t honor and protect this is, at best, access to a dynamic marketplace? wholesaler. This fact either a short-term solution or one that will R Partnership: Is a technology solution is just as true today necessitate additional manual intervention one that addresses its users’ needs while as ever. In addition to to manage compliance. competing with your business? You generics, a pharmacy PharmSaver’s What is your current cost of goods, brand must be clear that any partner must be must have access to a President versus generic, and perhaps more im- independent, not driven by either a brand, specialty, and Mike Sosnowik portantly, what is your overall dollar ratio wholesaler, PBM (pharmacy benefit OTC (over the count- between the two? Many pharmacies fall manager), or competing pharmacy. er) drugs, at competitive pricing available into the brand discount trap. Yes, cost minus R Dynamic: Is your technology provider up five to six days a week with next-day delivery. 6% is attractive, but if brands make up 70% to date today, with a proven track record Myth: A pharmacy must commit all or even of your volume, how much is that discount of updates and responsiveness to user, the vast majority of its volume to its primary costing you on the other 30%? Let’s look at market, and regulatory changes? wholesaler. This is obviously dependent on an example for a pharmacy with $1 million a Conclusions both a pharmacy’s underlying base and its month in purchases: Purchases: $1,000,000; velocity of growth. In today’s reimburse- Brand: $700,000; Generic: $300,000. There are a number of technology solutions ment-driven business, the ability to control For the cost minus 6%, the pharmacy must available today. However, one system has cost of goods defines a pharmacy’s profit- commit 100% of its volume to its primary been designed to be flexible and fulfill your ability and even its long-term viability. wholesaler: 6%; Brand savings: $42,000. pharmacy’s needs. Taking these two conflicting realities into However, in comparing generic prices, in the PharmSaver provides: consideration, the answer is somewhat intui- open market, we find overall savings of 20% REase of use and integration. tive. A balance must be struck that maintains to 30% after all rebates, some even higher. RIndependence. No affiliation with any your primary relationship while making Now, lets move this to a hypothetical real- competing organizations. sure you have the room to address cost and world example. At a 4.5% brand discount, reimbursement pressures. R Compliance and update history. you commit 70% of your volume. On brands, R“Reimbursement Alert” is the only pro- While the answer may sound simple, the you have increased your brand costs by spective reimbursement tool on the implementation is anything but. How does $10,500 ($700,000 at 1.5%). But on market. a pharmacy find the tools to manage its generics you have realized savings of wholesaler agreement, identify significant between $18,000 to $27,000 per month, RWholesaler management tools. Man- cost savings, avoid ever-growing reimburse- leaving a net savings of $10,500 to $16,000 age your wholesaler’s PVA, your generic ment pressures, and — dare we say — find per month. Over the course of a year you compliance, and/or top-line revenue the time to do it all? can add $90,000 to $200,000 of annualized using a parameter-driven rule set. Technology to the Rescue! savings straight to your bottom line. The PharmSaver system provides both the New technologies have become available Acknowledging the need for technology, analytic power and the access to a dynamic that potentially answer some or all of these how does one choose between platforms? marketplace that allows pharmacies to challenges. However, not all technologies are Here are some important factors to consider: accomplish more in less time and at no cost created equal. In evaluating technological R to the user. Visit pharmsaver.net to learn Costs, both direct and indirect. CT solutions, you need to first make sure you more. R Ability to manage and adhere identify the specific requirements to address Learn more about Pharmsaver at to your PVA. the needs of your business. Just as with tech- https://www.computertalk.com/buyers-guide nology, no two businesses needs are exactly R Integration: Can you seamlessly integrate /pharmsaver/.

november/december 2019 computertalk 23 AMERICAN SOCIETY FOR AUTOMATION IN PHARMACY

THE LEADING FORUM ON TECHNOLOGY FOR THE PHARMACY MARKET ASAP 2020 Annual Conference The Ritz-Carlton [Amelia Island, Florida January 15 – 17 Conference Highlights:

The U.S. Pharmaceutical Market: Trends, Issues, and Outlook Project IMPACT: Immunizations — New Innovations in Population Health USP <800> Hazardous Drugs Is Here: What Needs To Happen at the Retail and LTC Pharmacy? California Consumer Privacy Act: Requirements, Challenges, and Unintended Consequences The Amazon-Pillpack Venture: The Latest Lessons Learned on the Road: What Pharmacists Are Doing to Succeed Redefi ning Medication Access: Focusing Upstream to Improve Adherence and Quality Fight Tomorrow’s Battle, Not Yesterday’s: How Technology Can Advance Guideline Care Delivery in the Pharmacy Revisiting Readmissions and Transitions of Care: Current and Future Priorities

Online conference registration available by visiting www.asapnet.org/registration.html ASAP American Society for Automation in Pharmacy 24 november/december 2019 computer492talk Norristown Road, Suite 160 • Blue Bell, PA 19422 610.825.7783 • Fax: 610.825.7641 • www.asapnet.org pharmacy forward

Customer Service as Pharmacy Development Incubator

With independent pharmacy, owners have to Seeing Trends, be good at two things: They have to keep up Implementing Change with their pharmacy knowledge so they can be effective at counseling their patients, and Every pharmacy setting is different, and they have to develop their business skills to the issues that pharmacy staff call in with ensure they run a successful business. Here, to Engel’s team are unique. There are a few ComputerTalk’s Maggie Lockwood shares themes, though, including insurance and insights from Liberty's Adam Engel. getting paid based on insurance company “It’s an interesting job just from that perspec- requirements. The Liberty team helps in re- tive,” says Adam Engel, Pharm.D., director Liberty’s Adam Engel viewing the steps to take with the insurance of client services at Liberty Software in company to get a claim paid. On the clinical Southlake, Texas. “Pharmacy owners encoun- Community pharmacists side, Liberty has developed an eCare plan ter things on a day-to-day basis that I think rely on customer support and assists customers with submitting the I can relate to and help them with.” plans. “We’ve seen this slowly increase,” Engel departments to solve says. Medication therapy management After years in pharmacy in multiple settings, «ÀœLi“Ã>˜`wi`ˆ`i>à (MTM) is also a fairly common concern. from retail, grocery, big-box retail, and One of Engel’s favorite parts of his job is hospital settings, Engel decided he wanted to improve their systems. development meetings. The staff reviews to develop his business expertise and got an Here’s an insider’s look at features that could be improved or new fea- M.B.A. from Southern Methodist University. how to best take advantage tures that are ready for release. He serves as When Engel joined Liberty as director of a resource to the team, providing experience client services in 2017, it turned out to be a of that time on the phone. to make it more user-friendly for the custom- perfect fit: He got to step out from behind ment, so staff members know their roles and er. “I didn’t know that was going to be part of the bench, but remain closely connected to can handle specific issues quickly. He says my role,” Engel says. “But it’s one that I really pharmacy. that Liberty has hired a number of pharmacy enjoy. I can have a big effect on thousands Engel says he typically doesn’t share he has a technicians, since they understand the day- of people if I make a suggestion that can pharmacy degree when talking to custom- to-day routines in a pharmacy and how to prevent one extra click. That means our ers, although he has found that when he get through the prescription-processing pro- customers can more easily deliver a service works it into the conversation, customers cess. Mondays are a tough day in pharmacy, to their customers.” CT like to know they are working with someone and that trickles down to the customer who has been in their shoes. support department. And the first day of the Maggie Lockwood is VP, director of production month is even busier. “They can really be in at ComputerTalk. You can reach her at In Their Shoes the shoes of the customer on the other end [email protected]. A typical week at Liberty begins with calls of the phone,” Engel says. “Some pharmacies coming in on Monday morning, and the ser- are large enough to hire a computer guru, vice team members either troubleshoot the so to speak, to help them with the problems, HOW DO YOU GET issue themselves or route the call to another but for a lot of our customers, we’re their first SUPPORT? Join us for a department. Engel has developed imple- line of defense when it comes to comput- reader discussion. mentation training programs and teams to er-related problems — from hardware to Sign up online at support various customer support areas, like networking. And we take the time to try and wp.me/p9LtTd-2t1. printers, networks, and account manage- help them with those problems.”

november/december 2019 computertalk 25 technology corner

Joshua C. Hollingsworth, Podcasts for Pharmacists Pharm.D., Ph.D., Brent I. Fox, Pharm.D., Ph.D.

HOW DO YOU KEEP UP WITH Podcasts are audio (and sometimes video) from podcast to podcast. Here, we will cov- the ever-changing landscape regarding the programs made available in a digital format er high-quality podcasts that are relevant art and science of medicine, with all the that can be streamed or downloaded from to pharmacists. We will start with podcasts relevant new studies and findings, recent the internet. Most podcasts are free and produced by medical and pharmacy jour- FDA drug approvals, guideline updates, release content on a regular schedule, nals, then move to podcasts produced by medical reversals, relevant FDA warnings, putting out an episode a week, for example. pharmacists for pharmacists, and then cover etc.? How and when do you find the time To consume a podcast, most people use a a few general health-related podcasts that to consume the plethora of pertinent new podcast app on their mobile device. For in- may be of interest. Keep in mind that this medical information? stance, Apple makes the (creatively named) is just a sampling and is nowhere near an Podcasts app for iOS devices (iPhones exhaustive list. As we all know from experience, there’s and iPads), and Google makes the (just as generally not much time to sit and read at creatively named) Google Podcasts app for PODCASTS PRODUCED BY work in order to keep up sufficiently. There Android devices. In addition, there are many MEDICAL AND PHARMACY are always more pressing matters — ver- free third-party podcast apps that work JOURNALS ifying orders, consulting with physicians, on both iOS and Android devices. These filling prescriptions, counseling patients, include RadioPublic, Castbox, and Stitcher, Several medical and pharmacy journals etc. — that must be addressed while we’re just to name a few. Spotify, the popular produce podcasts. Generally, these pod- on the clock, and rightly so. So what about music streaming service, also includes casts serve as companions to the journal reading during free time, outside of work? podcasts in its library of content. These apps itself, with the latest podcast episode cov- According to the 2018 American Time Use can be used to find, listen to, and subscribe ering some portion of the content that was Survey, conducted by the U.S. Bureau of to podcasts of your choosing. Once you published in the journal’s most recent issue. Labor Statistics, adults spend on average 16 subscribe to a podcast, all new episodes Often, this will take the form of an inter- minutes per day reading as a leisure activity. will be automatically downloaded to your view or discussion with one of the authors That’s not a lot of time — plus, if you are device as they become available. of a recently published manuscript in the reading for pleasure, do you really want to journal. Alternatively, episodes may consist read technical medical papers and guide- There are podcasts for nearly any topic of the journal’s editors discussing research lines? Our guess would be, no. So how else you can imagine. According to the latest that was recently published in their journal. can you stay on top of the latest advances estimates, there are over 750,000 podcasts It seems that most, if not all, of the major in pharmacy and medicine? Well, what if the currently available, with more than 30 medical journals now have podcasts. These time you spend performing chores around million episodes. Essentially, anyone with include the New England Journal of Medicine the house, exercising, commuting to and internet access, a way to record audio (e.g., (NEJM), The Lancet, the Journal of the Amer- from work, and other daily activities that re- a smartphone or some other recording ican Medical Association (JAMA), the Annals quire little mental effort could serve double device), sufficient time, and a little bit of of Internal Medicine, and The British Medical duty, allowing you to get things done and research can produce a podcast. So, as you Journal (BMJ), among others. Some of these advance your pharmacy-related knowledge might expect, the quality in terms of both journals put out multiple podcast feeds. at the same time? Enter podcasts. content and production value varies widely For instance, searching “JAMA” in the Apple

26 november/december 2019 computertalk Podcast app returns 27 different podcasts that are part of the JAMA Listen and Learn Podcasts are an easy Network. Similarly, searching “BMJ” within the same app returns 33 way to stay informed of current trends. podcasts that are part of the BMJ Group. Some pharmacy-specific Get links to podcasts in this column at journals also produce podcasts. For instance, there’s the European wp.me/p9LtTd-2r6 Journal of Hospital Pharmacy (EJHP) Podcast, which is part of the covers “everything from home remedies to the latest medical aforementioned BMJ Group. Then there’s AJHP Voices, the American advances.” Their approach is appropriate for a lay audience, and the Journal of Health-System Pharmacy’s podcast, which “focuses on podcast has been featured on “Good Morning America,” NPR, and impactful, relevant, and cutting-edge professional and scientific other national outlets. The Peter Attia Drive Podcast, hosted by Peter content that drives optimal medication use and health outcomes.” Attia, M.D., brings on experts in various fields related to “health, per- formance, critical thinking, and pursuing excellence,” with ultimate PODCASTS PRODUCED BY PHARMACISTS focus on health and longevity. Dr. Attia dives in deep with his guests FOR PHARMACISTS each week in their area of expertise. Then there’s the Found My There are several podcasts that are produced by pharmacists Fitness Podcast, hosted by Rhonda Patrick, Ph.D., which aims to pro- (and other healthcare providers) for pharmacists (and other health- mote strategies to “increase healthspan, well-being, cognitive and care providers). Here are a few such podcasts that are rated highly. physical performance” through in-depth discussions with experts. The Best Science (BS) Medicine Podcast, produced by Michael Allan, As with any resource in medicine, you want to make sure the M.D., and James McCormack, Pharm.D., aims to give pharmacists podcasts that you subscribe and listen to are reputable and give and other practitioners evidence-based drug therapy content in a accurate and up-to-date information. This is more of a concern for practical and entertaining way. Similarly, the CorConsult Rx podcast, those “independent” podcasts, produced by individuals, and less so produced by Mike Corvino, Pharm.D., BCPS, aims to provide evi- for podcasts produced by established and well-respected medical dence-based medicine and drug updates to pharmacists and other journals and content providers. Otherwise, the approach you take practitioners “that are on the go.” The HelixTalk podcast is produced is up to you. You can subscribe to a particular podcast and listen to by pharmacy faculty at Rosalind Franklin University College of every episode it produces. Alternatively, you can track a few different Pharmacy in order to provide “real-life clinical pearls and discussions podcasts and consume only those episodes that are of specific inter- [that] will help you stay up-to-date.” The Elective Rotation Podcast, est to you. If you are looking for a specific topic (e.g., an overview of produced by Joseph Muench, Pharm.D., covers critical care and hypertension guidelines), try using it as a search term in your pod- hospital pharmacy information and claims to be the number-one cast app. You may find new and unexpected podcasts to enjoy this ranked podcast in this area of focus. Then there’s the Pharmacy Pod- way. Sharing reputable podcasts with your patients or colleagues is cast Network, which has more than 20 different podcasts, some of also a great way to disseminate valuable information. One topic which are hosted by pharmacists, covering different aspects of phar- that we didn’t find a podcast dedicated to is drug shortages. We macy and pharmacy practice, ranging from pharmacogenomics to know such a podcast would be relevant and valuable to many career development. The American College of Clinical Pharmacy ComputerTalk readers. So, do you regularly listen to any medi- (ACCP) also has a podcast, in which the hosts interview experts and cine-focused podcasts? Do you do so when accomplishing other influencers in clinical pharmacy and provide an overview of various tasks, such as commuting to work or working out at the gym? We research topics. welcome your comments and questions. CT OTHER HEALTH-RELATED PODCASTS Joshua C. Hollingsworth, Pharm.D., Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteo- There are other health-related podcasts that we find inter- pathic Medicine, Auburn Campus, and Brent I. Fox, Pharm.D., Ph.D., is esting and insightful, and that you may as well. Here are just a few. an associate professor in the Department of Health Outcomes Research There’s the People’s Pharmacy Podcast, hosted by Joe Graedon and Policy, Harrison School of Pharmacy, Auburn University. The authors (pharmacologist) and Terry Gradon (medical anthropologist), which can be reached at [email protected] and [email protected].

november/december 2019 computertalk 27 viewpoints

2020: Clinical Services

Out of Necessity? Tim Kosty, R.Ph., and Don Dietz, R.Ph.

WITH THE START OF A to new clinical services being created NEW DECADE, we expect chang- Creating value for by pharmacists. Innovation will be a es for pharmacy 2020 that have been a patients and payers necessity as pharmacists create new long time coming. We see a continual opportunities to employ their skills and decline in reimbursement rates, albeit will be the path to leverage technology to offer these new at a slower rate, and continued con- services. obtaining equitable solidation of retail pharmacies. There PATIENT ENGAGEMENT is now an oversupply of pharmacists, reimbursement for new STRATEGIES leading to lower wage rates for gradu- ating students. The new graduates are pharmacy services. Patients are taking more ownership seeking to use their clinical skills, and of their medical decisions. The man- we believe the lower wages and lack of macists have not generated sufficient tra has switched from “What can the jobs will lead new graduates and dis- gross profit to divert resources from the healthcare system do for me?” to “How placed pharmacists to create and offer dispensing of prescriptions to the pro- can I be involved in obtaining optimal innovative clinical services that meet vision of these services. However, the care?” Pharmacies have responded and the needs of our patients and/or payers. oversupply of pharmacists and reduc- begun implementing virtual services tions in wages for new graduates could such as text message reminders, OVER SUPPLY OF make the provision of clinical services adherence calls, and electronic transfer PHARM.D. GRADUATES more attractive. of prescriptions to other pharmacies. These innovations have been bene- Since 2010, 38 new pharmacy Furthermore, pharmacists are retiring ficial, but we believe a more holistic schools have opened, and nearly 5,500 at an older age. Only 47% of baby approach to patient engagement strat- new pharmacists are graduating each boomers have retired at age 65, creat- egies will soon be undertaken. year. With average student debt upon ing fewer openings for new graduates. graduation rising to $163,494 (a $40,000 Using Social Security as a barometer, Episodic interactions between a patient increase from 2012) and over 25% of retirement age has increased from 65 and pharmacist can cause patient new Pharm.D. graduates unable to find to 67, so conceivably more seasoned confusion and focus on specific issues full-time work upon graduation, the pharmacists are working longer instead rather than overall patient health. Retail landscape for pharmacy will inevitably of retiring. With the supply-and-de- chains are evaluating global patient have to change. mand curve changed from the last engagement strategies that enable 30 years, we expect that pharmacists’ patients to select the frequency and We find that universities have been wages will stagnate at best, and likely channels of communications with incorporating more clinical-services go lower, until a new equilibrium is their pharmacist. We believe these training into the curriculum. However, reached. Lower wages will change programs will engage patients in their retail pharmacy chains realize that the opportunity-cost dynamics when prescription drug therapy and enable clinical services performed by phar- comparing dispensing prescriptions pharmacists to play a more central

28 november/december 2019 computertalk role. With advances in technology, the of pharmacists and engaging payers costs of providing these interactions are While there are with an integrated approach to clinical decreasing through automation. services, leading to a reduction in costs numerous successful for payers. The primary objective of CHAINS TESTING THE efforts throughout the CPESN is quality improvement through WATERS new enhanced services and improve- country, we see value ment on existing service offerings. Our This year we have seen the large hope is that this serves as a pathway for chains pilot innovative programs in the integration of individual pharmacies to expand clinical in healthcare, including pharmacy. services in an organized fashion. Walmart is testing strategies for clinical clinical services in services provided by pharmacists and community pharmacies CONCLUSION other healthcare professionals. Walmart has also launched a health center ini- provided by CPESN Pharmacy consolidation will be tiative that will provide family practice ongoing. The resulting oversupply care along with pharmacy, optical, and (Community Pharmacy of pharmacists will create incentives laboratory services that cost $59 to Enhanced Services to explore, test, and implement new $99 per visit for an individual without clinical services models. We are entering health insurance, although many major Network) as a clinically a new labor market for pharmacists that insurance plans are accepted. CVS has will require changes in thinking and pivoted away from its MinuteClinic integrated network. services compared to what we have model to a newer, improved HealthHUB experienced in the past. Creating value individuals and families that poten- that provides more comprehensive for patients and payers will be the path tially will change how primary care is clinical services. to obtaining equitable reimbursement delivered. CVS Health believes it will be for new pharmacy services. New tech- successful with this model and use the Other patient engagement strategies nology will make patient engagement Aetna acquisition to drive members to that will continue to evolve are tele- a new focus for pharmacists, both at its new HealthHUBs. health and telemedicine. Easy access to chains and independents. Will you be care is valued by consumers. CVS has AN OPPORTUNITY leading the change or following? Best expanded its telehealth services to 32 FOR INDEPENDENTS wishes for a healthy and prosperous states and will continue to expand in 2020! CT rural areas where access to healthcare We see independent pharmacies as is not as readily available. Rite Aid has another incubator for pharmacy-based Tim Kosty, R.Ph., is president, and Don partnered with InTouch Health and clinical services. While there are numer- Dietz, R.Ph., is VP of Pharmacy Healthcare launched telehealth kiosks in several ous successful efforts throughout the Solutions Inc. The authors have more pharmacies. Their attempt to incorpo- country, we see value in the integra- than 68 years of experience, combined, in the pharmacy market. The authors can rate point-of-care testing will facilitate tion of clinical services in community be reached at [email protected] and patient engagement and clinical service pharmacies provided by CPESN (Com- [email protected]. opportunities for patients via collabo- munity Pharmacy Enhanced Services rative practice agreements. These retail Network) as a clinically integrated giants are creating an ease of care for network. CPESN is providing a network

november/december 2019 computertalk 29 catalyst corner

Patient Satisfaction Better with Marsha K. Millonig Pharmacist Discussion B.Pharm., M.B.A.

RESULTS RECENTLY RE- information. Several times a year I make accessible healthcare professional, and LEASED FROM THE annual J.D. a mental note to track the questions I am most of our counsel is provided to the Power 2019 U.S. Pharmacy Study showed asked during a pharmacy shift. The variety patient at no cost. The counseling provid- that patients enjoy visiting brick-and- might surprise those unfamiliar with the ed with a prescription is not separately mortar pharmacies and find a great deal day to day in the pharmacy environment. compensated by the patient. Yet in these of satisfaction from talking with their Last week during one short shift, on the times of decreasing reimbursements and pharmacist. More specifically, nearly 90% OTC (over the counter) front alone I was continued pressure on pharmacy margins of patients surveyed in the annual report asked about: from direct and indirect remuneration said they communicate with the pharma- • The best type and dosage form of (DIR) fees, lower-than-product-cost pay- cist and staff in person. vitamins for a 2-year-old patient, and ments and inability to service the patient’s what determined quality. entire medication needs due to some The U.S. Pharmacy Study measures cus- • What treatment parents could try for medications coming from specialty phar- tomer satisfaction with brick-and-mortar allergies for their first grader. macy, patients are still able to access and and mail-order pharmacies. The 2019 receive advice from pharmacists at nearly • The difference between several den- study is based on responses from 12,059 ture adhesives and dosage forms. every corner, for now. pharmacy customers who had a prescrip- tion filled during the three months prior to • What drug interactions existed for I wrote in the July/August ComputerTalk a dog being treated for a chronic the survey period of May–June 2019 (see issue about the correlation between phar- condition with more than one med- macy closures and decreased medication list below). ication. adherence. State pharmacy association • Which probiotic might work best for This does not surprise me, given my executives have talked about the calls they an adult patient being prescribed an are receiving from owners desperately experiences working as a pharmacist in antibiotic. a variety of settings in the past 25 years. trying to keep their doors open. And it is • Which brace would be best for a sore When I am practicing at the pharmacy, I not just independent pharmacies that are knee, and how to use it. try to help at the will-call window when being impacted: possible, because it allows that interaction • What available OTC antifungal could be used with a feeding tube. • Shopko shuttered more than 300 without the pharmacy technician asking stores earlier this year. the patient to step to the counseling • Walgreens announced it would be area and having me visit there. I can do A NO-COST SERVICE closing 200 locations. both at one time. Patients are hungry for Pharmacists are indeed the most • CVS announced 46 closures.

On a 1,000-point satisfaction scale, patients gave • Several Lunds & Byerlys pharmacies high ratings to their interactions with pharmacists: closed their doors. 940 points when four or more issues were discussed Pressure continues to mount, and the long-awaited rebate and DIR reform was 917 points when two issues were discussed rejected by two high-level Trump advisors. 884 points when one issue was discussed The pharmacy community continues to

30 november/december 2019 computertalk pursue the reform, and we will need to wait and see on relief. Access the references and additional resources Operations and staffing levels are being at wp.me/p9LtTd-2r4 managed extremely tightly in response to this pressure. It is an increasingly rare oc- J.D. Power 2019 U.S. Pharmacy Study. casion when I pick up a shift where things Articles on Shopko, Walgreens, CVS, Lunds & Byerlys are not behind or that the daily pressure to pharmacy closures. keep up is not great. In the meantime, flu DIR reform. season is upon us, and the goal to provide this important service is being emphasized United States Pharmacopeia (USP) announcements. in the pharmacy community; people have FDA Drug Supply Chain Security Act’s (DSCSA) return come to expect this important public requirements. health service from their pharmacist. This increased demand for services is being Compounding – Nonsterile Preparations Stakeholders who submitted appeals on accomplished with the same resources. In and <797> Pharmaceutical Compound- the compounding chapters have request- the long term, this balance is not sustain- ing – Sterile Preparations, as well as a new ed further review by an appointed panel. able. How long before patient satisfaction chapter, <825> Radiopharmaceuticals – decreases? Stay tuned on all fronts. I’ll keep you Preparation, Compounding, Dispensing, posted in the weeks and months ahead. There are some breaks coming. The FDA and Repackaging, has been postponed In the meantime, I encourage pharmacy has delayed enforcement of the Drug indefinitely until the appeals process has computer system vendors to continue to Supply Chain Security Act’s (DSCSA) return been completed. USP received appeals on think of innovations that can help further requirements on wholesalers to ensure certain provisions in <795>, <797>, and streamline workflow in the pharmacy and <825> from a broad range of individuals that all returned products have the bar- support their customers. CT coded product ID. I imagine this may also and organizations. My understanding is be pushed back for pharmacy/dispenser there is significant disagreement in the Marsha K. Millonig, B.Pharm., M.B.A., is compliance next year. pharmacy community about changes to president and CEO of Catalyst Enterprises, beyond-use dates on one of the mono- LLC, and an associate fellow at the Additionally, the United States Pharmaco- graphs, among other key issues. Now, University of Minnesota College of peia (USP) announced this week that the following its bylaws, USP will follow an Pharmacy Center for Leading Healthcare effective date for new revisions made on appeals process, which includes postpon- Change. The author can be reached at June 1, 2019, to <795> Pharmaceutical ing the official date of the monographs. [email protected].

Index of Advertisers American Society for Automation in Pharmacy ...... 24 PioneerRx ...... 3 BestRx Pharmacy Software ...... 5 QS/1 ...... 17 Datascan ...... 20 RxMedic ...... Inside Front Cover, 21 Integra ...... Inside Back Cover ScriptPro ...... 12 Liberty Software ...... Back Cover SoftWriters ...... 1 Micro Merchant Systems ...... 18 Speed Script ...... 19 PharmSaver ...... 22 Tabula Rasa HealthCare ...... 15

november/december 2019 computertalk 31 conference circuit

NCPA 2019 Annual Convention & Expo

SEE FULL GALLERY AT: wp.me/p9LtTd-2sZ

The National Community Pharmacists Association (NCPA) held its 2019 Annual Convention & Expo in San Diego, Calif. This year’s theme was “Changing The Pharmacy Payment Model,” which was represented across the conference educational and business program, as well as within the exhibit hall. View more photos of the event online.

Kirby Lester’s Geoff Dutcher, left, and Chris From left, Todd Evers, from Dauber At the Tabula Rasa HealthCare exhibit, Shine. Pharmacy, with QS/1’s Rich Muller and PrescribeWellness’s Briana Skalski, left, Brian Sullivan. and Kevin Boesen, right, with Stephanie Headrick from Duran Central Pharmacy.

Attendees checking in at the Integra Karen Slagle from Northside Pharmacy with exhibit. Micro Merchant Systems’ Brent Patton. Corey Edwards, left, from Health Data Wise with ScriptPro’s Nick Ruiz.

Attendees at the Synergy Medical exhibit.

Pharmacists check out Liberty Software’s Pharmsaver’s Phillip Idziak, left, and Mike exhibit. Sosnowik.

Phil Ho, left, BestRx Pharmacy from the AIDS Software’s Healthcare Stephen Barnes, Foundation left, and Vikas with R.J. Desai. Hedges & Associates’ Jeff Hedges. A group of attendees at a PioneerRx software demo.

32 november/december 2019 computertalk The !„w§ª0R0y²Xß0Xß0ß0 Potential Pharmacy Oversightssighsiightightht of )0y(ّÀ„ّ0y Blue àȌȲDz˜Ȍɩ²ȌǶɐɈǞȌȁ Realize Your Potential

EFFICIENT Process Automation

!„w§mXyÀ Pharmacy Logistics

XyÀ0mmXJ0yÀ Business Analytics

²0!Ǫ0 Information Sharing

The Integra Suite provides its clients with everything they need to realize their ةǐƵȁƵȲƊɈƵǿȌȲƵȯȲȌ˛ɈȺةƊǶǶȌɩǞȁǐɈǘƵǿɈȌƦƵǿȌȲƵƧȌǿȯƵɈǞɈǞɨƵوǏɐǶǶȯȌɈƵȁɈǞƊǶ and most importantly serve their patients better!

Contact us today and learn how Integra can help you attain your business objectives. www.integragroup.com / (866) 720-6846 / [email protected]

Integra is part of Smith Technologies, LLC, a november/decembersubsidiary of the J M Smith Corporation.2019 computer talk 33 99% CUSTOMER SATISFACTION

:LWKVL[IXOOWLPHRQVWD΍SKDUPDFLVWVZHJHWSKDUPDF\:H XQGHUVWDQG\RXUFKDOOHQJHVDQGDUHUHDG\WRKHOSZLWKRXWVWDQGLQJ WHFKQLFDODVVLVWDQFHDQGEHVWSUDFWLFHUHFRPPHQGDWLRQV

3KDUPDF\6RIWZDUHKHOSLQJFRPPXQLW\SKDUPDFLHVHQKDQFH SDWLHQWFDUHLQFUHDVHSDWLHQWVDIHW\DQGLPSURYHSURȴWDELOLW\

PHARMACY SOFTWARE FOR PHARMACY SUCCESS

View36 a demo now at www.libertysoftware.comnovember/december or call us at 2019 800-480-9603 computertalk &XVWRPHU6DWLVIDFWLRQUDWLQJIURP0DUFKFXVWRPHUVHUYLFHVXUYH\