Raising the Service Level in Long-Term Care Pharmacy

By Will Lockwood. Originally published at computertalk.com.

Don’t miss this great article published in ComputerTalk. Hear from your peers in the industry as they describe the ways they’ve found to be successful and serve their customers best. Topics cover software, patient care, document management (DocuTrack features prominently in one section), packaging, interfaces, communication, eMARS, and more. While the article is a bit long, it is definitely worth taking the time to read. Here’s an excerpt below:

Long-term care (LTC) pharmacies have been, by the very nature of the services they provide, on the leading edge of some important trends in pharmacy. For example, they’ve long been syncing prescriptions in order to provide cycle fills, and they’re the original adherence packagers. Then there are the platforms they’ve built out to create a connected care provider team, including web portals for LTC communities and interfaces between pharmacy systems and digital records platforms such as electronic medication administration records (eMARs). With this history of technology and practice innovations in mind, we checked in with four closed-door long-term care pharmacies to find out how they are continuing to raise the bar in the profession.

Committing to a Service Level

Managing the complex demands of dispensing workflow and patient care effectively is critical at any pharmacy, but the long-term care environment comes with very specific demands that mean these pharmacies really have to be on their game, particularly when there’s a clear growth path at hand. For example, about seven years ago Labi Avdiu and several colleagues saw an opportunity to take on a larger LTC business. So they created Medication Management Partners, which has since grown tremendously — from about a thousand residents its first year, to around 4,300 now. It is now licensed in seven states, soon to be eight. But to get where they are, Avdiu says, he and his partners had to come to terms with committing to the software they’d need to serve these new communities. The pharmacy ultimately selected FrameworkLTC from SoftWriters. “It became very apparent to us that the software we were using in our retail environment could not take on the growth that we wanted,” says Avdiu. “We could see that there’s a great deal of complexity that you have to manage in the LTC world, and the software platform you use needs to be built for this.”

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A high-performance LTC pharmacy also has to have the ability to layer customizations within its pharmacy management software, both LTC community by community and within a community itself. “An LTC community may have, for example, a memory care wing that wants things a certain way,” says Avdiu, “but also regular assisted living and independent living residents for which it wants things a different way.” Or, he reports, an LTC community may choose multidose for noncontrolled meds, but want all controlled substances or just schedule IIs in bingo cards. It may want specific hours of administration on meds for its assisted living side, but not for its memory care wing; or it may want certain classes of meds or all prescriptions for memory care residents packaged on a shorter cycle, since changes are more frequent.

Becoming a Partner

The right software can also drive innovative models, such as the one in use at GoldStar Pharmacy. “The central part of our approach to long-term care pharmacy is to be the patient’s medication management partner,” says A.J. Oben. “Our goal is first and foremost to help our patients stay at home, which is really the natural progression of where the industry is going. GoldStar’s focus is to do more than just fulfill medication orders. We are partners with healthcare providers and the patient.”

To this end, Oben says, the pharmacy assigns a health coach to each patient: “We’ve got a workflow in our pharmacy system from SuiteRx that tells each health coach which patients, for those who are living at home, or which LTC communities he or she needs to be calling that day.” As Oben explains it, six days before a scheduled delivery the SuiteRx system prompts the GoldStar Pharmacy health coach to review everything for that patient or LTC community, and make a phone call to ensure that the pharmacy is capturing any changes or events, such as hospitalizations, that might have happened along the way. And once a month, reports Oben, a clinical pharmacist reviews the entire file for a patient and makes recommendations to the physician. “This way, we know we have an accurate list of medications when we produce that patient’s multidose pack, which we’ve branded as the GoldStarPak,” he says.

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Keeping Your Head Above Water

Branshaw also offers examples of what you need from your LTC software in order to keep up with the demands of the market. He notes that having good visibility into your workflow is critical for avoiding bottlenecks that impede your service level. He points to the dashboard in Harbor Pharmacy’s QS/1 PrimeCare system that color-codes the different process queues — red, yellow, green — and shows how many tasks are currently at such steps as refills, voicemails, error resolution, QA, web portal messaging, and DUR alerts. This is a prime avenue for ensuring that there aren’t any unpleasant surprises and that the pharmacy has its staff and resources deployed correctly.

At Midwest LTC Pharmacy, Cindy Lobeda points to a need for document management software to handle the constant flow of orders and information coming in from and going out to prescribers and LTC communities. “In years past, all this information came in as paper faxes,” says Lobeda. “We used to have to take faxes off our fax machine constantly. And then we’d have to shuffle and reshuffle all that paper to move it through the process and prioritize what needed to be done next.” That’s not a tenable way to really build an LTC business, and Lobeda reports building a software platform centered on SoftWriters’ FrameworkLTC and Integra’s as the pharmacy’s foundation. “Document management is probably my favorite thing that DocuTrack we have implemented here,” says Lobeda. “It automates and prioritizes our inbound and outbound communications. We can automatically link all the paperwork to a prescription, and make it available in all the right work queues.” Lobeda’s staff has access to information at the click on a button, whether it’s to answer a question from an LTC community or in the event of an audit. “We can answer a question in seconds,” she says, “and preparing for an audit takes a few hours, compared to a few weeks.”

Read the full article here.