The ubiquitous telephone has become an omni-purpose service tool. Going by the therapeutic-sounding sobriquet IVR (for interactive voice response), the technology includes voice mail, automated reminders to refill Viagra scripts—seemingly anything but back rubs.
"When we started in this business in 1995, IVR was sold mostly to mid- to large-sized chains," said Debbie Sheppard, VP of Ateb Inc. in Raleigh, N.C., an IVR industry leader. "Now it's sold across the board to small, independent drugstores as well as chains, and even mail-order companies."
Products generally have a core foundation of hardware and communication software, enhanced by the more expensive modular add-ons. A simple unit, capable of recording and reporting refill requests to pharmacy software, costs $5,000, or even less. Of course, the more add-ons, the greater the cost, which can range as high as $20,000, or even higher. And some features—such as the increasingly popular automatic refill reminders to patients—have per-call fees. Ateb and other companies say their IVR products provide a positive return on investment in as little as six months.
Cost notwithstanding, IVR's wide-ranging available services are increasingly popular, said industry officials. "Our products sold as add-ons are in as much demand as our cornerstone IVR product," said Tim Garofalo, president of Voice-Tech Inc. in Venice, Fla., another leading IVR company. "We try to be as flexible as possible so pharmacists can purchase just what they perceive to be their greatest need. Customers can design their own products, based on how much they want to spend."
For example, Voice-Tech's line begins with its Refill IVR product, which allows callers to submit prescription refill orders that post directly to the work queue, without direct staff involvement, thus "allowing pharmacies to be open for business 24/7" and increasing work efficiency, said Garofalo.
IVR systems are not cure-alls, nor are they fool-proof. "The most important attribute for the use of technology in pharmacies involves the level of integration available between technologies. Nonintegrated systems can produce inefficiencies and errors," said Bill Felkey, M.S., a professor of pharmacy care at Auburn University in Auburn, Ala.
Most pharmacists do use their IVRs to receive new prescriptions and refill requests. If, however, on simple systems staff forgets to check the devices, said Felkey, the prescriptions may not be processed by the time patients arrive.
"Using an IVR system can in fact decrease a pharmacy's efficiency," added Felkey. "An IVR that only records voice messages or prints slips of paper will need to be processed manually by technicians. And manual processing can open up additional opportunities for errors.
"The best IVR system is fully integrated with the pharmacy's management system software," he continued. "An integrated IVR system allows patients to enter a prescription number by a touch-tone telephone or voice recording, which is then queued into the pharmacy management system for further action, with no additional manual steps necessary."
One pharmacist said that another problem with IVR is the same problem with much of technology: garbage in, garbage out: "My biggest pet peeve in retail pharmacy is the IVR system where doctors' agents leave prescriptions on the answering machine," Richard Phillips, R.Ph., of Miramar, Fla., recently told Drug Topics. "Time has to be spent tracking down these agents to clarify prescriptions left on the IVR. Anyone who has the important job of calling in a patient's prescription should have to pass a qualifying exam. These calls should not be left to untrained personnel."
Integration and human interface problems notwithstanding, IVR products are generally perceived by pharmacists as valuable customer service tools.
The University of Michigan Hospital's three outpatient pharmacies use Ateb's product pharmacy line. "With more than 700 prescriptions a day, 40% of which are refills, our patients depend on phoning in their refill requests," said Alice Schuman, business manager in the department of pharmacy services at the University of Michigan Health System (UMHS). "Integrating IVR into our existing dispensing system allows us to improve convenience, and it saves valuable staff time."