Improve Immunization Efficiencies With Automation

As the United States surpasses 26 million COVID-19 infections, immunization against the disease is critical. President Biden has pledged to increase the vaccine supply so that 100 million doses can be distributed during his first 100 days in office, and that means that community pharmacies should prepare to do their share.

But pharmacists still need to oer other immunizations as well, so the addition of these expected COVID-19 vaccinations will only add to the pharmacy’s workload. That’s why pharmacists need to think about how to improve workflow eciencies and create a stronger system management. Technology is often the answer.

Technology allows for faster counting and better record keeping, and for those pharmacies that can invest in automation, the impact can be exponential in improving eciencies, both in vial dispensing and in medication adherence packaging.

Peter Saad, PharmD, MBA, director of product strategy at pharmacy automation company Parata Systems, noted that the COVID-19 vaccine efforts will be new waters for retail pharmacy, as much of the process will be dierent, including, but not limited to, billing and tracking.

“Technology and automation will be key in streamlining processes for these pharmacies by freeing up time for pharmacists and technicians to focus on the clinical initiative of vaccine efforts and understanding the new waters,” Saad said.

More than ever, pharmacists are seen as frontline medical providers for the vaccine, and as such, they need to be front of house counseling patients. That’s why we are seeing retail pharmacies invest in technology, whether new to automation, or scaling their existing automation.

“Tactically, there are a variety of ways pharmacists can rely on technology for workflow and system management,” Saad said.

These include syncing patient medication regimens to monthly cycles to limit time to dispense/sell in the pharmacy, allowing more time for vaccine discussion and distribution; using Health Insurance Portability and Accountability Act compliant online form submission and preemptively inputting patients before arrival to streamline the vaccination process; and automating the filling process or hiring an additional pharmacy technician, as at least 1 technician will likely be occupied with receiving and inputting patient and vaccine information.

“If possible, have all refills filled via central fill, which allows for the ability to fill prescriptions quickly without using new resources, as this supports the bottom line and returns pharmacists and techs to activities that support patient care,” Saad said.

Innovative Strategies

Jason Turner, PharmD, owner of Moundsville Pharmacy in Moundsville, West Virginia, said a great way to create a strong foundation of efficiencies in a pharmacy is to initiate a medication synchronization program.

“Medication synchronization changes your workflow from being ‘on demand’ workflow, meaning when the patient calls in the prescription, you begin to work on it in a way where your pharmacy team is in control of when you process a large percentage of your prescription volume,” he said.

For example, there are 1800 patients enrolled in Moundsville Pharmacy’s SyncRx program—73% of monthly prescription volume.

“We are able to schedule the work with a strategy to be most efficient in our prescription processing and most available to our patients for clinical services, such as immunization,” Turner said.

Jason Ausili, PharmD, chief clinical officer for FDS, a provider of pharmacy technology solutions for independent pharmacists, noted that tech can help drive immunization efficiencies in numerous ways.

“It can be used for billing the medical benefit for vaccine and/or administration fees in a way that is streamlined with workflow, provide automated reporting to state registries for reportable vaccine events, and allow a pharmacist to query state registries for vaccine eligibility at the patient level,” Ausili said. “Tech makes clinical documentation easy and efficient and makes the patient scheduling process a more automated and organized experience.”

At Moundsville Pharmacy, there are 2 Kirby Lester units, a ScriptPro SP 200, and a Parata PASS 300VP to increase efficiencies in the sta, workflow, and programs.

Turner recommends using dierent colored paper for each immunization record, which allows the staff to access and recognize vaccines in the workflow quickly, from billing to vaccinating, documenting, and record storage.

“For larger pharmacy teams, I would create a workflow for your immunization prescriptions,” he said. “This way, if a patient comes in and requests a vaccine, everyone knows how that clipboard is to flow to maximize your eciency and not disrupt existing workflow.”

Because vaccine billing can be challenging, Turner suggests directing vaccine billing to 1 or 2 vaccine specialists to make sure they are processed timely and identify quickly if you are unable to bill a payer through your pharmacy management system.

Overcoming Challenges

Maximizing the features of pharmacy software is no longer an option, as many pharmacies continue to use their software the way they did 5 or even 10 years ago, either not detecting the upgrades in their pharmacy management systems or not knowing how to incorporate them into their workflow.

Too often pharmacies invest in automation, counting technology, or a fancy new bell or whistle for their pharmacy management system, only to find that it doesn’t change the outcome.

“Over the years, in working with and training pharmacy owners in medication synchronization, it has become clear that the physical workflow of the pharmacy—how the prescription moves about the pharmacy—and the processes that support pharmacy workflow really dictate the eciency of a pharmacy,” Turner said.

The expense of automation technology and lack of cash flow for retail pharmacies are no question the largest barriers for adoption. But Saad said the best way to increase efficiencies with existing staff is by incorporating automation.

“Not only will it allow pharmacists to move to the front of the pharmacy and practice at the top of their license, but it will allow for value-adding activities for patients, all the while technology is handling routine prescription fills quietly in the back of the pharmacy,” he said. “When pharmacies start to hit 200 scripts a day, there will already be ROI from the technology, helping to fix that cash flow problem and making the cost worth it almost instantaneously.”

Distributing the COVID-19 Vaccine
In 2021, there will be a lot of buzz around the approved COVID-19 vaccines and their availability, and although these vaccines have given pharmacists opportunities, they also have added pressure.

“The most important first step is to train your staff in how to respond to calls and inquiries about the vaccine,” Turner said. “This will help to keep inquiries consistent, concise, and informative for the patient. Utilize your automated attendant to record a manager’s message at the beginning of every received call and your on-hold system to provide additional information.”

The pharmacy management system will be able to record and bill immunizations. However, understanding what insurance you can and cannot bill will be important, keeping in mind that, even if you cannot bill the insurance, you cannot deny the patient the vaccine.

Additionally, when the vaccine supply increases, retail pharmacies will be busier than ever, which means long lines made even longer with social distancing efforts.

Saad said that although billing will be unified, normal business activities, in combination with vaccine efforts, will be hard to manage without relying on assistance, including technology and automation.

“After the pandemic passes, retail pharmacies need to accept what they have known for a decade: Fee for service is no longer viable,” he said. “If they don’t pivot their pharmacist role to one that is more collaborative and clinical in nature, they will be out of business in the next decade. Free up pharmacist time using automation, work to identify clinical services, and start providing."