Innovation is everywhere, but cumbersome pharmacy technology remains an issue.
One day, my wife Denise and I went to our local bank with a plastic card and put it in the machine. We had the option of withdrawing either $25 or $50 out of our checking account. The money dropped down in an envelope with the cash inside. This was amazing technology for 1981. I then went to work and pulled out the Smith Corona typewriter and started typing prescription labels.
Yesterday, I went to our warehouse club and pulled up to the gas pumps. I took out my phone and waved it at the QR code on the screen. I began pumping my gas without ever getting my wallet out of my pocket. I checked my email and saw I had spent $28.54 on pump #4 at 7:46 am. I went to the pharmacy, fired up the computer, and began my working day.
A new patient needed a shingles vaccine. She handed me her 2 prescription cards. We had to enter all the insurance data by hand, making sure we typed in the right bank identification, processor control, ID, and group numbers. After we submitted the claim, it was denied and we needed to use the Medicare Part D card. Next, we entered the alphanumeric information carefully to make sure all the letters and digits were correct. I got out my cheat sheet to make sure I added 4 additional fields, including administration fee, because this was for a vaccine. Then we went to another website to print out her prescreening form, and logged in the site of administration, lot number, and expiration date of the vaccine.
Two outstanding pharmacists who are working to make massive changes in our profession are Stephanie McGrath, PharmD, and my daughter Gretchen Garofoli, PharmD, BCACP. Both are working tirelessly to have pharmacists get paid for their clinical expertise through CPESN-USA. Their focus is on e-care plans, which enable pharmacists to show what interventions they have made that will produce optimal outcomes for our patients.
The biggest challenge with e-care plans is that the technology is clunky at best. Like anything else in health care, it takes more time to document your actions than to carry them out. I’m familiar with 3 of the major e-care plans and I’m not impressed with any of them. The one I use to bill for services to a provider requires 5 different systematized nomenclature of medicine clinical terms (SNOMED CT) codes to be documented. Whether you are documenting hypertension, chronic obstructive pulmonary disease, or asthma, you should not have to search through layers and layers for the appropriate 5 SNOMED codes.
The very best pharmacy software I was ever exposed to was in the late 1990s. It was built by a couple of pharmacists. To this day, I have yet to see a pharmacy filing system that was more pharmacist friendly than that one. I would love to see more pharmacists on the ground floor of software development. If only our pharmacy software could be as intuitive as the iPhones we all carry with us. When’s the last time you read the user manual for your smartphone?
When I stand in front of my pharmacy computer for 10 hours at a time, I often wonder why this technology seems so far behind the other technology I use daily. If we want to move this profession toward more patient-centric care, we must have the tools to do that. All I ask is that my pharmacy computer have the same technology as my gas pump.