Expert Interview: Mike Young of Parata Systems on Pharmacy Automation

Mike Young, vice president of pharmacy strategy at Parata Systems, sat down with Drug Topics® to discuss how pharmacy automation can be used to address old burdens and new challenges brought to light during the pandemic.

Drug Topics®: As high-volume retail and health system pharmacies continue to contend with long standing burdens and new challenges imposed by the pandemic, automation services are becoming increasingly relevant.

Mike Young, the new vice president of pharmacy strategy at Parata Systems, has 3 decades of experience in many pharmacy settings. In this interview, he defines his goals with his new role at Parata and discusses how innovation through automation can address medication adherence for struggling patients.

To start off, Mike, I'd love for you to introduce yourself and your new role with Parata Systems.

Young: My name is Mike Young, and I joined the Parata team about 2 weeks ago. My title is vice president of pharmacy strategy.

I've been a pharmacist for 36 years. I've worked in a variety of settings throughout my career, most notably on the retail side of pharmacy, so worked for chain drugstores and mass merchandise companies. Then about 12 years ago, I started to work in health systems retail pharmacy. So, I've worked for 3 health systems, the Detroit Medical Center Banner Health in Phoenix, Arizona, and most recently, Ascension, one of the largest health systems in the US.

Drug Topics®: So, pharmacy, I'm sure you're well aware, has undergone a lot of transformations in these last few months. I'd love to get your outlook on the pharmacist’s role in as a health care professional as it is now and going forward, how you envision that role transforming even more.

Young: What has been really good to see over the last 5 to 10 years in pharmacy is the elevation of the pharmacist as a larger part of the total health care team. You started to see that as immunizations in retail pharmacies and health systems started to really progress. That was one of the first clinical type things offered in a retail setting.

Then, as time has progressed, pharmacists have gotten more involved in total patient management, helping physicians to align the medication therapy for a patient. And they do that in various ways. Some of it is through collaborative practice arrangements, some of it is through adherence monitoring and improving medication adherence through medication synchronization and unique packaging solutions, things like that. It's been really interesting to see that evolve over time.

Another interesting thing that's happened, and mostly because of COVID-19, is to see the rise of pharmacy technicians. Many states now, because of the necessity of it, we're needing to have additional people get involved in vaccinating. And they've allowed, in certain states, pharmacy technicians to take on that responsibility. And that is so encouraging to see because with COVID-19, influenza, and everything else that pharmacists are doing now, in some chain stores, they're actually doing some of the testing for COVID-19. When they have to get a test because they were exposed. You're really creating a lot of additional burdens on pharmacy teams to not only fill all the prescriptions that they have to fill, but to take on one more thing that is vying for their time.

To see where pharmacy is going, it’s encouraging to see these roles expand. Because I think that what that's telling folks is pharmacists can continue to have a much more involved impact as part of the health care team. And creating a way for pharmacists to do that by improving efficiencies in the operation, expanding the roles of pharmacy technicians to take some of that burden away from pharmacists, I think that's all extremely encouraging, because pharmacists should be out front and center with patients, helping them to better manage their medications and offer a total review of everything that's associated with that patient. So, I'm very encouraged by what happened during the pandemic, to be honest with you, because I think it really spotlighted the role of pharmacists play as one of the most accessible health care team members in the US.

Drug Topics®: Absolutely. And despite this evolution of the role of pharmacies, as you mentioned, there's still a lot of burdens that the industry still has to deal with. Can you touch on some of those challenges that pharmacies are still contending with that are getting in the way of reaching their full potential?

Young: Yeah, a lot of things. The pandemic, for various reasons, has caused a pretty substantial labor shortage.

You see help wanted signs everywhere and pharmacies are not immune to that. So, there are some employers that are offering pretty good incentives for pharmacy technicians in particular to come work there, that you don't even really need to have skills to go work with some of these employers. And they tend to pay really decent wages for people. That's very enticing for pharmacy technicians, for restaurant workers, for people that work in bars, very enticing because it's a large percentage increase. So that's having an impact.

The employer that I just left, Ascension, we were wanting to ramp up our staffing for some planned volume expansion. And it was very difficult to find pharmacy technicians to even have them respond to ads and postings and things like that. So, yes, I think that's probably, if it isn't the number 1 issue that most pharmacists and pharmacy organizations are talking about, I think it's probably at least number 1 or number 2, for sure, because it's impacting everybody.

Right up there continue to be indirect and direct remuneration (DIR) fees that have an impact on pharmacists. The resolution and minimization of risk for DIR fees really is in that same clinical area that pharmacists need to be expanding into, because one of the important things to minimize your risk of DIR fees is to improve adherence.

Well, that takes a lot of time and effort on the pharmacist’s part in particular, to be able to have those discussions with patients. Pharmacists need to be freed up from some of the other things that they do, to be able to help with that. But then there's just all these pressures with low reimbursements, these retroactive DIR fees that are impacting everything. The organizations that can help and provide a solution to some of that I think are going to be positioned quite well.

And Parata is one of those companies that that does that. We offer solutions to improve efficiencies, adherence packaging solutions, all the tools that a pharmacist would need to expand their clinical performance, as well as to make them more efficient on the dispensing side of the operation. So, a lot of good things can come from those types of solutions.

Drug Topics®: Absolutely, freeing up time and increasing efficiency has definitely been top of mind for pharmacies lately. So, how can implementing centralized services address some of these challenges in the health system setting?

Young: Particularly in health systems, one of the things that is beneficial for the health system is to really grow and expand filling discharge prescriptions. There's a direct impact to helping patients, it leads to a higher level of patient satisfaction, because I know that I can have my prescription when I leave, and I don't have to go somewhere else to get that.

When you get discharged, it's not like you're all better. Usually, you're still aren't feeling all that great. So, to be able to have that prescription, go home, rest, and let my body heal are important things and, and that's why discharge programs are so important.

The second thing it would allow a health system to do is to expand whatever their prescriptions that they're filling from their medical providers. If they own a provider group or clinics, being able to take non urgent volume out of their retail pharmacies and centralize that would allow capacity for additional, more urgent volume that might come out of their discharge process, same day surgery centers that are maybe on their campus, prescriptions from their medical group that could be first time prescriptions for someone, so all those things are important.

And it will give the health system the capacity to be able to do that, and to take those less urgent prescriptions and put them in a centralized system, that would really lower the cost of fill for those prescriptions. When you can fill 70 to 90% of your volume in an automated way, it will definitely lower the cost of those. And that's why so many health systems today are very interested in these types of centralized solutions.

The other thing it does is that helps out with the labor issue that I already mentioned. Maybe 2 or 3 years ago, before the pandemic and before these labor issues arose, I might not have made the decision to pursue some sort of automated service or centralization, because I didn't think I needed it.

But now, because of the labor issue that's impacting everyone, that is causing a lot of people to think differently about implementing some sort of automation or centralization into their operations help with that.

The adherence solutions that we have at Parata, one in particular I think is very meaningful is our pouch packaging solution, where all of the doses for a particular time are grouped together in a single pouch. And they're put into a roll and then shipped in a box, so as you pull out the next dose and open it up, you will see, that might be your 8 AM dose, the next one that comes out might be your noon dose. And it's only the things you need at that time of the day.

What it helps a patient do is to know completely that I've taken my medications when I was supposed to, there's no guesswork in it. I often relay the story of my father-in-law, who was on 11 different medications and really struggled. It would take him hours to put them into this big, large pill monitor that he had. And he would struggle to remember, “Did I take that dose this morning?” And often he didn't.

The older you get and the more medications you're on, it becomes pretty challenging to be able to manage those on your own. So, these solutions help with that. It doesn't completely solve adherence problems, but it is one piece that you can have in your arsenal of things to help patients with improving their medication adherence.

Of course, there's counseling, there are oftentimes financial barriers for patients when you're on that many medications, there are a lot of expenses that come associated with that. So, really having in depth conversations with patients about some of the barriers to medication adherence is really important and helping solve that.

From a health system perspective, the good thing with all that is as we strive to improve medication adherence, and they're our own providers in a health system, then we can help to improve their star ratings, which in turn improves their reimbursement on CMS plans that they participate in.

For a health system that has everything contained in it like that, it's truly very meaningful to be able to improve adherence. And this is, again, one of those things that can help with that. There's a lot of other things that go into that, discussions and removing barriers, like I mentioned, but that's a big component of it.

Drug Topics®: That's awesome. Those solutions sound very valuable to patients, especially those that you described. So, with all of these changes, these transformations going on pharmacy right now, a lot of pharmacists are saying, “Well, I don't have time to implement a whole automation program.” What would you say to a pharmacist who hasn't considered innovation through automation services at their pharmacy yet?

Young: Well, if they're a high volume retail location, or high volume health system, retail or outpatient pharmacy, I think you're really missing the boat if you haven't considered that right now.

With all of the things that are happening with labor issues and continued pressure on bottom line because of DIR fees and lowered reimbursements, you really need to be thinking about these solutions.

Particularly at Parata, we don't offer a cookie cutter approach, we really listen to the drivers behind what's happening in a particular organization and seek to craft a solution that's tailored to what that health system or that retailer needs to have.

As we free up pharmacist time to do some of these other important clinical initiatives, their reimbursement levels can improve, their efficiency improves, and they don't have to be worried about not having the right number of pharmacy technicians in the pharmacy. These automation devices can rapidly fill prescriptions that will take some of that pressure off of the pharmacy team so that they can continue to expand their service offerings.