Pharmacy Technology: Disruption or Improvement?

The disruption that new technology gives the pharmacy industry also gives pharmacists more responsibility.

Although many pharmacies and prescribers have mastered electronic prescribing and share important patient information via electronic health records (EHRs), there is room for more digital disruption in pharmacy. According to the ONC, physician use of e-Rx using an EHR jumped from 7% in December 2008 to 70% in April 2014.

Integration of real-time information exchange between prescribers and pharmacists, EHRs, and digital tools have given rise to innovations in medication adherence and management, patient reminders to take medications, automatic refills, and electronic prior authorization.

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Disruption in pharmacy-using technology to improve outdated operations and enable advancements in capabilities-doesn’t mean reinventing the wheel; instead, technology and new tools promote convenience, affordability, efficiency, and patient-centered solutions.   

Not Disruptive?

“I don’t consider what is taking place as ‘digital disruption’ because we aren’t changing business models; we are enhancing them,” said Tom Skelton, CEO of Surescripts. “What is occurring today is the result of forward-thinking pharmacies that saw value in digitizing the prescribing process back in 2001. The spread of digitization to other inefficient manual processes is a natural progression of technology being used to refine and strengthen existing models, reduce costs, and increase patient safety and adherence.”  

Surescripts recently released tools to support prescription price transparency, the presentation of therapeutic alternatives, and an integrated prior authorization process. 

“These tools enable better prescription decisions by delivering timely, patient-specific information at the point of care, increasing fill rates and decreasing the time pharmacists spend on administrative processes related to pricing and coverage,” Skelton said. “Then they can spend more time counseling patients on their medication regimen.” 

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With an eye toward tackling the high cost of medications, FamilyWize uses a proprietary product, emRxcel, to integrate its prescription drug savings program with EHRs to help patients save on prescription drug costs. Patient adherence to their drug regimens is electronically monitored and communicated back to physicians.

A pilot program integrated emRxcel into the workflow of 338 ambulatory physician practices associated with Trinity Health. After 4 months of the pilot, 4,865 patients saved a total of $194,106 on prescription drug purchases.

Skelton say that digital tools in pharmacy offer a number of advantages to stakeholders such as improving care, increasing patient safety, driving greater medication adherence, and enhancing efficiency.

One of the primary advantages, Skelton said, is helping patients adhere to their medications despite high prices. “Technology exists today to solve this problem. Prescription price transparency is critical to lowering patients’ out-of-pocket costs and preventing ‘sticker shock’ at the pharmacy, while avoiding the hundreds of billions of dollars that medication non-adherence costs the system each year.”

Skelton anticipates that digital solutions will achieve a return on investment by improving prescription processing efficiencies between pharmacists and prescribers and by avoiding costs associated with patients who fail to pick-up prescriptions.

Granting Pharmacists More Responsibility

If not all technology or business model change is disruptive, then what is? “If you want disruption in pharmacy, then you need team-based care; outcomes-based reimbursement; and electronic sharing of data, such as adverse drug events, via an EHR,” said Tom Bizzaro, Vice President for Health Policy and Industry Relations at First Databank.

“Primary care is finally realizing the value of integration with pharmacy,” he said. Pharmacists adopted e-prescribing much more quickly than prescribers, he noted, but now the two groups work more closely together and acknowledge the advantages of the technology. 

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Providers’ perception of relying on pharmacists has improved because of pharmacists’ greater accessibility to the public and their ability to enhance adherence through medication therapy management, Bizzaro said. “Technology and automation have enabled pharmacists to come out from behind the counter and assume a larger role. Five years from now, pharmacists should not be counting out pills or labeling bottles; technology can do it.”

They should instead spend time reinforcing positive outcomes and counseling patients, Bizzaro said. “But if they are going to accept these responsibilities, pharmacists need the opportunity and means.”