Beyond the First Wave of Digital Pharmacy Innovation

Tony Willoughby, Pharm.D., CEO of Stellus Rx.

The good and the bad news about the digital future of pharmacy: Despite hundreds of millions of dollars invested in digital pharmacies in recent years, we’ve just started to scratch the surface for the impact that pharmacies and pharmacists can make on the health of our communities. The first wave of digital pharmacy companies has made the pharmacy experience more efficient, convenient and cost effective. But for millions of Americans, the pharmacy experience remains hyper-transactional. The medication journey remains filled with questions, confusion, fears and concerns, starting at the first time a patient receives a new medication and potentially continuing through every prescribed dose.

How many of us have friends or relatives who regularly take their medications incorrectly? They inadvertently combine doses or skip doses. They stop medication altogether because of a side effect or cost, but they don’t tell their physicians. They fill different prescriptions from different doctors at different pharmacies and a poor medication interaction occurs. Is it any wonder that medication nonadherence still costs our country upward of $300 billion dollars per year in unnecessary medical costs? And, worse yet, more than 125,000 deaths annually?

We have the opportunity to transform all of this — and more — by extending digital innovation in pharmacy beyond making the experience more efficient, convenient and cost effective.

We have the chance to use digital solutions to make the pharmacy experience more human and focused on building stronger relationships. .

Here are three ways the digital future of pharmacy can take shape:

The future of pharmacy must include trust

Year after year, Americans rate pharmacists among the most trusted professionals, comparable to medical doctors, military officers and grade-school teachers.

And yet — year after year — pharmacists continue to see their clinical and patient care responsibilities diminish and their production-related responsibilities increase. Tens of thousands of licensed clinicians find themselves so tied to filling and checking prescriptions that they’re unable to eat lunch regularly or even stop to use the restroom, much less spend time using the trust they’ve built with patients to help them with their health.

It's a vicious cycle of diminishing returns in healthcare: Pharmacists are pushed to reduce patient interactions and focus on volume-related, production-focused tasks. Consumers only see the value pharmacists and pharmacies tied to transactional speed, cost and convenience. As a result, “pharmacy transformation” gets conflated with operational efficiency gains, faster and depersonalized digital interactions, packaged and auto-shipped refills.

Meanwhile, medication regimens continue to increase in prevalence and complexity. More than two-thirds (69%) of U.S. adults, ages 40 to 79, used one or more prescription drugs in the past 30 days. Just under 1 in 4 (22.4%) used five or more. Pharmacists can be relied on as trusted experts to deliver help in navigating all those prescriptions, offering guidance on everything from ensuring that specific medications are working as expected for patients to removing administrative obstacles like prior authorizations to understanding how prescribed medications fit within the full context of a patient’s life and other social determinants of health.

The right technologies must enable this degree of personal interaction. Patient data, claims data, provider notes — all of that must be accessible and intelligently served up in ways that inform the pharmacist’s analyses and actions.

But more importantly, the right expectations must be set. A pharmacy company cannot expect its pharmacists to build impactful and enduring relationships with patients while basing every performance metric on volume and throughput. Digital investment must be channeled toward the automation of tasks that free up time for patient interaction and improve the richness of patient conversations.

The future of pharmacy must include risk

We hear often about the continuum of care. In reality, it is less of a continuum as it is a cross-continental train trip, with time-consuming transfers and stop after stop along the way. The typical pharmacy experience has been a notable culprit in this institutional frustration, often siloed off from physician-patient interactions and disjointed from care plan optimization.

Changing the experience requires pharmacy to be fully integrated into the care experience. The best way for that to occurs is by connecting pharmacy services to key pain points and value levers for physicians. Support of physicians who are in risk-based agreements — including Medicare Advantage, traditional Medicare and the assortment of value-based commercial contracts — presents an optimal entry point for this change. As these physicians are judged, in part, on patient adherence to prescribed medications, tighter integration of expert, trusted pharmacists into care plans can drive positive patient behaviors. These positive behaviors include a more complete understanding of their medication regiments, improved adherence to prescribed medications, and the urgency around keeping care providers informed about any changes in patient health.

At the same time, pharmacy services organizations can create aligned incentive structures with the physicians and other risk-bearing entities they serve by sharing in risk as part of their fee structures. This pivot from vendor to partner must be supported by digital innovation, in everything from algorithmic identification of patients who need pharmacist intervention, to the creation of flexible and secure, two-way data exchange among diverse provider populations and the near-real-time reporting of impact created on mutual performance measures.

The future of pharmacy must include authentic patient engagement

Of course, none of this matters if patients don’t lean in and become informed owners of their health. By digitally augmenting the expertise of pharmacists and resetting expectations of what patients should turn to their personal pharmacists for help with, we can support patients in every moment that matters. That occurs when pharmacists are empowered through their business environment and with the right digital solutions and data to lean in as well.

What we see is that patients not only benefit physically and financially from the identification and elimination of concerns and gaps in their care plans, but by being engaged in their own healthcare, they find peace of mind and develop trust with their care providers. This type of transformative, lasting change demands patient engagement. When patients feel informed and secure in their care plans, example after example shows that they want to ask questions, take their medications properly, take the necessary follow-up steps.

Digital solutions can — and must — facilitate all this, but personal, human relationships that focus on making sure patients feel known at every step of the health journey are most essential in driving the results that the entire industry seeks.

Tony Willoughby, Pharm.D., is the CEO of Stellus Rx.