From clinical judgement to patient outreach and counselling, pharmacists have a rich variety of valuable skills. Too often, though, their days are spent chasing paperwork, re-entering data across different systems and manually checking prescripts for interactions that software should be flagging.
It’s a struggle that Kristina Fox, a community pharmacist from Hobart, knows all too well.
‘My team was staying back an hour and a half every day, putting stock away, trying to follow up on the jobs for the day,’ she told PSA26 delegates at Sydney’s International Convention and Exhibition Centre earlier this month.
‘We were working really hard, but we were just not getting what we wanted to get done out of our day.’
Ms Fox, the managing director of Complete Care Pharmacy group, turned to digital innovation to manage the growing amount of her team’s work, looking to emerging technologies and integrated systems such as automated dispensing and integrated patient platforms to improve efficiency, accuracy, and community health.
‘The biggest opportunity isn’t about doing more,’ Ms Fox said. ‘It’s actually doing less of the wrong work and focusing more on patient care.’
Automation and integration
Community pharmacy, Ms Fox observed, had outpaced the systems built to support it. Electronic dispensing, an expanding range of prescription types, and broader service provision were now routine parts of her pharmacy’s day, yet simple, repetitive tasks, such taking prescriptions and dispensing medicines – were eating up large portions of the team’s time.
‘If you think about the current way that we dispense prescriptions, we’ve got all of those baskets lined up in our dispensary,’ she said. ‘Everybody grabs the next basket that’s available – and it may be a pharmacist that grabs the basket; it may be a dispensary technician – but you just grab the next one that’s in line.’
This approach, however, introduces clear inefficiencies. A pharmacist might take a basket and start processing a prescription even though their time could be better spent vaccinating a waiting patient while the dispensary technician manages the prescription.
Alternatively, if the basket contains new medication for that patient waiting for a vaccination, the pharmacist could avoid duplication and double handling by taking it into a consultation room and dispensing it to the patient, while administering the vaccination at the same time.
The answer lay in automation. Complete Care uses a digital workflow platform, Excipient, which allowed her pharmacy to embrace live queue management, digital prescription processing, automated dispensing integration and patient self-service capabilities.
For instance, digital workflow has changed how Ms Fox’s pharmacy dispenses medicines.
She has separated her dispensary from her clinic space, allowing dispensing technicians to work uninterrupted on each basket as it is prioritised. The digital workflow platform provides them with a virtual basket queue that is updated dynamically, creating a role-based workflow.
‘They see the digital notes that are attached to the basket, and they make sure that only the work that’s due for them gets sent.’
Using the extra time
For Ms Fox, creating these efficiencies freed up an enormous amount of time for her staff. Automating the process from taking a prescription to dispensing it saved an average of 10–15 minutes in each instance for her three full-time equivalent pharmacists, amounting to an extra 16 hours of pharmacist time each day.
And with this freed-up time, the pharmacists can turn to specialised tasks that draw on their talent: clinical review or counselling, for instance, or collaborative and virtual care.
Ms Fox advises three steps to ensure pharmacists can make best use of their expanded time:
- Where possible, pharmacists need a dedicated consultation space separate from the dispensary to ensure they don’t get drawn back into dispensing work.
- The pharmacist needs a service to take responsibility for: a part of the full scope of clinical offerings such as vaccination or compounding.
- A pathway to get the patient into that service.
‘You need to advertise the service, and you can use these clinical tools to prompt the patient when they come in and direct them to that service,’ Ms Fox said.
At her pharmacy, these processes have allowed a patient who comes in to experience an integrated system that might begin with a flu vaccine. A pharmacist, freed from dispensing, has the time to check the patient in and walk them into a private room for a guided consultation – helping them understand how medicines and medical conditions might be affecting them, as well as providing recommended treatments and lifestyle advice.
The resulting personalised care plan can then be printed so the patient can take it home, with the digital workflow platform arranging to follow up with the patient via a phone call or an automated text message.
‘I cannot tell you how much our patients have absolutely loved this, because they get that piece of paper – something that’s tangible to take away with them,’ Ms Fox said.
‘Most patients don’t take in more than one or two bits of information when you’re talking to them, so [this] integration has been absolutely incredible for our business and for the patients.’
Taking the next step
For any pharmacist seeking to implement integrated processes into their practice, Ms Fox recommends first taking account of the tasks that need to be done and selecting those done on repeat.
‘It might be scripts in, it might be dispensing, it might be scripts out,’ she said. ‘Find that one repeatable task that you’re doing all the time, and I want you to actually genuinely measure it,’ she said.
‘You will be super surprised at how long it takes us to do what should be a very simple task in pharmacy.’
From there, the pharmacy can determine whether the right person is currently responsible for that task and whether their time is better spent elsewhere.
However, adopting new technology is not a quick fix. Ms Fox cautions that pharmacists will get out of system integration what they put in; anyone expecting the technology alone to deliver efficiencies might not get the results they expect.
‘You need to rethink the way that you’re working in your pharmacies if you want these sorts of workflow tools to be a success, and then once you’ve created that extra time, make sure that you’ve got the right space for the pharmacist,’ she said. ‘Make sure that you’ve got someone who’s owning those services, and make sure you’re building that clinical capacity.”
The best outcome will result when full teams embrace the system, rather than a single enthusiastic proponent trying to bring along colleagues who are unwilling to learn how to make the most of a new platform. Fundamentally for system integration to work, pharmacists must change how they work along with adopting new technological platforms.
‘The future of pharmacy won’t be defined by who adopts the most technology,’ Ms Fox said.
‘It’ll be defined by who redesigns the way they work around it, so pharmacists can spend more time doing what only pharmacists can do.’
