Dwindling profits and the shift towards more clinically focused care prompted community pharmacists to identify new opportunities to expand services, practice at the top of their license, and optimize patient outcomes — all of which translated into additional revenue streams.
Leveraging the right technological solutions plays a key role in enabling pharmacies to transition to a more comprehensive approach to patient-centered care.
“We didn’t have a clear crystal ball, but we had a pretty good idea that pharmacists, at some point, were not going to be paid for the product. It’s going to be about the service they provide,” said Randy McDonough, B.S., Pharm.D., M.S., CGP, BCPS, FAPhA, Director of Clinical Services and Co-Owner of Towncrest Pharmacy in Iowa City, IA and Solon Towncrest Pharmacy in Solon, IA.
Randy McDonough and his partner Mike Deninger are at the leading edge when it comes to community pharmacies improving patient care through clinical services. McDonough oversees the development, implementation and quality assurance of clinical services including Medication Therapy Management (MTM), nursing home consultation, wellness screenings, immunizations, and adherence services. He is also board certified in geriatrics and as a pharmacotherapy specialist.
McDonough’s work in MTM extends to helping implement these services within the Iowa Medicaid Pharmaceutical Case Management Program. “Today, our pharmacy is making 2 to 3,000 clinical interventions collectively every month, and we have anywhere between four to six pharmacists at a time within the practice,” said McDonough.
Software solutions play a critical role in enabling pharmacies to deliver patient care. The two key solutions leveraged by Towncrest making it possible to deliver better patient care include Pharmaserv and PharmClin. McKesson’s Pharmaserv application has been Towncrest’s chosen and trusted pharmacy management system for years. Towncrest relies on Pharmaserv to help fill prescriptions, adjudicate claims, and document dispensing activities. It features a flexible and user-friendly interface that helps McDonough gain insight and efficiently manage operations.
PharmClin, a proprietary software that identifies patients needing clinical interventions, is McDonough’s and Deninger’s brainchild. Both former faculty at the University of Iowa College of Pharmacy, the clinicians developed the software to address patients’ needs while streamlining dispensing logistics. It is a dual-function documentation tool that allows pharmacists and staff to identify and document clinical interventions, improve prescriber communication, and collect clinical data from prescribers and vendors.
For clinical services, identifying the right opportunity at the right time is the key to taking advantage of the golden moment when the patient is in the pharmacy. Having to log into and check multiple applications and websites for each patient increases staff labor, decreases efficiency, hinders patient engagement, and limits opportunities for clinical interventions.
In addition, the lack of universally accessible electronic records limits community pharmacists’ access to complete patient health information. Pharmacy staff must rely on multiple electronic resources—many of which fail to generate cross-talk between platforms.
This burden only intensifies obstacles already plaguing community pharmacists as they struggle to generate revenue in a climate where profits continue to plummet.
Despite their major strides resulting from the use of Pharmaserv and PharmClin, increasing their options to provide further types of clinical engagements still remains an opportunity for Towncrest pharmacists.
To augment their existing software, McDonough and Deninger discovered Clinical Programs Solution (CPS) — a McKesson-crafted platform that gives pharmacists the flexibility to add or build clinical programs based on patients’ medical conditions and a business’s revenue goals. Of equal importance, CPS increases workflow efficiency by enabling multi-software cross-talk.
“What’s nice about PharmClin is that it does communicate with Pharmaserv, and that’s why we’re excited about CPS,” McDonough said. “It really gives us access to three systems so we’re able to help document patient interactions with pharmacists through that system.” McDonough feels McKesson’s multi-software integration capabilities have enhanced the quality and expansion of his practice.
Towncrest’s partnership with McKesson, the combination of Pharmaserv and Clinical Programs Solution (CPS), and McDonough’s and Deninger’s proprietary PharmClin solution are all proving highly beneficial to improving patient care and maximizing revenue.
“We have evolved CPS into a good tool for our technicians to document some of the things that they’re seeing, too, so that information can be passed on to the pharmacist.”
Expanding the level of patient care in his pharmacy is crucial to financial success, McDonough said. “You become an effective manager of your resources to where now, the whole financial metrics have to change, too,” McDonough said. “Compared to another pharmacy that may have the same volume of prescriptions that I do, my percent payroll to total sales is totally [askew]. It’s because we’ve now invested in our practice providing services,” he explained.
Software integration, using CPS, also helped the pharmacies expand their medication therapy management (MTM) services beyond third parties routinely used in many community pharmacies: They serve group homes and patients with traumatic brain injuries and intellectual disabilities. McDonough and his colleagues also provide many other services, including: drug information, nursing home consultations, and medication synchronization.
McDonough believes diversifying payers generates additional revenue, as well.
For example, he and his team forged relationships with numerous group homes to provide medication reviews. They also manage 600 to 700 beneficiaries for a payer. Each relationship carries a different payment structure.
Towncrest and Solon Towncrest have also formed other community-based partnerships. They offer compliance packaging assistance for a community mental health clinic. Known as the “Medication Adherence Program” or “MAP”, McDonough and his team work with psychiatric patients to improve their adherence.
As a result, the clinic now has Towncrest manage its patients who are taking long-acting antipsychotics and refers additional patients to McDonough’s team.
Looking forward, McDonough sees tremendous opportunity for McKesson’s CPS platform to increase external vendor synchronization.
Recognizing the challenge of rising costs for software and other tools to continue revolutionizing community practice, McDonough offers these words of advice to fellow colleagues seeking to expand their practice by recruiting technology and value added services:
“It’s not like we created these services overnight,” he revealed. “These are things that have evolved in the past decade, but all these services are functioning on their own and providing new income and new revenue for us.”
McDonough feels McKesson’s Clinical Programs Solution and Pharmaserv will enhance the clinical services that Towncrest has put in place, helping to more efficiently identify new patient intervention opportunities. Taking advantage of the crosstalk now available between the three systems, Towncrest can continue to improve patient care and grow the business through the delivery of even more clinical services.