Contributed by Nicholas Shanos, RPh, Owner of Suburban Pharmacy, Inc.
Q. How can a Pharmacy Management System (PMS) streamline prescription workflows and reduce dispensing errors?
A PMS can streamline multiple stages of the prescription workflow, from receiving electronic prescriptions through verification and dispensing. Typical capabilities include barcode scanning with lot and expiration information to support DSCSA requirements, automated drug interaction checks, and real-time clinical alerts, as well as access to integrated third-party resources such as Facts and Comparisons and clinical pharmacology tools. Some systems also incorporate pharmacist verification safeguards for “Tall Man Drugs” (sound-alike and look-alike drugs), as well as a structured five-point prescription check during verification. Additional features often include capturing patient acknowledgments at pickup and implementing a pharmacist hard-stop at the point of sale to ensure that appropriate patient counseling is provided when needed.
Q. What level of integration does the PMS offer with EHRs, IVR systems, fulfillment robots, and other existing pharmacy technologies?
There are many interfaces between PMS and third-party systems through their API. The interface that I use at Suburban is with EyeCon for verifying and counting. It stores pictures of the actual tablets counted, and it can force a double count of controlled drugs. It also records drug serialization.
A pharmacy management system built to interface easily with other technologies supported by a well-designed API — enables fast, streamlined development and rollout of new integrations. This approach allows pharmacies to adopt new tools quickly without disrupting existing workflows.
The PMS I use offers integration with:
• Many dispensing machines and compliance packaging: Parata, RxSafe, BlistAssist, and others.
• Pill counters: Vivid and EyeCon.
• Many IVRs: however, we don’t use IVRs to handle incoming calls to the pharmacy. I believe it’s important to have a person answer the phone. I do utilize the outbound patient messaging features, including text, voice, and email.
• EHRs: EPIC, Athena NextGen, Cerner, and about 12 LTC eMAR vendors.
Your PMS should serve as the “hub of the pharmacy” and be designed to connect with a wide range of third-party solutions, giving pharmacies the flexibility to work with the vendors they prefer.
Q. In what ways does the PMS support compliance, audit readiness, and regulatory reporting requirements?
The PMS software can maintain comprehensive logs of all transactions, including prescription fills, controlled substance tracking, and patient communications. These platforms often support automatic nightly reporting to state prescription monitoring programs (PMPs) and include integrated tools, such as a built-in PMP gateway to check in real time during data entry and pharmacist verification. The system we use also provides auto-reporting of vaccines to state registries at scheduled intervals and can generate provider notifications, such as sending a fax to a patient’s physician after a vaccination is processed. In addition, routine cloud-based backups are commonly performed, with some systems updating as frequently as every 15 minutes.
Q. How does the PMS optimize inventory management to prevent stockouts, manage expirations, and reduce waste?
The PMS we use at Suburban employs a perpetual inventory system that supports electronic ordering from multiple wholesalers and automatically updates on-hand inventory through electronic invoicing. The platform enables tracking of expiration dates as items are received and even allows for negative inventory levels, which works great for a very high-cost drug to make sure the claim is adjudicated before ordering.
In addition, Suburban’s PMS integrates DSCSA functionality directly into the platform, utilizing the new EPCIS standards for ordering and receiving. It can scan incoming inventory, verify shipments, and quarantine any questionable or incorrect products so the rest of the order can be used immediately. The system also offers an API that supports integration with third-party DSCSA vendors.
Q. What clinical decision support features are built in for drug interaction checks, contraindications, and patient safety alerts?
It’s essential to use a PMS that has significant clinical features. One great feature our PMS has is the ClinicalSmart Check, which automatically checks for drug interactions, allergies, duplicate therapies, and contraindications based on patient profiles and other custom alerts. Alerts are triggered during prescription entry and then during verification.
Q. How robust are the reporting and analysis tools for monitoring performance, forecasting demand, and supporting business decisions?
Robust reporting and analysis capabilities are essential for independent pharmacies seeking to operate efficiently, remain competitive, and make informed business decisions. Effective tools allow pharmacy leaders to monitor key performance indicators such as prescription volume, inventory turnover, patient adherence, and staff productivity.
Platforms can demonstrate this value by offering customizable insights through the generation of reports on prescription volume, inventory turnover, patient adherence, and staff productivity.
Q. What capabilities does the PMS provide for handling e-prescriptions and third-party insurance claims processing efficiency?
Our PMS makes it simple with direct integration. E-prescription handling is streamlined through integration with Surescripts. Virtual tech then auto-populates critical information, thereby reducing transcription errors and speeding up processing. We can instantly retrieve and populate insurance information into the patient profile with a single click, eliminating the need to enter those details manually. From there, we can submit the claim and efficiently handle rejections and prior authorizations. If prior authorization is required, we can initiate it directly through CoverMyMeds to streamline the approval process.
Q. How does the PMS improve overall pharmacy operations while allowing pharmacists more time to focus on patient care?
Finding a software management system that integrates a patient portal or mobile app is extremely valuable, as it eliminates the need to switch to another program to handle patient engagements, such as two-way messaging, appointments, questionnaires, refills, and sending a picture of their insurance card. All of these actions are completely HIPAA compliant. By automating administrative tasks, managing inventory, and streamlining prescription workflows, the PMS enables pharmacists to spend more time engaging with patients. This includes offering medication counseling, conducting MTM (Medication Therapy Management), and improving adherence — all of which enhance patient outcomes and satisfaction.
Q. If you are in the market for a new PMS, what key factors should you look for?
A few years ago, Suburban was operating on a different PMS. When it became time to evaluate new vendors, my priorities centered on how the system managed e-prescribing — specifically, how prescriptions or refills were received and processed, the level of automation involved, and whether an AI-driven model was in place to provide additional checks and safeguards.
These factors play an essential role:
• Patient/Customer Management: Comprehensive patient profiles
with key details such as allergies and medical history, along with communication tools like SMS messaging and adherence tracking.
• Inventory Management: Real-time inventory stock level (perpetual inventory), real-time automated reorder processes, and support for D-2 barcode with track-and-trace capabilities, which is extremely important.
• Reports and Analytics: Ready-to-use reports (including bin number reporting for PBMs and forecasting tools), designed to be quick and practical for a busy pharmacist. The interface should be updated, intuitive, and organized in a way that makes information easy to find and use.
• Customer Service: Responsive support within minutes and a dedicated account manager assigned to your pharmacy. They assist with both day-to-day needs and larger operational challenges. “It’s like having a quarterback — if they don’t have the expertise on what you are asking, they will get you the expertise.”
• Regulatory Compliance Issues: Support for controlled substance track-and-trace requirements and DEA audit readiness.
• Integration: Compatibility with a wide range of technologies, including POS systems, automation tools, and other third-party vendors.
• Price: for independent pharmacies, the more significant factors are the monthly maintenance and transaction fees, rather than the base monthly subscription cost.
