Improve medication adherence and increase patient loyalty with help from a Good Neighbor Pharmacy Business Coach
By Mark Ciarlone, PharmD
Declining script counts can have negative effects on the health of your independent pharmacy, impacting revenue and profitability.
Improving patient medication adherence is one way a pharmacy can counteract reduced prescription volume and increase patient outcomes. Is your pharmacy tapping into all its available resources around medication adherence? A Good Neighbor Pharmacy business coach will help a pharmacy and their staff strategize, implement, and monitor patient adherence programs with the goal to increase revenue and patient outcomes.
Adherence programs also help increase other revenue streams such as enhanced clinical services and front store sales. Strong adherence programs increase the efficiency of the pharmacy decreasing operational costs and decrease inventory generating a higher profit margin for the store. Among Good Neighbor Pharmacy premier members enjoyed a 1.5% better adherence measure versus non-premier members, thanks in some part to their access to business coaches.1
1. Educate patients about what to expect
A patient starting a new drug regiment can begin with great promise, but when a provider or pharmacy doesn't prepare a patient for all potential outcomes, he or she may stop taking the drug. If a patient starts feeling better, he or she might think the drug is no longer needed. If he or she feels worse, the patient could discontinue therapy to avoid side effects. If the patient experiences no change whatsoever, he or she may conclude that the drug isn't working. Oftentimes, therapies are called into pharmacies and never initiated due to failure of the patient to pick them up or the cost of a new drug regiment may be higher than the patient’s previous therapies, contributing to the patient prematurely stopping their treatments.
Prescribers ordering new initial therapy typically spend less than a minute telling their patients how a drug works and how they should expect to feel and the patient often has to initiate more information by asking questions.2 The pharmacist has the opportunity to fill in any gaps and provide an additional level of service to patients. Patients with chronic conditions are more likely to stay adherent once they feel assured that their medication is having a positive impact on their overall well-being.
How a Business Coach can help:
A Business Coach can help educate owners how to identify gaps in adherence and patient opportunities which improve patient outcomes. Using a variety of tools, your Business Coach will help you learn to identify which patients may need more attention and strategize how best to increase patient adherence.
2. Nurture relationships with patients
Patients see and interact with their pharmacist much more often than with their prescriber. One study placed per-patient primary care physician encounters at eight per year and per-patient pharmacist encounters at 13 per year.3 Pharmacists and community pharmacy staff establish relationships with every patient who walks through the door. Pharmacists ask patients how they are feeling, if a new dosage is working better or if they are experiencing any new side effects, for example. All of these questions can start a conversation and allow a patient to open up about concerns that could possibly lead to a patient becoming non-adherence. And since patients may have more questions once they are on therapy than before they begin therapy, a regular, open dialogue is important for building trust.How a Business Coach can help:
A Business Coach can help you strategize how to utilize tools to pinpoint individuals who are impacting your stores adherence measures and having a direct impact on store reimbursement.
3. Team up with prescribers
Good communication between the prescriber and the pharmacist is critical. Pharmacists should connect with patients’ prescribers to state when patients are having problems with their medication. For example, if a prescriber and a independent pharmacy share mutual patients, a pharmacist might say something along the lines of, “I see you have 30 patients that use my pharmacy. Most patients are adherent to their therapy, but there are potential issues that I see with adherence on these patients." This builds understanding that both parties are on the same healthcare team and are working together for the benefit of the patient.
How a Business Coach can help:
A Business Coach can help you leverage analytics to gain a better understanding of shared patients with prescribers and which marketing tactics will work best to communicate with them and their influential prescribers.
4. Engage the staff
An efficient and team-based workflow benefits the pharmacy and its patients. Pharmacists can engage the whole staff regularly by holding staff meetings and discussing everyone's role in caring for patients. Posting key performance indicators in the back of the pharmacy can engage the staff and stress the importance of managing a patient's care. Web-based tools like EQUIPP (Electronic Quality Improvement Platform for Plans & Pharmacies) gather pharmacy claims data from health plans and PBMs and produce monthly scorecards that can be shared among the pharmacy staff. Other metrics to track include the Week at a Glance; Med Sync Percentage; and Sync Candidates.
When everyone—from the front-end clerk to the pharmacy technician—embraces their role as a part of the care team, patient engagement improves. Give team members ownership of specific metrics and implementation of tools to create staff buy-in. They will be more likely to tune into even casual comments from a patient like, “I'm so tired of taking that pill," a clue that there could be a problem. A brief talk with the pharmacist may help prevent non-adherence down the road.
How a Business Coach can help:
A Business Coach will work directly with employees to strategize with them to be more effective in the workplace, as well as offer the owner tips on how to coach staff to meet metrics and conduct conversations with patients. The business coach can conduct a staff education stressing the importance and impact the employees have on the business.
5. Customize available technologies and support tools
What reporting tools is the pharmacy currently utilizing? If their software is lacking a specific functionality such as text messaging? Is there a third-party application that could assist the team? How is the pharmacy utilizing the tools and resources as part of their daily workflow? Utilization of technology also will help owners measure their stores and teams’ key performance indicators or measures. Many pharmacy systems also have the capability to highlight non-adherent patients for pharmacy interaction, saving pharmacies a lot of time and costs while improving patient outcomes. The key is to implement tools and or processes that allow pharmacies to perform more effectively targeting of patients that need additional care. More and more, patients are taking control of their own outcomes and looking at tools for managing their healthcare and improving adherence. Some patients may embrace a new app for their smartphone, while others might find a simple daily pill box to be just right. It’s not one size fits all, so asking a few questions about preferences is a good idea before making a solution recommendation; and following up and adjusting course may be necessary to get it right.
How a Business Coach can help:
A Business Coach utilizes a series of reports from InSite data and other reporting software to help owners analyze their store efficiency and identify an area of opportunities. The Business Coach can help a store implement strategies to utilize software to help the staff complete the tasks that ultimately improve patient outcomes, but also help the owners monitor their stores implementation and success of patient adherence programs.
6. Schedule appointments
Community pharmacies are expanding their scope of practice and taking on a larger healthcare role. At any given time, a phone is ringing and the line at the counter is growing while the pharmacy staff are addressing other issues. As workflow pressure mounts and the pharmacist must use documentation systems for medication therapy management, e-care plans, point of care testing, and immunizations. The pharmacy workflow would benefit from utilizing a scheduling tool, but still be flexible to allow walk-in visits. Pre-scheduling appointments, like point-of-care testing or medication therapy management services can help alleviate some of the pressure to have patient conversations during the busiest hours. Successful pharmacies manage their workflow by planning for patient services, rather than reacting to the next script in the queue. Unlike visiting a doctor's office, people show up at the pharmacy whenever it's convenient for them. The pharmacy’s workflow must be flexible enough to adapt when the customer comes in unscheduled.
How a Business Coach can help:
A Business Coach will help you strategize how to determine which tool is appropriate to identify these opportunities and streamline appointments.
7. Medication Synchronization
Medication Synchronization is the coordination of all medication refills for patients to pick up at the same time each month. This ensures a lack of interruptions in therapies and provides a better overall experience for patients—no more walking out with missing scripts or partial fills. Med Sync helps management control inventory, labor costs and helps forecast the needs of the pharmacy. More patients enrolled in medication synchronization leads to more predictable daily prescription volume for a pharmacy. Once volume is more predictable, pharmacies can schedule staff and order inventory more efficiently as well as add additional patient care services like point-of-care testing, MTM services, and immunizations.How a coach can help:
A business coach can share strategies to improve workflow, leading to gains in medication synchronization that help patients stay adherent and increase pharmacy business efficiency.
8. Take advantage of MTM platforms
The MTM process consists of five core elements. Medication therapy review, personal medication record, medication action plan, intervention and referral, and documentation and follow-up. Many pharmacies are asked to conduct comprehensive medication review (CMR) and targeted intervention programs (TIP) allow for more one-on-one conversations with patients that will help improve therapeutic outcomes. The education provided with these consultations not only improves a patient's health and well-being, but also results in increased prescription volume and services. Monitoring MTM platforms at least once a week allows pharmacies to service their patients identified on these platforms. If a MTM service is not completed by the home store in a timely manner then those opportunities may be sent elsewhere.
How a Business Coach can help:
A business coach helps the owner strategize and implement growth plans that lead to increase patient adherence and create a better patient outcomes.
To understand what's working in your pharmacy and what isn't, you not only have to gather extensive data from every area of your business, but you also need to leverage deep insight to figure out what it all means. That's where the expertise of your business coach makes all the difference. Our coaches have many years of independent pharmacy experience under their belts and a unique ability to translate numbers on the page into simple steps you can take to improve your business. They walk you through every report and offer straightforward guidance so you can make confident, data-driven business decisions that maximize the efficiency of your pharmacy.
References:
1. Average performance across all average proportion of days covered (PDC) categories among Good Neighbor Pharmacy Premier Pharmacies compared to non-Good Neighbor Pharmacy
Premier Pharmacies (January 2022 - 2022). 2,015 participating Pharmacies open and operating throughout stated time-period.
2. Tarn, D., Paterniti, D., Kravitz, R., Heritage, J., Honghu, L., Sue, K., Wenger, S. (2008, April 11). Retrieved November 15, 2016, from Patentent Education and Counseling, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582184/
3. Berenbeck, L., et. al. Evaluation of Frequency of Encounters With Primary Care Physicians vs Visits to Community Pharmacies Among Medicare Beneficiaries. JAMA Network Open. 15 Jul 2020. Accessed 31 May 2023
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364370/
4. Five-Star Quality Rating System. (2016, October 26). Retrieved November 9, 2016, from Centers for Medicare & Medicaid Services, https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/fsqrs.html