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Automated Pharmacy Workflow: Analyze, Optimize and Maximize

Productivity–An Industrial Engineering Perspective

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Keith Overfield, BSDirector of Consulting Services

Parata Systems LLCDurham, North Carolina

Faculty InformationPresenter:Keith Overfield, BSDirector of Consulting ServicesParata Systems LLCDurham, North Carolina

Moderator:

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Moderator:Nikhil Patel, RPh, PharmDDirector, Scientific Affairs Pharmacy Times Office of Continuing Professional

Education

This activity is supported by an educational grant from Emdeon.

Educational ObjectivesUpon completing the program, participants should be able to:

• Examine their information workflow and identify areas for improvement

• Understand the types of technology available (both software and hardware) and the benefits provided by each for all components of the healthcare cycle

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each for all components of the healthcare cycle• Understand the value of clinical pharmacy services within

their pharmacy, as well as ways to integrate within their current structures

• Identify opportunities to improve their pharmacy processes today with their current resources

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DisclosuresKeith Overfield, BS, has disclosed that he is currently an employee of Parata Systems, LLC.

The planning staff from the Pharmacy Times Office of Continuing Professional Education have no relevant financial relationships to disclose.

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The contents of this webinar may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

Pharmacy Accreditation

Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program is approved for 1 contact hour (0 1

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program is approved for 1 contact hour (0.1 CEU) under the ACPE universal program number 0290-0000-11-036-L04-P. This program is available for CE credit through July 21, 2011.

Type of Activity: Knowledge-based.

Automated Pharmacy Workflow: Analyze, Optimize and Maximize

Productivity:

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yAn Industrial Engineering Perspective

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Introduction

• Lead a lean six sigma industrial engineer team (specific healthcare certification) that applies lean tools, resources and knowledge to the pharmacy environment

• 4 base services:Performance focused servicesProcess focused services

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Process focused servicesStaff focused servicesEquipment optimization services

• Markets:Retail pharmacyLTC pharmacy and facility

Technical Sciences

workflow productivity efficiency

work sampling time study

Introduction

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Human Sciences

Economic Sciences

ergonomicsstaff utilization

balancing workloadmanagement tools

IEROIlabor cost/script

inventory managementprofitability

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Presentation Objectives

• Examine the information exchange process between physician, pharmacist, providers and patients and explore improvement opportunities

• Understand technological applications

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(both hardware and software) and the efficiencies they create in patient healthcare management

• Explore the benefits these technological applications create for expanding clinical pharmacy services

• Identify opportunities to improve pharmacy processes today with existing resources

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ANALYZE

Our World Today

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The Web of Data

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Patient Data

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Health Information Exchange –What is it?

•Health Information Exchange (HIE)The electronic movement of health-related information among disparate organizations according to nationally recognized standards in an authorized and secure manner.

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•Health Information Organization (HIO)An organization that oversees and governs the exchange activities of health-related information among independent stakeholders and disparate organizations according to nationally recognized standards in an authorized and secure manner.

The Benefits of HIE

Improve quality of care,

timeliness and

Decrease in patient

prescribing

Increases convenience

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Improve privacy and security of patient health

timeliness and patient safety

p esc b gerrors and workflow

efficiency

Enhances communication

between all patient

providers

Improves access to test

results and referral

consultations

Standard Pharmacy Process

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Future Pharmacy Processes

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OPTIMIZE

Upstream Technology Adaptability

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In-Pharmacy Efficiency $$

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Electronic Health Records (EHR )

The sharing of patient information is changing from a "point to point" model to a "many to many" setup – the core of this transformation is the Electronic Health Record, or EHR

Longitudinal electronic record of patient health information

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Includes patient demographics, progress notes, problems, medications, vital signs, immunizations, lab data and other reports

Generates a complete record of a clinical patient encounter

Automates and streamlines the clinician’s workflow

E-Prescribing

Reduces callbacks to physician practices

Decreases manual entry, providing time savings

A prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy

from the point-of-care

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and continuity of information

Supports better relationships with physicians and patients

Allows for faster dispensing

Lowers workflow costs that can be as much as 10% for pharmacy technicians

Target High-Impact Areas for High Return

Administrative 18%

Immunizations 4%

Break 3%

Non-Productive 14%

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4%

Register 14%

New Script Processing 14%

Refill Processing

9%

Script Filling24%

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Filling 62%

Pharmacy High Impact Areas

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Pick Up16%

Drop off/entry22%

Automation Solutions Full AutomationSemi-AutomationCounters/Scales

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MAXIMIZE

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HIE Impact on Pharmacist Time

• PV1: First VerificationPrevents medication prescription errors, look-alike or sound-alike drugs, incorrect dosing, drug allergy reactions, duplication of drugs

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drugsReduces time spent on data-entry by Technicians and Rph during Drug Utilization Review (DUR)Reduces calls to doctors for illegible handwritingReduces fraud and crimeAlerts pharmacy/prescriber of overdue prescriptions

Automation Impact Pharmacist Time

• PV2: Second verification

Automation ensures right drug and dose more efficiently/accurately than humans

Reduces wait times of patients for

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RPh to verify accuracy

Enables RPh to spend more time consulting patients

At least 5 states currently allow for reduced or no PV2 when automation is used and at least 10 others would consider variances.

Automation Benefits

Automated counting 99.99%

95%

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Grow Without Hiring

Inventory Management

Reduce Shrinkage

90%

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Technology to Increase Revenue

Automatic Refills

Time Savings

MTM Immunizations

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Refill by Scan, Walgreen’s mobile

app, allows patients to scan their

barcode to order a refill

RxCalc is a pharmacokinetics

calculator made by specifically

designed to handle aminoglycoside and

vancomycin kinetics

Remote Glucose Meter apps enables

pharmacists to better understand

how care is progressing

Med Calc/Doctor Calc provides recommended immunization

schedule based on medical and other

indications

Where Do Patients Get Their Information?

• 56% favor media and information service companies (e.g., Dr. Oz, The Doctors, iVillage, WebMD)

• 16% favor healthcare orgs or pharma (e.g., Mayo Clinic or

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Johnson & Johnson) • 12% favor consumer-driven

organizations for information (e.g., Patients Like Me, Daily Strength, Angie’s List)

• How many patients are asking pharmacists for information regarding their medical condition?

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CASE STUDY

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CareSpark

• CareSpark is a mature HIE community serving over 800,000 patients with 2,190 physicians and 21 hospitals

• CareSpark has shown:Improved access to health information and clinical best practices

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Clinical document growth rate of 25,000 documents per month Increased patient satisfaction with patient participation growth rate of 75,000 per quarter Reduced incidence of medical errors and duplicated services Reduced operational costs Lower malpractice claims and insurance costs

Educational Objective ReviewExamine the information exchange process between physician, pharmacist, providers and patients and explore improvement opportunities

Understand technological applications (both hardware and software) and the efficiencies they create in patient h lth t

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healthcare management

Explore the benefits these technological applications create for expanding clinical pharmacy services

Provide ideas to improve pharmacy processes today with existing resources

Question-and-AnswerSession

[Pre recorded]

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[Pre-recorded]

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Automated Pharmacy Workflow: Analyze, Optimize and Maximize

Productivity–An Industrial Engineering Perspective

THANK YOU!

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THANK YOU!

For any questions regarding this activity, contact: CEINFO@pharmacytimes.com