Pharmacies Share the Formula for Improving Patient Health (Part 1)

Speaker 1 (00:05):

At RX safe. We believe in improving patient health by challenging conventional wisdom, upending the status quo and transforming the retail pharmacy industry. Our innovative technology solutions are designed to accelerate your pharmacy success and change the way you do business. We develop long-term partnerships with pharmacies and other industry innovators to help attract new customers, create additional revenue streams, and transform the traditional pharmacy model become the adherence packaging leader in your community and practice at the top of your pharmacy license. Get started today. Visit our RX safe.com that's RX safe.com to learn more

Speaker 2 (00:45):

5, 4, 3, 3.

Speaker 3 (00:49):

Thanks for tuning into the pharmacy podcast network. The most influential podcast dedicated to the profession of pharmacy with over 80,000 listeners worldwide. Welcome to the pharmacy podcast network. Welcome to the RX safe podcast series. This special two part series is a re broadcast recording from a panel discussion title pharmacies share the formula for improving patient health. This is part two of the two episodes, which were previously recorded live at the national community pharmacy association annual meeting in Charlotte, North Carolina. Our panel was made up of several pharmacy owners who understand the real world issues of keeping patients adherent to their medications and connected to their community pharmacies. And now here's our host, the founder of the pharmacy podcast network, Todd Urie.

Speaker 4 (01:51):

So it's one thing to invest in new technology, teach your team, teach your technicians, your pharmacists, how to utilize the technology. Have it become part of your workflow. Have it become part of operation? Jan, talk to me about marketing this. How do you get this messaging out to your community that this pack is different and it's different than having to open up 6, 7, 8 con containers separately and pour 'em your hand and dropping all over the floor. Talk to me about that.

Speaker 5 (02:21):

Well, you know, we've tried some different methods. Uh, we started off marketing on Facebook marketing within our store. Um, we didn't make a lot of headway. Initially. We had about 75 patients already on packaging when we got our rapid pack. So of course we convert those, get some word of mouth, but we actually, um, our safe has a business transformation group and we in the first group. And one of the things that we did as part of that group is we sent a texting campaign to all of our patients. So back up a little bit, when we first got our robot, we thought, okay, we're gonna go after new patients. We just want new patients because that's new. We need this many patients to pay for this robot. Well, that didn't work. And so we, we did this texting campaign to our existing patients who are not adhere and we got a hundred patients in five weeks.

Speaker 5 (03:11):

Wow. And that is like instant cash flow. I mean, you already have these patients. Yes. But they're feeling what, seven times a year, not 12 mm-hmm <affirmative>. Um, and so that was like the boost that we needed and then that your word of mouth starts to go faster. Um, you know, it's, it's amazing how, when you get somebody on packaging, we've noticed that average patient has nine to 10 meds. Well, patients not on packaging have about three and a half. Well, do they really have three and a half or they just don't take it enough. And so that's their average. So it's amazing how much more profitable a packaging patient. They're almost double the profit of a regular patient is what we found in our store.

Speaker 4 (03:55):

What about marketing to your P and partnerships? Um, what about marketing to nurse practitioners that you might know in the community? Can you kind of expand upon how you're doing that with your physicians and your community?

Speaker 6 (04:09):

Yeah, so we actually started using our, our machine as COVID was starting <laugh>. Um, so it was a little challenging to get into some of the physician's offices, but we did, we did contact a few, um, home healthcare agencies. And I will tell you, they were very receptive to what we had to say. And we were able to get a lot of referrals off of just the home healthcare. But I do have physicians of course, that I talked to on a regular basis. And I just, uh, I had my marketing person just bring some packaging over to 'em even though we can't really formally visit with them. And then they're, then I'm getting phone calls. Okay. What is this all about? Tell me more, tell me more what you're doing, and then explain all the things that these guys were talking about. You know, we make them monthly phone calls, we're double checking.

Speaker 6 (04:57):

You know, we had, this happens so often that you, people are taking their levy rocks and with all their medicines at the end of the day, instead of taking it first thing in the morning, and they didn't even realize they were supposed to do that, even though we tell 'em that when they were getting it in the bottle, but now we actually have a pack that says, take this one in the morning. Uh, so if they still take it at night, uh, there's not a whole lot I can do about that, I guess <laugh> but, but I will say that we have had so many compliments from our local prescribers and even a lot of out of town prescribers, um, that, uh, are very excited about the opportunity for their patients to be, be, uh, adherent to their medications and know that we're watching over.

Speaker 6 (05:39):

And then if we see an issue, we pick up the phone and we them, and they're like, wow, because many of them are getting their doc or haven't been getting their doctor's visits in as often as they should because of the pandemic or other situations that that may be affecting them personally. So I can tell you, um, that local prescribers, nurse practitioners, physicians, home healthcare agencies I've even had hospices and some of our long term care or long term care facilities are very interested in what, what this packaging can do for their patients and, you know, the positive things that it can do. So

Speaker 4 (06:14):

What are you doing to

Speaker 7 (06:16):

Ours is mainly home health. Um, we, I do visit doctors some but home health. You really, I mean, you go, once you give them several boxes, uh, with candy in them, um, we got some of the smaller boxes. Um, there there's several different sizes. Um, but yeah, some of the smaller boxes just fill 'em with candy. Um, they show 'em to their patients. Then we take 'em to the home health nurses. We have one, um, I grew up about an hour away from where our pharmacy is and, um, the home health nurse there has just taken on to it, the pharmacy there isn't very forward thinking. Um, and so they just send us a lot of patients. So we ended up starting to deliver once a month, um, within a hundred miles. Um, we we've synchronized all those patients, um, to one week. And so we have, we have probably 50 that we deliver to, um, to about an hour away from our town because that one home health nurse, um, found out about it. They don't get paid to set up the, the pill planners anymore, but that's something that's expected for most of their patients. They have a lot of trouble with that. Um, and so they, um, I mean, it's a free, we offer it for free. So it's a free service that, um, they just get taken care of a lot better and we bring it to their house once a month. So the home health nurses really like that, cuz we're all there to help them stay home. Um, and so that's one way they can do it.

Speaker 4 (07:40):

So I've already heard, uh, Lisa's answer to this question. So I want east to answer this question instead, and that is the concept of return on investment. You're a pharmacy owner. You can't be spending money unless you know that there's gonna be some type of return on your investment within a period of time so that you can back up at the end of the year and look at your P and L and say, okay, this purchase made sense. So talk about the return on investment.

Speaker 8 (08:07):

Well, it's already been brought up once, you know, for one thing, your existing patients, they're filling their medicines more. So if they're filling it seven or eight times a year, they're filling it 12 times a year now. So there's part of it there without even landing your first new patient whatsoever. Um, so that's, that's a big deal in itself. Um, and you know, for us, we were the first in our area to have these kind of technology like this. So, um, we've definitely been able to acquire lots of new patients because of it as well.

Speaker 4 (08:40):

What about that 100 new patients that you brought on? What does that mean to the bottom line? Within a year's time of it being a complete 100 patients?

Speaker 5 (08:50):

Well, it brings a lot to the bottom line. Um, you know, people have asked me, you know, what does this cost? How do you afford it? You know, you need 30 new patients basically is that's what they'll tell you. When, when you buy it, you need 30 patients. The average patient takes 10 medicines, $10 profit per prescription, $3,000 a month. There's your payment. So it doesn't take long to get there even when you're using existing patients. Even if you say, well, it's twice as many because I was already feeling part of their stuff. Um, it doesn't take any time. And you know, that was a big concern. Me when I said in the middle of a pandemic, Hey Randy, can we buy this robot? He's like, what are you thinking? <laugh> we cannot spend any money. And I'm like, no, but look, this is how this is how you pay for it. And you know, bill hasn't figured out, he explains it to you in terms you can understand. And then you're like, well, how can I not have it? You know, my patients need this. I need to grow my business. I need to further differentiate myself from my competition. It's no brainer, really we're spending

Speaker 9 (09:48):

So much money on this bill. Uh, we were spending so much money on this bill with our, our labor and Janet did all the calculations and we were gonna save $1,500 a month. Yeah. <laugh>, which was crazy. You know, when we moved to pack my meds, that's awesome.

Speaker 10 (10:09):

Other big things, patient safety,

Speaker 4 (10:11):

Patient safety, patient safety, and not having to worry about them opening each individual. Also

Speaker 11 (10:19):

Also, when you hand also something for Tracy and I, that we've seen was, um, we had gotten to the, a threshold where we were using this bill as well. And we had gotten to a threshold where we couldn't safely take on more people, packaging them by hand with the space that we had and the staff that we had ad, um, when you get a machine like this and you're able to look at every pouch on the screen and verify it. And you're certain that every pouch has the right pills in it, the right pills, the right number of pills, all the pouches are there. There's nothing in there that's crushed. Um, that's huge for patient patient safety and from a liability perspective and for doing right by your patient. So you can really do a lot with the same staff you have, or, uh, maybe less, depending on how many people, your hand carding, then you can sleep a lot better at night. I know I slept a whole lot better at night after we bought the machine that the right pills are in the right pouch every time for the patient. And they're getting, getting what they're supposed to get.

Speaker 4 (11:18):

And in your, in your pharmacy, Thomas, talk about implementation of this system and, and the ability to integrate it into your existing, uh, pharmacy space that you had. Yeah.

Speaker 10 (11:29):

So we, we had actually added on a, a little bit of we're in a old, uh, pharmacy. We've been there since 1901 in the same build main street, 'em say, uh, long and narrow. Uh, so it's not a ton of great space. We had added on our office before we were even thinking about buying the robot. But we, we put in a space where we thought we might, would try to put something and then next thing you know, we bought a robot and put it in there. And, um, but it, it really does not need much space. I mean, 6, 5, 6 feet for the entire, uh, setup. You know, we, ours is as tight as it can be, but, um, you can really fit it in any area. If you try hard enough, if you shift some stuff around, it's got a small foot print, which is one of the reasons we, you know, wanted to go with with this system. And it's, uh, it worked out that we had the space, but I think I would've, I would've found the space no matter what, even if I didn't have it before. Uh, so,

Speaker 4 (12:25):

You know, I've noticed a community within a community and that is independent community pharmacist look out out for each other and bill and that our safe team. That's exactly what they're doing is they're building these pockets of experts about medication adherence, medication packaging. And then they're teaming you up with pharmacists who are a little bit ahead of you in the implementation of this and being able to market it, being able to afford it, answering questions, taking those away as mitigating as much of that risk as you can, because of the pressures that you're under as a community pharmacy owner, put your hands up. If you're under pressure as a community pharmacy owner <laugh> look yes. Does anybody

Speaker 10 (13:15):

Charge

Speaker 4 (13:16):

For this service transportation, anyone charging for the service?

Speaker 6 (13:21):

I honestly think melody that, that, um, our return on investment through supplement sales and increased adherence with the number of fills that we're able to gain every year more than pays for the, and to be honest with you, we did a calculation and it's not much more than what we paid to put Bo put it in bottles. Um, when you consider the, the labor involved with it, I mean, we we've taken our, you know, just talking about the real estate, sorry, I'm sitting here thinking about all the questions. I wanna that back because we had a small area. Uh, you saw our area when you came to our store, but I can tell you we've grown that area. Now. We ended up putting more cabinets in. It's not perfect, but, uh, I mean, it is a medication adherence, me sync, you know, packaging area. And that that team works together and there's just a few you of 'em and they work hard and they, they come cover our lunches in the other. And we're right next. I mean, we're in the same building, we're just in the next room. So, um, we, we were able to, um, figure the cost would pretty much negate themselves, um, uh, with that, uh, based upon, you know, the fact that all these other things would help make up for it, so I could be wrong, but that's just my thoughts. So charge either, but I

Speaker 10 (14:40):

Just wondered dead.

Speaker 12 (14:42):

I wouldn't consider make consideration for payers in

Speaker 6 (14:46):

That arena though. Yeah. It is more valuable to them. Absolutely. Patient safety and everything

Speaker 7 (14:51):

Mm-hmm

Speaker 6 (14:51):

<affirmative> so what, what he said was he, he would consider talking to payers about adding this as an incentive payment to us for offering this type of service, which I, I totally agree. I think it's worth at least $50 a pack, right.

Speaker 4 (15:06):

<laugh> for sure. What about the aspect of communication with family members with those that are a little bit more fragile because you can't hand this box to a, you know, someone who has dementia or has real issues, what kind of communication, what kind of, um, PDF or literature are you able to supply to a family member to get them, to coach them on adherence packaging?

Speaker 7 (15:37):

We have, we have one that is very confused and we, we actually highlight him. We, well actually take it back. The there's a sun on the morning one, so she can, she can recognize the morning one by the sun and a moon on the nighttime one. We go ahead and highlight, cuz we did use another packaging system before that had color. So we, you know, you just do what you have to do to help 'em. It can be used for anybody. It really does simplify things, but there's a moon on the morning and a, um, a moon, a sign on the morning and a moon on the night. So it's, it's very simple, but they do, we do sit down with them the first time, if they have questions or, um, anything like that.

Speaker 4 (16:15):

I'm a big technology nerd, Jenna, but technology can be great. But if you don't have a team supporting you, it's, you know, it's hard. I mean, it's not impossible, but can you describe a customer service relationship that you have with RX safe?

Speaker 5 (16:32):

Uh, it's pretty amazing. You know, in pharmacy we try so many different things and we deal with so many different companies and it's not always great, you know? Um, but I have to say, they're not just looking out, they're not just concerned about how you use their product. Um, I mean they have great customer support obviously, but just this business transformation side of RX safe, that a lot of people don't even know exists. They're working on growing your whole thing. Like they're working on you. Do you really understand what your payroll is? Um, you know, do you know how much it costs per script? I was like, no, well you should. Here's how you figure it out, you know? Or the whole, you know, how are we gonna market supplements? How are we gonna start doing these consultations? Um, it's just been a really good experience, um, from the very beginning it's they they're really looking out for your whole business, not just wanting to sell you a robot and then see you later.

Speaker 4 (17:37):

I want Lisa to just take what Janet just said and put it into my favorite synonym synonym with Lisa, which is KPIs, key performance indicators. That's who I think of when I hear that expression. Can you kind of fold that into the data in the analysis that you're doing for your clients and other pharmacy owners?

Speaker 13 (17:59):

Yeah. KPIs I can talk about for hours. I mean, to, to me, the profits in the data, and if you understand your KPIs and your benchmarks, then you know exactly what you need to focus on. So actively like payroll and some of these other key performance indicators as why they're called those is they're essential to your business. And the thing that I love about leveraging technology in general, you know, my very first pharmacy was in California and the rules there with like technicians and things like that are much stricter than a lot of your other states. I, I hear in a lot of your states, you can have like six technicians for pharmacists and all these kinds of things. We were at one <laugh>. And so we, I leveraged technology and had to adopt technology because that's what we had to do. But really if you understand the technology and how something like this works, you understand the impact on your KPIs.

Speaker 13 (18:44):

So you're not increasing your fixed costs. You're not paying more rent because you get a machine you're not paying, you know, more electricity. Well, you might pay a little more trucks, but teen tiny, um, you know, you're not paying more liability insurance on your building or things like that. Like your fixed costs are not increasing. You might have small operational costs like electricity and things like that, but your profit so much more, the margin that you create goes directly to profit it because you've already covered all of your costs. Your regular business that you already have is covering your costs. And when you do things like this, it incrementally adds so much more profit to your bottom line, every extra dollar that you get, because again, your costs are already covered. And so that's why all these people, when they talk about increasing get from your current customers, like that's one of the quickest ways to grow your pharmacies, to get more from your current customers, um, and then add on new customers.

Speaker 13 (19:38):

Uh, but yes, the KPIs are, are magic. And when you, when I help pharmacies and I see their financials and I take them through the process of pre-technology and post technology, I love the black and white, and I get to show those pharmacies the exact, how much money that they have made extra, how much net profit cuz hello, that's what it's all about. Who wants more net profit at the end of the year, right? Like, yes, everybody should be raising their hand, you know? And so you get to tell them in black and white numbers, because a lot of the things here are very intangible. Oh, my staff's happier. Or my patients are happier. And you know, they're kind of just feelings and guts and instincts, but ma'am you get to KPIs it's black and white. There is no arguing those numbers. And I love working with pharmacies and, and having them go through that transformation that, that I love that word. And, um, you can really see in black and white that this was a good financial decision. Cuz you know, as pharma, we tend to make things clinically like, and we have gone into debt and done all the, the kinds of things because the clinical benefit, but the financial decision, you need to watch out for the financial healthier pharmacy. And it's really fun when you see black and white of how good of a financial decision that was,

Speaker 4 (20:49):

Bill doesn't know I'm gonna do this, but I wanna ask him to come up here because I have some questions for bill, bill Holmes. I've known bill now for about five years and this man cannot stop thinking if, if 100% of his customer base sent him an email that everything is honky Dory. Everything's great. Bill would continue to try to think of what's next and what the innovation is. Bill. I want you to share with us some of the innovation you started with a completely different company before you brought RX safe to life. I want you to share with us what's next.

Speaker 14 (21:29):

You gotta get everybody to sign in NDA before you leave the room. <laugh> can do that. Well, what's really exciting about this show for us. And I'm so glad to be out talking to people. You know, we've been in business now in our 14th year at arc safe. This is my third successful startup company. And I love inventing things, but honestly they're not my ideas. They're not, I have 160 patents, not my ideas. They're your ideas. They really, really are. We've done. We figured it out the other day, about 22 trade shows a year for let's say 10 years, 220 trade shows. I talked to about a hundred of you, great folks at re show over a two to three day period. That's 20,000 interviews with pharmacy owners. I love it because every time I talk to someone, everybody, every time I do a demo or ask a question or someone asks more importantly me a question, I learn something.

Speaker 14 (22:24):

And I take all that stuff in my, in my brain. I sit there on the airplane and I think, wow, why don't we do that? Why don't we advance the state of this business? Why do we have to look at a booth? And we know these companies, you see them, they'll probably be out here on the floor today, 30 years, the same thing, the same product, the same way of ING, the same <affirmative> failure to properly inspect. We truly verify what we're giving our patients. And so we have two new products in our, our booth. One is a, an optical counting technology that counts pills and verifies them. That's new, including clear gel caps. And another is for those really difficult nursing homes that won't give up on blister cards. We've now taken our vision technology and made a blister card filler that can do 50,000 cards a month with a single operator.

Speaker 14 (23:22):

So I'm paralleled in productivity. And you know, I think about this from why are we all here today? We're not here to learn about business. I mean, I love the business expertise that our panel has and how they've been able to Excel and then provide better services to their community. But we're here because we're caregivers. I started this program a long time ago because my dad died with a MEA, broke my heart. My mom had passed away about 10 years before that he was living alone, world war II veteran didn't wanna get help. Didn't wanna go in a home. Wouldn't have someone coming in. Just, I got it, bill. I got it. Don't have to worry bought me. I got it. He had, uh, wet AMD and low vision. He had giant magnifying glass to do whatever he needed to do all day long. And there's those 12 pill vials in his bathroom along the sink that I'd see. Every time I go over there and one day dad knocked him over, did his best to put the pills back in the right bottles, but didn't get it right. And he went in the hospital was in the ICU for six months and that was it. So if we'd have had this

Speaker 14 (24:41):

In his bathroom, he'd still be here, us that simple. And so I thank all of you for giving me the ideas, to try to figure out a way that we can help people. Cause that's what we are, we're caregivers, but the business has to work too. And so, uh, people ask me, you know, how many patients can a pharmacy do? How many of these boxes, these monthly boxes can you do? And we've been, you know, asking our customers, how many can you do? And I think a Ben McNabb in Eastland, Texas, I think at Janet, Janet is doing awesome. Doing, uh, Ben is doing over 600 patients now with a single RX safe, rapid pack. And I thought that was pretty good. It is pretty good. But I checked with, uh, Paul Weinger at long-term care RX LT, CX Manno falls, Wisconsin, who was my first customer first paying customer for rapid pack years ago. They just bought their third one last week. And I ask his technician, Amanda, Amanda, I've been telling people they can, you 50, these 50, these boxes a day, a single technician, a single machine, a single shift, 50 of these a day. Is that still true? Is that accurate? Are you able to do that? And she told me no.

Speaker 14 (26:03):

And I thought, oh my God, I've been telling people it could be 50 and is telling me no. And then she quickly added, it's not 50, it's 80, 80 of these monthly boxes, one machine, one technician, one eight hour shift with perfect accuracy and very little rework guys. That's why I do it. And so what's coming next is the next version of that. So thank you for helping me help you.

Speaker 4 (26:34):

Thank you bill. I wanna thank you. I wanna thank you for being community pharmacists. I know it's not easy. I listen to long term care specialty community pharmacists. I listen to compounders. It's the community pharmacists that have have at the roughest out of all of those settings, including the hospital pharmacists, not saying that they don't have it rough. Everybody has their intricacies, but I wanna, I just wanna say thank you for what you're doing and what you're believing and being here at the national community pharmacist association and please whatever we can do to help you, uh, research for you find, uh, ways of increasing your business. Um, I'm so impressed with the RX safe team and how much they truly care. They're in this business. This is what they do. This is they do this day in and day out. Um, just as you do. And with that, I, I wanna thank you for attending today's, uh, presentation.

Speaker 15 (27:42):

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