Integrating medication timing into community pharmacy workflow improves patient care service delivery
The biggest benefit of med sync for a community pharmacy is the proactive selection of a date so that all of the patient’s chronic medications are filled simultaneously.
Across the country, pharmacists are adopting medication synchronization (med sync) programs that allow patients to immediately collect their chronic medications from the pharmacy. Research shows that medical timing programs improve medication adherence, an issue that is estimated to lead to preventable health problems for patients that cost the healthcare system an estimated $ 300 billion annually.
Med Sync helps improve adherence by eliminating the need for patients to remember to request refills. In addition, it avoids the patient having to go to the pharmacy several times.
Med sync benefits the pharmacy by making the workflow of the dispensing process more efficient. The biggest benefit of med sync for a community pharmacy is the proactive selection of a date and day of the week so that all of the patient’s chronic medications are filled simultaneously.
This allows the pharmacy to predict its prescription volume, which helps both staff planning and ordering inventory. All of these benefits lead to a reduction in on-demand prescription fill, which should allow pharmacists to provide more patient care and clinical services.
Being proactive in drug distribution allows pharmacies to extend their practice beyond distribution; However, many pharmacies find it difficult to implement a medical timing program. Creating a standard med sync workflow procedure and a more consistent implementation process will lead to better patient outcomes and a more predictable work environment for pharmacy staff. A common language document for med sync can provide a framework to create consistency in the implementation of the service.
How do I start a medical synchronization program?
Pharmaceutical organizations have implementation guides for community pharmacies wishing to get started. The Association of American Pharmacists Med Sync Pharmaceutical Practices Implementation Guide Describes the 10-step medical synchronization implementation and details the patient recruitment processes, medication synchronization, and daily tasks and procedures.
Implementation tools have been developed to help pharmacies adopt a medical timing program that aligns with the pharmacists’ patient care process. All tools are available online at no cost. A guide for medical synchronization focuses on the changes that need to occur within the community pharmacy, and an online survey tool helps determine if a pharmacy is ready to support medical synchronization.
Med Sync starts with 2 decisions: how to involve patients and how to involve providers in the process. It is essential to educate patients about the program by explaining the unique benefits of enrollment.
Helping patients facing financial barriers increases patient engagement. For some patients, filling all of their medications on just one day each month can create a financial burden with all the co-payments due that day. Creating practical solutions to reduce expenses often increases the likelihood of patient engagement.
Options to reduce the financial burden include drug assistance programs, prescription discount cards, bi-weekly synchronization, and setting up specialized payment programs. While these solutions alleviate financial barriers, pharmacies may not have access to these programs or services.
As a result, staff members may also research generic alternatives or consult with providers to help reduce monthly costs for patients.
Pro tip: Once patients are enrolled, you want to keep them enrolled. Dedicating staff time to care for patients enrolled in med sync builds trust and relationships, which can improve patient engagement.
Removing barriers to health literacy and transportation also increases patient engagement. The more patients understand their medications, the more likely they are to take their medications and stay on the program.
Compliant packaging can also help patients know how and when to take their medications. Medication synchronization services are linked to adherence packaging in many pharmacies to improve pharmacy workflow and improve patient engagement and adherence.
Additionally, medical synchronization increases convenience for patients with limited or no access to transportation. Patients only need to make one trip to the pharmacy, or if a pharmacy delivery service is available, it allows the pharmacy to make a single trip to the patient’s home.
The commitment of providers is also a facilitator in the implementation of med sync. It is essential to focus on communication between providers and relationships between providers and pharmacists. Providers will be engaged in medical synchronization if they have a good relationship based on continuous and consistent communication with the pharmacist. Provider engagement is seen as a factor external to the pharmacy and should be intentionally implemented to ensure continued collaboration.
Pharmacies with successful provider engagement educate providers about the program and its benefits before patient enrollment. Patients and caregivers are more likely to enroll in a medical sync program when it comes to a referral request from their provider.
This proactive approach allows providers to identify patients who are having issues with adherence and promotes a team approach to patient care. Pharmacy staff can educate providers about their medical synchronization program through in-person visits, phone calls, or faxes.
Pharmacies that are successful in synchronizing more than 50% of their prescription volume find that in-person visits are the most useful in facilitating quality relationships with providers.
To maintain ongoing engagement with providers, pharmacy staff should communicate regularly with providers about enrolled patients. Pharmacies should engage with suppliers to set up short refills, 90-day renewal requests, pharmacy waivers, and tracking of any medication-related issues identified as part of the medical sync process.
How Can I Maintain a Successful Medical Synchronization Program?
Organization of the program
The successful adoption of a medical synchronization program requires an adequate infrastructure which can include physical and human resources. Some pharmacies need a dedicated workspace and others integrate it into their current workflow.
In either case, having a clear process for enrollment, documentation, filling out, and counseling are necessary to be successful. Some pharmacies have adopted software systems to perform medical synchronization tasks, others use paper systems.
Human resources include the participation of several team members in the medical synchronization program. Successful programs engage staff members beyond pharmacists, such as technicians, cashiers, and delivery drivers.
Pro tip: Successful programs have defined criteria for patient enrollment. For example, some pharmacies specify a number of chronic drugs as a listing criteria. Other pharmacies identify patients who have low adherence scores. Some pharmacies automatically enroll all patients and allow others to opt out if they do not want their medications to be synchronized.
A major incentive to improve membership rates is the reduction of direct and indirect compensation costs. This alone is the incentive that many pharmacies use to start and maintain a medical sync program. Once the criteria are defined and shared with pharmacy staff, the program can be offered to patients.
Be sure to document that the offer has been extended to the pharmacy system. This documentation allows staff to track patient enrollment and allows providers to be informed once their patients enroll.
Pharmacy technicians, cashiers, and delivery drivers are critical to successful adoption and maintenance. A team approach is an effective strategy because it overcomes the time constraints that are often cited as a challenge when implementing community pharmacy services.
Having defined roles and responsibilities for pharmacy staff within the program and creating formal and informal training approaches are essential for successful adoption of medical synchronization. Technicians, cashiers and delivery drivers can easily identify patients to enroll.
They can also educate patients about the benefits of the program and document that an offer has been extended for enrollment. Technicians can call patients before the sync date to identify if any medication changes have occurred since the last fill.
This may include whether the patient has been hospitalized or seen the doctor in the past month to check for any medication changes. Technicians will also be essential to prepare the drugs.
Pro tip: Staff incentives are a strategy that improves skills and self-confidence, and drives adoption of medical timing. Incentives provide personal and professional recognition that some staff need. Incentives can include financial gain or positive praise. In some cases, incentives may be needed to help maintain staff engagement.
Literature search and real-world practice reveal a wide variety of medical synchronization implementation efforts. Aligning patient care services with med sync promotes integration of workflow within the pharmacy and engages patients in a regular dialogue about the safety and efficacy of their medications and self-management of their illnesses chronic.
This regular dialogue allows pharmacists to focus on disease state outcomes, such as lowering A1C levels for diabetes or blood pressure targets for patients with hypertension. Working with patients to maximize the benefits of their medications leads to better health outcomes and lowers overall costs of care.
About the Author
Stefanie P. Ferreri, PharmD, BCACP, FAPhA, is Distinguished Professor and Chair of the Practice Advancement and Clinical Education Division at the UNC Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill.