On February 8, 2011 in Las Vegas, NV, NCPDP held an educational summit “Leveraging New Technologies: Impact on the Patient and Healthcare Industry ". The program focused on the pharmacy of the future and discussed the impact of emerging technologies on healthcare, pharmacy and patient care. What transformational technologies are available today? What is on the horizon? How do these technologies support improved patient care and outcomes? What are the benefits and impacts on the patient, pharmacy, payer and vendor? What will be the role of the pharmacist and technician in the future?

Michele Davidson, R.Ph., Manager, Pharmacy Technical Standards, Development and Policy, Walgreens, Chair of Educational Programs Committee opened the program. Paul Hooper, Vice President of Pharmacy Network Services at Emdeon, served as moderator. He set the stage for discussion of drivers in our industry, including patient-centric healthcare, regulations and acts, and information technology initiatives.

Paul J. Oesterman, Pharm.D., Southern Nevada College of Pharmacy, spoke on “The Evolution of Pharmacy Through the 7 P's”. He examined how technology has impacted all phases of healthcare focusing on pharmacy and how technology allows for more informed patients. Prescriptions evolved from “hand-scribbled” notes to e-prescribed documents. The design of pharmacies changed from simple and traditional to deliberate layouts focusing on merchandising, adjacencies or specialty pharmacies. The pharmacist is no longer merely a dispenser of product but is recognized as a valued member of the healthcare team. The products dispensed reflect ongoing technological advances. The payers for pharmacy service are taking a more significant role in healthcare. Together these contribute to the new model of pharmaceutical care. He discussed the internet influencing patient healthcare decisions, and the changes in the relationships and interactions between patient, provider, and pharmacy.

Rick Sage, Vice President of Clinical Services, Emdeon, presented “The Magic in the Middle - Technology Infrastructure” where he explored the factors from the industry that is placing more demands and opportunities for pharmacists such as physician shortage, technology, services (MTM, REMS, lab result reviews) and all the exchanges of clinical information (CHINs, RHIOs, HIEs, ecosystems of exchanges, etc). Sage discussed the need for the expected convergence of all healthcare information (administrative and financial, and clinical). There are many opportunities for connecting healthcare entities and moving information between them. Discussion needs to break down barriers so information can be exchanged with privacy and security needs met. ROI may not work the first time; but the next evolution, with technology improvements on the receiver side, the ROI models then change. Technology moves at different speeds, but it continues to move. Adoption is key.

Robert E. Franz, R.Ph., Director of Clinical Studies, Medco, discussed “Leveraging Automation and its Impact on Dispensing”. He discussed the characteristics of a “system” and interactive planning of “where we want to be” versus “where we are”. Franz presented integrating the delivery of high-quality pharmaceutical care through state of the art delivery service pharmacies, state of the art cognitive pharmacies, and network partnership with retail/community pharmacies. One of the most advanced pharmacies in the world is the new next-generation automated 318,000-square-foot pharmacy, which opened in 2009, which utilizes automation and the skills of pharmacists, pharmacy technicians, engineering technology, and pharmacy support to dispense more than one million prescriptions a week at peak operation. Using the most advanced technologies, the pharmacy delivers among the highest level of prescription drug dispensing accuracy in our industry. A highly automated prescription dispensing system achieved dispensing accuracy rates 23 times better than those reported in a benchmark study of accepted pharmacy practices - resulting in a dramatic reduction in potentially serious drug-selection errors.

“Mobile, Money, and Medications” was the topic led by Robert S. Oscar, R.Ph., Founder, RxEOB, Today 40% of Americans own a “Smartphone,” and 20% access the Internet from a mobile device on a regular basis. Already 9% of cell phone users have downloaded a health “app.” Getting personalized pharmacy guidance to a consumer’s mobile device improves medication safety, promotes long-term compliance, fosters evidence-based care, lessens pharmacists’ administrative burdens, and reduces excessive drug costs. Specifically, mobile gets consumers information where it is most useful -- the exam room, the pharmacy counter, and the bathroom’s medicine cabinet. Capturing this value requires a properly executed program that combines clinical pharmacy expertise, data analytics, and deep understanding of user demand. He discussed attacking three problems together – improve care quality, reduce care costs, engage consumers directly. Oscar also provided a mobile Rx “design checklist”.

Scott M. Robertson, Pharm.D., Principal Technology Consultant in Health IT Strategy & Policy, Kaiser Permanente presented “The Consumer’s Health-Tech Market Place”. Consumers have access to a wide variety of technologies to help manage or improve their healthcare. Robertson presented a survey of market place consumer-centric health technology. Some products have been around for a while, while others are new and novel applications of technology. He explored products for Adherence, Monitoring, Drug Delivery, Safety, and Therapeutics; spanning from physical devices to applications and social media. Of particular interest is how healthcare, particularly pharmacy, can participate and leverage these technologies to aid the consumer. He also tackled health concerns that come along with some technology, as well as privacy, security and regulatory issues.

Wayne E. Armstrong, Senior Vice President, Argus Health Systems, Inc. posed the question “Does the Healthcare System REALLY Need to be Automated?” He presented a different view of the existing healthcare delivery system and the role of technology. He discussed the premise that in many instances the wrong constituents are driving the evolution of systems and the delivery of care. Armstrong discussed the various roles necessary to implement an effective strategic direction for delivering quality care with efficient administrative processes. What will drive the direction of healthcare in the future and its potential impact? He suggested thought-provoking changes in information exchanges and strategic missions of health plans that do not always require technology. He proposed that true analytics and forecasting should be integral to healthcare businesses. The consumer is coming and the industry needs to be ready to deliver information.

Thank you to all the presenters of the Educational Summit. Thank you to the sponsors Express Scripts, Inc. and Otsuka America Pharmaceuticals for their continued support of the educational programs. If you would like to be part of the team creating educational opportunities by joining the Educational Committee, please contact Meredith Button mbtton@ncpdp.org.

On November 2, 2010 in Portland, Oregon, in the NCPDP educational program “The New Economy and its Impact on Healthcare, Pharmacy, and the Patient" attendees explored the reality of the new economy and healthcare. Michele Davidson, R.Ph., Walgreens, Chair of Educational Programs Committee opened the program.

George VanAntwerp, General Manager, Pharmacy Solutions Group, Silverlink Communications, served as moderator.

Dilip Sedani, R.Ph., CFO of Pharmacy, Kaiser Permanente, led the program with "Defining the New Economy". How did we get here? What is the effect on the global economy and the responses to the financial crisis? Because of the recession and problems in the healthcare system, care is being put off due to income impact. Healthcare premiums have more than doubled in the last ten years. Sedani discussed the impact of healthcare reform. Futures include preventative care, Medication Therapy Management (MTM), comparative analysis, and virtual technology in medicine.

Gerald Cohen, JD, MBA, Oregon State Director, AARP, discussed "Impacts of the New Economy from a Patient’s Perspective". He provided insight via personal experience in his family. Cohen discussed partnerships with patients and caregivers. He highlighted the experiences in the AARP Oregon prescription lessons. The healthcare reform act affects long term care and impacts to the aging and includes social and medical home support. There is a need for more pilots and demonstrations.

A panel discussed "Changes Ahead for the Pharmacy Industry: What Will the New Economy Bring?" The panel consisted of Fred Eckel, R.Ph., MS, Executive Director, North Carolina Center for Pharmaceutical Care, Carla McSpadden, R.Ph., Director of Professional Affairs, The American Society of Consultant Pharmacists, and John Lynch, III, Vice President of Operating Policy and Internal Controls, Eaton Apothecary. The current healthcare system is broken. Change is coming. Pharmacy believes it has an important role to play. Many forces within and outside pharmacy will influence those changes. They reviewed some of those forces and suggested their impact on pharmacy.

McSpadden discussed that everyone is impacted by the aging population. We are moving from institutional to home and community-based services. She also provided background and the status of the short cycle dispensing to reduce pharmaceutical waste and the impact to the industry. Impacts are expected to be to billing, audit, and dispensing options. On the topic of MTM she noted that grants, medical home, Independence at Home pilots, Accountable Care Organizations, and other opportunities are now available.

A 340B overview was given by Lynch. He discussed various impacts of health care reform to the 340B environment – what happens if all are insured? Do people care when they don’t really pay? He spoke of health care reform and the formation of “exchanges” and their operational impact based on experience in the Massachusetts program.

Eckel reviewed the vision of what pharmacists should be doing versus what is happening. Will the new economy change this? Does the current model facilitate the pharmacist accomplishing this? The current environment may not be as conducive to what we think the pharmacist should be doing. He posed the question “Do we need more pharmacists to act as “recovering dispensers”?” and the need to think differently and measure success. Another consideration is there are more pharmacists graduating, but what is the economic impact of patients not picking up their prescriptions?

Jean Paul Gagnon, Ph.D., Sanofi-Aventis US, presented "Comparative Clinical Effectiveness Research (CCER), Health Information Technology (HIT), and Health Coutcomes". The initial CER legislation was in 2003 with funding in future years. The second impact was the ARRA in 2009. Gagnon discussed the meaningful use requirements of 2009 and following and the creation of the Patient-Centered Outcomes Research non-government Institute (PCORI) – a non-profit corporation to assist in making informed health decisions. He posed the ability to create a “Consumer Reports” for clinical effectiveness.

"How Will the New Economy Impact Payers and Providers?" was presented by Sean Karbowicz, Pharm.D., Manager of Clinical Pharmacy Services, RegenceRx, Health plans are facing political, economic, and technological dynamics never seen before. The rapid development of sophisticated, high-cost medications, the recent economic downturn, and increased government intervention result in new requirements and opportunities for pharmacy benefit delivery and management. Innovative solutions are needed to ensure that health care resources and dollars are used most effectively and can meet governmental requirements. He discussed a heath-plan based pharmacy benefit service to learn about rigorous application of scientific evidence, integrated pharmacy and medical benefits, and unique utilization management programs to address these complex issues, engage members and deliver sustainable prescription drug benefits.

George VanAntwerp discussed "Business Approaches to Survive and Thrive in the New Economy". Pharmacy is evolving – consumers are overwhelmed, and consumer engagement is evolving. There are new technologies, delivery model pressures, and PBM differentiation. There are new tools for consumers. He asked how much do practitioners want to engage patients. “Location” and counseling are now virtual. Entities are engaging retired practitioners, PBMs are offering counseling. VanAntwerp suggested that commercial MTM, pharmacy in the medical home, communications through “apps”, and greater coordination between retail and PBM are changes coming.

A closing panel of Fred Eckel, John Lynch, III, Gerald Cohen, Sean Karbowicz, Jean Paul Gagnon, and George Van Antwerp discussed demonstrating value and promoting awareness of the pharmacist – using touch points for customer satisfaction, where experts could assist in pointing the consumer to tools. The panel discussed how the industry can embrace MTM to continue to increase adoption. The topic then switched to copayment subsidies (marketing coupons) and the various perspectives of the consumer, pharmacy, plan, and employer. The panelists then had the opportunity to react to other presenters.

Thank you to all the presenters of the Educational Summit. Thank you to the sponsors Express Scripts, Inc. and Otsuka America Pharmaceuticals for their continued support of the educational programs. If you would like to be part of the team creating educational opportunities by joining the Educational Committee, please contact Beth Fagan bfagan@ncpdp.org.