Buckets in the Pharmacy? A look at pharmacy operations…

I’m a visual person.

In the pharmacy, visual cues help me make quick decisions regarding prescription status. As a student at a “chain pharmacy” I would put prescriptions in blue buckets or red buckets. Blue buckets for folks picking up their prescriptions in one to two hours, and red buckets for folks picking up in 30 minutes or less.

Throughout pharmacy school it was blue bucket versus red bucket. It’s a pretty efficient model. So efficient I took the practice up at the independent pharmacy that I manage. These buckets can easily be purchased online.

Then I went to business school and started studying operations management. I started to gain an appreciation for the blue bucket/red bucket workflow process. It was an effective method of ensuring customer satisfaction. It gave the Pharmacist visual cues as to what order prescriptions needed to be filled. Lastly, it helped maintain organization, thus decreasing “defects“. With the buckets you can simply drop the prescription in the bucket with the drug. Thus, things matched up when it was time to enter the order and fill the prescription.

I began reading articles on how other Pharmacist maintained organization. I read an article by a man that discussed how he used multiple colors of buckets. When I read the article, I felt like a pharmacy nerd when I read the article and became giddy. For me I had only known blue bucket and red bucket. How could I incorporate more buckets? I know I know…sounds lame!

I began writing up a method and came up with the following:


WORKFLOW

DROP OFF —> DATA ENTRY—>FILL PRESCRIPTION–>VERIFY PRESCRIPTION–>PICKUP PRESCRIPTION

BUCKET COLORS (Pharmacy Tech/Pharmacist organize accordingly

BLUE- prescription to be picked up in 1 to 2 hours

RED– prescription to be picked up in 15 to 45 minutes

GREEN– prescription medication is high dollar; pickup likely next day  

YELLOW-prescription has an issue ( order needs clarification, call pharmacy benefit plan, etc.)

BLACK– prescription to be compounded

WHY we WORKFLOW

Workflow improves patient safety. Please keep with the workflow to better serve our patients.


 

This is what works for me as the manager of a pharmacy. The buckets allow me to remain efficient and organized. Both Technicians and Pharmacist can be on the same page with a simple color cue.

I know some people will think this is entirely too much! I would completely understand if you felt that way. It’s an idea…consider it and think of ways that you can tailor it to fit your own practice. I use this technique for pharmacy, however this same technique could possibly be used in the operations of other business models.

Is your business predicated on “volume” to maintain appropriate profit margins? Colored buckets are a cheap investment and can potentially increase your worker’s efficiency. Increased efficiency will increase worker output. Maintaining appropriate output very well could be the difference in business success or failure. IMG_3806


Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Life of the manager— Think. Reflect. Improve!

What are you doing? Are you faking it till you make it? What’s the plan? Solve the problem! You don’t know what you’re talking about!

The more education I attained the more I realized that I had built a catalog of reference points. We read, we learn, and hopefully when the time comes we are able to reach back into the card catalog of our memories to find that one bit of information that will help serve the person staring at us looking for any bit of help.

In the pharmacy the realization that I’m consistently learning and re-learning is always upon me. On any given day, I can learn patience from a child, a bit of humor from a grandpa, and reminders of how to not take myself too seriously from co-workers.

A manager that knows how to motivate realizes that educating employees on how to do things the right way everyday is the difference between a success and failure. It’s the vital component to providing a service the public wants and the level of compassion needed to ensure the consumers of your product are retained.

Education isn’t just for classrooms. What are you doing to improve your chops as a communicator and as a teacher? Do you take the time to be quiet and watch those that are gifted perform their gifts? Are you capable of listening to an employee’s new idea?

As a manager of people be willing to learn from both those you manage and the customers you serve. Things can always be better, performances are never perfect and can always be improved. Never take for granted the opportunity each day that you have to serve the public. Focus on the foundational topics of your profession. How are you going to multiply if you haven’t learned to add and subtract? Hopefully, with reflection, you’re able to find reference points of education that were learned in the classroom and on the job that will allow you to expand and grow your business.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

Prior Authorizations: what can you do to help your prescribers

Prior Authorizations (PAs) are forms that are completed by the prescriber or prescriber’s agent (person that completes the form for the prescriber’s signature) for the patient to receive his or her medication. Reason’s for prior authorizations include: cost of the medication, the quantity of medication prescribed, early refills, off label use of a medication, or simply because the medication is not on the patient’s drug formulary.

Out of the many questions and answers regarding prior authorizations, the key information that the pharmacy will need to provide the prescriber with are as follows:

  1. National Provider Identification (NPI) of the Pharmacy
  2. Street Address, Fax Number, & Phone Number of the Pharmacy
  3. National Drug Code (NDC) of the medication in format 00000-0000-00 (first five digits are drug manufacturer, second four digits are drug identifier, last two digits are drug package size)
  4. Inform the prescriber of the package sizes that are available; some drug products only come as kits, unit dosed packages, or need to be reconstituted.
  5. The patient’s pharmacy benefits Identification number

The prescriber or prescriber’s agent can complete the process by adding the following information to the PA:

  1. Prescriber’s NPI, if unknown this can be searched via: NPI Lookup
  2. ICD-10 code that matches the diagnosis of the patient
  3. Street Address, Fax Number, & Phone Number of the Prescriber
  4. Last, but certainly not least..Get the Prescriber Signature!

Lastly, a good resource for prescribers and pharmacies is the website covermymeds. The site can be linked into your pharmacy’s software and faxes can be automatically sent to the prescriber with some rejection codes. For prescribers this is a great resource to complete PA’s electronically, and it gives you electronic access to the correct PA forms that correlate with the patient’s pharmacy benefit plan.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

The cost of pharmaceutical compounding…

“Ya’ll charged me $45, and the pharmacy up the street said they were gonna charge me $400!”

When searching for a pharmacy that compounds; ask the pharmacist if they’re able to file a claim for the prescription under the patient’s pharmacy benefits policy.

If a member of the staff states that the pharmacy can not file the claim under the pharmacy benefits ask the following questions:

  1. Did you attempt to file the claim under the benefits policy?
  2. If an attempt was made to file the claim on the policy; why was the claim rejected? What were the rejection codes?
  3. When the claim was filed under the benefits plan did the rejection message include a phone number?

A typical rejection for a compound claim is ingredient(s) non covered/ product service non covered. The phone number listed on the rejected claim can be used by the prescriber or pharmacist to call on your behalf and gain additional information as to why the claim rejected and if additional paperwork can be submitted on the patient’s behalf to get the compound covered under the patient’s benefits policy.

In regards to pricing — the things that a pharmacy takes into consideration when setting a price are as follows:

  1. Cost of Drug
  2. Cost of Suspending Agents/Flavorings/Preservatives
  3. Compounding Dispensing Fees — this factors in the overhead of producing the final product (labels, tech time, gloves, equipment, etc.)

From there, the pharmacy calculates pricing based on the following principles:

  1. The “Breakeven Price”— this is the price that can be set where the business loses no money.
  2. The price markup factors — Imagine if the cost of producing the product is $5. The business can then say their markup factor is 2. A markup factor of 2 means the selling price is $10. Gross profit margin can then be calculated as (Revenue-Cost)/Revenue. Thus, profit margin in the above scenario is 50%.
  3. Supply and demand — The greater the supply the less the demand and the less supply garners greater demand. Price therefore can shift up and down based on conditions in the market.
  4. Drug shortages in the market can induce price increases.

Be an informed customer at your community pharmacy. Asking questions about compounding can lead some of your pharmacist friends to talk your ear off.

Questioning your pharmacist on this topic will provide that pharmacist with an opportunity to teach, learn, and build trust with a member of their community.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

A Pharmacist’s role in the community…

As a pharmacy student I was fortunate to have the opportunity to be a Pharmacy intern in Eutaw, AL. The Pharmacist that served as my preceptor played a major role in serving that community.

First, he owned one of the two local independent pharmacies in the community. Thus, he filled folks prescriptions and provided jobs for people in the town.

Second, he served as the pharmacist for the local hospital that was licensed for 20 beds. You can’t have a functioning hospital without a pharmacist to dispense and order the medicine.

Third, he served as a consultant for the local nursing home which by law has to have medication chart reviews.

Fourth, my preceptor at various points in time owned multiple businesses in the community. One of his technicians told me that at one point he owned the “bait shop” in town. I mean you have to have good bait if you want to catch some fish!

Fifth, and just as important as anything aforementioned; he gave back to his community in the form of time, service, and money.

I remember a man in his early 50’s walking into the pharmacy and asking to speak with my preceptor. My preceptor walks down the steps of his pharmacy; his pharmacy was “old school” and the counters and shelving for dispensing the medication sat at an elevation in the back of the store. He and the gentleman discussed the need for the high school football team to have good uniforms that fall. The team had to be presentable for it’s Jamboree game which was coming up in a few weeks. Without hesitation my preceptor verbally committed a donation. The football team after all was a representation of the community.

On another occasion he helped folks by making sure people got their medications even when they couldn’t afford them due to lack of insurance. He frequently allowed customers to have charge accounts; allowing the customers to come up with the money and pay the pharmacy back in installments.

My preceptor that month had a lasting impression on me. It made me understand what a Pharmacist can accomplish in a day. One month with him helped me to define the level of impact that a Pharmacist can have on their community.

As a student I sat in class and listened to plenty of lectures regarding pharmaceutical science and pharmaceutical practice. In Eutaw I was forced to consider the social sciences (socio-economics, history, politics). These factors are just as important to consider when educating folks about medication and lifestyle modifications. I learned there was a reason why they call it “pharmacy practice”. Pharmacy like life isn’t always black and white — but rather shades of gray.

I’m blessed to have had the experience. It helped me to identify opportunities in the community that I serve presently. Imitation they say can be a form of flattery. I don’t plan on fully imitating the role my preceptor played in Eutaw, AL. However, I write this because at times Pharmacists can undervalue the role we play in the community and in the lives of the folks we serve and manage.

I do believe that each Pharmacist, including myself can identify their God given talents to play a greater role in the communities that we serve. Our main objective in the pharmacy is to dispense medications correctly. But outside of the pharmacy what can we do to show folks who we are and what we represent!? Hopefully by trying to figure this out, we can be more like my preceptor from Eutaw, AL and increase the value of the things we can accomplish in a day of work. This type of thinking I believe will uplift our profession and the communities that we serve.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

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Image created by Pearson Scott Foresman: https://openclipart.org/detail/230387/mortar-and-pestle

The “disruptor” is back, and they’ve come to visit your local pharmacy…

Amazon’s plan to purchase Whole Foods has caused quite a tizzy with some Pharmacists interested in seeing if this leads to new job opportunities in the market, or on the flip side potentially leads to job loss with a disruption in how drugs are delivered and consumed.

For me personally I turn to SWOT analysis to understand the pros and cons of transactions. SWOT stands for strengths, weakness, opportunities, and threats regarding a business or transaction. To get a brief overview of SWOT analysis visit wikipedia.

So with that being said…let’s take a look at what we have on our hand’s from my perspective…

Strength

  1. Amazon has plenty of money and is willing to spend it to keep the business growing. At the close of the bell on June 19, 2017, Amazon’s stock price is at $995per share. Gross revenue end of year (eoy) for 2016 was 135 billion dollars. Net income after operation expenses and taxes was 2.3 billion. Net profit margins for 2016 were a measly 1.74%. With so much money being made, why the low margins? Jeff Bezos, the CEO of Amazon is known for reinvesting profits back into the business. For Amazon, this has meant an emphasis on building infrastructure (fulfillment centers) and emphasis on technology and design (Amazon Fire, Echo, etc.). Don’t believe me? Click on this “article” published in 2013.
  2. Amazon is the “ultimate disruptor”. The company was essentially founded to disrupt; with the first disruption on how books could be sold and viewed on the internet. In my opinion, this company enjoys being a disruptor. Thus, they will know how to hire employees that will meet and exceed the demands of the consumer.
  3. In terms of potentially enter the pharmacy market; purchasing Whole Foods allows Amazon a traditional path for initially entering a market that can have some tough “barriers of entry”. Brick and mortar pharmacy locations can be setup at Whole Foods in a matter of months if they have the right staff in place.

Weakness

  1. The market already has both chain, specialty, and independent pharmacies meeting the needs of customers. Do we need pharmacies inside Whole Foods? Are the Whole Foods locations in idea markets as it relates to pharmacy?
  2. Pharmacy Benefit Managers can simply not allow Amazon to enter into the marketplace as a provider. This would create a barrier to Amazon’s entry and force the company to potentially create it’s own benefits company which would be costly and time consuming.
  3. Pharmacy is a business of supply chain. With the manufacturers working closely with the wholesaler and the wholesalers working with the pharmacies to create a marketplace for the consumption of goods. Each part of the supply chain has strict laws around their practice and distribution of drugs and medical products. Once again, this is a barrier to Amazon’s entry and it may be too time consuming and costly.

Opportunity

  1. Amazon already has mail orders through prime memberships. They have contracts in place with the postal service and other mail providers. Thus, mail order pharmacy can be an easier point of entry into the pharmacy market.
  2. There aren’t a ton of Whole Foods in each city. So, do they use their fulfillment centers to fill medications? Or would they rather setup closed door pharmacies at the Whole Foods locations and register each location as a mail order within the states they’re located? Either way the purchase of Whole Foods allows them to have more options.
  3. Automation has always been key to their success. How will they incorporate some of their technology in ways to change how pharmacy is currently practiced? Automation is already in use at most “big chain” pharmacies. How can Amazon use it’s technology to allow Pharmacists to fill prescriptions faster and more accurately?
  4. Knowing which medications people are on gives them a point of entry into each persons life. Now that they know your medicines, they can now data mine your information even further to know what you’re potentially going to purchase in the future. So potentially the real money to be made is on having the data. Dispesning the medication just allows a point of entry into your life. Medications are simply “loss-leaders”.
  5. Cash paying customers seeking alternative pricing to “big chain” stores.
  6. Being seen as a “disruptor” that brings about more transparency in drug pricing.
  7. Greater access to medicine for folks in countries that do not have the same level of healthcare as the United States.

Threat

  1. Major players (Caremark, Express Scripts/Medco, Optum Rx, Prime Therapeutics) will not give up market share without a fight.
  2. Healthcare law…what happens to ACA..is it repealed and replaced or just repealed?

Whats your opinion?

Is Amazon even interested in the pharmacy business? Are they just dipping their foot into the pool to get a sense of the market? Either way, it will be interesting to see how it all plays out.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Priced to sell….

Price sensitivity is the core concept to consider in trying to understand how brick and mortar businesses lost market share to the internet. Price sensitivity is the way customers perceive a price and the ensuing demand the product has on a given market. Four questions can be asked by the manager regarding a product and how to effectively price the product to sell.

  1. Is a product’s retail price too high?
  2. Is a product’s retail price too low?
  3. How many substitutes exist for the product?
  4. How many complements exist for the product?

There is a “buyers psychology” in determining how to price products. In understanding subtle human behaviors, an observant manager can easily increase their sales per square foot.

In this article I will discuss some of the things I’ve considered in increasing foot traffic and sells. By driving foot traffic, you can further teach patrons about your core business.

Know and understand your mission

A business must have a mission. That mission must be at the core of all selling activity.

Know your mission, understand your staffs strengths and weaknesses, and leverage it to increase sells.

Know and understand your customer

Your core audience will desire the same core goods to be sold.

Make sure those goods are in stock consistently. Work hard to ensure that stock outs of these core items are prevented.

Price products to move

Pricing aggressively is easy to say but difficult to do.

Create pricing tiers with corresponding markup factors to ensure consistency in customer expectations of price.

For example you make a rule to price products that cost under a dollar by a markup factor of 2, and products between $2 and $5 have a markup factor of 1.5.

Whatever rules you put into place just make sure the rules remain consistent. Have a goal, understand your margins, and price to move!

Limit the selection of products offered

Limiting product selection can be a good move for both the small business and the customer.

Your business can’t be everything for everyone. If you sell fried chicken well is there a real need to add hamburgers to the menu?

By limiting inventory, the business saves money on inventory carrying costs. The consumer also learns to have an expectation of whats carried and not carried at your store.

Leverage the products sold to discuss core business

Ancillary sales of products drive home your core business. When you go to a bakery you will notice that the baker also sells candles, forks, plates, and a cake cutter.

Consider asking yourself… What products complement my core business?

Use substitutes and complement products to increase sells

Bread goes with milk and salami can be substituted with ham. Having a simple understanding of this core principle will allow you to leverage sells of multiple products on your shelf.

If it doesn’t sell drop the price and remove the product from the shelf

Retail space is precious. There are only so many products that can fit in a store. Thus always ensure your core products are placed on a shelf in a manner to sell.

For products that aren’t selling well, find a way for your customers to give the product a shot.

This can be done by positioning the item in a new area of the store, or by discounting the product in a manner that may make the consumer give the product a try. If the product doesn’t sell don’t be afraid to pull it from the shelf! Discount the product to a breakeven price and move on.

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Sam Blakemore is a graduate of the McWhorter School of Pharmacy. Sam is the Pharmacy Manager of Peds Rx Pharmacy Solutions.  Feel free to connect with him via LinkedIn

The manager’s to-do list

What is the life of a manager…

  1. Reconciliation of payments
  2. Price strategy
  3. Cash flow statements
  4. Profit and loss statements
  5. Operations management
  6. Maintenance of facilities
  7. Human Resources

What a to-do list…

Suffice to say, that list could keep going. Out of all of those ingredients that define the “life of a manger” which ingredient means the most?

Pondering….pondering…ponder some more.

  • So.. it’s easy to say “no money no business.” So making money is most important…Very true and you wouldn’t be wrong!
  • It’s easy to say “if we can’t figure out our pricing strategy there’s not enough gross margin will lead to no business.” Very true very true and you wouldn’t be wrong!
  • It’s even easier to say…well “if you don’t have good operations management, then you can’t ensure a quality product that the customer will enjoy.” So true!!!!!

So… no money no business, no strategy no business, and no operations management no business.

But before all of that the most important ingredient in my opinion is the word “PEOPLE”.

Without good people a manager can scream about strategy until they’re RED in the face. Strategies can’t be implemented without quality people that are passionate about the task at hand.

Human resources in business school to me seemed to be this shadowy figure in the back of the room. It seemed to be too distant and cold. It felt too gray when what I wanted was black and white facts!

We go to business school to learn profit margin calculations. Those formulas are easier to calculate than an employees formula to how to have happiness at work. Reconciling accounts receivables and payables is easier than talking with an employee about their two week notice.

So what are some principles too consider when it comes to the topic of human resource management? These are broad topics on some things I’ve learned over the years…and maybe you can consider these points of discussion in your own manager’s playbook.

  1. Communicate—it’s easy to tell people what time to come to work. It’s not so easy taking the time to delve deeper and forming a true line of communication with your staff. Take the time to learn about their lives. Communicate with them about the things they’re doing well and the things that they can work on.
  2. Interview—always take new applications. Interview candidates even when all the positions are filled. By taking the time to interview, you will already have a short list of potential candidates when a position opens.
  3. Evaluate—hold evaluations twice a year if possible. Mid year and annual evaluations give both you and your staff an opportunity to reflect and recharge.
  4. Designate—find a leader within your staff and begin to develop their abilities to lead small groups. In doing so, you will help the employee develop leadership and become less of a micro-manager.
  5. Listen—be open to your staffs opinion. You will learn more about your business in 30 minutes by listening than you will by talking.
  6. Define a process—don’t rush the process. Take your time when making a hiring decision or worse a firing decision. Be methodical in your rationale and create a template that will help you define your current and future decisions.
  7. Understand roles—how can you understand your staff if you’ve never completed their daily tasks? Take the time to learn and perform the tasks of a staff employee. This will go a long way in helping to communicate expectations.
  8. Observe—don’t immediately jump in to save the day. You have to let people learn by at times allowing them to make mistakes. Observe the mistakes that were made and then take the appropriate steps to correct.
  9. Boundaries—there are boundaries that can be crossed. Define to your employees that work can be fun but that professionalism must be maintained.
  10. Teach—a managers teaching never ceases. Take joy in teaching your staff new ideas and ways to consider various topics. Stay informed and read about the latest ideas. Remain committed to your core foundational principles and reaffirm these principles by reviewing your company’s literature.

Nothing in this article included a discussion of how paid days accrue, or how to complete background check documentation. Thats the paper side of human resource management. This article is about being a manager that can help create an atmosphere conducive for success. Stay committed to your company’s foundation. A manager’s life is full of to-do lists but remember that without people those to-do lists never get completed!

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Sam Blakemore is a graduate of the McWhorter School of Pharmacy. Sam is the Pharmacy Manager of Peds Rx Pharmacy Solutions.  Feel free to connect with him via LinkedIn