Having spent the past 18 years using, implementing and maintaining pharmacy systems, I have often discussed whether a pharmacy gains or losses efficiencies by utilizing remote processing. Remote processing is also known as load balancing or alternate site processing. For the sake of this blog, I will refer to it as remote processing. Remote processing allows the pharmacist or pharmacy technician to complete activities for other pharmacies under the same ownership and requires that state pharmacy boards allow for the practice. These activities can include any pharmacy task other than the actual placement of the medication in the bottle and labeling the bottle, which in some cases, can be done by robotic automation. However, I will save that for another blog.
Remote processing generally requires that your pharmacy system separates the prescription filling process into more steps. The misconception is that this slows down the filling process for lower volume pharmacies staffed with just a pharmacist or a pharmacy technician. However, if your state allows it, the lower volume pharmacies can not only assist your higher volume pharmacies, but they are more likely to feel the strain of a missing pharmacy technician on days they are short staffed.
Do you have multiple stores in a single state?
If you have pharmacies in multiple states, then remote processing becomes more complicated. You either have to decide to share the workload within the state, or you must have processes in place that ensure you are following each states guidelines and that each pharmacist has a license in the appropriate states. I generally recommend remote processing for stores within the same state. The risk is not worth the reward when dealing with pharmacies across state lines.
Does your state allow for remote processing?
Not all states allow for remote processing. Some states allow for some administrative tasks such as insurance billing to be remote processed, but not the actual data entry of the prescription or any of the pharmacist activities. Check with your state board of pharmacy and your legal counsel before using remote processing methods.
Do you have a process for tracking the remote processing?
If your pharmacy system has the capability of remote processing prescriptions from other locations, then you most likely can track who completed the remote tasks, and the pharmacy that completed the work. However, if you don’t have the technology in place to implement this process, I would not recommend moving forward with remote processing manually. For every step of the prescription filling processed remotely, you will have to track: the person that completed the task, any access to personal health information, the licensed pharmacy that completed the work.
Will you allow control substances to be remote processed?
Although there is not generally any rules that restrict control substances from being remote processed, the pharmacist still has a responsibility to review all necessary information regarding a prescriber’s writing habits, and patient’s filling history to dispense a control substance. Approving the dispensing of a controlled substance when the pharmacist is not familiar with the patient or prescriber can put the pharmacist in an uncomfortable position. If your organization decides to allow remote processing control substances, be sure to give your pharmacist all the tools they need to feel comfortable completing the tasks.
Is your organization ready for drastic change?
Implementing remote processing of prescriptions is no easy feat. Once you get over the regulatory hurdles, you must convince the pharmacy staff that the additional work they will take on will benefit the entire organization, decrease fill times for patients and they will gain the benefit of having their prescriptions remote processed when they need the help. However, these benefits are difficult for pharmacy staff to accept until they have been in the trenches and required the assistance themselves.
Is it worth it?
From my experience, yes. What I find is that lower volume pharmacies tend to help to most but also benefit the most when they need the assistance. Once you can get past the change management aspect of convincing the pharmacy team that they are going to assist other locations, you see some amazing benefits to your organization. Some examples I have witnessed are:
- A busy pharmacy that had both their technicians out sick on the same day and the pharmacist was working with only a clerk. The pharmacist was distraught knowing that the day would start that way. However, with the other pharmacies assisting through remote processing, the only technician duty the pharmacist had to complete was counting the medication.
- In mid flu season, a pharmacy was overwhelmed with requests for immunizations. The pharmacist was both happy to have the immunization business but knew he was falling behind in his work. Once the prescriptions started falling behind schedule in the queue, they were picked up by surrounding pharmacies. I will never forget him telling me the story of him coming back to his workstation after completing an immunization and all his work was caught up and all he had to do was the final verification step.