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By Ravi Patel, PharmD
Community pharmacy is an integral part of the healthcare experience for patients and clinicians. At Blueberry Pharmacy, we have had to create both the best in-person and online pharmacy experience through our membership model, launched in the middle of a global pandemic. What puts the “community” in the experience as more interactions between patients and pharmacies migrate digitally?
With the recent pandemic, more services add “tele-” to their workflow. Since each patient may have a different experience in a pharmacy, there are a lot of difficult challenges to account for when recreating the online pharmacy experience. In terms of workflow, getting a patient’s prescription to a pharmacy has shifted from paper scripts and call-ins to e-scripts. The growth of online pharmacies introduces the step of getting a new prescription via telemed or having to transfer an existing prescription to the online pharmacy. Already, in this online process, there is an additional consideration for both the patient and clinicians involved. Add to this new online pathway the challenges of confirming patient medication and disease profiles, assessing medication appropriateness and safety, and counseling a patient on monitoring and side effects. These are hard enough for brick-and-mortar pharmacies that perform these steps when the patient is in the store. When online, the steps for getting a prescription, completing a patient profile, and assessing the outcomes of medication have to somehow avoid falling through the cracks. Online messages, phone tag, multiple SMS text chains, and emails compound the cracks.
The challenge in striking a balance between a delightful user experience online and safe/effective medication optimization are often at odds. In the economics of scaling an online experience with medications, there is minimal incentive to account for all of these potential pitfalls of pharmacy workflow while still getting patients to use an online service. When ordering a single medication from a specific online pharmacy (for example medication to prevent hair loss, birth control subscription services, ad hoc antibiotics), the most efficient option is to check as many boxes as possible and move on. Contraindications are boiled down to questionnaires. Medication interactions based on patient inputted medication lists. Patient counseling limited to a check box or buried in the terms of service. All challenges that community pharmacies face when a patient shows up to the pick-up window. When something goes wrong, there is a human somewhere in the phone chain or at the counter to help troubleshoot the problem. When online, problems exist and perhaps get lost in the cloud. Responsibilities for these problems lay somewhere between the patient, who is just trying to get the best care with their available resources, and the pharmacy, who is just trying to deliver the best care with their resources.
The membership model for pharmacy still faces these challenges of care for patients both analog and digital. It does, however, help define the incentive of the pharmacy to invest the time and ongoing resources to the tasks that are often overlooked, in the form of a minimum, guaranteed professional service fee (dispensing fee=cost plus). Membership models introduce even more challenges and opportunities with digital experiences. Managing recurring payments can be a challenge to incorporate into pharmacy dispensing or point of sale systems. Memberships offer recurring revenue and can connect to other community resources such as discounts to local businesses. While offering unique challenges and values, the membership model helps strike a balance between the online pharmacy experience and the truly “community” in-store pharmacy experience.
It will take hard work, failures and learning, and recognition of obstacles to make the best experience in healthcare through both online and in person experiences. Memberships offer a great pathway to start.
