The Future of Telepharmacy

by Gavel and Pestle | Pharmacy Podcast Network

Show Transcript

Major:
Hey guys, my name is Major, this is Darshan and this is the Gavel and Pestle Podcast. Today, we are interviewing Tim Yokana, did I say that right?

Tim:
Yeah, you got it Major.

Major:
There we go. We’re going to be interviewing Tim about his company Scaled Enterprise Solutions. And Darshan?

Darshan:
Yeah, so, I’m doing good. Major and I were laughing right before this call ’cause I was doing really really well, I was having a good time, and Major’s like “ah, you need to be little bit less excited ’cause it’s not sounding… like you need to be awesome,” and you know what? I’m really excited about today’s talk ’cause it’s something I’ve wanted to talk a little bit more about. I’ve worked with Tim on this stuff before and I just thought this was great conversation to have on the Gavel and Pestle. Because it’s time to talk about telepharmacy. And it’s one of those things that sounds futuristic and it sounds like those things you hear about on Star Trek, but it’s here, it’s happening today. And Tim’s doing it. So I asked Tim if he’d be interested in coming on and talking, and he was down for that.

So Tim, how are you doing? Everything been good?

Tim:
I’m doing great Darshan, thank you. I know you’re the real busy one where we can’t get a hold of you but I really appreciate the fact that you reached out, that you set this up so that we can at least get the conversation going, because I know that, as you mentioned telepharmacy now has kind of been the buzz word and I’m in Illinois and over the past few years, a lot more people are starting to get a little intrigued on what this whole telepharmacy game is. So I’m glad that we’re having this conversation to go into a little more detail with it.

Darshan:
Which begs the obvious question, what is telepharmacy? You want to get us started with that?

Tim:
What telepharmacy is the concent where a pharmacist doesn’t really have to be at the dispensing pharmacy anymore. Back in the days when there was still typewriters and handwritten prescriptions, the pharmacist had to physically be at the dispensing site so that they can make sure that all the orders are correct before it goes out to the patient and the patient gets consulted, etc. etc. Now with the new age of modern technology, in addition to a lot of the things that the larger chains have been doing already for the past couple years, it’s kind of created this movement within independent pharmacies where telepharmacy is starting to take it’s foothold.

[00:03:22]
Essentially what you’re able to do in a telepharmacy is verify medication orders from a remote site. You can have your independent pharmacy wherever, Philadelphia, and then in Pittsburgh you have a telepharmacy that has a certified technician working and you can dispense orders without having to physically be over there. In essence what it’s doing is it’s empowering these independent pharmacy owners to, instead of their prior restrictions of only being able to go based off how much staffing they have. They’re able to expand their footprint a lot larger and they’re also able to help a lot more patients a lot with it as well.

Darshan:
The reason I kind of got excited about it, Tim, and I don’t know if that we’ve had this conversation, is because as you may or may not know, I’ve been talking a lot about Amazon, I’ve been talking about this fact that Amazon is gonna come in and how the typical independent pharmacist, if they don’t adapt, they’ll have to die. So the big question is, how do you adapt? Because the pharmacists as we know, you’ve worked behind the counter, I’ve worked behind the counter, and we both know that what you get is this overwhelming amount of people coming at you and you don’t have time to think outside the counter. And what I thought telepharmacy does, it gives you an opportunity to finally get that pharmacist out there talking to people. And it gives you the ability and the freedom. And I thought that was what was interesting about it.

But the thing that people worry about is… I’m not gonna get into details of SES but the piece I do want to talk about, and this is what sort of excited me about it, was the fact that, it’s not a super expensive solution. And I don’t want to talk about pricing or anything like that. But it’s one of those things that enables expansion and I know you and I have talked about this a little bit, but even provides a potential revenue opportunity pharmacists themselves and for pharmacies, is that right? I know we’ve been talking about this for a little bit.

Tim:
Right. Correct. Absolutely. So our model essentially what we’re attempting at doing, you kind of mentioned Amazon coming in, what I’ve realized is a lot of these larger chains, the thing that they’re trying to get more of that they’ve been struggling to build upon is the relationship and loyalty aspect of patient care. So independent pharmacies really have a leg up in that type of realm where they’re getting the same patients coming back over and over again, simply because they’ve known them and they’ve taken care of them for so long.

Now, it’s not the time as back in the day where you can get $10 bucks in dispensing fees for each medication that you get out. So as you mentioned, the pharmacist is really gonna have to get out of the counter and go out and actually start interacting a little bit more with these patients and providing other services that might be a little bit more time intensive. I’ve worked several years over a decade with a very large pharmacy chain, and you seen this over the past few years where their model actually has the pharmacists outside of the pharmacy.

So in essence, they’ve been using what Scaled Enterprise Solutions has developed for the independent pharmacy industry. But they’ve been doing it for themselves for the past few years, and in essence what they’ve ended up doing is, the models been proven that they’ve been able to offer a lot more MTMs, they’ve been able to offer a lot more immunizations, they can do a lot more compounding, they can do other things that medicare and medicaid and private insurers even, are starting to recognize that these are services that are essential in driving better patient outcomes, which is really the entire way that this entire healthcare industry is progressing towards. And pharmacists, especially independent pharmacies, really have a key component that they need to begin to take advantage of. Because otherwise, as you mention, if you don’t adapt, you’re gonna die.

And that’s one thing that’s been a pilar in the pharmacy industry is the independent pharmacies. And I hate downtrends in any industry. But specifically this independent pharmacy industry, you’re slowly starting to see less and less pharmacies opening up, simply because of the constraints that’s required for start up costs, for licensing, and pharmacy students are coming out of school with tons of loans, so they can’t even get a loan for them to start a business up. And as you mentioned, that’s where Scaled Enterprise Solutions really comes in, where we can say “hey listen, if you guys want to open up a pharmacy and you’re just starting out, we have a way for you guys to still be able to make money, because you’re going to be assisting these other pharmacies with some of that workload that they weren’t able to take care of on their own.”

Darshan:
Which I think is awesome, actually, another thing, Tim you and I haven’t discussed this, but one of the other options is that people have raised to me is this idea that telepharmacy system even allows for not only taking some of the grunt work off, but also provides pharmacists with the opportunity talk to experts. Experts that they wouldn’t necessarily have access to if they were simply operating as independent pharmacy. One of the things I was thinking of is having access to a compounding expert that is not just dedicated to one site, but is able to help people across the entire state in many cases. I think those are opportunities that telepharmacy opens up that I wish I had access to if I was starting up my own independent pharmacy that I had access to if I was starting my own compounding pharmacy. Maybe a vet pharmacist, all those, and I’m not sure if SES is interested or is getting into that right now or in the future, but I think these are the types of discussions we can finally start having. And access specialized expertise that we might eventually get access to.

Has that been a part of the conversations you’ve had Tim? Or has that sort of been more of a offloading of the grunt work if you will.

Tim:
We’ve began our efforts in beginning to recruit pharmacy clients who would be interested for Scaled Enterprise Solutions. That is something that we are considering down the road. A lot of these things Darshan, to be honest with you, I’ve been very luck to have seen it first hand. How a lot of these things ended up rolling out. And even in the larger chain aspect, they’ve been doing that where they have specialized pharmacists in specific areas simply conducting reviews and that type of stuff and as you mentioned, it’s a subject matter expert that’s really a resource for pharmacies that may not have that type of knowledge on tab all the time.

So they’ve been using this. It’s something that’s been there and that’s part of the reason, the driving force for why their level of success has been continuing in such a constantly restricted system where you’re getting nickel and dime non-stop from either BBMs, from either distributors, what have you. Those are items that are really really important for us to address from an independent pharmacy perspective. And as you mentioned, not having staffing to begin with, and in addition, trying to find somebody who’s going to be specializing in immunitive specialized mediations in a pharmacy for independent pharmacy. It’s [far 00:11:18] between where you’re gonna be able to find those people. Definitely, that’s something that we do have on our road map that we’re gonna be exploring, once we’ve begin proving this concept out a little bit further.

Darshan:
I didn’t actually know that. I was really proud of myself when I asked that question. You’re like, “no, we’ve thought of that.” So, that’s cool. But here’s another thing, and Major’s being shy right now, so he’s actually typing out questions for me to ask.

Major:
I’m not being shy.

Darshan:
But this is a valid question.

Major:
I’m being respectful Darshan.

Darshan:
You’re being respectful. Major, why don’t you ask the question?

Major:
Sure sure. So Tim, I didn’t want to interrupt you because this is kind of a pretty involved… I’m actually curious, maybe walk me through a patient’s telepharmacy experience and what instances is it better than a face-to-face interaction?

Darshan:
Why would someone visit a place that uses telepharmacy?

Major:
Is it a site that’s not their home? Or is this something they can just do at home?

Tim:
Are you speaking in regards, Major, to the actual patient? Or are you speaking in regards to the pharmacists, where they’re working out of?

Major:
The patient themselves. And I have a different question about the pharmacist experience but specific to the patient, what’s their experience like with a telepharmacy?

Tim:
Their experience at a telepharmacy, the major, no pun intended by the way with your name.

Darshan:
He loves that joke.

Tim:
The major convenience with telepharmacy is, prior to this being available, pharmacy specifically in rural areas, in urban areas that are not really conducive to justify the cost of opening up a pharmacy, this allows that to happen. So for example, if I’m in Illinois right now, you got a bunch of cities and towns that are down state, ’cause it’s not only Chicago, right? It’s a huge state. But, the volume of prescription that you’d have to dispense at one of these other locations outside of the city, is huge. You don’t have access to as many patients, so a lot of these chains avoid opening up those types of pharmacies. And in addition to it, a lot of these independent pharmacies can have their own type of niche in those areas.

Now where the telepharmacy piece comes in is that if I’m an independent pharmacy, I can open up a telepharmacy in one of these rural areas and it could be 3-4 hours away if I were to drive over there, but I’m still able to help out some patients in a location that typically would not have had that level of convenience or availability from pharmacy’s perspective. So that’s where they’ve been seeing a lot of these telepharmacies pop up.

Major:
What if I have diabetic medication? How would I, going from my living room, how would I order or fill that prescription?

Tim:
You’d do it just as a regular pharmacy prescription. Whether your doctor prescribes it electronically to the telepharmacy, whether they call it in, whether you drop the prescription off. So it’s still a brick and mortar location that you’re going to. You’re interacting, there’s a certified technician that gonna be there and it’s really based on the independent pharmacy owner, how they want to package that environment. If they want to have it as a traditional retail community pharmacy where you have some over the counter offerings, and you have the pharmacy in the back. If you want to have a fountain and a deli, you can do that. You know what I mean? The opportunities are endless for how you want to operate this. Specifically what it is, the only difference is your pharmacist is not on site, so your pharmacist is conducting these verifying orders and providing consultations using this technology and software, to be able to still maintain compliance with federal and state boards of pharmacy. In essence, what it’s doing it’s creating more availability of pharmacists in areas and locations that were really deserts before.

Major:
So it allows them to kind of have bigger umbrella of service. How difficult is it for a smaller, independent local pharmacy to include telepharmacy services? Do they have to open up a brick and mortar telepharmacy site? Or can they use an established building? Or, would maybe a U.S. postal office or some sort of regulated facility work?

Tim:
That part, Major, I am not 100% sure on. The one that we’ve been working with, they have been opening up brick and mortar locations. Like I said, it’s kind of difficult, like now, prior to Scaled Enterprise Solutions coming up with this, beginning to offer this opportunity, pharmacists were unable to sometimes even run one location. Let alone, try and open up and filled up a telepharmacy that build up their clientele and have to leave that original pharmacy to go over… you know what I mean? There’s a lot of administrative duties that are required as a pharmacy owner, that you may not have the time to do.

It’s similar to just opening up your traditional independent pharmacy. It’s just, you don’t have to worry about the pharmacist staffing. What we’re doing is we’re saying, at Scaled, that “hey, we’re gonna give you guys some additional time. However you guys feel is the most effective way to use that extra time, go ahead and use it. And if it’s to open up more locations, great! We’ll help you guys with that. If it’s providing more MTMs, providing more of these other services that are reimbursable, do that! Do whatever it is that you guys want to do with that added time because it’s like, nobody’s making more time, right? We have a very finite amount. And it’s important that we use it the most effective way possible.” And that’s what we’re doing at Scaled Enterprise Solutions. We’re really providing an invaluable asset which is time.

Major:
That’s interesting.

Darshan:
I’m going to sort of answer the question later in another way, which I think, Major and I have been doing a lot of talking around this whole patient centricity thing. So I think Major is maybe coming from that direction. To the point Tim is making Major.

Major:
Right, right.

And the reason why I was asking this specific is both Tim, you and Darshan have first hand knowledge on how to run a pharmacy. What better way to get those questions answered then go to the source kind of thing?

Darshan:
Right, no the point I was trying to make Major, was that, what Tim’s really saying in all those words is, from a patient perspective, it’s completely seamless. The patient doesn’t necessarily know that it’s a telepharmacy. Only the pharmacist and/or the team need to know that there’s a telepharmacy solution available.

Now, if there’s a technician that might be a bit of a give away. But, the way it’s possible to work is the patient would never know. But, at the same time, it gives more access and more availability of a pharmacist themselves in more locations. And that becomes an advantage as well.

Tim:
Let me also add to that. I just want to add to that what you mentioned is that the level of quality and the level of actual checks and all that stuff that requires to be done, actually in a telepharmacy operates just as effective, if not more. So, the software that’s provided allows the pharmacist to still conduct the same level of verification for every order that goes out. So there’s no drop in care, there’s no less accurate if you go to a telepharmacy as opposed to this. That’s not the case at all. So, that’s one of the things that I want to clear up and make sure that people understand that. That this is something that’s actually providing even better care because we’re actually seeing the images that are going out, we’re actually seeing everything physically, visually when we’re checking every single order. And in addition to it, it’s documented. So a lot of those things, as far as audit trails are concerned, providing any information on potential drug events, all that stuff is available.

In essence, what it’s doing it’s creating even a better model for these independent pharmacies to operate in as well.

Darshan:
Now, I do want to say one thing, sort of coming from a legal standpoint. Is that, telepharmacy is not always available in every location, in that, some states are still dealing with archaic laws. But obviously that’s not true to most states. For example, I think, Tim, you and I have discussed some of the states that have. Do you want to talk a little bit about that as well?

Tim:
Yeah, absolutely. So our headquarters is actually out in Arizona in Phoenix. Actually just a couple months ago, Arizona was listed as one of the newly adopting telepharmacy states. So they’re beginning to allow telepharmacies to open up out in Arizona. Illinois has been one of the early adopters for telepharmacy. I’ve had conversations with several pharmacy owners here in Illinois and they’ve either heard of it, their actually opening up their own telepharmacies or their interested in getting involved, they just don’t know. So those are the two major states and we’re actually focusing our primary efforts right now in getting clients and pharmacy owners signed on to our network, specifically in Illinois. Just because for the simple sake that it’s already there, it’s available and people are aware of it. A lot of other states are gonna be difficult in the beginning until they get a couple years under their belt. And they realize what the benefits are with telepharmacy. It’s always almost like a bell curve. It takes some time until they realize what the concept is, they sign on, they realize the benefit, and they start, it just kinda goes on from there.

There are other states in the country that also allow it. There’s some maps that are available online for some of these software provider companies that they do offer knowledge on which states allow the regulations, etc.

Darshan:
Tim, We’re gonna have to call it right now ’cause we’re starting to get a little on the long side, and I know that people tend to start turning away at a certain point, but one of the things I did want to say was this was amazing, this was excellent. And thank you for joining us. Tim, we’re gonna allow for a short plug. Tim, did you want to talk a little bit about how people can reach you?

Tim:
Yeah, absolutely. You guys can reach us with Scaled Enterprise Solutions by visiting our website, it’s SES – S as in Sam, E as in Erik, S as in Sam – .healthcare. There’s no .com, no .org, anything like that afterwards. So just SES.healthcare. If you go to our contacts page, you can fill out a form over there, and one of our team members will be able to reach out to you. If you’re an independent pharmacy owner in Illinois or in Arizona, reach out to us, see how we can help you guys regain your time, and make sure you guys are succeeding in this industry as opposed to closing your doors.

Darshan:
There you go. Again, thank you again, Tim. Major, this was awesome as always.

Major:
Great information

Darshan:
Yeah this was good. This was different. And we’re excited to maybe potentially keep the conversation. Tim, would you mind coming back on in the future if that works?

Tim:
I would absolutely love to. It was great talking to both of you Major and Darshan. Thank you again for having me.

Major:
Tim, how hot is it in Chicago out there today? Are you in Chicago? You said Illinois.

Tim:
Yeah, I’m in Chicago. It’s 81 but it’s a lot cooler than Phoenix. So I’ll take this any day of the week.

Major:
There you go. So my name’s Major, this is Darshan, and today we’ve been interviewing Tim from Scaled Enterprise Solutions. That’s SES.healthcare. SES.healthcare to see what else he can offer you guys.

Podcast Disclaimer

The opinions stated in this podcast are the sole and present opinions of the host and do not necessarily represent the opinions of the Kulkarni Law Firm, PC and/or its attorneys. Such opinion(s) may change over time. Such opinion(s) should not necessarily be attributed to the institution for which these individuals may work or otherwise represent in any capacity. These blogs do not constitute legal advice and should not be construed as such.

Recent Podcasts