Latest / Pharmacy Podcast Network / The Future of Long-Term Care Pharmacy: AI, Automation & New Revenue Models | SuiteCast

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The Future of Long-Term Care Pharmacy: AI, Automation & New Revenue Models | SuiteCast · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
• 0:22
  Speaker 1: Welcome to Sweetcast, a podcast sponsored by SweetRx Pharmacy Technology Platforms.
• 0:28
  Speaker 1: exploring the strategies, technologies, and leadership practices helping pharmacies improve performance,
• 0:35
  Speaker 1: expand patient care, and build sustainable revenue.
• 0:40
  Speaker 2: Dr.
• 0:41
  Speaker 3: Thomas Hansel, PharmD, he has his MBA as well. He's
• 0:45
  Speaker 3: a pharmacy growth strategist, a podcaster.
• 0:48
  Speaker 4: I love podcasters. Public speaker.
• 0:51
  Speaker 3: He's been in the long-term care industry for years, known
• 0:55
  Speaker 3: as a leader for people that know him, someone that
• 0:57
  Speaker 3: really cares about the success of our consultant pharmacists. And
• 1:02
  Speaker 3: he hosts the ASCP Rx Experience podcast, and you can
• 1:07
  Speaker 3: find more about him on LinkedIn. Tom, it is so
• 1:11
  Speaker 3: good to welcome you to the Sweetcast podcast. How are you?
• 1:15
  Speaker 2: Very good. Todd, I want to thank you for giving
• 1:18
  Speaker 2: me the opportunity to get on here. I've been watching
• 1:20
  Speaker 2: you for a very long time. I refer to you
• 1:23
  Speaker 2: as the grandfather of pharmacy podcasting. But what you've done
• 1:28
  Speaker 2: an amazing job at is you've made pharmacy public. You've
• 1:32
  Speaker 2: made it relevant. You've brought our problems to the rest
• 1:35
  Speaker 2: of the world. And so I admire you greatly, and
• 1:39
  Speaker 2: I appreciate all the efforts you've done to give pharmacy
• 1:42
  Speaker 2: a voice.
• 1:44
  Speaker 4: Thank you, Tom. I appreciate that comment.
• 1:48
  Speaker 3: The godfather is so much sexier than grandfather. So I
• 1:54
  Speaker 3: like thinking I've been turned by Sean Nairn out of Pittsburgh,
• 1:58
  Speaker 3: the RX podfather.
• 2:00
  Speaker 4: And I'm like, I could.
• 2:01
  Speaker 3: Go with that one. But I am a grandpa now.
• 2:04
  Speaker 3: I have three grandchildren, which is just mind-blowing. When I
• 2:09
  Speaker 3: hear them call me Pappy T, I.
• 2:12
  Speaker 3: I'm just, sometimes I'm like, who are you talking to?
• 2:14
  Speaker 3: Like who, what is going on?
• 2:16
  Speaker 2: But I'm not that old.
• 2:17
  Speaker 4: I can't.
• 2:18
  Speaker 2: Yeah.
• 2:20
  Speaker 3: So our, our paths have crossed. We share a love
• 2:25
  Speaker 3: for the black and gold as you, if, if people
• 2:28
  Speaker 3: are watching this on YouTube, you'll see Tom's a terrible
• 2:31
  Speaker 3: towel in the background. We're, we're both a little nervous
• 2:35
  Speaker 3: about the upcoming season. And I think it's a transitional
• 2:40
  Speaker 3: season per se, but yeah, We also hold another love
• 2:43
  Speaker 3: in our hearts, and that is long-term care pharmacy, because
• 2:46
  Speaker 3: when I left telecommunications, which was one of the most
• 2:49
  Speaker 3: boring parts of all of my careers, I fell into
• 2:54
  Speaker 3: it with soft writers out of Pittsburgh, and it was
• 2:58
  Speaker 3: the absolute best career move I had ever made. And
• 3:03
  Speaker 3: when I found out what pharmacists actually do and how
• 3:08
  Speaker 3: they become so integrated into their patients' lives and how
• 3:13
  Speaker 3: the smallest of changes from their perspective ends up setting
• 3:18
  Speaker 3: the stage for living better. And the world of deprescribing
• 3:23
  Speaker 3: and the world of nutraceutical and the world of the consultancy,
• 3:28
  Speaker 3: it opened my eyes up and realizing that the majority
• 3:32
  Speaker 3: of these pharmacists, they weren't good marketers. They weren't really
• 3:35
  Speaker 3: into business development. And how could I come up along
• 3:38
  Speaker 3: beside them and support them to do more and to
• 3:42
  Speaker 3: connect and, and to use what we built in 2009,
• 3:47
  Speaker 3: the first podcast to, to blow them up and to
• 3:50
  Speaker 3: get them out there. And you, you've been somebody I've
• 3:53
  Speaker 3: been watching and, and your consultancy and your, um, setting
• 3:59
  Speaker 3: of the dominoes up in the strategy that you put
• 4:02
  Speaker 3: into place. Tell our listeners just in case they don't
• 4:05
  Speaker 3: know about Tom Hansel, um, your little bit of your background.
• 4:09
  Speaker 2: Yeah, certainly. Well, like you said, I'm from Pittsburgh, so
• 4:14
  Speaker 2: I bleed black and gold. And that's kind of where
• 4:17
  Speaker 2: the origin story is at. But, you know, I got
• 4:20
  Speaker 2: into pharmacy for all the wrong reasons. When I was
• 4:24
  Speaker 2: growing up, you know, you had an option as a
• 4:27
  Speaker 2: young man to join the army or go work in
• 4:31
  Speaker 2: a factory or like my dad did, go be a
• 4:33
  Speaker 2: coal miner. And I'm a clerk at, do you remember
• 4:37
  Speaker 2: Hook's Apothecary? That was way back in the Midwest. And
• 4:43
  Speaker 2: I was a clerk up front in the cashier. And
• 4:45
  Speaker 2: I see this guy back there who's above ground in
• 4:48
  Speaker 2: the air condition, making more money than my dad ever
• 4:52
  Speaker 2: made as a coal miner. And flirting with all the ladies,
• 4:55
  Speaker 2: all the single ladies that came back to pick up
• 4:57
  Speaker 2: their medications. And I thought, I want that job. Just
• 5:01
  Speaker 2: for those reasons. It seemed air conditioned and nice and friendly.
• 5:04
  Speaker 2: So I went to pharmacy school and got out of
• 5:07
  Speaker 2: pharmacy school and started working retail and paying off my
• 5:11
  Speaker 2: school loans as we all do. And then I quickly
• 5:14
  Speaker 2: realized I don't really like this. I feel like I'm
• 5:18
  Speaker 2: in an assembly line and I'm not counseling anyone. It's
• 5:21
  Speaker 2: just as fast as you can go. I can barely eat.
• 5:23
  Speaker 2: And I just I thought, man, I made a pretty
• 5:27
  Speaker 2: expensive mistake. And then I had a friend of mine
• 5:31
  Speaker 2: talk to me about this opportunity as a general manager
• 5:34
  Speaker 2: of a long term care pharmacy. And I thought, what
• 5:37
  Speaker 2: is that? And I went and interviewed and thought, oh,
• 5:42
  Speaker 2: my gosh, I'm running a business and this is fun
• 5:44
  Speaker 2: and I'm not. you know, we certainly have pharmacists and,
• 5:47
  Speaker 2: you know, but I'm not worrying about the, you know,
• 5:51
  Speaker 2: the coupon for diapers or whatever it is, or, you know,
• 5:54
  Speaker 2: whatever's happening at the time in retail. And, and, you know,
• 5:57
  Speaker 2: I felt like I was making a difference and I
• 5:59
  Speaker 2: could work with the nurses and doctors and I could
• 6:02
  Speaker 2: help multiple patients. And, and it just, it just hit
• 6:05
  Speaker 2: a chord with me. And I fell in love with it,
• 6:07
  Speaker 2: fell in love with long-term care pharmacy. And so I
• 6:10
  Speaker 2: spent 20 years running long-term care pharmacy operations and Just
• 6:14
  Speaker 2: never really thought that I would ever do anything else.
• 6:18
  Speaker 2: And then we started getting into automation, packaging automation, hardware automation.
• 6:23
  Speaker 2: And that was fun because it was, you know, getting
• 6:26
  Speaker 2: away from kind of the old way we did it
• 6:28
  Speaker 2: in the 90s and multidose. I certainly believed in multidose
• 6:32
  Speaker 2: adherence and it was helping my nurses. It was helping
• 6:35
  Speaker 2: my patients. And I thought this is this is better
• 6:38
  Speaker 2: for everyone. It's just a better way to do pharmacy.
• 6:42
  Speaker 2: And I was working at the time for a company
• 6:44
  Speaker 2: that owned and operated a nursing home chain. So instead
• 6:48
  Speaker 2: of reporting to a pharmacist, I reported to a guy
• 6:52
  Speaker 2: that was an administrator that worked with administrators and DONs.
• 6:56
  Speaker 2: And when I would go to conference, it'd be the
• 6:58
  Speaker 2: pharmacy guy and 500 DONs administrators all telling me how
• 7:03
  Speaker 2: to do pharmacy, what they need. And it changed my
• 7:06
  Speaker 2: life because I was like, man, I've been doing pharmacy
• 7:09
  Speaker 2: thinking about as from a pharmacist. And they're explaining to
• 7:14
  Speaker 2: me how they need it as an administrator, how they
• 7:15
  Speaker 2: need pharmacy to behave as a DON. And so it
• 7:19
  Speaker 2: really kind of caused me to really evolve as a
• 7:24
  Speaker 2: pharmacy operator. And a little bit after that, I got
• 7:28
  Speaker 2: an opportunity when Parada and TCG came together to be
• 7:33
  Speaker 2: the long-term national vice president of long-term care for that
• 7:37
  Speaker 2: combined company. And Once again, just loved it. Instead of
• 7:42
  Speaker 2: working in my five, six pharmacies, I now got to
• 7:44
  Speaker 2: go and learn from 400 pharmacies across the nation and
• 7:48
  Speaker 2: big central fill packagings and small independent mom and pa.
• 7:52
  Speaker 2: And I found all the ways that I was doing
• 7:54
  Speaker 2: pharmacy wrong and how to do it better. And just
• 7:57
  Speaker 2: that years of experience of helping them really automate to
• 8:01
  Speaker 2: maximize their production. And again, it was just another evolution
• 8:06
  Speaker 2: for me. It just helped me learn even more and
• 8:09
  Speaker 2: as that was kind of winding down and coming to
• 8:11
  Speaker 2: an end, I started thinking about the future and really
• 8:16
  Speaker 2: kind of the hardware back end I thought had evolved
• 8:19
  Speaker 2: quite well over the last 10 or 15 years. But
• 8:22
  Speaker 2: what hadn't really evolved was the front end, was software related,
• 8:27
  Speaker 2: order entry and billing and PB1 and all the manual
• 8:31
  Speaker 2: stuff we do up front. And so That's where I've
• 8:34
  Speaker 2: spent the last few years really working on developing different
• 8:38
  Speaker 2: AI softwares and working with different pharmacies on how to
• 8:42
  Speaker 2: bring that same efficiency optimization mindset to the front end,
• 8:46
  Speaker 2: not just to the back end.
• 8:48
  Speaker 3: And what's brought us together is a common friend, CEO
• 8:54
  Speaker 3: of SweetRx and Nick's passion for operations and framework and
• 9:03
  Speaker 3: and being able to put together networks of decisions that
• 9:09
  Speaker 3: are very specific to the operation and then plug in
• 9:13
  Speaker 3: the power of what artificial intelligence has the capabilities to do,
• 9:20
  Speaker 3: but not doing it from the developer's perspective, doing it
• 9:23
  Speaker 3: from the end user's perspective, the AKA that consultant pharmacist
• 9:28
  Speaker 3: in the space of serving assisted living centers and skilled
• 9:32
  Speaker 3: nursing centers and helping to understand the data and the
• 9:39
  Speaker 3: replication of decisions and accessing more information about the patient
• 9:46
  Speaker 3: and then plugging in systems that can accentuate and enhance that.
• 9:52
  Speaker 3: And what's special about today's interview, it's my first opportunity
• 9:56
  Speaker 3: to talk about a little bit about the Evolved Rx
• 10:00
  Speaker 3: platform that you've helped to build. Tell our listeners what
• 10:04
  Speaker 3: that is and how it's much different than, because the buzzword,
• 10:08
  Speaker 3: I mean, when I entered pharmacy 2004, it wasn't until
• 10:13
  Speaker 3: around 2010 that the workflow was the buzzword. Hey, workflow, workflow.
• 10:20
  Speaker 3: And now today it's the AI.
• 10:23
  Speaker 4: Hey, it's AI.
• 10:24
  Speaker 3: Well, AI is great, but if it's not implied and
• 10:31
  Speaker 3: implemented and designed from internal, I think it's just smoke.
• 10:37
  Speaker 3: I think it's a lot of smoke and mirrors. I
• 10:38
  Speaker 3: think it's a lot of, it's a sexy talk. It's
• 10:41
  Speaker 3: kind of that buzzword, but evolved Rx, it makes sense
• 10:46
  Speaker 3: from an insider's perspective.
• 10:49
  Speaker 2: Yeah, certainly. I mean, at the end of the day,
• 10:51
  Speaker 2: there's a lot of software companies out there. And you're right.
• 10:55
  Speaker 2: AI is the most popular buzzword. There's no doubt about it. Yesterday,
• 11:03
  Speaker 2: no one had AI. Now, not today. Everyone and their
• 11:06
  Speaker 2: sister says, well, we got AI. We got AI. And
• 11:08
  Speaker 2: there's nothing to prevent or, you know, keep the people
• 11:12
  Speaker 2: from saying that. But, you know, my focus is kind
• 11:16
  Speaker 2: of in my role is to help pharmacy owners and
• 11:19
  Speaker 2: pharmacy managers kind of not be misled or bamboozled out there.
• 11:25
  Speaker 2: There are some good AI products out there, and some
• 11:28
  Speaker 2: of them are kind of scratching the surface of what
• 11:30
  Speaker 2: it can do, but some of them are significantly more
• 11:34
  Speaker 2: equipped And so, you know, what we're trying to kind
• 11:38
  Speaker 2: of bring to the industry is the understanding, whether you
• 11:43
  Speaker 2: use this product or not, but it's the understanding of
• 11:46
  Speaker 2: what you deserve as a pharmacy operator, what is capable
• 11:51
  Speaker 2: out there and what you should be in control of.
• 11:54
  Speaker 2: And so, you know, margins are tough. Reimbursement continues to
• 11:58
  Speaker 2: go down. Labor costs continue to rise. And, you know,
• 12:02
  Speaker 2: we're we're in a very uncomfortable margin battle, if you will. And,
• 12:08
  Speaker 2: you know, that's kind of where where these things kind
• 12:11
  Speaker 2: of start at. There's not a pharmacy out there that says, man,
• 12:15
  Speaker 2: I'm making enough money. I'm good.
• 12:18
  Speaker 4: Please.
• 12:19
  Speaker 2: You know, we don't need anything else. No, they're hurting.
• 12:22
  Speaker 2: And IRA, for example, specifically, more specifically in long-term care pharmacy,
• 12:28
  Speaker 2: IRA might've been a good thing for America in a
• 12:31
  Speaker 2: lot of ways, but it had unintentional negative consequences to
• 12:36
  Speaker 2: long-term care pharmacies because we were solely dependent on the
• 12:40
  Speaker 2: transaction of dispensing a drug. So I spent most of
• 12:45
  Speaker 2: my time, money, and growth into how many medications I
• 12:50
  Speaker 2: can dispense and certainly brand drugs and rebates were kind
• 12:55
  Speaker 2: of what we leaned on to make a profit. And
• 13:00
  Speaker 2: now with IRA, that's getting extrapolated almost overnight. Long-term care
• 13:06
  Speaker 2: pharmacies in 2026 alone are probably averaging somewhere around a
• 13:09
  Speaker 2: 20 to 25% decrease in profit margin just because of
• 13:14
  Speaker 2: IRA alone. That doesn't even count the changes in insulins
• 13:18
  Speaker 2: and the increase in labor and those type of things.
• 13:21
  Speaker 2: So it's a struggle, and I can't really control it.
• 13:25
  Speaker 2: I can't make it go away. So the way I
• 13:28
  Speaker 2: look at it is I can either start adding a
• 13:30
  Speaker 2: bunch of patients and prescriptions, which is so easy to do,
• 13:33
  Speaker 2: you know, grow as fast as I can, right? Hard
• 13:36
  Speaker 2: to do. Or I think what's the most reasonable thing
• 13:39
  Speaker 2: to do is to try to control my labor cost.
• 13:44
  Speaker 2: And what I mean by that is making sure that
• 13:46
  Speaker 2: my most highly trained, highly compensated employees are not stuck
• 13:52
  Speaker 2: doing mundane, repetitive work, but they're stuck working at the
• 13:56
  Speaker 2: top of their license and they're doing things that really
• 13:59
  Speaker 2: requires their intelligence, requires their certifications and their ability and
• 14:05
  Speaker 2: And requires that relationships with the D.O.N. 's and the
• 14:08
  Speaker 2: patients and prescribers and getting away from head down and
• 14:13
  Speaker 2: computer just pounding out, pounding out work. And and we're there,
• 14:17
  Speaker 2: you know, we're there as a as a technology in
• 14:20
  Speaker 2: this world. And we're just trying to deliver that same
• 14:23
  Speaker 2: type of high level cutting edge technology to long term
• 14:27
  Speaker 2: care pharmacies, because most of them are still in that
• 14:30
  Speaker 2: kind of old school way of of just trying to
• 14:33
  Speaker 2: get the work done by by just crunching through it.
• 14:37
  Speaker 3: So there's 11, I want to say 11,500 people turning
• 14:44
  Speaker 3: 65 years old every day. And there aren't enough facilities
• 14:54
  Speaker 3: to help those in need of either assisted living or
• 15:00
  Speaker 3: skilled nursing. And the long-term care pharmacy that's positioned for
• 15:07
  Speaker 3: the future of what's about to come and the panicle
• 15:10
  Speaker 3: of this happening within the next five to eight years
• 15:15
  Speaker 3: of reaching the top of the mountain of a population,
• 15:19
  Speaker 3: or it might actually even be longer than that, that
• 15:22
  Speaker 3: means that we have to start positioning how we're working,
• 15:25
  Speaker 3: what we're working with, the information that's accessible to us,
• 15:30
  Speaker 3: the personalized services that are now in demand more so,
• 15:35
  Speaker 3: than they were even when I entered pharmacy because people
• 15:38
  Speaker 3: know so much more. And AI has that good and
• 15:42
  Speaker 3: bad balancing act on all senses and all capacities of society.
• 15:51
  Speaker 3: And when I think of pharmacy, it's the same thing.
• 15:54
  Speaker 3: So I guess it's more of a philosophical question to
• 15:59
  Speaker 3: you is, tell me about that balance from your perspective.
• 16:03
  Speaker 3: And that the pharmacy, the new pharmacist that went through
• 16:10
  Speaker 3: the same thing that you went through, where they're in
• 16:13
  Speaker 3: a chain environment right now, they're in a community retail
• 16:17
  Speaker 3: environment right now, they've been in it for two years
• 16:20
  Speaker 3: or five years, they know that it's not fulfilling to
• 16:24
  Speaker 3: them because it feels too much like fast food, you know,
• 16:27
  Speaker 3: fast food pushing things out and not... getting into the
• 16:32
  Speaker 3: life of a patient that they want to be. So
• 16:35
  Speaker 3: talk to me about that dynamic and how AI is
• 16:39
  Speaker 3: giving us an opportunity to strip out some of the
• 16:42
  Speaker 3: repetitive stuff that pharmacists still have to do and now
• 16:47
  Speaker 3: inserting the pharmacist's mind and experience to really making differences.
• 16:51
  Speaker 1: Certainly.
• 16:52
  Speaker 2: I mean, you're right on about the number of people
• 16:56
  Speaker 2: turning 65. In fact, we have close to that number
• 16:59
  Speaker 2: of people now turning 85. And so they're not just
• 17:02
  Speaker 2: getting older, but they're staying alive longer. And by the
• 17:06
  Speaker 2: year 2030, we're going to be kind of at the apex.
• 17:09
  Speaker 2: There's going to be around 73-ish million seniors in America.
• 17:14
  Speaker 2: And 98% of those will not be in an institutional
• 17:20
  Speaker 2: setting like a skilled or an AL. But they still
• 17:23
  Speaker 2: need the same type of care and access that a
• 17:28
  Speaker 2: long-term care patient in a skilled or AL needs. needs.
• 17:33
  Speaker 2: You know, I often say when we're talking about this
• 17:35
  Speaker 2: subject is, you know, my place of residence shouldn't determine
• 17:39
  Speaker 2: my level of care. And, you know, I might not
• 17:45
  Speaker 2: need as much, but I should still have access to it.
• 17:49
  Speaker 2: And so those 70 million or so seniors who are
• 17:52
  Speaker 2: living at home should have access to a long-term care pharmacist.
• 17:57
  Speaker 2: You know, how do you go from Helping if there's
• 18:00
  Speaker 2: just not going to be enough beds to go around,
• 18:03
  Speaker 2: there's going to be a lot more seniors. But, you know,
• 18:06
  Speaker 2: how do you expand your reach and be able to
• 18:09
  Speaker 2: help more people by kind of doing it the same
• 18:12
  Speaker 2: way that we've always done it? And so it's really
• 18:15
  Speaker 2: about let's stop wasting pharmacist and certified technicians time on
• 18:21
  Speaker 2: basic labor points. And let's start utilizing their time where
• 18:26
  Speaker 2: pharmacy expertise is needed. and to be able to take
• 18:29
  Speaker 2: that extra time with a patient and be able to
• 18:31
  Speaker 2: walk them through, whether it's over the phone or in person,
• 18:34
  Speaker 2: but be able to help them manage through. There's a
• 18:36
  Speaker 2: lot of seniors that are living at home alone, don't
• 18:40
  Speaker 2: have really access to understand things. You know, back a
• 18:43
  Speaker 2: hundred years ago, the pharmacist was the doctor of the town.
• 18:47
  Speaker 2: They'd come to their pharmacy, they'd get all their medical advice, and,
• 18:50
  Speaker 2: you know, they were the center of the healthcare. And
• 18:52
  Speaker 2: they should still be as accessible, but the pharmacists are
• 18:56
  Speaker 2: too busy behind the counter just working as fast as
• 18:58
  Speaker 2: they can. And so bringing them out and knowing that
• 19:02
  Speaker 2: work's getting done independently of them and they can spend
• 19:05
  Speaker 2: that time as that front person or on the phone,
• 19:08
  Speaker 2: I don't think there's any way that we're going to
• 19:10
  Speaker 2: be able to get there without automating a lot of
• 19:12
  Speaker 2: those just manual repetitive tasks.
• 19:16
  Speaker 4: Another thing in the operations, and I.
• 19:21
  Speaker 3: I think of Nick and his leadership at SweeterX as
• 19:25
  Speaker 3: the financials, the reporting, the building additional efficiencies based on
• 19:32
  Speaker 3: how many keystrokes are taking place in order to get
• 19:35
  Speaker 3: a prescription from entry to final review to connecting it
• 19:40
  Speaker 3: with my logistics system, getting it delivered, double-checking it, bringing
• 19:45
  Speaker 3: the information back, reporting it to an electronic health record.
• 19:50
  Speaker 3: So on that side of it, Tom, what are your
• 19:53
  Speaker 3: visions for how AI can be plugged into a pharmacy
• 19:58
  Speaker 3: management system to pull out, but not only pull out,
• 20:01
  Speaker 3: but push in good information?
• 20:05
  Speaker 2: Well, even before we go there, I think something that
• 20:09
  Speaker 2: SweetRx has done a really good job at and something
• 20:11
  Speaker 2: that I've enjoyed working with them is the accessibility of data.
• 20:17
  Speaker 2: You know, it has to start there. And you can
• 20:22
  Speaker 2: get all the AI and software and tools that you have.
• 20:25
  Speaker 2: But if you don't have access to your data, then
• 20:28
  Speaker 2: you're kind of handcuffed, right? I mean, at the end
• 20:31
  Speaker 2: of the day, it's your patience. It's your prescriptions. It's
• 20:34
  Speaker 2: your data. But if I've got to call any software
• 20:37
  Speaker 2: company and I've got to ask permission for that data,
• 20:40
  Speaker 2: or even worse, they charge me for my own data,
• 20:43
  Speaker 2: then it delays my ability to do what I need
• 20:49
  Speaker 2: to do. And so I think all pharmacies should have
• 20:54
  Speaker 2: clear and unbridled access to their data. They should have
• 20:57
  Speaker 2: it whenever they need it in real time. And then
• 21:01
  Speaker 2: they should be able to utilize their data however they
• 21:03
  Speaker 2: want to do it. And SweeterX has done a really
• 21:06
  Speaker 2: good job of that. They have APIs. And I'm just
• 21:14
  Speaker 2: a dumb pharmacist. I'm not a big tech AI programmer
• 21:18
  Speaker 2: or developer. But the evolution in the world is really
• 21:24
  Speaker 2: getting away from flat files and HL7s and those type
• 21:28
  Speaker 2: of things and moving towards a a real-time, interactive, bi-directional API.
• 21:35
  Speaker 2: It's like the difference between Polaroid photos and a real-time conversation.
• 21:41
  Speaker 2: That HL7 is a snapshot of data at that moment
• 21:44
  Speaker 2: in time. But APIs and to be able to have
• 21:48
  Speaker 2: interaction with my data all the time, and not just
• 21:52
  Speaker 2: the pharmacy management system, but I'm talking about any software
• 21:55
  Speaker 2: in general, right? And so I think that's really the
• 21:58
  Speaker 2: main thing When we talk about workflow, you talk about
• 22:01
  Speaker 2: where AI could be used. The real question I always
• 22:04
  Speaker 2: start off with is, do you have access to your data?
• 22:07
  Speaker 2: How do you have access to data? Do you have
• 22:09
  Speaker 2: to ask permission for it or you have very limited
• 22:11
  Speaker 2: access to it? Because it starts there. No data in,
• 22:14
  Speaker 2: I can't do much with it. But if we can
• 22:16
  Speaker 2: get the data and we can access it, now I
• 22:18
  Speaker 2: can utilize AI in multiple, multiple different ways.
• 22:23
  Speaker 3: I think about going back to something we just talked about,
• 22:26
  Speaker 3: which is the expansion of our seniors and the need
• 22:30
  Speaker 3: for additional care, you said something I want to touch on.
• 22:33
  Speaker 3: And I think your perspective is going to be really
• 22:37
  Speaker 3: interesting for our listeners. So roughly 32,000 to 40,000 assisted
• 22:44
  Speaker 3: living and residential care communities in the United States, we
• 22:48
  Speaker 3: know that they're at, if you look this up on
• 22:51
  Speaker 3: some of the standard documentation out there from groups like
• 22:55
  Speaker 3: the AHCA or the NCAL, they'll say that we're at
• 23:02
  Speaker 3: 70% capacity. By 2030, they think it's going to be
• 23:06
  Speaker 3: nearing 92% capacity. So long-term care pharmacy at home is
• 23:13
  Speaker 3: a buzzword. It used to be called the combo shop,
• 23:17
  Speaker 3: and it was the community pharmacy that dipped its toes
• 23:21
  Speaker 3: into assisted living and built themselves a really nice business
• 23:25
  Speaker 3: that they were known in their community as not only
• 23:27
  Speaker 3: the community pharmacy, but also the provider of some of
• 23:30
  Speaker 3: the assisted living centers that cater to what they need
• 23:35
  Speaker 3: instead of the individual patient per se. They were really
• 23:37
  Speaker 3: able to do a wide stance of delivery of different services,
• 23:41
  Speaker 3: but then send the consultant into that center and then
• 23:45
  Speaker 3: dial into the personalization of medicine, which has to keep happening.
• 23:51
  Speaker 4: But my question to.
• 23:52
  Speaker 3: You is, We know that the community pharmacy is paying
• 23:56
  Speaker 3: a lot of attention to long-term care pharmacy at home
• 24:00
  Speaker 3: and finally getting paid for some of the services by
• 24:03
  Speaker 3: doing different criteria and tackle boxes, emergency kits, and 24-hour
• 24:09
  Speaker 3: service and things that they have to do. My question is,
• 24:13
  Speaker 3: what about the long-term care pharmacy in that community, in
• 24:17
  Speaker 3: that area, in going the opposite direction where they're now
• 24:20
  Speaker 3: thinking maybe a home should be mapped out as just
• 24:24
  Speaker 3: another assisted living center. And instead of serving 10 centers
• 24:30
  Speaker 3: in my community, I'm now serving 250 centers in my community.
• 24:35
  Speaker 4: But what are your thoughts around that?
• 24:38
  Speaker 2: Well, I think it's necessary if you really want to
• 24:42
  Speaker 2: grow your top line. I know why long-term care pharmacies
• 24:46
  Speaker 2: are a little resistant to do that is because it's
• 24:49
  Speaker 2: harder and it costs more. I get paid less and
• 24:52
  Speaker 2: I have to work harder. It doesn't sound like a
• 24:54
  Speaker 2: good mix. But with that said, I've got a choice
• 24:58
  Speaker 2: to make in my business. I can keep on swapping
• 25:01
  Speaker 2: those 4 million skilled and AL beds back and forth
• 25:04
  Speaker 2: between my competitors, or I can try to figure out
• 25:07
  Speaker 2: a way to go after the 70 million seniors that
• 25:09
  Speaker 2: are out there. And so it's a different business model
• 25:13
  Speaker 2: and it takes a different mindset. I think long-term care
• 25:17
  Speaker 2: pharmacies are uniquely positioned to do it very well. Because again,
• 25:21
  Speaker 2: we understand seniors, we understand their needs. Yes, there's some
• 25:27
  Speaker 2: additional cost to it and some different things in different
• 25:30
  Speaker 2: ways I got to bill it. So it'll never have
• 25:33
  Speaker 2: probably the profit margins that a long-term care skill bed has.
• 25:37
  Speaker 2: But the quantity is so much greater that there's certainly
• 25:42
  Speaker 2: a very good business model for that. There are some
• 25:45
  Speaker 2: companies that have been out there that do that nationally.
• 25:49
  Speaker 2: right now and do central fill and do nationally. But
• 25:51
  Speaker 2: they don't just deliver like some central fill pharmacies do.
• 25:57
  Speaker 2: They take extra care of their patients. They call them.
• 26:00
  Speaker 2: They have a discussion with them every month. They found
• 26:02
  Speaker 2: out any changes in their health. They have people go
• 26:04
  Speaker 2: by and make sure the environment and make sure they
• 26:07
  Speaker 2: have electricity and their refrigerator meds. And, you know, they
• 26:10
  Speaker 2: go well above and beyond. But the real goal is
• 26:14
  Speaker 2: about the outcome of the patients. You know, I've said
• 26:17
  Speaker 2: more than once that my job as a pharmacist is
• 26:20
  Speaker 2: not to dispense drugs. My job as a pharmacist is
• 26:23
  Speaker 2: to make sure that my patients are adherent to the medications.
• 26:26
  Speaker 2: And that requires me to go the extra mile and
• 26:29
  Speaker 2: make sure they have the conditions and their environment and
• 26:32
  Speaker 2: the ability to communicate freely. So I can help walk
• 26:37
  Speaker 2: them through whatever struggles they're having or misunderstandings they're having
• 26:41
  Speaker 2: and kind of be there for them. And so I
• 26:44
  Speaker 2: think pharmacies, long-term care pharmacies that are willing to go
• 26:48
  Speaker 2: after that and go the extra mile and get that
• 26:50
  Speaker 2: business model figured out, they're going to have a lot
• 26:52
  Speaker 2: of success because the need is there. The quantity is there.
• 26:56
  Speaker 2: The number of people are there. And so I think
• 26:57
  Speaker 2: they can build quite the successful business from doing that,
• 27:01
  Speaker 2: but hard to incorporate that in your current day-to-day operations.
• 27:04
  Speaker 2: It really needs to be almost like a separate line,
• 27:07
  Speaker 2: a separate division. I agree.
• 27:10
  Speaker 3: And then the operator who nerds out on technology and
• 27:14
  Speaker 3: starts saying, where is remote patient monitoring going from a
• 27:19
  Speaker 3: reimbursement perspective? How could I couple in a durable medical
• 27:23
  Speaker 3: equipment solution that to the people that need the walkers
• 27:27
  Speaker 3: or need the oxygen or need, you know, whatever's happening
• 27:31
  Speaker 3: and including some of the more aggressive players in the market. Tom,
• 27:36
  Speaker 3: I've even seen them build a new division and separate
• 27:42
  Speaker 3: it from their other LLC or their corporation. And now
• 27:45
  Speaker 3: they're doing home care services where they're coming in and
• 27:50
  Speaker 3: they're doing some cleaning. They're doing some cooking. They're doing
• 27:53
  Speaker 3: a little bit of shopping. There is a market, in
• 27:57
  Speaker 3: my opinion, and you may probably will share this, that
• 28:01
  Speaker 3: if the long-term care pharmacy, the pure player, does separate
• 28:06
  Speaker 3: and build a new division of home care service, there
• 28:11
  Speaker 3: is a huge opportunity to use their expertise and their
• 28:16
  Speaker 3: knowledge of exactly what you just said, living longer, living independently,
• 28:22
  Speaker 3: not necessarily in a skilled environment, but maybe in a
• 28:25
  Speaker 3: skilled environment too, because the home is still going to
• 28:29
  Speaker 3: be a place where you're going to start being able
• 28:31
  Speaker 3: to build systems into the home so that you could
• 28:34
  Speaker 3: deliver a day-to-day person coming to deliver skilled services, especially
• 28:40
  Speaker 3: for those that can afford it. But that is a
• 28:43
  Speaker 3: growth dynamic that I like how you put it, where
• 28:46
  Speaker 3: you said it becomes almost like a separate division of
• 28:50
  Speaker 3: in whichever way you're flowing. Are you flowing from the
• 28:52
  Speaker 3: community to the long-term care, or are you flowing from
• 28:55
  Speaker 3: long-term care to the community? But whoever can use the
• 29:01
  Speaker 3: Rubik's Cube the fastest and come up with the solution,
• 29:05
  Speaker 3: I think there's huge opportunities in every market within the
• 29:08
  Speaker 3: United States.
• 29:10
  Speaker 2: And all that you just said is not dependent upon
• 29:13
  Speaker 2: the PBM.
• 29:14
  Speaker 4: True.
• 29:15
  Speaker 2: That's all revenue that is outside the PBM. And that's
• 29:18
  Speaker 2: really where it starts to become special because again, we
• 29:21
  Speaker 2: have a margin battle going on and we're under the
• 29:26
  Speaker 2: control of three PBMs, 85% of prescriptions in America. And
• 29:31
  Speaker 2: that continues to be an ongoing fight up the Capitol Hill.
• 29:36
  Speaker 2: But at the end of the day, I start diversifying
• 29:38
  Speaker 2: and I start being almost like a mini Amazon to
• 29:41
  Speaker 2: that patient. And I start getting into other clinical billings
• 29:45
  Speaker 2: and other things like that. None of that's dependent upon PBM.
• 29:49
  Speaker 2: And so those are great, consistent revenue streams. And now
• 29:53
  Speaker 2: I'm providing full holistic care. I'm not just dispensing medications.
• 29:57
  Speaker 2: I'm becoming a healthcare provider and working with or collaborating
• 30:00
  Speaker 2: with other healthcare providers. And it becomes pretty special at
• 30:04
  Speaker 2: that point. And so, you know, if I was a
• 30:07
  Speaker 2: young pharmacy owner that felt like I had some years
• 30:11
  Speaker 2: ahead of me, that I would have to figure that
• 30:14
  Speaker 2: out because I think diversifying your revenue, getting away from PBMs,
• 30:20
  Speaker 2: and then back to the conversation on AI, one of
• 30:23
  Speaker 2: the challenges or rate limiting steps in the past was, man,
• 30:26
  Speaker 2: I got to hire how much people to do that. Well,
• 30:29
  Speaker 2: not if you have the proper platform. And that's where
• 30:34
  Speaker 2: we kind of start seeing, well, where are we at
• 30:37
  Speaker 2: with pharmacy and artificial intelligence? And it's really kind of
• 30:41
  Speaker 2: at the beginnings in what most people know publicly. But
• 30:45
  Speaker 2: there are automation platform out there that automates and puts
• 30:50
  Speaker 2: AI throughout your entire workflow, including tracking your RPM data
• 30:56
  Speaker 2: and values. you know, including tracking the nutrition values and
• 31:00
  Speaker 2: those type of things. And so that those exist, they
• 31:03
  Speaker 2: just need to start getting incorporated into long-term care pharmacies.
• 31:09
  Speaker 3: And Tom, there are systems out there, wonderful systems that
• 31:12
  Speaker 3: do an incredible job, but they have built themselves into
• 31:17
  Speaker 3: the corner of something that they become an expert in,
• 31:20
  Speaker 3: whether that is, hey, my system was built for the
• 31:24
  Speaker 3: community pharmacy. And then all of a sudden they're like, no,
• 31:27
  Speaker 3: my system was built for the long-term care pharmacy. SweetRx,
• 31:32
  Speaker 3: because of their pedigree, starting in community and then becoming
• 31:36
  Speaker 3: a champion in long-term care pharmacy, that is a platform
• 31:40
  Speaker 3: that can give you the basis and the systems in place,
• 31:45
  Speaker 3: the reporting, the API readiness to be able to go
• 31:49
  Speaker 3: in both directions.
• 31:50
  Speaker 4: And I think that's powerful.
• 31:53
  Speaker 2: Yes, certainly. Again, majority of pharmacies to do one thing,
• 31:58
  Speaker 2: one thing well. I think if you can open up
• 32:02
  Speaker 2: your revenue stream, open up your patient types, you know,
• 32:06
  Speaker 2: it's question is, is how many seats at the table
• 32:09
  Speaker 2: can I get? If I just do one thing and
• 32:11
  Speaker 2: I do it well, then fine. But if I want
• 32:13
  Speaker 2: to diversify my revenue, then I'm going to have to
• 32:17
  Speaker 2: get into other areas that maybe I naturally hadn't normally
• 32:22
  Speaker 2: got into. I'm going to have to get into nutraceuticals.
• 32:24
  Speaker 2: I'm going to maybe get into infusion. I'm going to
• 32:26
  Speaker 2: have to get into long-term care at home and other
• 32:29
  Speaker 2: things like that. And so, you know, being able to
• 32:32
  Speaker 2: really that growth mindset, you really don't want to be
• 32:36
  Speaker 2: limited by your software. At the end of the day,
• 32:40
  Speaker 2: you don't want to not be able to go after
• 32:42
  Speaker 2: a marketplace because, you know, I've got a square peg
• 32:45
  Speaker 2: in a round hole. And so the more versatile that
• 32:47
  Speaker 2: that software can be, then the more, you know, patient
• 32:51
  Speaker 2: segments I can go after.
• 32:53
  Speaker 3: I like what you said also mentioning infusion care and
• 33:00
  Speaker 3: how there will be patients that are going to need that.
• 33:03
  Speaker 4: They don't want to leave their home.
• 33:05
  Speaker 3: Do you have a system in place that can start
• 33:08
  Speaker 3: building the parameters, the collection of the data, the outsourcing
• 33:16
  Speaker 3: of those systems that get put into the home and
• 33:18
  Speaker 3: then get double-checked and triple-checked to make sure that they're
• 33:23
  Speaker 3: working properly for home infusion. I talked to Senator Shane
• 33:28
  Speaker 3: Reeves of Twelve Stone, I want to say it's been
• 33:32
  Speaker 3: a year now, maybe a little longer, and his building
• 33:36
  Speaker 3: of centers in Tennessee is just it's doubling of the need,
• 33:42
  Speaker 3: but he's also mentioning how the home is becoming the
• 33:46
  Speaker 3: new place where, where healthcare happens. And you know, watching,
• 33:52
  Speaker 3: watching him from the pure long-term care play 20, 25
• 33:58
  Speaker 3: years ago to now a hybrid is that's a, that's
• 34:02
  Speaker 3: a model for, like you said, if you're a, you know,
• 34:05
  Speaker 3: you're a, a 28, 35 year old pharmacist right now,
• 34:10
  Speaker 3: and you're already in long-term care and you want to
• 34:12
  Speaker 3: know what's the, what's my long-term care plan, not to
• 34:16
  Speaker 3: play on words, but it's, it's becoming a hybrid because
• 34:20
  Speaker 3: there's going to be more demand and more demand for
• 34:22
  Speaker 3: specific services. And as a pharmacist, you can, you can
• 34:26
  Speaker 3: play in 100% of this.
• 34:27
  Speaker 4: Yeah.
• 34:28
  Speaker 2: And in programs like PACE, Kind of merge those two worlds,
• 34:32
  Speaker 2: if you will. And, you know, I've serviced PACE accounts,
• 34:36
  Speaker 2: and that's continued to grow in popularity. For Medicaid, for
• 34:40
  Speaker 2: state Medicaid, PACE is a no-brainer. They decrease their cost
• 34:44
  Speaker 2: and they don't have the risk. But that is enabling
• 34:47
  Speaker 2: people to stay at home, but to get more premium
• 34:51
  Speaker 2: long-term care services and long-term care help. But I now
• 34:55
  Speaker 2: have a doctor, a provider that understands all my needs.
• 34:59
  Speaker 2: And I'm interacting with that specific doctor not once or
• 35:03
  Speaker 2: twice a year, but once or twice a week. And
• 35:06
  Speaker 2: they're monitoring my health and they're working with their different vendors.
• 35:09
  Speaker 2: And so That's a good example of kind of where
• 35:12
  Speaker 2: those two worlds of at-home retail and long-term care are
• 35:16
  Speaker 2: kind of coming together. And so there's a lot of, again,
• 35:19
  Speaker 2: growing popularity. I don't think there's enough pace out there,
• 35:23
  Speaker 2: but they need to continue adding that. For a state Medicaid,
• 35:27
  Speaker 2: I think it's a no-brainer slam dunk. I think all
• 35:30
  Speaker 2: states should have multiple pace programs if their population demands that.
• 35:37
  Speaker 3: All right, listeners, if you're driving, doing something where you're
• 35:42
  Speaker 3: just listening, don't worry about it. I'm going to have
• 35:44
  Speaker 3: it in the show notes. Take a look at EvolvedRx.
• 35:49
  Speaker 3: Once again, that's EvolvedRx.com. Reach out to Tom. He is
• 35:54
  Speaker 3: on LinkedIn as well. I'll have a link to his
• 35:56
  Speaker 3: profile in the show notes. And Tom, I want you
• 36:00
  Speaker 3: to promise you'll come back as a Pittsburgher, as a podcaster.
• 36:05
  Speaker 3: I'd love to have you on the show again and,
• 36:08
  Speaker 3: and let's talk shop.
• 36:09
  Speaker 2: Well, absolutely. And you know, we all know our silos
• 36:13
  Speaker 2: are going to go nine and eight this year as
• 36:16
  Speaker 2: they do every year. So we're, we already know the
• 36:18
  Speaker 2: outcome of the season. I actually saw a, a meme
• 36:22
  Speaker 2: and it said potential best and worst records of every
• 36:25
  Speaker 2: team in the NFL. And it was 0 and 16
• 36:29
  Speaker 2: or 0 and 17 and 17 and 0. And all
• 36:31
  Speaker 2: 31 teams in Pittsburgh, 9 and 8 or 9 and 8.
• 36:37
  Speaker 2: It's been a little difficult being average, but we're hoping
• 36:41
  Speaker 2: to be a little bit above average this year. So
• 36:45
  Speaker 2: everyone's going to win the Super Bowl in August.
• 36:48
  Speaker 4: That's right.
• 36:49
  Speaker 3: Tom Hansel, thank you so much for being on the
• 36:52
  Speaker 3: Sweetcast brought to us by SweetRx.
• 36:56
  Speaker 4: Check them out at SweetRx.com.
• 36:59
  Speaker 3: If you have any questions about systems, both Tom and
• 37:02
  Speaker 3: I have been soaking in pharmacy technology systems for 20
• 37:06
  Speaker 3: years now. I can't believe we can say that. And
• 37:10
  Speaker 3: Grandpa Todd, Grandpa.
• 37:12
  Speaker 4: Tom Hansel here.
• 37:14
  Speaker 2: That's right.
• 37:15
  Speaker 4: Talk to you soon.
• 37:16
  Speaker 3: Thank you.