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Pharmacists at the Center: Public Health, AI & the New Pharmacy Model | TWIRx · Pharmacy Podcast Network

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1:34
Speaker 2: You are listening to the global network of podcasters dedicated
1:38
Speaker 2: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
2:09
Speaker 3: Hey, special this week in pharmacy. I am pinching myself
2:14
Speaker 3: because I get an opportunity to interview a superstar that
2:18
Speaker 3: you may not know as a pharmacy podcast listener and
2:21
Speaker 3: listening to twerks week after week.
2:24
Speaker 4: Dr.
2:24
Speaker 3: Alex Adams, PharmD, Assistant Secretary for the Administration for Children
2:30
Speaker 3: and Families, the ACF, And I have a Pennsylvania, my
2:34
Speaker 3: own state leadership here, Dr.
2:37
Speaker 5: Robert Mayer, PharmD.
2:39
Speaker 3: He's the president and chief operating officer of the Pennsylvania
2:42
Speaker 3: Pharmacist Care Network.
2:44
Speaker 5: Gentlemen, welcome to TORX.
2:46
Speaker 6: Glad to be here. Thanks for having me here.
2:48
Speaker 4: Thank you, Todd.
2:50
Speaker 5: All right.
2:50
Speaker 3: We got to get this out of the way, Alex.
2:53
Speaker 3: Just the softball question before we start drilling you with
2:55
Speaker 3: some hard stuff. And that is, why did you want
2:58
Speaker 3: to become a pharmacist in the first place?
3:00
Speaker 6: Well, you know, it kind of followed the family profession.
3:04
Speaker 6: Dad was a pharmacist. Grandpa was a pharmacist. Great-grandpa was
3:07
Speaker 6: a pharmacist. So I was born to be a fourth-generation pharmacist.
3:12
Speaker 6: They joked that my blood type was RX positive. I
3:16
Speaker 6: married a pharmacist, and we had a future pharmacist that
3:20
Speaker 6: we're raising. So, you know, it really followed the family business. And,
3:25
Speaker 6: you know, I believe deeply in what pharmacists, especially in
3:29
Speaker 6: community settings, can do. I will say, prior to graduation,
3:33
Speaker 6: I got probably more interest in the policy side of
3:36
Speaker 6: the profession and found every pharmacy speech has the same elements.
3:44
Speaker 6: We're the most accessible healthcare professionals, we're among the most
3:48
Speaker 6: trusted healthcare professionals, but we're the most underutilized professionals. And
3:54
Speaker 6: I don't know that I ever had the patience to
3:56
Speaker 6: stick around hoping that somebody would recognize our potential and
4:00
Speaker 6: utilize us. I wanted to knock those doors down, so
4:03
Speaker 6: I did pivot early in my career to the policy
4:05
Speaker 6: side of the profession.
4:06
Speaker 3: Yeah, and you really jumped in and dug in deep
4:11
Speaker 3: with Idaho's Department of Health and Welfare as their director.
4:16
Speaker 3: Talk to us about the inception of that and then
4:20
Speaker 3: where that led you next.
4:24
Speaker 6: As I said, I married a pharmacist. My wife is
4:26
Speaker 6: an Idaho pharmacist. She used to work at APHA and AACP,
4:30
Speaker 6: so kind of the alphabet soup of pharmacy family here.
4:35
Speaker 6: When we decided we wanted to have a family, looked
4:38
Speaker 6: at moving back to Idaho, which is where she's from,
4:43
Speaker 6: the skies opened up from the heavens. Around that time,
4:45
Speaker 6: we were talking about moving back to Idaho. the executive
4:48
Speaker 6: director of the Idaho Board of Pharmacy position opened up.
4:51
Speaker 6: So I applied and was fortunate to get that. As
4:55
Speaker 6: I said, I never was one for patients. So I said, well,
4:58
Speaker 6: if I'm going to do this and I'm going to
5:00
Speaker 6: move across the country and I'm going to take the
5:02
Speaker 6: Board of Pharmacy position, I want to be the state
5:05
Speaker 6: everybody looks at with envy. Before that, you know, frankly,
5:09
Speaker 6: we had to look at Canada with envy, Alberta, Canada,
5:13
Speaker 6: of all places, pharmacists at independent prescriptive authority.
5:15
Speaker 7: They had the ability to adapt.
5:17
Speaker 6: Prescriptions. And, you know, I remember one time presenting at
5:23
Speaker 6: the University of Pittsburgh at telling the graduates, if you
5:26
Speaker 6: want to practice at the top of your education, the
5:28
Speaker 6: top of your training, you got to go to Alberta, Canada,
5:32
Speaker 6: of all places. And I wanted there to be a
5:36
Speaker 6: place in the U.S. that would rival that. And frankly,
5:38
Speaker 6: I wanted to go further than Alberta. So when I
5:41
Speaker 6: started at the with about 100 pages of regulations. And
5:49
Speaker 6: when I ended, we get it down to like 20-ish
5:52
Speaker 6: or so pages of regulations. We got rid of all
5:55
Speaker 6: the ticky tacky stuff of how hot your hot water
5:58
Speaker 6: has to be, how much light has to get to
5:59
Speaker 6: the back of your counters, what type of doors and
6:02
Speaker 6: hinges you have to have. But more importantly, we created
6:06
Speaker 6: breathing room for prescribing. And it was a very iterative process. Initially,
6:11
Speaker 6: when I started, I started taking packages to our legislature
6:14
Speaker 6: where we would allow pharmacists to prescribe for very discreet
6:18
Speaker 6: things like naloxone and tobacco cessation products and tuberculosis skin
6:24
Speaker 6: tests and things like that. And it just, it wasn't sustainable.
6:28
Speaker 6: Each one of them, you had to run a bill.
6:30
Speaker 6: Each one of them was opposed by other professions. Each
6:34
Speaker 6: one of them, you then had to lard up with
6:36
Speaker 6: training requirements on TB skin test and annual continuing education
6:41
Speaker 6: requirements and all of that. It just wasn't sustainable. I
6:45
Speaker 6: think the thing that really changed the trajectory was when
6:51
Speaker 6: we ran the tobacco cessation prescribing bill, you had a
6:54
Speaker 6: physician get up to oppose it who basically argued, and
6:58
Speaker 6: I'm saying basically argued, was it was safer to smoke
7:02
Speaker 6: than it was for pharmacists to help people stop smoking.
7:05
Speaker 6: It was such a disingenuous argument and so shrill that
7:10
Speaker 6: the legislature said, let's get out of this business and
7:13
Speaker 6: let's just give pharmacists broader prescriptive authority. So I worked
7:17
Speaker 6: with a couple legislators. We drafted some broad language that
7:20
Speaker 6: rather than saying drug by drug, drug category by drug category,
7:24
Speaker 6: that pharmacists could prescribe anything that didn't require a diagnosis,
7:28
Speaker 6: was preventive in nature, was for a condition that was
7:31
Speaker 6: minor or self-limiting, or for things that can be used
7:34
Speaker 6: in emergency situations. And that was the first time a U.S.
7:38
Speaker 6: state had opened broad prescriptive authority. But it also put
7:45
Speaker 6: the onus on the board. We had to then write
7:47
Speaker 6: regulations defining what is a minor and self-limiting condition. And
7:52
Speaker 6: we ran into the same problem. I ran a slate
7:55
Speaker 6: of regulations at the board that included like 20 to
7:57
Speaker 6: 30 things on it. It was medications for urinary tract infections,
8:01
Speaker 6: medications for flu and strep, medications for cold sores. And
8:05
Speaker 6: every single one of them was opposed. Like the most
8:07
Speaker 6: vivid memory I have was a representative of, I believe,
8:12
Speaker 6: the Board of Medicine opposing those one by one. And
8:15
Speaker 6: for cold sores, she got up and said, how is
8:17
Speaker 6: a pharmacist going to distinguish between herpes labialis, a cold sore,
8:23
Speaker 6: and genital herpes? And I remember saying anatomical distance. And
8:29
Speaker 6: it just got to the point where Like, we started
8:34
Speaker 6: looking outside the profession. How have others done this? There's
8:37
Speaker 6: no way nurse practitioners had to go through this for
8:42
Speaker 6: every drug category or physician assistance. We stumbled into standard
8:46
Speaker 6: of care regulation. Rather than identifying everything as an itemized
8:52
Speaker 6: checklist or list of permissions, you flip the script. If
8:56
Speaker 6: something is not prohibited, it's allowed. as long as it's
9:01
Speaker 6: within your education, your training, your professional experience. So we
9:07
Speaker 6: pulled in some folks who had regulated in the medical
9:10
Speaker 6: professions and nursing professions and say like, what regulation says
9:14
Speaker 6: after open heart surgery, you have to remove the sponge
9:18
Speaker 6: from the chest cavity? Well, there isn't one, but it's
9:21
Speaker 6: the standard of care. So really immersed myself into this
9:26
Speaker 6: standard of care philosophy And we were the first state
9:32
Speaker 6: to get rid of all of those regulations, got rid
9:34
Speaker 6: of everything around immunizations, smoking cessation, TB skin tests, all
9:39
Speaker 6: of those things that we had run one by one,
9:41
Speaker 6: fought battle by battle. We ended up just eliminating all
9:44
Speaker 6: of that and said pharmacy practice is going to be
9:47
Speaker 6: governed by a standard of care. Pharmacists can do anything
9:50
Speaker 6: within their education, training, and experience as long as it's
9:53
Speaker 6: not prohibited. So I remember going around and doing a
9:57
Speaker 6: bunch of presentations to pharmacists throughout the state. and saying,
10:00
Speaker 6: you know, the answer to darn near every pharmacy law
10:03
Speaker 6: question is now, it depends. You know, can I prescribe
10:08
Speaker 6: for X? Well, it depends. Is it within your education?
10:12
Speaker 6: Is it within your training? Is it within your experience?
10:15
Speaker 6: You're polled in front of the Board of Pharmacy. Would
10:16
Speaker 6: you be willing to justify it? how this was in
10:20
Speaker 6: the best interest of patient care. And it was a very,
10:24
Speaker 6: I will say, uncomfortable mindset for a lot of pharmacists
10:27
Speaker 6: because Many pharmacists, I'm sure not all of your listeners,
10:31
Speaker 6: but many pharmacists are just very type A personalities and
10:36
Speaker 6: don't do well with gray area. They like things black
10:39
Speaker 6: and white and rule-based. And it depends is a very
10:44
Speaker 6: uncomfortable area. But for this profession to be sustainable, for
10:48
Speaker 6: this profession to really be able to be utilized and
10:52
Speaker 6: not just sitting at pharmacy conferences grousing about being underutilized,
10:56
Speaker 6: you really have to be governed like other health professions,
10:59
Speaker 6: specifically the medical and nursing professions, which is by a
11:03
Speaker 6: standard of care. So we got that done about 10
11:06
Speaker 6: years ago in Idaho, and it's really great to see
11:09
Speaker 6: other states are now embracing that and seeing that as
11:13
Speaker 6: a model of reform.
11:16
Speaker 5: Thank you for that.
11:17
Speaker 3: I see some contrast and some comparison opportunities with Pennsylvania
11:23
Speaker 3: and Pennsylvania's initiatives with the PPCN, the Pennsylvania Pharmacist Care Network. Rob,
11:29
Speaker 3: what are those kind of variables in comparing what Alex
11:35
Speaker 3: shared at a federal level? What's happening at Idaho? Now
11:38
Speaker 3: it's pulling it into a federal level, but talk to
11:41
Speaker 3: us about the PPCN here in Pennsylvania.
11:45
Speaker 8: I mean, a lot of our contracts and why we
11:48
Speaker 8: created our clinically integrated network, which was being created right
11:51
Speaker 8: around when CPSN and.
11:53
Speaker 4: It was a natural fit, was.
11:56
Speaker 8: We had a way to talk to payers about what
11:58
Speaker 8: we can do. And pretty much most of our contracts
12:01
Speaker 8: are within our scope of practice here in the state
12:03
Speaker 8: of Pennsylvania, because every state does, just as Alex said. Now,
12:07
Speaker 8: the problem we have and where we've grown very well
12:12
Speaker 8: of showing how we can impact and improve asthma outcomes, diabetes.
12:17
Speaker 8: And in fact, one of our newer ventures, which kind
12:20
Speaker 8: of lines up with where Alex's role is, is we're
12:23
Speaker 8: doing a maternal health program, which is very important because
12:27
Speaker 8: a lot of our counties don't have access to OBGYN care.
12:31
Speaker 8: And when we're working with our Medicaid providers, they're going,
12:34
Speaker 8: you know, this is a need. And so, but where
12:39
Speaker 8: we run into limitations, and that's why I'm excited that
12:42
Speaker 8: our state, that our state association, PPA, and our Pennsylvania
12:47
Speaker 8: Society of Health System Pharmacists are really starting to look
12:51
Speaker 8: at standard of care. We got a long way to go,
12:54
Speaker 8: but we're getting leaders together to talk about it because
12:57
Speaker 8: I'll go to a payer.
12:58
Speaker 4: I'll give you an example.
13:00
Speaker 8: We can, pharmacists can do testing lab-wise for RSV, influenza, strep,
13:09
Speaker 8: and COVID.
13:10
Speaker 4: But if we want.
13:11
Speaker 8: To be able to do hemoglobin A1C, which now is
13:15
Speaker 8: a self-test at home, we got to get a full
13:18
Speaker 8: lab license and we have to get a medical director.
13:21
Speaker 8: And that is not an easy feat, especially when a
13:24
Speaker 8: lot of our physicians work for health systems and may
13:27
Speaker 8: not want a partner. But You know, when we talk
13:31
Speaker 8: to our payers, what's the most needed thing? Getting an
13:35
Speaker 8: accurate hemoglobin A1C tied to their value-based contracts, but also
13:40
Speaker 8: the pharmacist needs that information to provide care.
13:43
Speaker 4: So I think that.
13:45
Speaker 8: We've come a long way in what we do, and
13:48
Speaker 8: we've gotten Medicaid provider status, which has been slowly growing
13:52
Speaker 8: in our state. But that standard of care, I echo
13:55
Speaker 8: what Alex said, that instead of doing this mother-may-I having
14:00
Speaker 8: the ability to practice what we do. For those naysayers
14:04
Speaker 8: who say, well, I don't want to do it, well,
14:06
Speaker 8: you may not have to if your organization doesn't. I
14:10
Speaker 8: grew up in a community pharmacy, but I also had
14:13
Speaker 8: the privilege of doing a residency, working in a physician clinic,
14:17
Speaker 8: and I worked some in the VA. We've been doing
14:20
Speaker 8: this in the VA model for years, credentialing and far
14:25
Speaker 8: as I know, there's not too many pharmacists that have
14:27
Speaker 8: caused harm. And I liked your analogy that we're also
14:31
Speaker 8: extenders because, you know, with this whole rural health transformation
14:35
Speaker 8: in Pennsylvania, we got Pittsburgh and Philly, but there's a
14:38
Speaker 8: lot of rural in Pennsylvania.
14:41
Speaker 4: This is really something that is needed.
14:44
Speaker 8: Hopefully that kind of echoed, you know, what our conversation was.
14:50
Speaker 3: Yeah, Alex, what you were saying and setting the stage
14:53
Speaker 3: for We were diving into Pennsylvania, but we want to
14:56
Speaker 3: see this spill out throughout the entire nation. And I'm
14:59
Speaker 3: not sure if that's provider status. I'm not sure if
15:02
Speaker 3: that's a new way of thinking of what a pharmacist
15:05
Speaker 3: is capable of doing within the setting. When we talk
15:07
Speaker 3: about specialty rare disease, much different than senior care, much
15:11
Speaker 3: different than pediatrics, much different than general community pharmacy, immunization programs,
15:17
Speaker 3: birth control, for goodness sakes. where we have different centers
15:22
Speaker 3: that are closing for one reason or another, and now
15:25
Speaker 3: it's our pharmacists that are picking up the slack. This
15:28
Speaker 3: kind of ties back into your missions with caring for families,
15:33
Speaker 3: caring for children. Talk to us about other initiatives that
15:38
Speaker 3: you're working on, Alex, and how even Pennsylvania and other
15:42
Speaker 3: states may be able to back up, repeat some of
15:44
Speaker 3: the things that you're doing so that we can fortify.
15:47
Speaker 6: Yeah, a lot to unpack there and love your framing
15:51
Speaker 6: of it. You know, I think the first thing I
15:53
Speaker 6: would start with is pharmacy is primarily governed at the
15:58
Speaker 6: state level. So, you know, I know there's a lot
16:00
Speaker 6: that look to Washington for action, but this is really
16:04
Speaker 6: an issue where you should be interfacing with your state legislature,
16:07
Speaker 6: your state board of pharmacy and others because your scope
16:11
Speaker 6: of practice is defined at the state level. Second thing
16:16
Speaker 6: I would say is a lot of people tend to
16:19
Speaker 6: look at changing the law as the endpoint. It's my
16:23
Speaker 6: experience that changing the law is opening the door. Whether
16:26
Speaker 6: or not people walk through that door relies on all
16:29
Speaker 6: of these other factors. And, you know, Alberta was always
16:33
Speaker 6: a perplexing example for me. As I said, prior to
16:36
Speaker 6: getting standard of care in Idaho and seeing that kind
16:38
Speaker 6: of sprinkled other states like Alaska and Iowa, and it
16:42
Speaker 6: sounds like Pennsylvania is having some of those conversations. Alberta
16:46
Speaker 6: was really the model exemplar in North America. But there
16:51
Speaker 6: were studies that showed five years after pharmacists getting independent
16:55
Speaker 6: prescriptive authority in Alberta, only 5% of pharmacists had actually
16:59
Speaker 6: prescribed a drug. So I think there's a tendency to
17:03
Speaker 6: think changing the law is the end point. I initially
17:07
Speaker 6: would say... I was frustrated by low uptake, but I
17:11
Speaker 6: also think that's a sign that these things work. Not
17:14
Speaker 6: every pharmacist has to move forward. Not every pharmacist might
17:17
Speaker 6: have the education, training, or experience to do some of
17:19
Speaker 6: these things. Not every pharmacy organization wants to move forward
17:23
Speaker 6: with some of these things. So law opens the door.
17:27
Speaker 6: Whether or not people walk through it is a complex
17:30
Speaker 6: dynamic of payer policies, patient acceptance and demand, corporate policies,
17:36
Speaker 6: risk mitigation, liability insurance, and personal preferences and choice. Oftentimes
17:43
Speaker 6: what you see, like when pharmacists started immunizing, it took
17:46
Speaker 6: 20 years for From the first pharmacist immunization law to pass,
17:52
Speaker 6: two and a half of the profession had become credentialed
17:56
Speaker 6: as immunizers. So some of these are playing the long game,
18:00
Speaker 6: but there are certainly things, organizations, that's what Robert's organization does.
18:04
Speaker 6: They're helping get pharmacists comfortable and ready and able to
18:08
Speaker 6: walk through those doors and fill in those gaps that
18:11
Speaker 6: laws can't. I will say federally, though, this is a
18:14
Speaker 6: moment of opportunity. I have the privilege to serve here
18:17
Speaker 6: at the U.S. Department of Health and Human Services, and
18:19
Speaker 6: there's been a number of things that we think can help.
18:24
Speaker 6: One is in the Rural Transformation Fund that CMS issued
18:28
Speaker 6: had expressed points given, and the points helped influence how
18:34
Speaker 6: much funding went to each state, and some of the
18:35
Speaker 6: points were based on what your pharmacy scope of practice
18:38
Speaker 6: law is. are with a specific suggestion of broad independent
18:41
Speaker 6: prescriptive authority. One of the things I oversee is the
18:44
Speaker 6: ACF Administration for Children and Families. One of my top
18:48
Speaker 6: goals is to prevent foster care entry. One of the
18:51
Speaker 6: top reasons for foster care entry is parental substance use disorders.
18:56
Speaker 6: One of the ways you can prevent or treat, most
18:59
Speaker 6: importantly treat, parental substance use disorders is medications for opioid
19:03
Speaker 6: use disorder. And earlier this year, we announced federal funding
19:08
Speaker 6: match for medications for opioid use disorder. And then subsequent
19:14
Speaker 6: to that, I teamed up with Dr. Oz and Chris Carroll,
19:17
Speaker 6: who was running SAMHSA, and we put out a letter
19:21
Speaker 6: to states encouraging them to fully utilize their pharmacist workforce
19:25
Speaker 6: as independent prescribers of medications for opioid use disorders in
19:29
Speaker 6: accordance with a standard of care. So there is a
19:32
Speaker 6: federal match available for those medications available to pharmacists but
19:38
Speaker 6: you would have to work with your state child welfare
19:40
Speaker 6: agency to identify the population who's eligible. So a moment
19:46
Speaker 6: of opportunity, but still contingent on local interface with state agencies.
19:55
Speaker 3: I love the dominoes that can fall, but like you said,
19:59
Speaker 3: just because there's a law that's been passed, it's the
20:01
Speaker 3: implementation that's the most important part, and it is controlled
20:06
Speaker 3: wherever the state is in their progression. Robert, it reminds
20:11
Speaker 3: me of PPCN and the different buckets of what you're
20:15
Speaker 3: concentrating on, where you're going to the health systems and hospitals,
20:18
Speaker 3: you're going to the independent community pharmacies, you're helping out
20:21
Speaker 3: with a grocery store, standardization of care of how we're
20:25
Speaker 3: using food as medicine. Talk to us about PPCN and
20:29
Speaker 3: how you're helping the state to move forward and unpacking
20:32
Speaker 3: some of this to make it a reality rather than
20:34
Speaker 3: just laws or policies?
20:36
Speaker 6: Yeah.
20:37
Speaker 8: So, I mean, we've been, we've had the opportunity both
20:41
Speaker 8: through PPCN and our subsidiary, we're a subsidiary of our
20:46
Speaker 8: state association of partnering with our, you know, department of
20:50
Speaker 8: health and also our local departments of health that are
20:54
Speaker 8: in the counties that have counties that have them And
20:58
Speaker 8: one of our biggest initiatives recently is our Momentum Project,
21:03
Speaker 8: which is to help with, you know, maternal health. And
21:07
Speaker 8: it's not just maternal health from, you know, from before
21:11
Speaker 8: the child.
21:12
Speaker 4: Is born, but it's also after the child is born.
21:14
Speaker 8: Because we know that there's issues after the child is
21:17
Speaker 8: born in terms of, you know, postpartum depression. Also dealing with,
21:22
Speaker 8: you know, you know, vaccines and continuity of care. One
21:27
Speaker 8: of the things that we have in a lot of
21:29
Speaker 8: our pharmacies that are especially in underserved areas, which underserved
21:33
Speaker 8: doesn't necessarily mean rural, but it could also be an
21:36
Speaker 8: urban area, is getting that person to an OBGYN. We
21:43
Speaker 8: have a pharmacy here in Pittsburgh that, you know, identified
21:46
Speaker 8: a woman who's been pregnant for almost a whole trimester,
21:49
Speaker 8: you and has not even seeked maternal health care. And
21:55
Speaker 8: so the risk, and this person was somebody that had
21:59
Speaker 8: substance abuse. So there's things that we can do that
22:04
Speaker 8: can impact that. And we've seen what pharmacists can do
22:08
Speaker 8: via vaccines, but that extension, because it's hard to get
22:13
Speaker 8: in to see your healthcare practitioner, all right? My wife
22:17
Speaker 8: was going to get a physical and she needs to
22:19
Speaker 8: for her nursing job and the doctor canceled even though
22:22
Speaker 8: she had appointment a year ahead of time. Now she
22:24
Speaker 8: can go see the PA or whatever, but just getting
22:27
Speaker 8: access to care because the way our system is right now.
22:31
Speaker 8: So I think those are the things that when people
22:34
Speaker 8: push back about, oh, can pharmacists do this?
22:37
Speaker 4: We can, we're trained to do it.
22:39
Speaker 8: We just have to give that confidence level And I
22:42
Speaker 8: think having our network, what it does is it provides
22:46
Speaker 8: a confidence level for that payer and for those partners
22:50
Speaker 8: that we're working because you got to hold quality because
22:53
Speaker 8: if you don't hold quality, then people aren't going to
22:55
Speaker 8: trust you.
22:56
Speaker 4: And that's one thing that we can do help that.
23:01
Speaker 5: And the payers have to see the results.
23:03
Speaker 3: They have to see the outcomes in order to continuously
23:06
Speaker 3: continue to fund it and then be attracted to those programs.
23:10
Speaker 4: I love that.
23:12
Speaker 3: Alex, you know, this has gone by way too fast.
23:17
Speaker 3: I want to just put an invitation out to you,
23:21
Speaker 3: even after your time at the federal level, you know,
23:25
Speaker 3: when you go back to Idaho, I want you to
23:27
Speaker 3: remember Pharmacy Podcast Network. We have 40 some shows with
23:31
Speaker 3: all themes of the senior care, our pediatricians practicing our
23:35
Speaker 3: specialty rare disease.
23:36
Speaker 5: This is an open platform for you.
23:38
Speaker 3: If you ever have something going on, you want to
23:40
Speaker 3: team up with a state organization, you you want to
23:42
Speaker 3: kind of dig into something to get more attention around it,
23:45
Speaker 3: I would love to have you back.
23:46
Speaker 5: But really appreciate you being here on Twerks.
23:49
Speaker 6: Appreciate it. Thanks for all you do.
23:51
Speaker 4: Thank you, Alex.
23:53
Speaker 8: And also, you know, you're a perfect example of what
23:56
Speaker 8: our younger professionals need to follow is that if we
24:00
Speaker 8: speak our mind and we keep talking.
24:02
Speaker 4: We can change this profession one by one. So thank you.
24:04
Speaker 4: I want to give my own personal professional thanks.
24:08
Speaker 6: Appreciate it. Thank you.
24:10
Speaker 3: Shout out to our pharmacy students out there. Listen to
24:13
Speaker 3: this interview. You have a future in pharmacy leadership. If
24:17
Speaker 3: that's what you want to do, press for it. Link
24:20
Speaker 3: up with people like Rob Mayer on LinkedIn. Reach out
24:23
Speaker 3: to me. I'll get you tied in with other people,
24:25
Speaker 3: but keep pushing. Leadership in healthcare starts with you. And
24:29
Speaker 3: don't ever say, don't ever take no the first time.
24:32
Speaker 3: Keep pushing, keep seeing what is possible and what you
24:35
Speaker 3: can do as a pharmacist. And listeners, you're the champions.
24:38
Speaker 3: Thank you, pharmacists. Thank you, pharmacy technicians, for what you do.
24:42
Speaker 3: And thank you so much for listening to This Week
24:44
Speaker 3: in Pharmacy.
24:45
Speaker 9: If you run a specialty program, you already know where
24:48
Speaker 9: your margin goes. It goes to headcount spent on coordination,
24:51
Speaker 9: to patients who abandoned therapy before the second fill, to
24:54
Speaker 9: the manufacturer contract you couldn't win because you couldn't prove
24:57
Speaker 9: your outcomes. to limited distribution access that went to a
25:00
Speaker 9: competitor with better reporting. One journey from Cassian Rx is
25:05
Speaker 9: built to change that math. One platform connects your patients,
25:10
Speaker 9: your prescribers, your pharmacy workflow, and your data, so throughput
25:14
Speaker 9: goes up, freeing up staff to provide care that matters.
25:17
Speaker 9: Automated engagement keeps patients on therapy, protecting the refills that
25:21
Speaker 9: drive your revenue. Real-time outcomes reporting gives you the performance
25:24
Speaker 9: data manufacturers and payers actually ask for. and your prescribers
25:28
Speaker 9: get the visibility that keeps referrals coming back to you.
25:31
Speaker 5: It's fully white-labeled.
25:32
Speaker 9: Your brand, your patient relationships, your data. It runs on
25:36
Speaker 9: top of your existing pharmacy management system. No rip and replace.
25:39
Speaker 9: Grow volume, prove value, keep what you've earned. OneJourney by Cassian.com.
25:45
Speaker 9: OneJourney by CassianRx.
25:48
Speaker 3: Hey, welcome back to Twerks. What a great episode. What
25:52
Speaker 3: a great interview. Thank you, Rob Mayer.
25:57
Speaker 5: And Dr.
25:58
Speaker 3: Alex Adams, what a place setter for pharmacists to think, hey,
26:05
Speaker 3: do you belong in public health? Do you belong in
26:07
Speaker 3: public health leadership? The answer is yes, you do. That
26:11
Speaker 3: was a trick question. Hey, on our next segment here,
26:16
Speaker 3: one of the most effective aspects of your business of pharmacy,
26:22
Speaker 3: I don't care what sector you're in, I don't care
26:26
Speaker 3: if you're a consultant pharmacist or in specialty or any factor,
26:31
Speaker 3: long-term care pharmacy is being able to define how are
26:35
Speaker 3: you going to use artificial intelligence in your operations and
26:40
Speaker 3: how is it going to parallel the infrastructure you already
26:43
Speaker 3: have to make things more efficient, to make things work better,
26:47
Speaker 3: but then also thinking of it from a strategy perspective
26:53
Speaker 3: and not just slap it on because it's the hot
26:55
Speaker 3: button or it's the trendy thing to do, because you
26:58
Speaker 3: don't want trends involved in your business. You want solid
27:02
Speaker 3: solutions that absolutely make sense and that are proven. That's
27:06
Speaker 3: why I bring the best of the best on. I
27:08
Speaker 3: want to introduce John Booz. He is the CEO of
27:12
Speaker 3: Hendren AI.
27:13
Speaker 5: John, welcome to Twerks.
27:15
Speaker 10: Thank you for having me, Todd.
27:17
Speaker 3: Excited to have you here. You and I are headed
27:20
Speaker 3: to the NASP Inspire 2026. We're going to be doing
27:24
Speaker 3: some interviews there. We're going to be diving into how
27:27
Speaker 3: does AI impact rare disease, digital therapeutics in specialty pharmacy.
27:35
Speaker 3: therapeutic interchanges, decisions around reimbursement, lots of things to talk about.
27:40
Speaker 3: But today, we want to introduce you to the listeners.
27:43
Speaker 3: We want to get the Hendren name out there to
27:46
Speaker 3: let everybody know. By the way, go to h-e-n-d-r-e-n dot a-i.
27:53
Speaker 3: Once again, Hendren dot a-i to learn more. But John,
27:57
Speaker 3: right out of the.
27:58
Speaker 5: Gate, give us some background and overview on Hendren AI.
28:03
Speaker 3: Sure.
28:03
Speaker 7: First, the name.
28:04
Speaker 10: It's the Viking God of Knowledge. Everyone asks me, where'd
28:07
Speaker 10: you get that name from? So I was looking for
28:10
Speaker 10: all of the gods of knowledge and wisdom, and all
28:13
Speaker 10: of them were taken. And probably one of the worst
28:15
Speaker 10: gods of knowledge was Isis. So nobody wanted to have
28:18
Speaker 10: that name. So in terms of picking out names, I
28:21
Speaker 10: actually found Viking God of Knowledge. I thought it was
28:22
Speaker 10: a great idea to be able to name Hendren after that.
28:25
Speaker 10: And in terms of being able to really show the
28:28
Speaker 10: God of Knowledge or God of Wisdom and being able
28:31
Speaker 10: to correlate that with some of the pharmacy disruption that
28:34
Speaker 10: we're essentially pioneering within the platform, with this intelligence platform
28:40
Speaker 10: within the pharmacy. So from end to end, looking at
28:43
Speaker 10: first principles thinking, And at the same time, how do
28:46
Speaker 10: we do a platform redesign of this from the beginning?
28:52
Speaker 10: And the things that we've spoken about prior to this was,
28:55
Speaker 10: how do we add point solutions? And point solutions by themselves,
28:59
Speaker 10: like pharmacy management softwares, weren't enough. So this intelligence platform
29:04
Speaker 10: really solved some of the problems that we've been experiencing
29:06
Speaker 10: in pharmacy amongst handling phone calls on the screen, spending
29:11
Speaker 10: numerous hours talking to patients because patients want the Amazon
29:14
Speaker 10: pharmacy experience. And we found that to be able to
29:17
Speaker 10: do that, not only just for really independence, but also
29:21
Speaker 10: at the same time, chains, mail order pharmacies, and specialty pharmacies.
29:26
Speaker 3: For people that are driving or walking or doing something,
29:29
Speaker 3: you're just listening to your podcast. First of all, thanks
29:32
Speaker 3: for listening. But for those that are looking, if you're
29:36
Speaker 3: seeing us on YouTube or watching us on LinkedIn stream,
29:40
Speaker 3: a system under load, the health system and pharmacies are
29:45
Speaker 3: absorbing the same pressures of staffing and rising costs and.
29:48
Speaker 5: Administration and workflow.
29:50
Speaker 3: If you can leverage artificial intelligence, John, it's a game changer,
29:55
Speaker 3: but you have to have an organization that knows what
29:58
Speaker 3: they're doing And like I said, this cannot be a trend.
30:01
Speaker 3: This needs to be delivered through proof. And we come
30:04
Speaker 3: from an organization, we come from specialists and providers that
30:10
Speaker 3: rely on evidence-based knowledge. And I almost feel that AI
30:15
Speaker 3: in pharmacy needs to go through some kind of standardization
30:19
Speaker 3: or criteria analysis. around delivering something that is truly evidence-based
30:23
Speaker 3: and always remembering that. But talk to us about the
30:27
Speaker 3: hot buttons and some of the things that your clients
30:29
Speaker 3: are experiencing in using AI through the power of Hendren AI.
30:35
Speaker 10: So essentially the customers are looking at it from a
30:38
Speaker 10: de-risk basis. So you're a pharmacist, so we like to
30:41
Speaker 10: look at evidence, objective, subjective, and what clients are typically
30:45
Speaker 10: looking at is a de-risk product. So essentially understanding that
30:50
Speaker 10: It comes with its troubles, comes with its goods, and
30:53
Speaker 10: we usually get questions like, are there any hallucinations? Will
30:57
Speaker 10: this start going off the guardrails? And what we usually
31:00
Speaker 10: comfort them with saying is that there's going to be
31:02
Speaker 10: rule-based control over the AI agent's ability to go back
31:07
Speaker 10: and forth and what lane they can stay in. There's guardrails.
31:10
Speaker 10: So that's essentially some of the, I would say, the
31:12
Speaker 10: major questions that we end up having in terms of
31:15
Speaker 10: being able to say, Will these AI agents on the
31:17
Speaker 10: screen or over the phone do their own thing outside
31:20
Speaker 10: of the guardrails that we end up training it with?
31:23
Speaker 10: And really, the answer is no, as long as they're
31:26
Speaker 10: being monitored, right? And there's some instances that happened actually
31:29
Speaker 10: with NVIDIA and Hugging Face where essentially OpenAI and their
31:35
Speaker 10: bots were able to go out there and essentially go
31:37
Speaker 10: to Hugging Face, and they were trying to attack Hugging Face.
31:42
Speaker 10: There are possibilities where open AI really didn't do enough monitoring.
31:46
Speaker 10: They have millions of agents working simultaneously and they haven't
31:49
Speaker 10: had any oversight. But that's not the case with us.
31:51
Speaker 10: Our DNA is security and compliance and making sure compliance
31:56
Speaker 10: is very important to us. HIPAA compliance is very important.
31:59
Speaker 10: To be able to have a seesaw within our organization
32:01
Speaker 10: managing those things is really what gives us our competitive
32:05
Speaker 10: advantage and moat against the competition that's in the market
32:08
Speaker 10: right now. And not Many organizations can say that. A
32:12
Speaker 10: lot of the folks that are really in the market
32:14
Speaker 10: right now have glanced over those kind of things. And
32:17
Speaker 10: we're dealing with large enterprise organizations from large mail order pharmacies,
32:21
Speaker 10: specialty pharmacies, health systems that are essentially leveraging this kind
32:25
Speaker 10: of technology. And the security clearance is not easy. So
32:29
Speaker 10: this isn't a corner pharmacy that you have one key
32:31
Speaker 10: decision maker. You're just getting an agreeable answer to them.
32:35
Speaker 10: These are really bureaucracies and enterprise organizations where there's a
32:39
Speaker 10: whole security department where we're answering 120 controls, making sure
32:42
Speaker 10: that we're compliant.
32:46
Speaker 3: Talk to me about why pharmacy, though, in comparison to
32:49
Speaker 3: so many other sectors of even health care.
32:52
Speaker 5: What is it about pharmacy?
32:55
Speaker 3: I mean, I know that you're a pharmacist yourself, but
32:58
Speaker 3: where did you see the opportunity to jump into this?
33:03
Speaker 10: Well, it was very early. So I would say around
33:06
Speaker 10: the end of 2023, probably a year after ChatGPT came out,
33:11
Speaker 10: we realized there was an opportunity to be able to
33:13
Speaker 10: leverage voice AI. And there's a lot of companies out
33:16
Speaker 10: there that were doing voice AI. Even now, it's become
33:19
Speaker 10: a plethora of those. But what we really... pushed forward
33:23
Speaker 10: was the vision language models. And if you understand vision
33:26
Speaker 10: language models, and I'll really explain it very easily, is
33:29
Speaker 10: usually a chat GPT that runs on OpenAI's platform essentially
33:34
Speaker 10: is a large language model. And the vision language model
33:37
Speaker 10: essentially just reads what's on the screen. And vision language
33:41
Speaker 10: models also could read what's on a camera. So what
33:44
Speaker 10: we said was these prescriptions are typically coming in handwritten,
33:47
Speaker 10: and how do we leverage those vision language models to
33:50
Speaker 10: be able to gather that information with OCR and then
33:54
Speaker 10: be able to map it into the pharmacy software? And
33:57
Speaker 10: that's really what got us going because voice AI was
33:59
Speaker 10: really present at the time. But when it came to
34:02
Speaker 10: vision language models, Even the talent in the States right
34:05
Speaker 10: now is very minimal in terms of understanding what vision
34:08
Speaker 10: language model can do. And we're not just talking about pharmacists.
34:11
Speaker 10: We're talking about computer science engineer graduates, folks that have
34:14
Speaker 10: been in really the career. This is not something that's
34:18
Speaker 10: quite present. So you could have, for example, New York
34:21
Speaker 10: City cameras run with vision language models to look for
34:23
Speaker 10: terrorists and burglaries and all this stuff. But not many
34:27
Speaker 10: folks have really geared into the understanding of how can
34:30
Speaker 10: we leverage this vision language model to be able.
34:32
Speaker 9: To do work.
34:33
Speaker 10: Be productive, operate AI agents on the screen, to be
34:37
Speaker 10: able to do some of the things that technicians are
34:39
Speaker 10: typically doing in the pharmacy. And we know there's a
34:41
Speaker 10: shortage of technicians, there's a shortage of pharmacists, in terms
34:45
Speaker 10: of it's more of an outflow since COVID. And that's
34:48
Speaker 10: where the opportunity really aligned in terms of productivity. And
34:51
Speaker 10: we know that margins have really tanked for independents out
34:54
Speaker 10: there that are running at 2% to 5% net margins.
34:57
Speaker 10: So we said, Technology is essentially deflationary, and how can
35:01
Speaker 10: we improve those pharmacies' net margins by really implementing this
35:05
Speaker 10: technology by using AI agents, voice AI, and automation to
35:10
Speaker 10: really say whoever's out there in terms of a primary
35:12
Speaker 10: platform or pharmacy management software will essentially API into your
35:17
Speaker 10: organization to be able to give that pharmacy the plumbing
35:21
Speaker 10: of the intelligence platform on top of the pharmacy software
35:24
Speaker 10: without losing any security.
35:28
Speaker 5: So there's something on the.
35:31
Speaker 3: Website that talks about perspective and projected savings, and it's
35:39
Speaker 3: very impressive. So kind of review that with our listeners
35:43
Speaker 3: because this really got my attention.
35:46
Speaker 10: Yeah. So the cool thing about AI agents is you
35:49
Speaker 10: can have numerous of them. So in terms of thinking
35:52
Speaker 10: about it from a logical perspective, if you have one
35:55
Speaker 10: technician and they're doing– for example, eight hours on the
35:59
Speaker 10: phone for a 12-hour shift. That's where you really get
36:03
Speaker 10: your savings. With voice AI, you can have numerous agents.
36:06
Speaker 10: You can have 10 agents making phone calls simultaneously to
36:09
Speaker 10: 10 providers, about 10 different patients. So think about it.
36:14
Speaker 10: If you're calling 10 different providers, about 10 patients per provider,
36:17
Speaker 10: that's really where the savings comes. And in terms of
36:20
Speaker 10: what we typically look at is an hourly labor cost
36:23
Speaker 10: for a technician. So if you're in New York or California,
36:25
Speaker 10: you're paying your technician $ 30 an hour, and you're able
36:28
Speaker 10: to use this kind of technology for down to 10
36:31
Speaker 10: cents a minute, you're able to factor in a lot
36:34
Speaker 10: of the labor costs into the AI cost savings because
36:38
Speaker 10: you're only being charged when those calls are being made.
36:41
Speaker 10: But at the same time, we obviously can't discount the
36:44
Speaker 10: fact that technicians are doing work outside of the screen
36:46
Speaker 10: and outside of the phone, right? So they're stocking shelves,
36:49
Speaker 10: accepting orders. So technicians are actually getting vaccine shots this fall.
36:54
Speaker 10: So like, you know, a lot of things going on
36:55
Speaker 10: with technicians, but at least we can relieve them of
36:57
Speaker 10: the burden of handling at least half of the phone
37:00
Speaker 10: calls that are coming through and at least handling the
37:03
Speaker 10: OCR part of it through AI agents and not having
37:06
Speaker 10: to do like sort of a first pass where you're
37:09
Speaker 10: essentially eyeballing a script and entering them into the computer system.
37:14
Speaker 3: Something I also found really interesting, just as some backdrop
37:17
Speaker 3: for our listeners that probably don't know, is your work
37:21
Speaker 3: with pharmaceutical manufacturers and how that is becoming blended into
37:26
Speaker 3: the operations of pharmacy because of direct-to-consumer and how that's
37:30
Speaker 3: going to continue growing. So give us some backdrop on
37:33
Speaker 3: how you've worked with some of the manufacturers.
37:37
Speaker 10: So the ICP is very important because at the end
37:39
Speaker 10: of the day, the pharmacies... the essentially health systems and
37:44
Speaker 10: the pharma companies want to work together so that patient
37:47
Speaker 10: care is improved and that patients have access to medications.
37:50
Speaker 10: So pharma companies are in the business to remove those barriers. Unfortunately,
37:54
Speaker 10: some insurance companies are in the business of putting up
37:56
Speaker 10: more barriers and essentially trying to get those medications to
37:59
Speaker 10: the patients becomes a problem. So what we're in the
38:03
Speaker 10: business of as pharmacists to get those medications real quick,
38:06
Speaker 10: obviously we're not bypassing insurance companies or PBMs. What we're
38:09
Speaker 10: doing is automating whatever needs to be automated that's requested
38:13
Speaker 10: by the insurance company. So if it's filling out a
38:15
Speaker 10: PA form, and if it needs a diagnosis, for example,
38:18
Speaker 10: for an ozempic, right? We have APIs with Epic, Cerner, Athena,
38:24
Speaker 10: some of the small EHR systems that are out there.
38:26
Speaker 10: And if it's missing a diabetes diagnosis, we can go
38:29
Speaker 10: straight into Epic and pull that diagnosis code and fill
38:32
Speaker 10: that information. Previously, you have to call that provider, figure
38:35
Speaker 10: out what the diagnosis code is, go in there and
38:38
Speaker 10: try to figure out all these things. But In general,
38:41
Speaker 10: if you think about some of the hurdles that are
38:43
Speaker 10: really running from the provider side, obviously pharmacies cannot do PAs, right?
38:48
Speaker 10: But so what ends up happening is the providers have
38:50
Speaker 10: to do this, the office managers, and probably these PAs
38:53
Speaker 10: won't be taken care of. What will happen is there'll
38:55
Speaker 10: be like step therapy. They'll say, well, that drug is
38:58
Speaker 10: not covered. We'll figure something else out that could be covered, right?
39:01
Speaker 10: So from our perspective is we've gotten APIs from the
39:05
Speaker 10: provider side for all the EHRs. We've gotten APIs for
39:08
Speaker 10: most of the pharmacy softwares. And what we've done is said,
39:12
Speaker 10: we're going to work on both sides of the aisle.
39:14
Speaker 10: And pharma has come in and said, let's remove those
39:16
Speaker 10: kind of barriers. How can we remove the barriers that
39:18
Speaker 10: patients get access to it, specifically in specialty pharmacy? So
39:23
Speaker 10: we've been working with Assembia to try to free out
39:25
Speaker 10: those kind of hurdles with them, with the pharma companies.
39:28
Speaker 7: And we have.
39:29
Speaker 10: a handful of pharma companies right now that we're working
39:31
Speaker 10: with to be able to remove those barriers.
39:36
Speaker 5: All right.
39:36
Speaker 3: So you and I are headed to Inspire 2026. I'm
39:42
Speaker 3: really excited about this year. There's a change in the
39:46
Speaker 3: venue from being called NASP to inspire, and the inspiration
39:53
Speaker 3: that that brings to people that are digging into specialty care.
39:57
Speaker 3: How does Hendren AI work in the specialty pharmacy space?
40:03
Speaker 10: So very similar to what I mentioned to the pharmacy space,
40:07
Speaker 10: the only caveat is the module where we would essentially
40:11
Speaker 10: look at bad debt. we would essentially look at credit reports.
40:16
Speaker 10: Because for example, if there's a medication there that's $ 50, 000,
40:18
Speaker 10: no specialty pharmacy wants to essentially give a patient a medication,
40:22
Speaker 10: they'll never end up paying after insurance covers whatever it covers.
40:25
Speaker 10: So the extra module that would be there is looking
40:28
Speaker 10: at bad debt, credit checks, pinging insurance companies with a
40:32
Speaker 10: change healthcare ping. Obviously, we don't want those in your
40:36
Speaker 10: corner pharmacy or your typical mail order pharmacy, their profits
40:39
Speaker 10: per prescription. There's nothing in comparison to specialty pharmacies. So
40:44
Speaker 10: those modules stand out for specialty pharmacies so that you'd
40:47
Speaker 10: be able to get those kind of features that they requested.
40:50
Speaker 10: And for us, those are really caveats that specialty pharmacies
40:54
Speaker 10: have come up to us. I mean, I remember in
40:55
Speaker 10: Assembia in last April, we actually had a dozen organizations
40:59
Speaker 10: come out to us and say, we want you to
41:00
Speaker 10: build out a PMS system straight with AI intelligence, including
41:05
Speaker 10: these modules. So this is basically based on demand from
41:09
Speaker 10: the group that's out there, especially pharmacies, saying, hey, we
41:13
Speaker 10: need you to really do this because this is what's
41:14
Speaker 10: missing in the market. And we've essentially looked at those
41:17
Speaker 10: kind of requests and made them real.
41:21
Speaker 3: We are looking forward to spending some time with you
41:24
Speaker 3: in Washington, D.C. We're going to be digging into more
41:28
Speaker 3: of the Hendren solutions. We also have a special series
41:32
Speaker 3: coming out. from the Pharmacy Podcast Network, all about Hendren AI.
41:36
Speaker 3: It's going to drive a lot of our listeners to
41:40
Speaker 3: demystifying how to leverage AI and partnering with Hendren and
41:45
Speaker 3: your team. I am thrilled to have you part of
41:48
Speaker 3: the Pharmacy Podcast Network, John. Really appreciate you hopping on
41:52
Speaker 3: twerks at the last minute. You did this as a
41:54
Speaker 3: favor to us. Thank you so much for showing up.
41:57
Speaker 3: I will see you in DC.
41:59
Speaker 5: I can't wait.
42:01
Speaker 10: Me as well, Todd.
42:02
Speaker 7: Thank you so much.
42:03
Speaker 10: I really appreciate the opportunity and we're going to see
42:05
Speaker 10: you next week, everyone. Absolutely.
42:07
Speaker 5: Hey, stay tuned.
42:09
Speaker 3: We have another interview coming up with RX Blue. Just
42:14
Speaker 3: hold right there for a commercial break.
42:16
Speaker 5: We'll be right back with more Torx.
42:20
Speaker 11: Pharmacy teams today are expected to do more than ever.
42:24
Speaker 11: Process prescriptions faster, manage growing workloads, navigate constant interruptions, and
42:30
Speaker 11: still deliver exceptional patient care. That's why Outcomes is introducing
42:35
Speaker 11: a new pharmacy experience across both Rx30 and Computer Rx,
42:40
Speaker 11: designed to help pharmacies work smarter, move faster, and operate
42:44
Speaker 11: with greater confidence. Rx30 delivers a modern, intuitive workflow with
42:50
Speaker 11: streamlined navigation, guided processes, unified work queues, and automation that
42:55
Speaker 11: reduces manual effort, while preserving the trusted foundation pharmacies rely
43:00
Speaker 11: on every day. At the same time, computer Rx continues
43:04
Speaker 11: to evolve, with enhancements focused on performance, workflow efficiency, stability,
43:09
Speaker 11: and practical automation that remove friction from daily operations. Together,
43:15
Speaker 11: these investments are centered on a single goal, helping pharmacy
43:18
Speaker 11: teams spend less time navigating software and more time focusing
43:22
Speaker 11: on patients. Whether you're an Rx30 or computer Rx customer,
43:27
Speaker 11: you'll benefit from a pharmacy experience designed around real-world workflows,
43:31
Speaker 11: reduced complexity, improved efficiency, and continuous innovation. The future of
43:37
Speaker 11: pharmacy technology is about changing how you work and making
43:41
Speaker 11: every step work better along the way.
43:44
Speaker 3: Hey, welcome back to This Week in Pharmacy. This is
43:48
Speaker 3: the third part of our segment today, and it is
43:52
Speaker 3: packed with information. One of the pieces of information, my favorite,
43:56
Speaker 3: My favorite piece of anything with regards to what is
44:02
Speaker 3: pharmacy really has always been technology.
44:05
Speaker 5: It's where I was comfortable.
44:07
Speaker 3: And marketing and selling technology, pharmacy management, software technology.
44:13
Speaker 5: I met Vince.
44:14
Speaker 3: I don't know if it's been, has to be more
44:17
Speaker 3: than 10 years.
44:17
Speaker 5: We're getting old, Vince.
44:18
Speaker 3: But RxBlue, you can find more information at rxblue.com. Vince,
44:26
Speaker 3: welcome to This Week in Pharmacy.
44:29
Speaker 12: Thanks for having me. Always great to see you and
44:31
Speaker 12: talk with you, my friend.
44:33
Speaker 3: Yeah, the evolution of RxBlue is coming a long way.
44:35
Speaker 3: It's the third variation. I believe it is the third
44:39
Speaker 3: variation of your website, and it looks freaking amazing. The
44:42
Speaker 3: logo has been upgraded, smarter workflow, faster fills, fewer interruptions.
44:50
Speaker 3: I can't wait to dig into this and figure out
44:53
Speaker 3: what's happened with RxBlue and how it's evolved.
44:57
Speaker 12: Yeah, happy to have you do that, and thank you
44:59
Speaker 12: for the kind words. Putting these websites together, they're always
45:03
Speaker 12: a work in progress. They're ever-changing, moving with the paradigm,
45:06
Speaker 12: and we're trying to be at the forefront of everything
45:08
Speaker 12: that we do.
45:10
Speaker 3: Pharmacy technology has evolved tremendously. When I started at SoftRaters
45:16
Speaker 3: in 2004, it was the first SQL-based system in the
45:20
Speaker 3: pharmacy land and definitely in institutional pharmacy and long-term care.
45:25
Speaker 3: And now we jettison to 2026 where artificial intelligence, that's everything.
45:30
Speaker 3: Everybody wants to always talk about that. And I've found
45:34
Speaker 3: that there are a lot of outside organizations that are
45:38
Speaker 3: trying to creep into the pharmacy management space.
45:41
Speaker 5: And I'm not trying to be.
45:46
Speaker 3: Biased per se, but I only kind of trust AI
45:49
Speaker 3: in the hands of of organizations that have taken the
45:53
Speaker 3: punches in the face and have been around a while
45:55
Speaker 3: to kind of layer up their, their databases and the
45:59
Speaker 3: structure and the workflow and understanding pharmacy, and then adding
46:04
Speaker 3: AI to it, which then of course can become, you know,
46:08
Speaker 3: 10 times more efficient or effective than, than what it is.
46:11
Speaker 3: But what's your view on how technology has, has been
46:15
Speaker 3: evolving over the really it's, it's, it's on the fast
46:18
Speaker 3: track over the last three years.
46:21
Speaker 12: Yeah, that's absolutely right. And what we try and do
46:26
Speaker 12: is make sure that the technology understands the pharmacy's workflow
46:30
Speaker 12: and adapt that technology to said workflow. So the question
46:37
Speaker 12: we ask our pharmacy clients, whether they're onboarding or current clients,
46:43
Speaker 12: is how does your pharmacy work, right? What can we
46:47
Speaker 12: do to adapt our technology to meet your need? Perhaps
46:52
Speaker 12: there's some new items that they come up with that
46:55
Speaker 12: would make their workflow just feel like it's over the top.
46:59
Speaker 12: So we work with our clients to implement not only
47:04
Speaker 12: current technologies, we call it pharmacy automation, which is kind
47:10
Speaker 12: of our homegrown AI that we have. And I think
47:15
Speaker 12: that that difference of applying that technology to our product
47:19
Speaker 12: line is fundamental to who we are.
47:24
Speaker 3: Yeah, I also know that you've been around long enough
47:28
Speaker 3: to see the shift in the plate tectonics of what
47:32
Speaker 3: is pharmacy technology. And this is a industry that that's
47:37
Speaker 3: where I started my career. And I've seen systems and
47:41
Speaker 3: pharmacy software change.
47:45
Speaker 5: Peripherals.
47:46
Speaker 3: Other systems like workflow systems or data document management systems
47:51
Speaker 3: get gobbled up by bigger organizations. And when I look
47:56
Speaker 3: at what's happened with PBMs and how vertical integration has
48:01
Speaker 3: impacted healthcare because of it being more about the insurance
48:07
Speaker 3: and more about the payment and more about the money
48:09
Speaker 3: than it is about the care.
48:11
Speaker 5: So that bothers me.
48:12
Speaker 3: So I know what pharmacists are going through, and what
48:16
Speaker 3: pressures are put on pharmacists because of those models. So
48:21
Speaker 3: I hope that with all of the PBM reform that's coming,
48:24
Speaker 3: that that's going to change and maybe we can break
48:26
Speaker 3: some of that up. Well, guess what, listeners? That's happening
48:30
Speaker 3: in technology too. And I wrote a pretty fiery, passionate
48:34
Speaker 3: blog back in March, and it said vertical integration in
48:38
Speaker 3: pharmacy software system, this is a risk to pharmacy stability.
48:44
Speaker 3: And I don't know if you've read this yet, Vince,
48:47
Speaker 3: but when you do read this, and readers, if you
48:50
Speaker 3: haven't read it, just go to pharmacypodcast.com, go to our
48:52
Speaker 3: blog section. It's called the PPN Pulse. But I'm meticulously
48:59
Speaker 3: analyzing that if you put too many systems and too
49:03
Speaker 3: many pharmacies and too many organizations and all these businesses
49:07
Speaker 3: on the same exact platform. And you also have a
49:10
Speaker 3: switching organization and you also have document management. I mean,
49:15
Speaker 3: it sounds wonderful in concept. It really does as a
49:18
Speaker 3: person that loves technology, of course. being able to do that.
49:21
Speaker 3: But I think it poses a massive risk to the
49:25
Speaker 3: independent pharmacy provider. And I think it poses a massive
49:29
Speaker 3: risk to data integrity.
49:33
Speaker 5: And so many other things that we could go down
49:35
Speaker 5: the line.
49:36
Speaker 3: But what do you think has happened over the years, Vince,
49:39
Speaker 3: with with all of the buyouts and VC coming from
49:45
Speaker 3: the outside of the industry. And to me, it just
49:48
Speaker 3: seems like a, it really does. I'm sorry, I'm going
49:51
Speaker 3: to say it. It really seems like more it's about
49:53
Speaker 3: the money than it is about, we love pharmacy. This
49:56
Speaker 3: has been our lives for how long, Vince? I mean,
49:58
Speaker 3: this is our, pharmacy is literally our life. So what
50:02
Speaker 3: do you think of what's happening?
50:04
Speaker 12: Yeah, decades, my friend, decades. The industry is a continuous
50:09
Speaker 12: whirlwind of acquisitions, consolidations, and companies that are now accumulating
50:16
Speaker 12: multiple pharmacy systems. Somewhere along the way, that relationship with
50:20
Speaker 12: the pharmacy became increasingly transactional. At Blue, we deliberately chose
50:26
Speaker 12: another path. We are proudly privately owned. We're accessible. We listen.
50:31
Speaker 12: We are that yes, we can company that wants to
50:33
Speaker 12: work with you to be your business partner. So, you know,
50:36
Speaker 12: we make decisions based upon what makes sense for pharmacies
50:40
Speaker 12: and for the product, not the other way around. A
50:43
Speaker 12: pharmacy should never feel that it has to move to
50:46
Speaker 12: a particular system because a large organization owns it or
50:50
Speaker 12: because everybody else appears to be moving in that direction.
50:52
Speaker 12: There's no need to keep up with the Joneses here.
50:56
Speaker 12: If a pharmacy is not happy with their current software company,
50:58
Speaker 12: moving to another PMS owned by that same parent company
51:02
Speaker 12: will equate to more of the same. I encourage pharmacy
51:06
Speaker 12: owners to inquire as to who owns the software that
51:09
Speaker 12: they choose to use. All pharmacies have a choice in
51:13
Speaker 12: their PMS. The pharmacy owner should ask one question. Who
51:18
Speaker 12: do I want as my technology partner? That decision is
51:23
Speaker 12: much bigger than choosing software.
51:26
Speaker 8: Yeah.
51:27
Speaker 7: Yeah.
51:28
Speaker 5: Your partner's important and, and.
51:31
Speaker 3: Understanding their legacy and understanding what their, what their plan is,
51:36
Speaker 3: you know, what, what's the end game really, and.
51:39
Speaker 5: What's their focus. Um, so yeah, let's talk about that.
51:43
Speaker 3: And you've, you are part of that philosophy of transparency and,
51:49
Speaker 3: and doing what's right for the, for the client, for
51:52
Speaker 3: the pharmacy operator, so that They can move their practice forward.
51:56
Speaker 3: They can make more money. They can be better. They
51:58
Speaker 3: can get more patients and do things. So what does
52:01
Speaker 3: that mean in practice in your philosophy about transparency?
52:07
Speaker 12: Well, we are a very transparent organization. We don't operate
52:12
Speaker 12: on bait and switch. A pharmacy should know exactly what
52:16
Speaker 12: it's buying, what the costs are, and what it's going
52:19
Speaker 12: to receive. So it's important that people realize that free
52:22
Speaker 12: upfront conversion and software, should not become mysterious fees several
52:28
Speaker 12: months later to pay back those said fees. And that's
52:32
Speaker 12: what happens with a lot of these freebies. And we're
52:36
Speaker 12: very deliberate about that. We also do not believe that
52:40
Speaker 12: every good idea needs to become another module with another
52:44
Speaker 12: charge attached to it. If one of our pharmacies identifies
52:47
Speaker 12: enhancements that improve workflows, and make sense of the broader platform,
52:53
Speaker 12: we want to hear about it. Tell us, we're very open.
52:57
Speaker 12: We very often say yes to change requests and deliver
53:00
Speaker 12: them fast. And we take a tremendous pride in that.
53:04
Speaker 12: So our thought is that that's what being a partner
53:09
Speaker 12: is all about.
53:10
Speaker 5: Yeah, that makes sense.
53:13
Speaker 3: So talk to us more about What makes RxBlue different
53:18
Speaker 3: in comparison to some of the other systems that are
53:20
Speaker 3: out there?
53:22
Speaker 6: Sure, sure.
53:23
Speaker 12: So I think the difference with RxBlue is why we
53:27
Speaker 12: do what we do. Blue was created because we believe
53:30
Speaker 12: pharmacies deserve a better relationship with their technology company. We've
53:35
Speaker 12: been in this industry for a long time, as you said, Todd,
53:38
Speaker 12: and I can name names of Pharmacy systems that are
53:41
Speaker 12: no longer with us and that were acquired multiple times
53:44
Speaker 12: that are now owned by large VC firms. So at
53:47
Speaker 12: a certain point, we just decided to jump ship and
53:49
Speaker 12: create Blue using modern technology, cloud connectivities. And that's exactly
53:54
Speaker 12: what we do. So we believe that pharmacies should have
53:57
Speaker 12: control of their pharmacy and that the technology should be
54:02
Speaker 12: simple to use. Customers should have a voice in how
54:06
Speaker 12: the product evolves. And that is true. such a large
54:11
Speaker 12: point that their input makes the system what it is.
54:15
Speaker 12: They use it every day. We provide a piece of
54:18
Speaker 12: software that is their livelihood. And if we can make
54:22
Speaker 12: that livelihood better, we'd love to hear about that. At Blue,
54:26
Speaker 12: we believe that support should actually mean onshore support. At Blue,
54:32
Speaker 12: we have a product that we call in-house our Pharmacy
54:35
Speaker 12: Concierge Client Care. And that's exactly what it is. It's concierge,
54:40
Speaker 12: white hub service, all onshore, answering the phone calls live
54:46
Speaker 12: in most cases and resolving issues on that first call.
54:50
Speaker 12: And we believe that independent pharmacies deserve a technology partner
54:53
Speaker 12: that values their independence. So why does RxBlue exist? And
55:00
Speaker 12: I think that the why is in everything that I
55:02
Speaker 12: just stated. And once people understand that why, the product
55:07
Speaker 12: makes a lot more sense.
55:08
Speaker 5: You're right about these modules.
55:11
Speaker 3: I've watched it, and I consulted and worked with companies
55:16
Speaker 3: that would come out with the new module, the POS system,
55:21
Speaker 3: the workflow system, the document management system, the reimbursement auditor system.
55:31
Speaker 3: There's a lot of add-ons that we've evolved with in
55:36
Speaker 3: the way that pharmacy management systems have evolved in itself.
55:42
Speaker 3: And it's no fault of the systems that are out there.
55:44
Speaker 3: It was kind of like what was happening between 2005
55:49
Speaker 3: and 2015. It just feels different to me now. So
55:55
Speaker 3: what's the next thing that you think is going to happen?
55:57
Speaker 3: Because is it necessarily another pharmacy management system? Like where
56:04
Speaker 3: could this go? My vision is marrying, depends on what
56:09
Speaker 3: sector of pharmacy you're in. If you're in community pharmacy,
56:12
Speaker 3: if you're in long-term care, if you're in specialty, or
56:14
Speaker 3: if you're a mixed bag, for goodness sakes, because there's
56:17
Speaker 3: tons of pharmacies out there that are now doing a
56:19
Speaker 3: little bit more compounding. They're doing some more assisted living.
56:23
Speaker 3: They're doing long-term care pharmacy at home. That's explosive right now.
56:28
Speaker 3: And having a software system that could do everything And
56:31
Speaker 3: then on top of that, you put a CRM system,
56:35
Speaker 3: a customer relationship management system on top of it, where
56:38
Speaker 3: you could literally manage relationships and build patients for life
56:43
Speaker 3: and connect in the EHR. What do you think is
56:46
Speaker 3: going to happen to the next gen pharmacy management system?
56:50
Speaker 12: Well, you're absolutely right. And the technology that's all around
56:54
Speaker 12: us has made our lives so much simpler. From your smartphone,
56:58
Speaker 12: your smart home, the car you drive, It's sometimes overwhelming.
57:04
Speaker 12: I often kid that sometimes walking around with the world
57:07
Speaker 12: in my pocket, hence my cell phone, is more of
57:10
Speaker 12: a blessing or a curse than a blessing. Yet in pharmacy,
57:16
Speaker 12: we routinely hear from onboarding clients their previous software does
57:20
Speaker 12: not work with their desired workflow. My response, again, is
57:25
Speaker 12: as to why. Why should pharmacy be stuck or need
57:28
Speaker 12: to change successful workflows simply because the software was designed
57:33
Speaker 12: a certain way? So we like to tell people, tell
57:36
Speaker 12: us how you want to operate and let's determine how
57:39
Speaker 12: technology that we have can best support that workflow. That
57:44
Speaker 12: is what technology is supposed to do. And we believe
57:46
Speaker 12: pharmacists expect more from the companies that can provide that.
57:52
Speaker 5: I like that.
57:53
Speaker 3: And I like the fact that There's other things that
57:58
Speaker 3: our pharmacists are going to be creative as business owners.
58:02
Speaker 3: They're going to come up with, and it might not
58:05
Speaker 3: fit a pharmacy management software system. It might have to
58:09
Speaker 3: be something that they build or they have to buy
58:13
Speaker 3: another piece of software for.
58:16
Speaker 5: So talk to me.
58:17
Speaker 3: About the evolution of what you're doing because you mentioned
58:23
Speaker 3: to me What is the pharmacy operating platform? What's the
58:28
Speaker 3: coming of this model that could lead to something that
58:32
Speaker 3: you and I were describing for a pharmacy operator?
58:35
Speaker 5: What is POP?
58:38
Speaker 12: Yeah, well, thanks for that question. And we're excited about
58:40
Speaker 12: what that means and all it entails. So if we
58:43
Speaker 12: think about what a modern pharmacy actually does, it manages prescriptions, workflows, patients, communications, payments, deliveries,
58:50
Speaker 12: so much. The list goes on and on. And that's
58:57
Speaker 12: much bigger than simply managing prescriptions, everything that a pharmacy
59:00
Speaker 12: does in today's world. So we started asking a very
59:03
Speaker 12: simple question. What if the next evolution of pharmacy technology
59:07
Speaker 12: isn't another pharmacy management system? Because pharmacies don't simply manage prescriptions.
59:13
Speaker 12: They operate very complex businesses. And that technology underneath that
59:18
Speaker 12: business should help operate the pharmacy as a whole. And
59:22
Speaker 12: that is the transition we see from the traditional pharmacy
59:26
Speaker 12: management system PMS model to what we call the pharmacy
59:30
Speaker 12: operating platform or POP.
59:32
Speaker 3: That's a visionary statement and understanding what that could become.
59:38
Speaker 3: So from your perspective and for the listeners, what does
59:44
Speaker 3: that mean? What do you see the pharmacy operating platform
59:49
Speaker 3: or POP, what do you see that becoming?
59:52
Speaker 12: So we see that becoming the level above the pharmacy
59:58
Speaker 12: management software that is currently used today. So one single
1:00:04
Speaker 12: company that provides everything you need to operate on a
1:00:08
Speaker 12: daily basis, all your workflow, communication, deliveries, et cetera, but
1:00:12
Speaker 12: also telepharmacy piece, a pharmacy connect care for LTC that
1:00:19
Speaker 12: can be connected to from nurses, doctors, facilities, A delivery
1:00:24
Speaker 12: system that's either something that's more for an independent or
1:00:29
Speaker 12: for a large-scale enterprise clients. We have a lot of
1:00:34
Speaker 12: pieces and parts of our system that we built out
1:00:37
Speaker 12: that not everybody has. Very few systems have their own
1:00:41
Speaker 12: integrated IVRs, and most people have POS these days. But, again,
1:00:47
Speaker 12: we feel like we are the one-stop, single-source solution of
1:00:50
Speaker 12: robust products. that create the POP. And we have this today.
1:01:00
Speaker 12: It exists. It's not something that we're building out. We
1:01:04
Speaker 12: knew that the industry did not need another acronym.
1:01:07
Speaker 1: However, we.
1:01:09
Speaker 12: Feel that POP as itself defines the higher echelon of
1:01:17
Speaker 12: software companies out there that can provide that single source
1:01:23
Speaker 12: solution for all their software needs. Why would a pharmacy
1:01:26
Speaker 12: want to purchase product from seven different companies and have
1:01:29
Speaker 12: seven different invoices and seven different support staffs when they
1:01:33
Speaker 12: can just come to one single source that truly wants
1:01:36
Speaker 12: to be their business partner and give them world-class service?
1:01:40
Speaker 12: That's what POP is.
1:01:41
Speaker 5: That's awesome.
1:01:42
Speaker 3: So just for the listeners to know, just to learn more,
1:01:47
Speaker 3: if you could go to rxblu.com Once again, that's rxblue,
1:01:53
Speaker 3: B-L-U dot com. Take a look at this system. It's
1:01:57
Speaker 3: very different. You're going to be very impressed with some
1:02:00
Speaker 3: of the screenshots and the look and the feel of it.
1:02:03
Speaker 5: Go through what it means to be.
1:02:07
Speaker 3: A pharmacy concierge client and then reach out to Vince.
1:02:11
Speaker 3: Go to their contact section. Ask questions. Is RxBlue the
1:02:16
Speaker 3: next system that you should be investing in? and it
1:02:19
Speaker 3: being much different.
1:02:21
Speaker 5: And you and I.
1:02:21
Speaker 3: Talked before that fits very well to the concept of RxBlue.
1:02:26
Speaker 3: We talked about the blue ocean strategy and how going
1:02:30
Speaker 3: into a direction of the ocean that is not touched,
1:02:34
Speaker 3: where everybody else is churning in the red. And that's
1:02:39
Speaker 3: a play on the blog that I wrote out too,
1:02:41
Speaker 3: because the big red is just gobbling up existing systems.
1:02:46
Speaker 3: Is there really innovation? Is there really there something happening
1:02:49
Speaker 3: that's part of the evolution of the pharmacy market? Or
1:02:53
Speaker 3: is it just about eating up their competitors? And it's
1:02:58
Speaker 3: a churn of the blood in the water. That's the
1:03:00
Speaker 3: red ocean. RxBlue's concept is about that blue ocean. And
1:03:05
Speaker 3: I still believe you're on that trail and you're in
1:03:08
Speaker 3: those waters. So it's good to see you to continue
1:03:11
Speaker 3: that philosophy, Vince. And We're rooting for you. Can't wait
1:03:15
Speaker 3: to see you. Are you going to NCPA?
1:03:20
Speaker 12: We will not be at NCPA, no.
1:03:22
Speaker 7: All right.
1:03:22
Speaker 3: Well, we'll have to catch up at some conference, but
1:03:25
Speaker 3: look forward to meeting up with you next. Probably DiversifierX
1:03:30
Speaker 3: Profit Summit will be it.
1:03:32
Speaker 12: For sure, yeah. We will be there. We have a
1:03:33
Speaker 12: close relationship with Lisa Faust and Heather Harrow. I can't
1:03:38
Speaker 12: say enough positive things about those ladies. They're truly moving
1:03:41
Speaker 12: the mark in this industry.
1:03:42
Speaker 5: Yeah, absolutely. They don't sit still.
1:03:45
Speaker 3: Yeah, they're going to be part of the next dose
1:03:49
Speaker 3: pharmacy conference where we just talked to Jordan, Dr. Jordan,
1:03:54
Speaker 3: the founder of that, before you came on Twerks today.
1:03:56
Speaker 3: And that'll be exciting. But Vince, thanks for being here
1:04:00
Speaker 3: and being on Twerks.
1:04:02
Speaker 12: Thank you for having me. Hopefully I'll see you in
1:04:04
Speaker 12: PA in October.
1:04:06
Speaker 5: Yeah, we'll see you then.
1:04:08
Speaker 12: Take care, Todd.
1:04:09
Speaker 6: Thank you.
1:04:11
Speaker 13: You've built your pharmacy through hard work and determination, and
1:04:15
Speaker 13: the right partner can help give you the tools to
1:04:17
Speaker 13: take it further. At Independent Pharmacy Cooperative, we're more than
1:04:24
Speaker 13: a GPO. We bring your team, your purchasing strategy, and
1:04:28
Speaker 13: the tools to expand your pharmacy, from digital health and
1:04:32
Speaker 13: connected care to new programs that give you a path
1:04:35
Speaker 13: to growth. That means smarter buying that protects your margins,
1:04:40
Speaker 13: Modern tools that expand patient care and new revenue streams
1:04:43
Speaker 13: that actually stick. Because when everything works together, your pharmacy
1:04:48
Speaker 13: doesn't just keep up, it grows. Independent Pharmacy Cooperative, giving
1:04:53
Speaker 13: you the freedom to farm.
1:04:56
Speaker 3: Hey, special This Week in Pharmacy feature from sponsors that
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Speaker 3: Total Store Expo. And now we're meeting up in Washington, D.C.
1:05:18
Speaker 3: for the NASP Inspire event, the National Association of Specialty Pharmacy.
1:05:24
Speaker 3: We're all gathering in National Harbor to talk about the
1:05:28
Speaker 3: future of specialty pharmacy and how First Data Bank has
1:05:33
Speaker 3: extremely special interest in what it means to to be
1:05:37
Speaker 3: a specialty pharmacist and how to support specialty pharmacist operations.
1:05:42
Speaker 3: But today on Twerks, we're talking about something that came
1:05:45
Speaker 3: up in the news recently. This just came out at
1:05:47
Speaker 3: the end of August where FDB moves ambient listening beyond
1:05:52
Speaker 3: notes with AI-powered prescribing agent This is the first commercial
1:05:56
Speaker 3: deployment of the FDB script agent with Tebra converts ambient
1:06:02
Speaker 3: encounter dialogue into structured prescriptions for clinical and clinician review,
1:06:09
Speaker 3: grounded and trusted medication adherence. And with me here from
1:06:14
Speaker 3: FDB is Dr. David Delaney. David, welcome to Twerks.
1:06:20
Speaker 7: Thanks, Todd. I really appreciate you having me on the show.
1:06:24
Speaker 14: We're huge fans of Twerks and the great work you're doing,
1:06:26
Speaker 14: so really glad to be here today.
1:06:28
Speaker 5: I won't make you stand up in Twerks, by the way.
1:06:30
Speaker 5: I'm feeling much more relieved now.
1:06:34
Speaker 7: My anxiety level's dropped now.
1:06:36
Speaker 3: I think I just hurt my back doing that, too,
1:06:38
Speaker 3: so let's see what I get.
1:06:40
Speaker 5: Hey, this is great. Great news.
1:06:43
Speaker 3: You know, I hear a lot about AI. I think
1:06:46
Speaker 3: just like if I back up to make everybody... know
1:06:50
Speaker 3: how old I am, and I feel old when I
1:06:52
Speaker 3: say this, but there was a time in U.S. history
1:06:56
Speaker 3: called the dot-com gold rush. And that was between 98
1:07:01
Speaker 3: and 2003, where industries flocked to doing anything internet-enabled and internet-involved.
1:07:10
Speaker 3: And a lot of it was chaos because they weren't
1:07:12
Speaker 3: exactly sure how to apply it. AI is in that
1:07:17
Speaker 3: same situation right now, especially in healthcare. And in healthcare,
1:07:20
Speaker 3: by the way, it's a lot more sensitive because these
1:07:23
Speaker 3: are people's lives that we're talking about. Organizations like FDB
1:07:28
Speaker 3: make me feel better, make me feel like I can
1:07:33
Speaker 3: exhale and be more relieved because of the infrastructure of
1:07:37
Speaker 3: how you use data and technology over the past 20, 30,
1:07:40
Speaker 3: 40 years of how you've staged. So now when AI
1:07:44
Speaker 3: comes along, It's not like you just came out of
1:07:47
Speaker 3: the box with this.
1:07:48
Speaker 5: This is something that has been fortified.
1:07:51
Speaker 3: Tell our listeners about this announcement and what this means
1:07:55
Speaker 3: for our pharmacy clinicians.
1:07:59
Speaker 7: Well stated, Todd.
1:08:00
Speaker 14: I think there's just obviously huge potential with this AI
1:08:05
Speaker 14: revolution we're in the midst of. I think your analogy
1:08:08
Speaker 14: with the whole dot-com problem. situation is really apropos. When
1:08:12
Speaker 14: you're going through it, people kept on saying everything was
1:08:15
Speaker 14: going to change and everything, businesses were completely obsolete, old businesses,
1:08:21
Speaker 14: and everything was going to.
1:08:22
Speaker 7: Be brand new.
1:08:23
Speaker 14: And I think the human tendency is to over-index on
1:08:27
Speaker 14: how quickly things change, but under-index on the size, magnitude,
1:08:32
Speaker 14: and scale of the ultimate change it brings. And I
1:08:34
Speaker 14: think when you look back at that whole dot-com revolution,
1:08:39
Speaker 14: you know, it's.
1:08:40
Speaker 7: Just pretty incredible now. Pretty much every facet of life
1:08:42
Speaker 7: has changed.
1:08:43
Speaker 14: And, you know, maybe not at the pace people had
1:08:46
Speaker 14: originally thought, but, you know, it's virtually unrecognizable from before that.
1:08:51
Speaker 14: And I think the same thing's happening with the AI
1:08:55
Speaker 14: revolution now. But as you state, I think a fundamentalist
1:09:00
Speaker 14: is that the technology of large language models are probabilistic, right?
1:09:05
Speaker 14: They estimate the likelihood of a word falling in a sequence.
1:09:09
Speaker 14: And while that can be highly accurate, hallucinations are real.
1:09:13
Speaker 14: And when you're dealing with things like medications, ensuring accuracy,
1:09:18
Speaker 14: you know, absolute accuracy in a deterministic fashion is absolutely paramount.
1:09:23
Speaker 14: And so that's exactly why I believe FDB is well
1:09:26
Speaker 14: situated to be a major player in it. We're actually
1:09:30
Speaker 14: turning 50 years old next year. So, um, Yeah, so
1:09:33
Speaker 14: we're going to have some great celebration of the company
1:09:37
Speaker 14: being around 50 years.
1:09:39
Speaker 7: And so, I mean, we're a Six Sigma shop.
1:09:41
Speaker 14: We have honed our editorial and how we approach and
1:09:44
Speaker 14: manage data over decades. But don't mistake that for not
1:09:50
Speaker 14: being agile as well. And so we are very much
1:09:52
Speaker 14: embracing AI. But it's from the context of having a
1:09:56
Speaker 14: foundational bedrock data set, which is carefully honed with humans
1:10:01
Speaker 14: in the loop. and is accurate, and basically leveraging that
1:10:04
Speaker 14: to ground AI. If thinking about it, it's almost as
1:10:09
Speaker 14: if we're having a trusted pharmacist for AI to ensure
1:10:14
Speaker 14: that what comes out of it is accurate and actionable.
1:10:17
Speaker 7: So I think that's a net for us overall.
1:10:20
Speaker 14: And regarding this announcement, I mean, really, this is the
1:10:23
Speaker 14: first move toward the capability to ensure that all inbound
1:10:28
Speaker 14: prescriptions are complete, correct, and covered the first time.
1:10:34
Speaker 5: Like full stop.
1:10:35
Speaker 14: And I think when you look at where your audience
1:10:37
Speaker 14: spends their days fixing things today, that is, I think,
1:10:42
Speaker 14: a really laudable, very, very important goal.
1:10:45
Speaker 3: David, it's the clinical documentation that always held up prescriptions
1:10:50
Speaker 3: back in my long-term care pharmacy technology days when there
1:10:54
Speaker 3: wasn't proper document management, not only the systems in and
1:10:58
Speaker 3: of itself, but the connection to the prescription, the tracking
1:11:01
Speaker 3: of the prescription and the documentation to support it. So
1:11:04
Speaker 3: we already seen how ambient AI transforms the clinical documentation.
1:11:09
Speaker 3: Why is moving from simply creating notes to actually generating
1:11:14
Speaker 3: a structured prescription such, why is that so important for
1:11:17
Speaker 3: the next step for healthcare AI?
1:11:21
Speaker 14: I think it's a great question. When you look at Ambient,
1:11:24
Speaker 14: first of all, it's gaining tremendous traction. And really, I
1:11:27
Speaker 14: think we're at the tipping point where in terms of
1:11:30
Speaker 14: source of prescriptions, Ambient is going to be larger than
1:11:35
Speaker 14: things traditionally entered through an EHR order entry system, right?
1:11:40
Speaker 14: When you look at clinicians' life, the prescribers, where their
1:11:46
Speaker 14: friction point at heartburn is, it's what they call pajama time.
1:11:49
Speaker 14: And that's the time spent Once people are home, catching
1:11:53
Speaker 14: up on the administrative work. Doctors and providers doing prescriptions,
1:12:00
Speaker 14: they talk all day long. They're not tired of talking,
1:12:02
Speaker 14: but they're tired of sitting down at a station doing
1:12:04
Speaker 14: data entry and checking and doing everything else. So I
1:12:08
Speaker 14: think it's very natural to expect that when their conversations
1:12:11
Speaker 14: are being captured and turned into notes, that that piece
1:12:15
Speaker 14: of it, the prescription piece also happens and reduces that
1:12:19
Speaker 14: administrative burden and friction point.
1:12:23
Speaker 5: So what do you think about that?
1:12:24
Speaker 3: You look a little bit into the future, not that
1:12:26
Speaker 3: far because it's happening pretty quickly, but the technology scales
1:12:30
Speaker 3: into ambulatory care, hospital system, specialty pharmacy, shout out to
1:12:37
Speaker 3: the specialty pharmacist out there. There's so much documentation in that.
1:12:41
Speaker 3: sector of pharmacy. So what happens downstream for pharmacy? And
1:12:44
Speaker 3: what I mean by that is, is could AI generating
1:12:49
Speaker 3: clinical support, it could reduce the friction, it could save time,
1:12:54
Speaker 3: but talk to us about other benefits that you could
1:12:57
Speaker 3: see coming from this.
1:12:59
Speaker 14: Yeah, I think the net is when you talk to
1:13:03
Speaker 14: a pharmacist, and taking this job has been really great.
1:13:05
Speaker 7: I'm a physician by background. I practiced for a dozen years.
1:13:08
Speaker 14: And as I've gotten deeper into kind of the space here,
1:13:12
Speaker 14: first of all, my apologies to all the pharmacists in
1:13:14
Speaker 14: your audience for prescriptions I probably wrote that were not
1:13:17
Speaker 14: well-formed and caused effort. Like, you know, no one does
1:13:20
Speaker 14: this with intent. It's just not knowing anything. kind of
1:13:23
Speaker 14: what's happening downstream and perhaps the chaos that we might
1:13:26
Speaker 14: be kind of creating by just being quick or not
1:13:29
Speaker 14: being really, really clear. But I think the opportunity is,
1:13:33
Speaker 14: particularly for FDB, we sit at the prescription side, at
1:13:36
Speaker 14: the prescriber side. We also sit at the fulfillment side.
1:13:40
Speaker 14: And with Vela, now we also have the pipes that
1:13:43
Speaker 14: connect the two. So we can see what's happening, where
1:13:46
Speaker 14: the abrasion points are on the fulfillment side, where rework occurs,
1:13:50
Speaker 14: that if we just had better information at the fulfillment point,
1:13:54
Speaker 14: we could avert a callback to try to figure out
1:13:57
Speaker 14: what's going on. And so it really comes down to
1:14:00
Speaker 14: leveraging that insight at the fulfillment side, upstream, and the
1:14:04
Speaker 14: proverbial one ounce is better than pounds of cure. If
1:14:07
Speaker 14: we can just prevent the error from occurring and or
1:14:10
Speaker 14: send through information that lets a pharmacist know a clinician
1:14:13
Speaker 14: is aware of something when they prescribe it so.
1:14:15
Speaker 7: They don't have to make that callback.
1:14:17
Speaker 14: And it's really that cycle creating a flywheel of improvement
1:14:20
Speaker 14: that we're aiming for.
1:14:21
Speaker 3: For the listeners, we brought up a prescription that Dr.
1:14:27
Speaker 3: David Delaney wrote back in 2015, and this was a
1:14:30
Speaker 3: scribbly mess.
1:14:33
Speaker 7: That very well could be.
1:14:34
Speaker 14: You know, I always used to tell people back when
1:14:36
Speaker 14: we used to write that, you know, when I went
1:14:38
Speaker 14: to medical school that I tested out of the bad
1:14:40
Speaker 14: handwriting class that make all the doctors ensure we all
1:14:44
Speaker 14: had sufficiently bad chicken scratch.
1:14:46
Speaker 7: So I tested out. I was so good at it
1:14:48
Speaker 7: already coming in.
1:14:49
Speaker 3: All kidding aside, though, I remember when I was intensive
1:14:54
Speaker 3: between 2004 and 2013 ish. The pharmacy management system realm
1:15:02
Speaker 3: was changing. Databases were changing. Accessibility to custom reports was changing.
1:15:09
Speaker 3: A part that was still missing was documentation and was
1:15:13
Speaker 3: also predictive next steps in processes that really took up
1:15:19
Speaker 3: a ton of time. I see that already happening with
1:15:22
Speaker 3: artificial intelligence paralleling the strength of pharmacy management technology and
1:15:28
Speaker 3: then systems like FDB has in place. This is exciting
1:15:32
Speaker 3: because now we're going to be able to drill down
1:15:34
Speaker 3: into specific things happening in disease state management. And that's
1:15:40
Speaker 3: kind of like my next question for you. What are
1:15:44
Speaker 3: you most excited about when it comes to artificial intelligence
1:15:47
Speaker 3: in healthcare and what might come of the future if
1:15:51
Speaker 3: you put on your you know, put on your future goggles?
1:15:54
Speaker 3: What do you see coming soon out of AI and
1:15:58
Speaker 3: healthcare and patient management?
1:16:01
Speaker 7: Yeah, I think the possibilities are endless.
1:16:04
Speaker 14: Again, I think when we look back to how we
1:16:07
Speaker 14: practice today will be virtually unrecognizable in the future. You know,
1:16:13
Speaker 14: what I really believe as a clinician, like who practiced
1:16:16
Speaker 14: for many years, is that, you know, a lot of
1:16:19
Speaker 14: controls today are very clumsy. If you try to prescribe something,
1:16:23
Speaker 14: you know, a lot of times you get down to
1:16:25
Speaker 14: the very end and then on the prescriber side and
1:16:28
Speaker 14: there'll be an alert saying, hey, this.
1:16:29
Speaker 7: Was a really bad idea.
1:16:31
Speaker 14: And while that's useful, like the clinician would very much
1:16:33
Speaker 14: prefer to be told upstream you know, kind of be
1:16:37
Speaker 14: guided there. So I think kind of thinking through very
1:16:40
Speaker 14: good assistive driving on a car is something that is
1:16:44
Speaker 14: kind of there always in the background helping you if
1:16:46
Speaker 14: you're about to do something.
1:16:47
Speaker 7: That might not be good to give you an alert.
1:16:51
Speaker 14: And also when you need it, like to be able
1:16:53
Speaker 14: to pull in, you know, for counsel.
1:16:56
Speaker 7: You think about as a clinician, if you.
1:16:58
Speaker 14: Had essentially a virtual pharmacist at your side and, you know,
1:17:01
Speaker 14: you go to prescribe something and the patient has like
1:17:04
Speaker 14: a Pen allergy that includes cephalosporins.
1:17:07
Speaker 7: And you need to treat a certain illness.
1:17:09
Speaker 14: What would your best medication be to prescribe? And really
1:17:14
Speaker 14: being able to distill the knowledge of maybe an ID
1:17:16
Speaker 14: specialist and a pharmacist to be able to consult in
1:17:20
Speaker 14: line as you're working to kind of have that intelligence there.
1:17:23
Speaker 7: So I think it's very assistive, human in the loop.
1:17:27
Speaker 14: Just ensuring that we're practicing with the contextual knowledge, not
1:17:31
Speaker 14: only to help us make better decisions, but more quickly
1:17:34
Speaker 14: with less abrasion.
1:17:37
Speaker 5: David, this has been good.
1:17:39
Speaker 3: We are excited about our continuing work with FDB and
1:17:44
Speaker 3: getting information out, getting this kind of information out for
1:17:47
Speaker 3: the listeners. Driving in your car, doing something where you're
1:17:51
Speaker 3: not looking at a screen, don't worry. In the show notes,
1:17:54
Speaker 3: we're going to have a link to the FDB announcement
1:17:58
Speaker 3: so that you can read more about this advancement, the
1:18:03
Speaker 3: FDB script agent, and what this means for you as
1:18:06
Speaker 3: a pharmacist. David, you got to bring other pharmacists back
1:18:10
Speaker 3: with you next time on Twerks.
1:18:12
Speaker 5: Let's Twerks more.
1:18:14
Speaker 7: Sounds good. Thanks so much for your time, Todd.
1:18:15
Speaker 12: Thank you.