Lisa Faast: Well, hello, everyone, Dr. Lisa Fasst here and I have a wonderful episode today with a fellow pharmacy owner. And we're going to be talking about pharmacy automation technology. If you have been following me at all or know how I run my pharmacies, and you know that I absolutely love technology, I typically am an early adopter, I'm always one of the first ones to try some new software, some new gadget, some new technology. And frankly, that becomes out of a need of where I grew up in pharmacy, if you will, I owned my first pharmacy in California, and California has really restricted laws on the number of technicians we can have for pharmacist, if you just have one pharmacist on duty, you can only have one technician, I know, it's crazy. Whenever I tell Midwestern pharmacy owners about that were there, a lot of them don't have any limits, you know, their mind is kind of blown. And
so I was forced to lean into technology in order to improve efficiency, and, you know, keep patient safety and all the things that we're concerned about, because we were restricted on the kind of help that we could have. And so I love pharmacy automation dispensing. I've owned a lot of the big robots out there, myself and my own pharmacies. And I've obviously worked with a lot of pharmacies who have, you know, bought these. And when I talked to pharmacy owners about adding
some of these automated dispensing robots into their pharmacy, they're hesitant. Their first one is always well, it's really expensive. And you're right, they do cost money, and they are expensive. Yes, you can finance them, and
you make the payments really affordable. But there is a cost to them. And when there is a cost like that a pharmacy owner, rightfully so should always be concerned, and am I going to get my money back? Like how am I going to use this? Is this technology really going to help me either save money? Or is it going to help me grow my pharmacy so that I'm earning the extra revenue, not only to pay for the machine, we don't want to just break even, we want to go above that, and we want to create profits. And so these automation technology, different
dispensing systems out there, and there's several, several different ones out there. They can actually help you grow your pharmacy and become more profitable. And so I have a wonderful pharmacy owner, Steve role that has done this in his own pharmacy and he's in he's in a small town. Many times when I talk to pharmacy owners, they say, oh, that sounds great, but I'm in a small town, and they kind of use that as a barrier to success. So I think it's fantastic that Steve is going to be sharing his story. And he's comes from a very small town, much smaller than, you know, a lot of the pharmacies that I've owned and operated and, and he's been highly successful in improving his pharmacy growth and metrics by leveraging prescription automation. So Steve, thank you for joining us
today. Welcome to the episode, please introduce yourself. Tell us a little bit about your pharmacy where you're from where you're located, so that we can get to know you a little better. Steve Roell: Thanks, Lisa. My name is Steve Roell. I have three pharmacies in the Upper Peninsula, Michigan, rural Upper Peninsula, our largest store and kind of our sister store where we have most of our technology is located in Iron Mountain Michigan. I don't know if you've ever heard about your mountain,
but if you're a sports fan, I'm Tom Izzo and Steve Mariucci graduated from Iron Mountain High School and I guess that's our claim to fame. So I'm like you I've been always identify pharmacy owner for about 19 years, been a pharmacist for 37 years. But I've always been an early adopter to where technology has not believe it or not. 937 years ago, when I started, I was like one of the younger pharmacists that you know, was more the technology guru. Now I feel I'm on the other end of the spectrum and have a lot of other younger pharmacists that are better at technology, but I can still fumble through it. But we have always had a lot of technology we haven't obviously, we have an IVR system. We have a script pro
SB 200 that we had, we had IVR then we had an SD 200. Then we had a TCG RX packaging machine, this big, large packaging machine that was labor intensive. You feel the little exception trays. And you know if anybody's looked into that they
kind of know about that. And then about a year or so ago, we switched to be made a switch to the TCG RX, much smaller. And as we grew, our pharmacy also got more cramped. So the extra space, you know, was it was a nice addition to by getting rid of the TCG RX. So, um, and that machine is a little bit more, it's a lot less labor intensive, and where it's a lot less pharmacist labor intensive, I feel, you know, and let's face it, that's that's your most expensive labor and your pharmacy. So, um, it's been a good thing for us. You know, we've also adopted, you know, bed sync real early on, and we have lots and lots of patients on med sync probably 65 to 73 sent at least of our patients are missing. And I think that's
a key, if you're going to add like an RX safe or something technology, you need to be able to plan your workflow. You know, and it's in med sync allows you to do that, you know, and so that's my first tip, whether, you know, probably the most important thing, if you're thinking about added, adding, you gotta get your patients synced, as many as you can to free up or to your time and to let you kind of schedule your your workflow a little better. We are busy. This past 12 months, we averaged a little over 19,000 prescriptions a month. So we feel between 600 and 1000 1100 a day. We're open 20. We're open seven days a week. Lisa Faast: Yeah, that is nuts. I just want to take a moment
like, congratulations. That is That is amazing. And I mentioned earlier in my opening that you're in a small town. And so I think it's really important to kind of point out like, you're filling just under 20,000 scripts a month, and a town of about what 12,000 ish people or so yeah, but we have a radius that we draw from. As far as there's always, there's always a bigger radius. But it's, you know, just to kind of bust that myth that you can't be a busy pharmacy, or you can't earn the business and majority of your community when you're in a small town. You know, I think you just you know, proved the the mythbuster that that's not possible. So just want to say
congratulations on that. So Steve Roell: yeah, and I could throw up probably from my pharmacy throw baseball through Walgreens window. So. So we're right across the street from Walgreens. And we have a Walmart, pharmacy in our town too. But we're the only independent pharmacy. So we've kind of emerged as kind of like,
in I don't even want to say a specialty pharmacy, because when we fill that many prescriptions, we're obviously not just spilling specialty drugs, but but we tend to gravitate to the more complex patients, you know, we do all the assisted living facilities in the town. And when you kind of get that reputation, the other business kind of flows to you know, we're, we don't have a drive thru. And so, you know, we're doing that, and I think that helps. I think it helps with workflow too. You know, when Walgreens moved, moved across the street, I ran a big eight radio ad that said, radio campaign that said, you know, at the drugstore, we believe drive throughs are for French fries, and hamburgers, not for your prescription. We
don't have one and we'll never have one. You know, I mean, you know, so I love it. I love it. You know, you know, like your health is more important than that. You know, so we want to
talk to you kind of thing. And we've kind of that's kind of our, what we pride ourself on is customer service, customer interaction, that kind of stuff. But um, technology certainly lets us do that. Lisa Faast: Yep. So when, you know, you've obviously have gone through that decision making process as somebody who has considered technology because you've had lots of different technologies. And so if somebody is watching this, and they've
thinking like, gosh, you know, I go to these trade shows, or maybe somebody was at our pharmacy profit Summit, and they saw, you know, our safe, and they saw the robots there. And they're kind of like trying to make that decision of, is it worth it? You know, how do you answer that, I mean, you gave us your numbers. So and I just want to like recap some of those. So you grew, you do just under 20,000 a year now. And the year before that, you did about 17,000 a year. So you've increased your prescriptions, you know, somewhere around 13 to 14%. And you mentioned in our in our call that over half of those increased prescriptions came from packaging. And so that's a
huge difference. And I think the big change happened when you had the right technology, because you had the TCG RX before, I'm not to say that it's a bad machine. It's just I just like with PMS systems, it when you have these big kinds of things that are integral to your pharmacy, everybody's workflow is different. Everybody's demographics, different, your staff is different. But it was it was causing a hindrance, partly because of the size and the labor intensive. And then
when you switch to the art safe, it's like your packaging exploded when you had over 50% of that growth from packaging. So you know what to say when somebody's like, should I get this machine? I think you gave a first third great rule of thumb you got to have sync, I absolutely am. And like Amen to that. You've got to be proactive in filling prescriptions. These are monthly recurring things we know when people are going to be dating their stuff, we don't have to be so reactive. We can
be reactive to the amoxicillin 's or the you know the other kinds of things but we shouldn't be reactive for those regular meds, Steve Roell: but can be reactive to the lack of them. Yeah, we gotta call you something else. Lisa Faast: Yeah. Goodness gracious, that easy. Yeah, it's a whole other conversation. And, but you know, like, let's Save that reactiveness for the cute needs. And so, you know, kind of taken all that in now that you're on the other side of having gone through several technologies and even change the same technology. You know, you went from one strip packager to
another strip packager, what what would you say to somebody who's having that thought process of, because we're here, at the end of the year, section, section 179 tax breaks are here, a lot of people make that decision to buy a robot at the end of the year, because they do it out of tax pressure, and then they don't know what to do with the darn thing. Steve Roell: So right, and also, every pharmacist says, listening, knowing that filling more prescriptions doesn't necessarily mean you're making more money, you know, and, and so, yeah, we have a lot big numbers, but you know, it's all about profit, it's not about numbers. So, we're also a combo pharmacy, you know, and we have a contract with Jerry man. Now,
I know, there's a couple other people out there that do that, but are with that, you know, our, our packaged prescriptions, our patients, our packaging, our build through a separate NPI number that we got, when we became a combo pharmacy, and none of those prescriptions are subject to dir fees, that's big, you know, and I know they're supposed to go away in 2024. But we all know, they're gonna find a way to get their money, you know, and, but right now, and I can't comment on how, what the difference is, because right now there are dir fees are so you know, smoking mirrors, but we are starting this next month, we're gonna be able to get claim level detail on our dir fees. So we'll be able to kind of do some analysis with our package prescriptions and our non package prescriptions and dir fees and stuff like that. So that'll be really interesting. But that's where in my mind, we're, you know, one place where we're getting a lot of return on investment, you know, you know how much you're paying and dir fees. So if you can move 20% of
your business or so out of that, you know, is that 20% Less dir fees, you know, I mean, maybe in theory, so, um, you know, and then we're able to grow without labor, but I will say now that we have a meeting just next week with our packaging department, pharmacists and technicians, because they're starting to struggle, they're trying to say, Yeah, okay, we grow up now this, but now we need some more help, you know, and we're attended to that, and we were aware of that, but, um, I mean, you can't grow indefinitely without without any help. But, um, you know, the DIR fees are a big thing. And I think that sometimes it's overlooked to do that combo, pharmacy thing. And if you're doing strip packaging, you're certainly going to qualify for that. And it's not difficult, because you're a combo pharmacy, you don't have to keep separate inventories, and it's just just got to fill the paperwork and pay a little bit of monthly fee. That's about all it Lisa Faast: really is. And I want to touch on that. Because I
remember I'm I'm an older generation as well. And I remember back in the day, when it was a very manual process, and you had to have, you know, we have a separate shelf that was just for this inventory. That is not the way anymore, it really is very simple. And I'm a Jerry med fan, too. And there are other people out there that do it, but I you know, I just have the most experience with them. But yeah, it is fill out some paperwork, pay a fee, and it becomes a lot easier. So it is not a whole lot of work. And you don't need a lot of
prescriptions to benefit. I mean, frankly, if you have just a few patients, it is worth it. Because you're right, you save on the DIR fees, reimbursements can actually be different and change. And so there's a lot of benefits even with a small
number of patients. Steve Roell: Right, and we have pioneer RX software system. And, you know, we we can identify those patient that other NPI, it's all runs in the background. Nobody has to think like how my billing is I'm billing THIS to THIS NPI or that NPI or this picture, it just, it's seamless, as far as that goes to. So, so it's Yeah, that's one thing for sure. If you're gonna get a
packaging machine, you're gonna want to take that next step into becoming a combo pharmacy. Lisa Faast: Yep. What How did you know it obviously did help increase volume for you. So what was your you know, did you have
a plan in mind beforehand? Or did you formulate a plan after the fact like, how did you make it to where people are like, that's interesting. I want that whether it's a patient or potential patient or whether it was a provider, you know, somebody that might send you patients? Steve Roell: Yeah, a couple of things. When we had our old system and because it was so labor intensive, we charged for packaging. You know, we didn't charge our assisted living
facilities, but our just our outpatients are just customers, if they wanted to have them as package, we charge them $10 a month. And, you know, a lot of people on fixed incomes or whatever that that, that that was a deterrent, you know, and so when we got our TCG RX machine, we took away the fee, you know, we put up posters in our pharmacy Would you like to, you know, receive your meds like this, there's no extra charge. You know, and, and I know people are gonna say like, Oh, you do all that and you don't charge Well, there's a, you know, you pay for vials, and you pay for caps, and you pay for all that other stuff, too. So there's some expense there. And the other thing is when you're packaging your prescriptions, yeah, they're getting prescription, they're getting 12 fields a year, they're getting however many fields, they're not, you know, if they're three days late, you know, 12 months out of the year, you got 11 fills out of that, you know, you didn't get 12 fields. So you're keeping your meds, your patients compliant, you're helping your star ratings, you're getting more feels, you're losing your dir fees, you know, it's a whole combination. It's not one thing.
Lisa Faast: Yeah, I completely agree. I, the way that I've analyzed it in our pharmacies that we've implemented the RX safe, rapid pack, is it's almost like a wash, you know, yes, there's a cost of labor and a cost of dispensing, but there is on the retail side to like, like you said, vials and things, you know, so to me, it's about a wash, because and like you said, you get that extra fails, you get those compliances, we tend to stick to the 30 days, I know some pharmacies do 28 days where you know, then you can get like the 13, Phil, we tend to stick to the 30 days, I just have never been in a community that didn't like not getting those two extra days of you know, others, we Steve Roell: get dirty just, Lisa Faast: we do 30. So I mean, you know, I don't think there's a right or wrong, whatever works for your patients is fine. But yeah, so I kind of see that as a wash. So to me, you know, that's
the cake. And then the let the lack of dir fees is, you know, icing and then you just keep pouring on some more icing because can you talk a little bit about being a combo pharmacy, and the different reimbursement rates? Have you seen a difference in that? I know, it's kind of plan specific. We've only seen differences in one plant ourselves. But have you noticed any difference in the
reimbursement rates? Steve Roell: Not a lot, you know, and maybe that will come? I don't know, but that's, you know, that's not one thing I mentioned in my reasons. But I'm saying because I don't know that there's a grand difference in reimbursement other than the DIR fees, and even kind of, well, reinbursement bucket. Lisa Faast: The DIR fees are huge. Yeah, I mean, that those, those are huge themselves, and I just know that shift to medical at home, I know, are safe is working, they're working with, you know, ncpa they're working with a lot of things to try to get those, those medical at home, you know, reimbursements changed to be like to match the facilities kinds of things. And
so we've seen one plan, you know, do that, I just kind of curious if you had seen it, not that it was necessarily a reason, I think that's kind of in the future, but I think it's coming, Steve Roell: I think it's coming in, I think it's gonna be localized in pockets, and it's gonna, you know, hopefully, you know, make a trend across the United States, you know, the, the other area where you can market it to is to people my age, whose parents are in their 70s and 80s, and still living at home, but they're, you know, their sons or their daughters are trying to manage their meds, and they get it that's takes a lot of time. And it takes a lot of effort on their part. And if you can take that away from them. That's also a place where you can market and get in get new patients. So it's not always marketing to the patients themselves. Sometimes it's
marketing to the family, Lisa Faast: The family, that's it, that's a really big point. I have surprisingly found that people that are in my shoes, you know, the the the mom, the parent with you know, full time jobs with multiple kids, multiple sports, I prefer the packaging, it's a convenience thing, it as it is not really so much a compliance issue. But if I have kids, and if they're on vitamins, or they're on a prescription, or they're on something, it is so much easier to you know, hand out the packs to everybody, and you don't pulling down all these bottles, like don't forget the convenience factor either. And,
I mean, yes, it's convenient for the elderly parents too. But that one is really more I think of a compliance, like, we want to make sure our parents are taking their meds because chances are they're really important meds, whereas, you know, maybe my kids vitamins aren't so important. But I do want them to take it, but it's really more of a time convenience factor. So I think there's both the safety and health and, you know, better outcomes with compliance. But
there's also just the time and you know, Hey, did I remember to give my kid the vitamin D today, you know, kind of thing. So I think there is that sandwich generation where they have both of those needs, they're looking to improve their time, and they're looking to improve the health of, you know, family members and loved ones. So, I've actually been surprised by how many like moms and busy parents I say, Mom, because I'm a mom, but busy parents in general, how they're interested in the compliance packaging. Steve Roell: You know, another place school nurses love it.
Yep, a lot. Especially, you know, for those kids that are taking medications during the day that they have to pass out. Instead of just, you know, can you give us an extra bottle and that kind of stuff, and then you know, that comes in the pills and all that kind of stuff. You know, That's another place you can kind of target that, you know, is the schools in school nurses? Lisa Faast: Yeah, a big one that I will I don't know, if you've gotten into this, but summer camps, summer camps are the exact same thing. So for kids that need to take, you know, vitamins, prescriptions, anything to summer camp, I've known some pharmacies that they do so much packaging in just this the summer months for summer camps that it pays for, you know, the entire year, because of the influx for for camp and they've kind of become like camp specialists, and they work with the camps and they make sure they have all the, you know, the medical information they need, but then they package everything. And, and that is the only way that camp some of those camps will only allow, you know, then to come that way, because you're right, it's so much easier than trying to count pills. And, you know, oh, my gosh, we're one short, what
happened to this and the safety and security is just, you know, far and above what happens with vial. So that's another really big area. I don't know if you have any summer camps up in Michigan, but that that might be an option for you. Steve Roell: We're not too many, because everybody has their own camp.
Lisa Faast: Yeah. Well, you won't find me in your neck of the woods in winter, that's for sure. I'll stick to my southern roots, and stay warm. But maybe that maybe in the spring and
summer, we'll we'll head up there. But any last words for somebody that's, you know, is just a little hesitant? I'm not sure we know, we mentioned some of the tax benefits, which you know, you get to take advantage of each year if you if you order, but any other last words of somebody who might be considering adding automation, whether it's an art safe, rapid pack machine or something else? Steve Roell: I rarely talk to anybody that regrets it, you know, like, like, two years, they might regret it a month after they purchase it. Because it's it is, you know, there's a learning curve and all that stuff. But you talk to those pharmacists a year down the road or something, you know, nobody seems to ever regret any technology, you know, that they embrace, once they got it figured out, you know? Lisa Faast: Yep, no, that is perfect. So if somebody wants to
just check out your pharmacy, I think you've got a really great awesome thing going there, they're going to be up in your neck of the woods or something. What was the name of your pharmacy and the website of your pharmacy? Steve Roell: They have a pharmacy is the drugstore. I didn't name it, but I bought it. And in our website is tdsrx.com. Lisa Faast: Awesome. And if you're listening to this, and you're interested in the strip packing machine that Steve has been talking about, it is the RX safe, rapid pack, which when I first saw the machine, it blew me away, it's a very, very small footprint, especially compared to some of the other packaging machines out there. And it's also very fast, which, you know,
Steve has talked multiple times that it was much less labor intensive than his previous model, but you can always contact our safe, it's our ex safe.com Just go to their website, they've got tons of videos and tons of information and see if it's the right fit. And it is it is December, we are recording this in December, there's still probably time if you want to take advantage of some tax breaks, some of us have had some really good years, some really good profitable years and you might be looking to, you know, offset some taxes and it's something that you would be purchasing anyways, then now might be the time to reach out and see if you can get it in before the end of the year to take advantage of that. So thank you for spending some time with me today. Steve, it was a pleasure to get to know you better and I know you've helped many pharmacy owners and I greatly appreciate it.
Steve Roell: Thank you and if anybody wants to talk to me personally they can they can go to our website tdsrx.com and find my contact information. Lisa Faast: Perfect. Thank you so much. Steve Roell: Okay, thank you, Lisa.
2023-01-04