Pharmacy management system

The pharmacy management system, also known as the pharmacy information system, is a system that stores data and enables functionality that organizes and maintains the medication use process within pharmacies.

These systems may be an independent technology for the pharmacy's use only, or in a hospital setting, pharmacies may be integrated within an inpatient hospital computer physician order entry (CPOE) system.[1]

Necessary actions for a basic, functioning pharmacy management system include a user interface, data entry and retention, and security limits to protect patient health information.[2][3] Pharmacy computer software is usually purchased ready made or provided by a drug wholesaler as part of their service. Various pharmacy software operating systems are used throughout the many practice settings of pharmacy across the world.[4][5][6]

Purpose

The pharmacy management system serves many purposes, including the safe and effective dispensing of pharmaceutical drugs. During the dispensing process, the system will prompt the pharmacist to verify the medication they have filled is for the correct patient, contains the right quantity and dosage, and displays accurate information on the prescription label. Advanced pharmacy management systems offer clinical decision support and may be configured to alert the pharmacist to perform clinical interventions, such as an opportunity to offer verbal counseling if the patient's prescription requires additional education in the pharmacy.

Pharmacy management systems should also serve the pharmacist throughout the Pharmacists’ Patient Care Process, a cycle developed by the Joint Commission of Pharmacy Practitioners (JCPP). The process details the steps pharmacists take to practice tangible, proven care to their patients.  

Pharmacist patient care process

The JCPP's pharmacist patient care process consists of five steps: collect, assess, plan, implement, and follow-up.[7] Ideally, the pharmacy management system assists with each of these practices. The pharmacy system should Collect data at intake and continue to store and organize information as the pharmacist learns more about the patient's medications, their history, goals, and other factors that may affect their health. The technology within the pharmacy information system should allow the pharmacists to Assess the collected information to form a Plan and Implement creative strategies that address the patient's issues. After implementing a plan, the pharmacist should routinely Follow-Up with the patient and make adjustments as needed to further progress.  

Core Features of Outpatient Pharmacy Management Systems

The outpatient pharmacy management system allows the pharmacy to carry out daily operations. Available features vary across different systems, but all pharmacies require core functions and capabilities to perform their duties.

Dispensing Workflow Management

The action most associated with pharmacy is the dispensing of medication. Dispensing occurs from receiving the prescription from the patient or prescriber to finalizing the prescription before it is picked up by the patient.

  • Intake: Also known as the Data Entry Station, this is the first step in a typical independent pharmacy's workflow. When the prescription is received by the pharmacy, the technician or pharmacist enters the data into the system.
  • Pre-Check: Before filling the prescription, the pharmacist has an opportunity to review it for potential drug interactions, appropriate dosage, duplicate therapies, or transcription errors that may result in multiple scenarios ranging from a third-party claim rejection to harming the patient.
  • Fill: Here, medications are dispensed. They can be counted and verified by hand, or a dispensing robot can be integrated into the workflow to complete this task.
  • Check: The pharmacist confirms the filled prescription contains the right medication, dosage, and supply. Once the prescription is verified, it is placed in the Will Call Bin.

Third Party Claims Adjudication

Pharmacists work alongside physicians and payers to coordinate patient insurance benefits. The pharmacy management system can be an asset in this process. In cases involving a medication not covered by the patient's insurance company, the pharmacist must receive prior authorization from payers to dispense the medication. Some available systems are capable of automatically generating prior authorization requests and completing claim adjudications.

Clinical Information Management
  • The Patient Profile summarizes patient data in a cohesive display. Pharmacies use patient profiles to document basic information (age, address, phone number, allergies), known health conditions, insurance and prescriber information, laboratory values, immunization history, and other necessary details related to patient care management.
  • Prescription Profiles record patient fill histories (both prescription and non-prescription medications) so pharmacists can monitor adherence, prevent duplicate or conflicting therapies, and avoid negative drug interactions.
  • Medication Synchronization, or med sync, is ideal for patients with multiple maintenance medications. The pharmacist organizes all of the patient's medications to be filled on the same date each month, minimizing patient confusion and the number of visits to the pharmacy.

Inventory Management

Various systems provide inventory management tools that allow pharmacists to reorder items, return unused stock, and organize shelf labels. Ideally, pharmacies keep a lean inventory to avoid spending money on products that remain undispensed on their shelves. Pharmacy management systems also support the electronic data exchange (EDI) between pharmacies and wholesalers, which digitizes shipping and receiving orders, catalog updates, and pricing changes.

Usage-Based Ordering

A system feature that notifies the pharmacy when the balance on hand (BOH) has changed for an item and may need to be re-ordered.

Pricing and Billing

Within a pharmacy, financial intelligence is crucial for maintaining the store's business. Pharmacy management systems are capable of identifying profit losses from direct and indirect remuneration (DIR) fees, rebilling third parties for claims resubmissions, and tracking market changes so the pharmacy can continually offer competitive prices.

Accounts Receivable

Also known as “A/R Accounts” or “Charge Accounts,” these allow patients to pay the amount owed to the pharmacy at a later date. These patients are typically residents of long-term care facilities, or patients who receive prescription deliveries.

Reporting

Because pharmacies interact with patients and multiple facets of healthcare (payers, prescribers, facilities, etc.), they gather and store data within their pharmacy management systems. This data may be utilized for implementing business intelligence practices, documenting patient responses to new care strategies, or supplied to an auditor during an inspection or certification process.

Advanced searching

System users may employ the search capabilities to find broad selections of information, or use filters and specific standards to refine results and isolate the desired data.

User-customizable reporting

Cutting-edge pharmacy management systems offer customizable reports to their users. Reports may be based on pre-existing templates, or pharmacies may create their own tailored reports according to their needs.

Vendors

Outpatient software vendors

Outpatient pharmacies typically are retail pharmacies that offer patient care services outside of hospitals and treatment facilities. Outpatient pharmacies, also known as community pharmacies or independent pharmacies, offer care in the form of medication therapy management (MTM), patient education, and clinical services.  

PioneerRx

PioneerRx's Windows-based pharmacy management system debuted in 2008. The software is updated weekly and includes functionality suggested and voted on by its users. PioneerRx's main features include medication synchronization management, configurable clinical decision support, user-customizable reports, financial intelligence, and an enhanced workflow. PioneerRx also offers mobile applications for inventory management, delivery, and patient counseling.[8]

Rx30

Developed in Florida in 1980, Rx30 is a multi-platform software that offers automated pharmacy processes, vendor integrations, and compounding functionality.[9][10] The Core Services include Accounts Receivable, Point of Sale, and Virtual Pharmacist, a feature that automates the refill process. On October 6, 2016, Rx30 announced its merger with Computer-Rx.[11]

NRx by QS/1Ⓡ

QS/1 was founded in 1977 by pharmacist and MIT grad Jim Smith and is currently based in Spartanburg, SC.[12] QS/1 offers multiple pharmacy software solutions, including NRx. NRx's capabilities include advanced security, real-time workflow monitoring, patient education monographs.[13]

Inpatient software vendors

Inpatient pharmacies operate within hospitals and dispense medications to admitted patients receiving treatment. Inpatient pharmacists manage patient health alongside doctors and nurses, and the pharmacy management system must integrate with the various systems operating throughout the hospital to maintain accurate Electronic Medical or Health Records (EMR, EHR).

Epic Willow

Epic, named for the long-form poems chronicling hero's lives, began in 1979 by founder Judith R. Faulkner. Epic software currently manages over 200 million patient electronic records.[14] The Willow Inpatient Pharmacy System, when combined with other Epic systems, allows pharmacies access to medical administration records (MAR) and links all aspects of the ordering and dispensing process to simplify collaboration amongst all parties involved in patient care management.[15]

Cerner PharmNet: Medication Manager

Cerner Corporation has provided health information technology (HIT) to hospitals and healthcare systems since 1979.[16] Cerner PharmNet enables pharmacists to automate their workflow processes and center care around the patient, not the encounter. This software allows pharmacists and doctors to manage prescriptions and verification from the same order in order to streamline medication management.[17]

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See also

References
  1. "What Is a Pharmacy Information Systems (PIS)? - Definition & Uses". Study.com. Retrieved 2019-03-25.
  2. "A Primer on Pharmacy Information Systems". HIMSS. 2001-05-04. Retrieved 2019-03-25.
  3. "Pharmacy Information Systems: The Platform for Elevating Care in Specialty Pharmacy". Specialty Pharmacy Times. Retrieved 2019-03-25.
  4. The Pharmacy Technician. Perspective Press. 2016. ISBN 9781617315572.
  5. DAA Enterprises, Inc. (13 September 2017). Pharmacy Management Software for Pharmacy Technicians: A Worktext - E-Book. Elsevier Health Sciences. ISBN 978-0-323-48498-5.
  6. Quiett, Linda (2012). Clerical and Data Management for the Pharmacy Technician. ISBN 9781285225821.
  7. "The Pharmacists' Patient Care Process - JCPP". jcpp.net. Retrieved 2019-03-25.
  8. "Pharmacy Software – PioneerRx – Top Pharmacy Software System". Retrieved 2019-03-25.
  9. "About Us - Rx30 The Pharmacy Management System". Rx30. Retrieved 2019-03-25.
  10. "Transaction Data Systems – Rx30". ComputerTalk For The Pharmacist. Retrieved 2019-03-25.
  11. Rx30. "Rx30 and Computer-Rx Announce Strategic Combination". www.prnewswire.com. Retrieved 2019-03-25.
  12. "Our Story | QS/1". www.qs1.com. Retrieved 2019-03-25.
  13. "NRx Pharmacy Management System | QS/1". www.qs1.com. Retrieved 2019-03-25.
  14. "About Us | Epic". www.epic.com. Retrieved 2019-03-25.
  15. "Willow - Pharmacy | laheyhealthseniorcare.org". www.laheyhealthseniorcare.org. Retrieved 2019-03-25.
  16. "About Cerner". www.cerner.com. Retrieved 2019-03-25.
  17. "Key is closing the loop". Healthcare IT News. 2007-05-01. Retrieved 2019-03-25.
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