100+ Ways to Make Your Pharmacy Better

Want to start improving revenue, making your pharmacy safer, provide the latest services, or improve operations but don't know where to start? 

Here are 100+ ideas to get your brain going:

1. Get a temperature monitoring device that is CDC-compliant

The temperature monitoring devices for your freezer or refrigerator that are CDC-compliant have a probe suspended in glycol, can track and record temperatures every 15-30 minutes (with reports that can be downloaded), are calibrated/traceable, and have alarms for out-of-range temperatures, among other features.

Post: Important considerations in choosing a refrigerator/freezer temperature monitoring device

Thomas Scientific CDC-Compliant Excursion-Trac Traceable Temperature Monitor

2. Check refrigerator and freezer temperatures twice-daily, including checking the min-max. Take action if it is out of range!

One of the most common misses I see in pharmacies is in tracking temperatures. Temperatures should be recorded twice-daily and include a min/max. Also, you should have an action plan in place for handling out of range temperatures. You can find out how to handle that in the CDC Vaccine Storage and Handling Toolkit.

Get your free temperature logs with here.

Post: Handling a Refrigerator or Freezer Temperature Excursion

Free Product: Excursion Labels

3. Get a pharmacy reconciliation service and be sure you are paid for all the claims you submit

Pharmacy reconciliation services will set you up on EFT for all payments, compile your 835 (remittance) statements, and line up virtually every prescription with the payment to be sure you were paid and were paid accurately. They will also resubmit claims when there is an AWP change that resulted in underpayment. This is a service every pharmacy needs and if you don't have one you should get one.

In the meantime, if you haven't done so, get set up on EFT for your major payers.

Link: EFT (Direct Direct Deposit) enrollment forms

4. Start a medication synchronization program

In addition to improving adherence, MedSync can improve revenue by reducing Return to Stocks and improving efficiency. By proactively calling your patients and refilling all their medications at one time you can reduce phone calls, reduce time at the register, and boost patient satisfaction.

Check out this article by Mckesson on the benefits of MedSync.

5. Get procedures in place for handling of hazardous substances and be sure the pharmacy is ready for USP <800>

USP 800 was written to protect healthcare workers from hazardous substances and applies to all healthcare facilities, including community pharmacies. It is a long chapter and much of the information might be related to only certain types of facilities (ex. compounding or administering HD’s, which is not most community pharmacies), so be sure to check out the post on it for tips specific to the types of HD commonly encountered in the community pharmacy as well as other helpful resources to get you up to speed.

Post: Hazardous Drug Handling in the Community Pharmacy

6. Get a water purifying system for reconstituting antibiotics.

Tap water, as most of us know, is not generally acceptable  for reconstituting antibiotics. If you're still using the system of buying the jugs of water and using graduated cylinders, consider upgrading to a water purification system that meets USP standards. You won't have to worry about running out and being stuck without water and you can be sure you are getting high-quality water every time (after all, are you sure those jugs don't get dirty after a month or two on the shelf opened?)

Here’s an example of a system purpose-built for pharmacies.

In the meantime, if you're still using graduated cylinders, consider setting up a reconstitution system like this one that will at least be more efficient for staff.

7. Ensure you are checking both Federal and state databases for exclusions

Hiring someone (or filling a prescription written by a provider) who is excluded from billing services to Federal programs (Medicare, Medicaid, etc.) can be a costly mistake. Check your staff when they are hired and monthly afterwards.

Post: Exclusion list screening

Free Product: Monthly exclusions screening worksheet

8. Get prepared for an accurate inventory count

Getting an accurate inventory count is really important to be sure the Cost of Goods Sold (COGS) reported on your income statement is accurate. Be sure to mark all opened bottles, segregate and label items not to inventory (mark it as "DNI" - Do Not Inventory).

Post: What is that inventory adjustment all about?

9. Start a home delivery service

It seems like even the big chains are investing in home delivery and/or mail order big time these days, and if you really want to stay on top of the competition home delivery is a great way to do it. Medspeed and Lyft are two that are in the business; there is also a startup named ScriptDrop that allows you to send automatic notifications to them, where they will coordinate with couriers to pick up the medications.

10. Start a Medication Therapy Management (MTM) program.

MTM can be a great way to earn some extra revenue during downtime as well as boost your Stars ratings, which affects reimbursement for many insurance plans.

For MTM through insurance, OutcomesMTM is really nice because they will give you short interventions, they call TIPs, that can be completed relatively easily. Mirixa is also commonly used; you can sign up for both to maximize your MTM opportunities.

Another option is to advertise it as a cash-paying service for a reasonable price to patients and to doctors' offices (to refer their high-risk patients).

Post: How to do a medication reconciliation

11. Start a smoking cessation program

Most insurance companies will pay for some sort of smoking cessation product, including even Chantix, for no copay to the patient. Why not proactively identify patients, counsel them, and then either refer them to the state tobacco quitline and/or get a prescription from the doctor's office?

If you call the doctor's office, get a prescription for a product, and run it through insurance you can boost revenue and improve the public health. I was at Safeway when they were the first national chain to implement Ask-Advise-Refer with every patient encounter and as a company we had an enormous impact.

Another benefit to the patient and to revenue is that you can then recommend necessary vaccines, like Pneumovax.

12. Start a travel vaccine clinic

If your state allows you to give travel vaccines (which most do) then you should consider starting a travel clinic. While it can be expensive to bring in a provider, some pharmacies have partnered with contract travel companies like this one; they charge a flat rate to the patient and then send vaccine recommendations and travel medicine prescriptions over to you.

13. Launch corporate wellness services, including on-site MTM, chronic care management, and medication delivery

This could really be big business for a pharmacy willing to go after it. Instead of having to go through insurance for MTM, why not just go straight to the employer? Offering a flat fee or a la carte service levels would allow employers to just pay you directly (at a better rate for both of you and with less hassle) for you to reduce their healthcare costs. 

If you can prove to them the cost reductions you’re bringing to the table are much higher than what you’re charing you’ve got a winning business model.

14. Get into pharmacogenomics

Genomics is at the forefront of pharmacy and, quite frankly, will probably become one of the biggest job markets for pharmacists when robotics and technicians take over dispensing. You don’t need to buy one of those big expensive machines yourself; instead, contract out with a company that does the testing and then interpret the results and make recommendations to the patient and physician based on them.

Here’s an article on genomics that lists some lab companies in the business. Also, you will need some extra education and training to get up to speed; University of Florida has training programs and even an annual conference in genomics.

Post: Pharmacogenomics in the Community Pharmacy

15. Clean up all of your records and throw out unnecessary ones.