Megan Billingsley: Hello, everyone, and welcome to today's webinar, Exceptional Patient Experience, Leveraging Tech for Smarter Healthcare Operations. We're excited you could join us. My name is Megan Billingsley, and I'll be moderating today's event. Today, we'll be discussing how shipping and mailing can shape the patient experience, as well as help HCPs provide greater continuity of care. As consumers, we've grown accustomed to same-day delivery and being able to track where our shipments are at all times. Patients increasingly have those same expectations, and we'll discuss how convenience is key to keeping patients involved in their care. But we'll also talk about the broader benefits for patients and the role for shipping and mailing in enhancing patient outcomes. And finally, we'll delve into the benefits for healthcare organizations and how shipping and mailing can enhance the way HCPs connect with their patients. We are thrilled to be joined by our speakers, Anne M. Richardson, MBA, Founder and Principal Consultant at Leadwell Healthcare Consultants. Mary Catherine, or MK, Shealy, PharmD, Executive Director of Ambulatory Pharmacy at Grady Health System. And Erin Evans, Director of Product Management, Partnerships and Innovations.
Erin Evans: I learned a ton from MK and a lot of her peers just walking the dock and walking different practices. So it goes from that commercial thing into just product management for a good long time, learning how to make the product, make it work, refine it, find out all the things that you didn't expect were important suddenly become very important. And so anyway, glad to be here.
Megan Billingsley: And we're very glad to have you as well. Thank you. So now that we know our panelists a little bit better, let's dive into our discussion. As I mentioned in the intro, our patients are also consumers and they're used to very quick, easy and convenient shipping solutions for consumer goods. So my first question is, how are these expectations impacting health care? MK, why don't we have you kick this off?
Mary Catherine (MK) Shealy, PharmD: Yeah, this is a really great point, and I think that it is becoming more and more of a focus for us in the pharmacy space. Our patients are used to same-day shipping. They're used to ordering something, and within 20 minutes, their food at their door. That is what they expect from us. their drugs. That's what they want from their medications that are coming to their door. They want that same amount of transparency to say, when did it leave you? When is it going to get here? And can I watch it on my app to see where it, when it's going to be here? Our patients live very, very busy lives and they don't want to have to be tied to their house to wait for something to get there. They want a window of time that they need to be there. It's really kind of interesting when we started this during the pandemic, again, everything was coming through the mail or everything was coming and they gave us a little bit of grace. That's not the case anymore. They really want us to nail down when it's getting there and they really want amazing access to that information. They don't want it to be only through mail. email they want a text message they want a phone call they want all of it so that they can decide how the information comes to them and decides how they can use it it's also really important from our provider perspective as well we need our providers to be able to see from their health record from their encounter what drugs got to what patients at what time so that they can continue to ask and make sure that patients are being adherent to their medications okay so it's not enough to just say that it got dispensed they want to know what day did it get there so we can't just rely on the dispense within the pharmacy system meaning that it left us they need to know the day that it was received by the patient so that they can say okay you got your injection that you only take every two weeks Three days ago, have you taken it yet? Oh, no, I haven't. Okay, and then how does that impact the rest of their care? It's all very, very integrated, and so we need our systems to be the same way. We need that transparency, especially when it comes to when they're getting it and how they're taking their meds.
Anne M. Richardson, MBA: Well, so my comment on that in terms of a logistics, so if we look at our, in a health system, our patients are our consumers, although most providers like to refer to them as patients, but they are our consumers as well. But conversely, our healthcare providers and our care teams need to know and understand the logistics as well in terms of, so if we have solutions in a health system that we say are going to deliver things in a timely fashion and communication. It's so important that leadership and others who communicate and engage the care teams in terms of what these solutions are, they need to have a real understanding and buy-in to be able to work that system most efficiently to the advantage because we can't just say to the patients, we have this wonderful system and we're going to deliver within a day or whatever the case may be. we have care teams that are strained now more than ever because of shortage of staffing and persistent vacancies. So I think the communication that we can all do internally is so important that we not to be a cheerleader, but that we have our own internal people understand it, use it, know the successes and they cheerlead it so that they're able to communicate with the patients. Um, but when we have bottlenecks in that regard with the logistics and whatnot, um, it becomes one more challenge that care teams on any given day, depending on the organization you work in and your staffing, it can cause great stress.
Erin Evans: And that was, oh, I'm sorry, Mae. No, go ahead. That was something that really surprised me when I would visit pharmacies was the logistical prowess and knowledge of, these pharmacy operators, they like MK, you could easily step in and run a warehouse. Like you, you would be in your element. You've like the, who knows? I don't know if it started during the pandemic, but the knowledge of, of various carriers and cutoff times and all these things that just only operations nerds know are, are, it's the same language. I was really surprised by that. I thought it would be, you know, less, less, I guess, less acumen, I guess, on the logistics side. But no, I mean, you guys are negotiating contracts and, you know, moving carriers up and down, depending on what service levels you're trying to achieve. And it's really impressive.
Mary Catherine (MK) Shealy, PharmD: Yeah, I think that's something that's really a challenge for us too. You know, I'm a pharmacist. I count my fives. I put pills in bottles. I make sure they're the right meds for patients. But making sure that all of the pieces line up was a huge challenge for us. And I think that's something that... Again, that integration that you helped us build on the tech side was so valuable for like you think about it like the like the Domino's tracker or whatever. It tells you your pizza is being made. Your pizza is being boxed like they want all of those timestamps on things. They don't want to know just the beginning and the end. All patients kind of want to know the in-between. And same with providers. So now we are integrated, like you mentioned, with Willow Ambulatory, with an Epic. And so our providers can see every step of the process. Hey, it's waiting to be filled. Hey, it's waiting to be verified. Okay, now it's ready for the patient to come get it or whatever that may be. that's great the patients don't quite have that same level of of transparency that our providers do so it kind of makes it a little bit harder same when it comes from like and this is something you've helped us with on countless times the auditing side pbms want to know that this patient got this drug and they make you prove that and they make you prove that two three years ago which you know all the carriers don't have that so usps only keeps it for six months So the solution that we use helps us to be able to retain those records so that it's a lot easier for us. Otherwise, we got to pay back thousands of dollars for drugs that made it to patients. We just can't prove it because we don't have that robust of kind of an inventory of what was sent.
Erin Evans: That was a big learning for me. Again, I'm not a pharmacist, so sort of just as an outsider looking in on this. And so- Being able to retain that data ended up being one of the biggest selling points, I suppose, for our folks in the field. And I had read a stat that was focused on independent pharmacies, but the stat was still salient in that these auditing processes cost, on average, a pharmacy $24,000 a year. which might seem trivial if you're a health network like Grady, but not trivial if you're running a small pharmacy in a small town. So that's real money, and it's somewhat weaponized. They're always going to pick on the most expensive medications in the longest possible period. I think they're allowed to go back seven years, maybe 10, as far back as 10 years. So initially when we built it, we had it. data retention at seven, and I think last year we expanded that to 10 years. I hope no one's getting audited on year nine, but... I hope not. Yeah, that's extreme.
Anne M. Richardson, MBA: So, I have a comment about this discussion, which I think is great, is that... Erin, as you know, not every partner in a health system is going to have the expertise, even though MK is being humble here. She's learned it, you know, as she's gone along because she's had to, and she is clearly a subject matter expert in it. But let's face it, hospital systems today don't have those subject matter experts. And sometimes it's to no fault of their own because they have break and seize and turnover and so forth. So all the more reason, that you need to be able to have these respected partnerships with relationships with a company like in your case, Pitney Bowes, because, you know, our successes on behalf of our patients come from relationships and trusted and respected relationships and partnerships and not selling. And it's that consultative approach that, I mean, if not for MK going on the road and teaching other health systems what she knows, you know, you're not going to find that in every health system. In fact, it's rare that you would have that expertise. Even with downsizing in health systems today, unfortunately, at the top level of leadership is some of these subject matter experts that are losing their jobs.
Erin Evans: Yeah. You guys give me too much credit. Yeah. Yeah. And that, that, um, you know, we're talking about patient experience here, but one of the things I took away from just a lot of site visits was you mentioned employee burnout and, and, um, short staffing and like, and anything that I can do, I, we collectively, I suppose that to make the experience for the pharmacist better, um, became a kind of a passion point for me and shipping is not a fun process. No one likes to do it. I don't enjoy it. And it's, it's like the least, you know, that's probably not why you went through pharmacy school, you know, and to be taping up a poly bag or what have you, but it's just this grim part of a daily job. So it's the, as many steps that I can eliminate and as many like, as many seconds or minutes that I can save on the process. It seems like the compounding benefits are just as important as the patient experience to me. A pharmacist has more duties and jobs now than they did 10 years ago.
spk01: True.
Erin Evans: And I don't know if their pay has changed that much in 10 years, but yes, I would not expect it to be.
Anne M. Richardson, MBA: No, and that's where relationships and partnerships with external solutions are so important. because the challenges are increasing and it's becoming more and more difficult. Patients have demands. Patients are waiting longer to be seen in some cases because access is diminished for lots of reasons. And so by the time they get to a provider and a hospital system, tensions are high. And so we have providers who are the epitome of professional people who are patient-focused, but on the other hand, they're human beings. And so we have to look at them and say, you know, we expect them to be perfect for the patient, but come on, they're human. And so everything we can do behind the scenes, and I'm passionate about this as well, to take care of things, not take away things from them, but partner with them to make all of those non-direct patient care, let's say, activities and workflows as smooth as possible so that when it comes to caring for the patient, the patient has no idea what they went through. But in the meantime, they're delivering such a product and service that the patient is happy, they're satisfied. And conversely, so is the care team, because they're like, we delivered what we said we were going to deliver, and this is what the patient needs.
Megan Billingsley: Excellent. Thank you all. I think that's a strong foundation to set for today's conversation. So as we're starting to wade into the operations and cost efficiency side of things, I'd really like to hear more about the importance of shipping and mailing within the healthcare organization itself. So Aaron, how about we have you kick this off?
Erin Evans: Sure. So just to clarify, that's intra and intra-healthcare organizations. So a lot of these hospital networks have large campus environments and just distributing and moving not just medicines, but just equipment, you know, IV pumps, things of that nature. Chain of custody matters. And so they don't have an infinite supply of these things. And, you know, there are, this is an area I don't think that we've explored deep deeply enough, we have products that are that are chain of custody products for intra office mailing. But so they should be extensible in this space. And it's I think there's some learning ahead of just how deep does it need to go? Is it just a matter of who touched it last? Or going deeper into, you know, their emerging technologies like RFID, which is has always been there, but it's getting cheaper and cheaper. And you yourself have probably used RFID, like if you have an AirTag, for example, you have people tracking their luggage in Portugal that they got lost and they can see it pinging just because people walking by the device, you all have a repeater or something on your phone that you can... trigger these RFIDs, and that's how an air tag works. But as that gets lower and lower in cost, you can start to fix it to apply it in different ways. So maybe an IV pump would make sense because it's a pretty expensive asset. But being able to geospatially know not only who touched it, but where it physically is, what floor it's on, on a 30-story building or something, could be very useful. So those are things I think there's a load of opportunity there. And the other piece that we are in but I think needs as complicated as lockers. We're talking about lockers here. I just want to clarify the locker technology we're talking about is obviously the concept of a locker is very old, but these are smart lockers. They are accessible via your mobile device entering a one-time passcode or a key of some kind. There's a video for a custodial and documentation of who's accessing the locker. There are security controls and measures to control who can access it and even who can access it from the pharmacy side. So they might have a back end of the locker where they're seeding things into it. So it's a The technology is very different, even though the concept is the same. The power seat is no longer just a little keypad or something. So there's also innovations of some of them are refrigerated, and there are different kinds of lockers. I've seen, you know, they might have a different footprint. They might be more, you know, smaller, but a lot more kiosks or a lot more bins, if you would. But all of them are digitally controlled, you know, through... modern security standards. So, MK, you're actually kind of an increasingly kind of an expert on the topic.
Mary Catherine (MK) Shealy, PharmD: Yeah, I want lockers so bad. So I think you're exactly right. There's times where the pharmacies are closed. There's times where we need to get drugs up to the floor for the patients, but they're not quite ready to go yet, but the drugs are ready to go. And so, but then we close in 30 minutes. So having a secure place that we could put them rather than just a medication room, one person, one locker, one MRN, we know who got it out. All of those things are super interesting to us in the hospital space. We want to know that who took it out of the med room or the locker in this instance is who was supposed to get it. And then, like you said, chain of custody, like this is hugely important for controlled substances. This is hugely important for a super expensive meds. Patients often, you know, they get a phone call after they leave the hospital and they say, hey, did you get all your medicines? Well, no, I didn't get such and such. Well, actually, we can prove that we gave it to you and this is where it is. Can you go check your bags? Oh, yeah. And now I have it. Or, oh, no, they didn't give me my oxycodone. But did we or did we not? And that's not just from a hospital standpoint, but from a personnel standpoint, that keeps our discharging nurse safe from all of those other kind of. accusations that would come. It allows us to get people out of the beds faster because there have been more than one time where a patient has had to stay overnight because the pharmacy wasn't open and the provider wasn't willing, wasn't comfortable sending the patient out without their medications because they're unhoused or they live really far away. There's so many use cases that we can, but you're right, Erin, there's huge regulatory issues with this. So in the state of Georgia, we are not allowed to do this. So going and talking to our board of pharmacy, going and talking to different legislators to help them understand that this actually is a very safe process, I think will help us. But man, I... I can see such great things in being able to utilize systems that already exist that someone can ship their, what, hundreds of dollars, thousand-dollar iPad, and we put it in one of these lockers. Why is it any different for medications that a patient's going to get?
Erin Evans: I mean, if you think about it, they're going – medications are being delivered into mailboxes.
Mary Catherine (MK) Shealy, PharmD: Into an unsecured mailbox.
Erin Evans: They're being delivered into college campuses. There's got to be plenty of drugs in those lockers, whether they're prescribed or not otherwise. Right, true. So – It's kind of funny. The regulations exist for a reason, but in a lot of ways, they're actually preventing progress and better experiences and outcomes. It's state by state, too. So Ohio is another state that doesn't allow, and we have a, you might know them. I think it's Sanford Health? No, Ohio State. Okay. are another advocate and champion pushing for this, but there's regulations that prevent it from being brought forward. So it's a state-by-state basis, unfortunately. So it takes a lot of push from both sides, not just us pushing it, but the individual health networks that are championing this. And the other thing, not only is it You mentioned that discharging patients after, or not even discharging them and keeping them in a bed, which is obviously a very expensive outcome for everybody. Parking's a challenge. And so we've had people ask us, can we put lockers in the parking garages or other places that are more accessible to patients for distributing?
Mary Catherine (MK) Shealy, PharmD: I'm not ready to do that yet.
Erin Evans: Yeah, that seems like... That's a bit much for me. We weren't either. For the record, we weren't ready to do that either. But the ask was valid. Like it's, you know, it's, you have to park, you got to walk a mile to get, you know, you get lost in these hospitals. So the closer and easier, more accessible, probably not in the garage would be, you know, maybe not too accessible, but you know, yeah.
Anne M. Richardson, MBA: So I have a comment. So if we look at the topic of this, the inpatient experience, and I have many examples of this, but patients can have a wonderful inpatient experience, the nursing, the surgeons, the operating room, radiology, and so forth. So when that survey goes out for Press Ganey, and I've had these conversations with people who monitor these statistics, but also patients when we've done operational improvements, The experience for the patient from their perspective could be, let's say, five star until the discharge. Yes. You say, what happened? The discharge was delayed. Regardless, it doesn't matter what the delay was. But if the delay was so bad, they actually stayed an additional night. But the patient was already communicated that they were going to get, we're going to try to discharge you, Mr. So-and-so, by noon tomorrow. So then that patient... has a conversation with their family, they're readying the home, they're readying the ride, all those things, all those logistical things, and then that doesn't happen. That will take your five-star rating for patient satisfaction and go right down the toilet. Conversely, interesting when we talk about state legislation, Certain areas of the country, certain states and certain regions of states have incredible bed capacity challenges. Why? Because hospitals are closed. Hospitals have closed services because they lack physician specialists and whatnot. So right now, currently, I'm in Massachusetts and in Boston. We had bed capacity issues at a lot of our hospitals because neighboring hospitals in the state of Massachusetts, but also in other New England states, Rhode Island, Maine, New Hampshire, for example, there's incredible leakage out of those states. So they go into Boston. So when you have a hospital trying to run an emergency room and you've got borders and so forth and patients that legitimately need to be admitted, um, That's a huge reason why logistically we need to smoothen our flow and get patients out of a bed if it's deemed medically safe, remove all those barriers for why we can't discharge them in a timely fashion. So I'm a huge, huge supporter of that. There's no reason to have patients in bed an hour longer, let alone a day longer, because we can't get them what they need to go home safely. And in this discussion, it's medications.
Megan Billingsley: I was going to say, Anne, that really is a great point because we do often think of patient experience sort of in a silo, but there are so many moving parts that go into delivering excellent, seamless care. So when you strengthen your operational efficiencies or make life easier for clinical and non-clinical staff, you're delivering a better patient experience as well. So thank you for getting into that. Now, I know our viewers are keen to learn more about how to turn these insights that you've shared into action. So what steps can healthcare leaders take to use shipping and mailing to enhance their patient experience? Anne, why don't we start with you?
Anne M. Richardson, MBA: Well, I mean, so we need our leaders, our frontline managers, mid-level managers, right up the chain of command to the C-suite to understand and vet what the solutions are, understand them, and what's the value add to our care team. One of the challenges that I know, because I speak from experience, but it's even more of a challenge today, is that the bandwidth of our leadership is such that Erin spoke earlier of the breadth of a campus, let's say, for a health system, but health system leaders now are managing multiple hospitals, and in some cases, across state lines. So imagine being those leaders responsible for the logistics. So we need to just make sure that we vet our solutions with the people who are actually providing the care, in this case, whether it's a direct patient care provider or the pharmacy and so forth, and talk about these solutions and get buy-in and educate from the stakeholders to be able to make sure that if we're going to be spending the investment of both time and money, that it's actually effective. effective for all stakeholders and that it's properly communicated and that we get buy-in.
Mary Catherine (MK) Shealy, PharmD: Yeah, I completely agree. I think one of the things that does that, though, is kind of what Erin mentioned earlier. The less clicks you have to do, the less extra, the more integrated it is into the process, the more likely, number one, people are to get it right, the more likely that people are going to use it to its fullest capacity. Making sure that our staff understands how to use it and how to trigger it so that it does enhance the patient experience is I think is really, really important. My staff does not like to do a half a second more than they have to to get something out the door because we're shipping so much throughout the day. I think that's really important. I think also something that we've talked about a lot, Aaron, is the analytics behind it. So we need to be able to analyze the patient experience that we're having. Hey, is there a particular zip code where we have more undeliverable packages? Is there a particular patient population or whatever it may be, a drug? that tends to get returned more often. Those kind of things are things that we need to do better with and we need to have better solutions for because it's great. I can track the number of packages that I get out. That's good. But what would be amazing is if I knew that those actually made it to the patient, the percentage of time that they did. And honestly, those are things that you have to have for specialty pharmacy accreditation. Those are ones that you have to have for particular things. That goes back to the C-suite for me to say this was a good investment that we made We had issues with drugs. So we all know that USPS is not the fastest carrier out there. And we were sending some temperature specific items and they were making it. So you also have to put like this little tag in the box that tells you, hey, it made it to you at the right temperature. It wasn't making it in time. So we had to shift and now have to send that through our like same day courier service that we do. But had we not had that ability to kind of go back to the patient and say, hey, or if the patient hadn't called us and told us, we'd still be sending things through USPS and patients would be getting drugs that are no longer viable.
Erin Evans: I think that there's still opportunity even beyond that. There are, you know, key indicators that There are things we could do more of through analytics. So there's key indicators that something is going to be late. And if the carrier hasn't scanned it within a certain period of time after the label was created, you know before it's even left the carrier's warehouse if it's going to be late or not, especially if it's temperature controlled. So being able to have the heads up alerts and analytics to dig in and without having to hear it from patients later to be able to look preemptively at your network health. And network meaning logistical network, I suppose. I think there's a lot more insights that can be surfaced. Now, we have analytics products, of course. I'm just thinking from the perspective of what do you need to know. You don't need to know that it got there on time. You should assume it would. You should know when it's not going to be. And, you know, the red alert kind of scenarios.
Mary Catherine (MK) Shealy, PharmD: Well, then I can preemptively do service recovery or I can preemptively make sure that I send out a new one to the patient so that they are not late on their therapy. Like we're not talking about, you know, the dress that you ordered from Amazon. We're talking about somebody's drug that keeps them out of the hospital. Like this is a big deal.
Erin Evans: Yeah. Yeah.
Anne M. Richardson, MBA: Well, and I think that there's, not think, we know that there's value in systems that can give us real-time logistics. So if you're a manager, for whatever reason, you know, if you look at a process and you are able to look at in real-time a dashboard on what's going on in your area, right? for multiple inpatient units, multiple hospitals, whatever the case may be. We know we have the analytics, but the more we can have real-time, it's not to say that somebody would need to monitor it 24-7. Let's say pharmacy, in this case, you would, but over pharmacy. So as you go up the chain of command, there's value in people being able to, for when they need it, for whatever the reason is in that moment in time, to be able to go into a dashboard and have real-time that things are flowing. not to mention that it validates that we're doing the right thing and we're going in the right direction.
Mary Catherine (MK) Shealy, PharmD: Yeah, and it helps me with my staffing. Okay, I know Mondays and Tuesdays are big days. Let me add an extra person there, but reallocate them on Thursdays and Fridays because they're not needed in that space, but hey, my retail location that's pushing out discharges, they need an extra person. So being able to kind of see in tandem my shipping dashboard with my Willow ambulatory dashboard in terms of supply and demand would be really, really helpful.
Megan Billingsley: Yeah, these are all excellent points. And MK, I love what you're discussing here about how it even helps with your staffing. And you've been through it, trying to figure out what works best. So can I ask you to share more about what Grady Health System considered in order to find the optimal solution?
Mary Catherine (MK) Shealy, PharmD: Yeah. So We vetted a lot of people. So we had one system, again, that we went live with during COVID. They were fine. I mean, again, it got it out the door. That was about it, though. We knew that we wanted something that integrated with the health record because before we had two separate systems, meaning providers and clinical pharmacists, even our pharmacy team themselves didn't have really good access to know if patients were getting their stuff. So we knew we needed that integration in. we also knew that we wanted to be able to let patients know that things were coming in the way that they wanted to do that. So a text message or an email, not just having to call us and say, hey, I put in my refill three days ago. Where is it at? Have you even sent it yet? We wanted that to be a push out to the patient. And then, honestly, the first time that we met with Aaron and the first time that we met with the Pitney Bowes team was they got us kind of understood. I remember vividly, Aaron, I hope you don't mind me sharing this story. I remember vividly on our first call, we were talking about audits and he was like, Oh yeah, no problem. We keep records for seven years. And I was like, Oh my gosh, this guy knows pharmacy. He understands what we deal with. So I immediately felt more comfortable about the solution that we were going to go with because not only had they thought ahead of what we needed, but they had solutions to problems that we were having with our other, um, system and integration, well, lack of integration that we had before.
Megan Billingsley: Excellent.
Erin Evans: Thank you so much.
Megan Billingsley: Go ahead.
Erin Evans: You know, I have to give some credit to Epic here as well. When we did this integration, I'm pretty sure we were the first, maybe the only, and it was very difficult. It was not easy. It was very technical because this is where e-commerce and healthcare diverged greatly. The security and authentication just to get access into the systems, being able to see what we need to see but not see anything else, to satisfy our own very cautious legal team, to learn the language of their systems and what each of these things mean and mentally transcribing them into things that internally people around here understand was a really long process. I think Epic was actually really great to work with in putting this together because they were learning with us. You know, they're not shipping company either.
spk01: Yeah.
Erin Evans: So that's something, you know, I didn't know much of this coming in. And that's where a lot of the learning process started was actually working with them on the technical side of things.
Megan Billingsley: Thank you for sharing that. So we are nearing the end of our discussion time, but before we turn it over to some questions from our audience, I'd love to know if there's any additional thoughts that you'd like to share. So MK, why don't we start with you?
Mary Catherine (MK) Shealy, PharmD: Yeah, I think in my 15 years of being a pharmacist in healthcare, it has grown tremendously. I remember being an intern at a retail location and it was, you know, come pick up your drugs or bust. It was, you know, you need to give me what I need and you need to meet me where I'm at. That is not how we function anymore. We are all about information. We are all about the sharing of that information. And I think we understand as a healthcare team now that it's way more collaborative than it used to be, meaning we need to meet patients where they're at. And that's the same as far as it goes with any pharmacoequity that we're talking about, be it transportation to get your meds, be it you know, the ability to communicate in different ways. And so it's really important to understand where your patients are at, what their needs are, and then the ability to meet those needs. It's not up to me anymore to say, this is the box, you fit in the box. Our patients are pushing the boundaries and they're helping us be really innovative with the things that we need to do because it's all about making it so that our patients can be successful with the treatments that they're on. And it's really exciting. We're at a really, really exciting point, I think, in healthcare.
Erin Evans: I agree. Just as a, you know, I go to the doctor and pharmacy a lot myself and just little things that you know, I get an intake form on my cell phone so it can pre-populate my name and address and email. So I don't have to type it all out or write it. I can't even read my own handwriting. So having to write it out in the, in the, in the waiting areas, it's a nightmare, right? So, so like getting, getting some of that stuff digitized and just more convenient for me is, is just as a patient definitely a better experience. So I hope I never have to fill out another form by hand again and,
Mary Catherine (MK) Shealy, PharmD: We do too, apparently.
Erin Evans: Yeah, yeah.
Mary Catherine (MK) Shealy, PharmD: You can't read your handwriting.
Erin Evans: Exactly, right. I couldn't read it, so I don't know how you would.
Anne M. Richardson, MBA: So I have a couple of thoughts. Listening to MK's excitement about the progress that you're making on behalf of patients and patient satisfaction is really important. But as an administrator who is a lay administrator, non-clinical but clinically savvy, I always view our jobs is to develop, build, and sustain that infrastructure so that the direct patient care providers and care teams can do their job and have that enthusiasm. So we do shoulder and we should shoulder some of that pain of building, hiring, and getting the executive leadership to understand, you know, the need for more space or more staffing or whatever the case may be, and also solutions to So there needs to be that partnership between the administration and the care team. But I also want to say this about solutions. Today, as you all know on this panel, there's a lot of noise out there. There's a lot of startup companies and a lot of companies out there. That, you know, it was before the pandemic, but then the pandemic brought a lot of people that came in and said, here's an opportunity for us to fix all these pain points. Very well-intended groups and companies. But at the end of the day, when we as leaders in health systems have very little bandwidth, not to say that all the – companies out there that have been around a long time are the best solution because there could be new entrants to the market that can challenge them and be better. But in the meantime, it does make sense to go to the subject matter experts, whether it's the subject matter expert consultants, but also subject matter experts in the companies that we choose that we're going to vet. And certainly there's going to be some new entrants that, you know, might be those companies that have been around a long time. But so, MK, it doesn't surprise me when you say that you've vetted. And I'm not here to plug, you know, any one company or speak against another, but just speaking from experience, if I don't have a lot of time, And I'm going to look at five companies. I'm going to look at maybe a few new ones, but I'm not going to look at five companies that are looking for a beta site and their startups. I'm going to be looking for tested companies that can come to the table and say, you know, that's a really good question. But they've been around for so many years. They've got a development team that can help tweak that, that pain point and develop it. And actually implement it. And I love Aaron's point about what a great partner Epic was. And again, I mean, I've worked on Epic implementations as well. And I know a lot of providers who don't like Epic. I'm not saying I love it or I hate it. But on the other hand, you want to work with a partner that. is, you know, humble enough that they're going to come to the table and learn so that the next client that comes along, whether it's an Epic client or it's a Pitney Bowes, you all partner together and for the benefit of patients. And in this case, patient flow, which is really what ties into patient satisfaction is the throughput.
Megan Billingsley: Absolutely. Absolutely. I think that is the perfect place to wrap up our discussion. So thank you all so much for sharing your expertise. And I know our viewers are coming away with lots of ideas on how shipping and mailing play a key role in patient-centered care. Before we wrap up for the day, I do have a few questions from the audience. So we'll work through as many as we can. Erin, the first one here is for you. You had mentioned about driving innovation every day. So which technologies and capabilities are just over the horizon that you're most excited about?
Erin Evans: Oh, man. I could get accused a lot of indulging science fair experiments. So there are always things that I get excited about. I mentioned RFID earlier is exciting to me. There has to be some commercial hook in it for me to get a company to turn on a dime. And there's a lot of, you know, you have to have a groundswell of demand, I suppose. So I'm more fixated on on the smaller things, like just making things work better as they are. Um, again, just reducing clicks. Um, you know, right now I really like, I really like having our products interoperable with their technologies so that there's less, honestly, it's just, it's better experience for them too. Like if you don't have to have. Um, a huge professional services engagement to set something up and turn it up and get going. What we built with Epic, it can scale down too. So it's built hypothetically to be self configurable. We've never really gone there, but that would be an interesting, you know, there's a lot of healthcare organizations that just don't have budget for, you know, but they still have a need. And so I'm interested in how do I democratize or take these same things and make them less costly to implement and, and, and service, if you would, so that more companies can take advantage of them. We talked about Epic today, but there's other integrations besides Epic that are very similar, if you would. But just expanding that access to make it easier for our customers to become our customers. even if they're small. So we mentioned independent pharmacies. I get asked a lot about, what about a popular one is Pioneer Rx, for example. Well, you have to go about what you build for that particular audience. It has to be built a certain way, and it has to be sold a certain way. It wouldn't be very cost effective, I suppose, to have salespeople knocking on doors at a small independent pharmacy. But they still have a need. and they need to be met. So how do you make those things secure, safe, reliable, easily installable so that it can get up and running faster and honestly cheaper so that they can afford it? It has to be right sized for the right audience. So I guess I'm less interested in newer technologies and more into just expanding access to two of my products, my company's products.
Megan Billingsley: Well said. Thank you. Our next question here says our health system wants to invest in innovations like the lockers you discussed, but we're running into challenges with regulators. So in your experience, how are other health systems handling these conversations?
Mary Catherine (MK) Shealy, PharmD: Yeah, I'll jump in on this one. So we are walking this journey right now. The way that we are going about it is number one, figuring out what the hangups are. So for instance, in the state of Georgia, we have to, pharmacists, a pharmacist has to offer to counsel every patient. So how would we do that? Or in – so South Carolina walked this road five years ago-ish. One of their issues was, again, safety, security of controlled substances. So how do you address that? How do you write policies and procedures around that? Can you get in front of your board of pharmacy in our case and say, hey, look, we'll pilot it for you. We will get one of these. We're writing all of our policies. We will do this. You come in and have conversations with us. We'll give you whatever information that you need. But I think identifying the why that they have a no – is really important because then you can turn that no into a yes. But it is, it is a challenge. I am not going to say that it's not hard. We've been working on this for a really long time. But I think again, understanding that the lockers in this instance or other innovations that you're going for and what the capabilities are with whomever you're working with, I don't want to over-promise and then not be able to deliver to the board of pharmacy. So understanding all of those things, I think also makes it really, really helpful to kind of get the right people's ear and have those conversations.
Megan Billingsley: Excellent. Thank you. Next question says, with sending, automation can help streamline some steps in the workflow. So what steps can health systems take to identify potential sources of human error in sending and address them accordingly?
Mary Catherine (MK) Shealy, PharmD: Yeah, we deal with this, unfortunately. There is human error that happens in anything, especially when you are doing a repetitive process like shipping and mailing. It is really easy for someone to kind of just get on autopilot. So first things first that we always do is we teach the STAR method to all of our staff. So stop, think, act, and then review what you're doing. It's one of our high reliability principles that we teach our staff. But again, there is certainly still that autopilot that happens. To us, the amount, we try to be very intentional with the hard stops that we put in. or with the alerts that come up because we also know in healthcare, alert fatigue is very real. So making sure that we identify, in our case with our medication safety officer, have an outside person come in and look at the process. That was really important for us because I understand it, the tech understands it, but if someone else is coming in and they're identifying, oh, hey, wait, you're scanning this when really you could be inputting it or you're inputting it, but really you could be scanning it, That made all the difference in the world to us in changing a couple of things, which has made us so much more reliable and so much safer for patients. But getting that outside input, I think, was really, really helpful for us.
Erin Evans: That was a star method. Is that what you, is that, what was the A? Was that act? Act.
Mary Catherine (MK) Shealy, PharmD: Yes. Got it.
Erin Evans: Okay.
Mary Catherine (MK) Shealy, PharmD: Stop, think, act, review. Yes. It's a really good one. We do it in all sorts of aspects of healthcare, but it, you know, we all need to stop and just take a minute. And then, especially before you're sending something to a patient that could be completely wrong.
Erin Evans: Got to get it right. Yeah. We just encountered a scenario at a different, um, hospital network where they had accidentally sent the wrong medicine to the wrong patient because they I guess took a lunch break or something in between like filling an order and then came back thinking the other order was complete and so they put the next label so I you know they were challenging us to come up with ways to prevent that from ever happening and so you know that's obviously a process thing but humans when they get into a pattern can lose track of the inputs and outputs very easily. And once you do, everything that happens after that is in error now, too, because you've created this down. Once you start putting the wrong label in the wrong package, every package that comes after it will probably be out of sequence, too. It comes up all the time. So I don't know what the solution is to that, but we've got a couple peers of mine internally looking at ideas that we could. We want to make sure we can solve for that, but we also don't want to introduce additional steps that just make it more laborious. So it's a balance. And that balance might come with some risk.
Megan Billingsley: Good point. Thank you very much. Our next question here is for Anne. They say, I loved your point on the importance of buy-in from frontline workers. What can leadership do to get staff on board and make the rollout a success?
Anne M. Richardson, MBA: Well, so I think it's the culture of not just for one solution or technology that comes along to solve a particular pain point, but the more we can have a culture of, you know, a lot of people talk about psychological safety, where people can be creative and innovative, you know, at any level of the staffing to be able to share ideas. And, you know, more of a bottoms-up approach in terms of solutions and what ideas do the people that actually do the work, what ideas do they have, and then they take it up to their management and so forth. So when you have an organization that's top down, let's say, and even it could be the most transformational solution that's out there that seems like, oh, this should be easy, but you might get pushback. And it's not because people aren't keeping their eyes and ears open to what their solution, but People do better when they're not talked to or they're mandated when they're actually part of the solution. So, again, if people understand the benefits of it and it's a culture where they're included and their voice matters, buy-in is a lot easier and implementation is a lot easier.
Megan Billingsley: Excellent. Well said. I think we've got time for one more question, so we'll finish with this one. Patient expectations are evolving quickly. So with that in mind, what do you think the ideal shipping and mailing capability will need to look like in five years to meet patients' demands? Aaron, you want to tackle this one?
Erin Evans: Yeah. You experience it every day. I mean, Amazon-like delivery, the ability to modulate the speed of that delivery, to be able to watch it like a pizza tracker coming on your phone, all Where do they put it? Is it in my mailbox or is it behind the mailbox? Sometimes it doesn't fit in the mailbox if it's a large container. And do they put it somewhere safe? Or maybe if I'm not home, I don't want them to put it there. So coordinating the delivery is a big deal. I can envision there's still a lot of opportunities to just make that that experience more secure through things like lockers or where instead of leaving it in a mailbox, which actually is not very secure at all, having them come to pick it up somewhere not only has some security advantages, but it actually reduces the overall cost. Now, as a patient, I'm not thrilled to have to go in and pick up my medicine versus get delivered, but I myself have to go pick up my medicine. They don't ship it to me for some reason. And I have to wait in line. And most of the times it's just a benign antibiotic or cholesterol medicine or what have you. And it's a maintenance dose. So I've been taking it for years. And so why do I need to wait in line behind all these people? And then they swipe your card and it's three cents after your insurance has covered it. It's like three pennies. And I had to wait in 30 minutes and um i think locker experience in those scenarios would be a massive improvement not in all scenarios if it's a brand new medicine that i do need console you know that probably needs to go to the line but um there are new technologies coming out i mean um telehealth and things like that have been increasing you could potentially be at the locker and they phone you on your you know your your um your facetime or what have you and um
Megan Billingsley: and consult that way i think there's a lot of opportunities where technology is already coming into play in other aspects of our lives that would just be extensible in in healthcare as well excellent thank you so much well that is all the time that we have for today i'd like to thank our speakers ann mk and aaron for a great discussion today we appreciate you sharing your insights with us and i'd also like to thank our audience for joining us today we hope to see you again soon have a great day
