We had the pleasure of sitting down with David Bush, a Outcomes® telepharmacy customer and one of the first telepharmacy operators in the state of Indiana, to talk about his journey from when he first learned about telepharmacy, to how he implemented it to grow his business and serve more patients.
How long have you been a pharmacy owner, and when did you first hear about telepharmacy?
I opened my store in 1997 in Greenfield, IN. I bought the land and built the building, and started from scratch with no prior customer base.
I first heard about telepharmacy a few years ago at the Cardinal Retail Business Conference (Cardinal Health’s annual trade show). I ate lunch with a gentleman who was operating a couple of telepharmacies and went to a session where a pharmacist gave a presentation about his experience with telepharmacy. I started learning more about how it works and was allured by the idea that I could serve more patients and expand my business in a way that was sustainable in a low-volume area.
Nearby Morristown, IN contacted me in the past asking me to bring a pharmacy to their town. They used to have a traditional pharmacy, but the low volume of prescriptions filled there couldn’t sustain it. At the time I told them that there was no way I could make the numbers work to open a pharmacy there. After I heard about telepharmacy, I began to think it could be a great option for Morristown.
In July 2018, the state passed legislation that allowed us to practice telepharmacy in Indiana, and we jumped right in. We are the second to get our telepharmacy approved in the state.
What factors led you to believe that telepharmacy would be a good option for you?
Growth for pharmacies anymore relies primarily on reducing costs. In today’s world it’s nearly impossible to increase your revenue on prescriptions. The only real option for growing your business is to reduce costs as much as you can.
Telepharmacy made a lot of sense from the standpoint of reducing the cost of production in areas that didn’t require as high of volume.
Tell us about your partnership with the hospital to expand healthcare services to Morristown. What is that experience like for patients?
There used to be a clinic in town, but there weren’t enough people in town to sustain it. They put a kiosk in the clinic to provide telemedicine services, but were still paying staff to monitor the kiosk operations which wasn’t sustainable.
When we decided to put a telepharmacy in Morristown, we partnered with the hospital to have the telemedicine kiosk within the pharmacy.
Now patients can come into the pharmacy, talk with providers from the hospital via the kiosk, the doctor can submit the prescription to the telepharmacy and the patient can get that prescription filled right there on the spot. It has been very beneficial for the patients because now they don’t have to drive the 20 miles to visit their doctor and get their prescriptions. We really have become a hub for patient care.
The telepharmacy is really a win for me, a win for the hospital, and a win for the patients in the community as a whole.
What do you say to the argument, “I don’t need to open a telepharmacy in (nearby town) - those residents already come to my pharmacy anyway?”
I’ve been here in Greenfield for over 20 years now and can tell you confidently that I don’t have all the business here in town or in the area of my pharmacy.
I’m missing out on people even here in my own town, so the chances are good that I’m missing out on potential customers in Morristown too. There’s a much greater probability that I can capture a portion of those customers if I’m right there in town. I think, quite honestly, you have your head in the sand if you think you’re getting all the business possible from a nearby town. You really need to be there physically and be a part of their community if you want to really get their business.
Would you recommend telepharmacy to others? What would you tell someone considering telepharmacy?
In low volume areas, telepharmacy is a stronger model than a traditional store. Since these areas don’t have enough prescription volume to sustain a pharmacy with a full-time pharmacist, a telepharmacy is a more financially viable option. Also, if you start with a telepharmacy and build up your business, you can always add a pharmacist into that location once you get up to a sustainable script count.
The telepharmacy model allows pharmacy owners to work within the current parameters to operate at a lower cost while increasing the value to customers.
People are always saying that telepharmacy takes pharmacists jobs away, but that makes no sense. You’re taking pharmacist’s jobs by not putting a pharmacy in that nearby town. We are serving more patients and need a pharmacist to check prescriptions and counsel those patients. Telepharmacy increases the opportunity to expand patient care and keeps the pharmacist’s job secure. Not only that, but it opens up the opportunity to expand clinical services and add more pharmacist jobs in the future.
Even the big players are having trouble sustaining their business and are looking to central fill or other solutions to help their bottom line. It’s ignorant for small players like me to think we don’t need to adapt and change to survive. Telepharmacy is one way that I can continue to provide service and keep business strong.
Why did you choose to work with Outcomes, and how would you describe your experience?
Anytime you do something of this nature, you want to have strong support from the people you’re buying from. Not only was Outcomes telepharmacy much cheaper than any alternatives, but they had a much better idea of what was going on in the market as a whole. A member of the Outcomes team actually came out to help me look for locations in our neighboring towns, even though I was pretty confident we were going to go with Morristown for our telepharmacy.
They even went so far as supporting us when we presented to the state board of pharmacy. One of the folks from the Telepharmacy Regulatory Affairs team was right beside me as we went to the board, which was very important. They know what they are doing, they understand the product and market and see the long-term value of helping you with your business.
They've been an incredibly supportive group. Communication between the stores and strong customer support is important to make sure the anxiety is reduced on our end and Outcomes does an excellent job with that.
But in addition to their customer service, I also really like how the Outcomes software is very easy to learn and understand. I don’t have to worry about devoting a whole 6 months or so to get a new staff member acclimated with the system. I am usually able to train employees on how to use the system within a day or less, which is a big time-saver and a great testament to how well they understand their users and built the product with us in mind.
How do you market your telepharmacy? What do you recommend for other telepharmacy owners?
So far, a lot of what we’ve done has been on social media. My daughter is one of my pharmacy technicians and she’s helped a lot with the marketing efforts. We’ve also presented to hospitals in the area to build awareness for the pharmacy and increase patient traffic.
TV commercials have also been beneficial for us. We have run commercials for our Greenfield pharmacy in the past, so we re-worked the messaging to make them relevant to Morristown.
Something you notice in small towns is that there are usually 1-2 places where people congregate most often. In Morristown, those two locations would be the Dollar General and a local restaurant that is the go-to lunch spot in town. Knowing this, we’ve started to experiment with geo-fencing advertisements (ads will be displayed to people when they’re in the selected locations). I’m excited to see how this helps drive traffic to the store.
How have patients reacted to the technology? Have they taken issue with the fact the pharmacist isn’t there in-person?
Originally I was concerned customers would have a hard time from a technology standpoint and worried they would prefer to have the pharmacist here in person. However, the design of the software makes it so easy for patients, and my concern about the patients not liking the video counseling has been totally unfounded. Most patients use FaceTime now anyway, so they are very used to the concept.
Since a large portion of Morristown’s population is 65 or older, one of our main focuses is to make sure everyone who walks into the store knows they can talk to me at any time.
We make sure everyone knows I am still here as their pharmacist, I'm just here virtually on the tablet. The technician can touch a button to connect patients with me at any time. Patients have been very happy with the way it works. They seem to feel like there’s not a lot of difference between having me there in-person or having me there on-screen.
One patient even said to me, “I actually get to talk to a pharmacist quicker here than I do if I go to [big pharmacy he used to go to].”
What do you think having a pharmacy means to the community?
People are excited to have a pharmacy in town now. I like to get feedback from every customer on what they like and don’t like about their experience so I can find ways to continually improve it for them.
You really have to gain the trust of a small town. The people of the town want to make sure you are what you say you are. It takes time to build that trust and prove yourself to the town, and so far it has been great and the residents of the town really love the convenience.
Like I said, it's really been a win for everyone.
Want to discuss more about telepharmacy or already know how it works, but you're wondering if it's available in your state? We've got you covered on that, too!
