While pharmaceutical waste reduction is a key opportunity for pharmacy’s cost management efforts, this can only be accomplished with timely, accurate inventory data. At Advent Health, we struggled to implement cost savings programs in our various facilities because our returns data was insufficient. Advent Health, located in Altamonte Springs, Florida, comprises 50 hospitals and offers long-term care, physician practices, urgent care, and hospice services. The system employs more than 80,000 staff members with approximately 5 million patient contacts per year.
The Need for Better Data Access
At Advent Health, systems and products are selected when a contract is up for review, or if current systems or workflows need to be re-examined. The latter was the case with our reverse distribution system, as it was a struggle to obtain accurate data in a timely manner. At that time, the vendor did not have a user portal where information could be easily accessed; rather, data on what products were being returned and what products were being credited had to be requested, and then there was a waiting period before the information was received. Sometimes this could take weeks.
We encountered Pharma Logistics at a hospital pharmacy trade show and learned that they offer a user-friendly portal that provides information in real time. Further, Pharma Logistics users can mail in returns versus waiting for a vendor representative to visit the sites to conduct the removal. This feature was especially appealing, as it would reduce both the costs and the time spent on these tasks.
Training and Implementation
Pharma Logistics visited one of our campuses to conduct a demonstration, and the system was well received. As we moved forward with the implementation, they assisted with educating staff on the new system via webinars, videos, and in-person training to answer any questions from our team. With the new system in place, we are now able to maintain products in inventory closer to their expiration dates and ensure that inventory turns are as effective as possible.
The mail return program offered by Pharma Logistics eliminates the need to have a vendor representative visit the facility to process returns; instead, each facility can elect to manage the returns process at their own pace.
Previously, returns would sit in a bin on the shelf awaiting collection from the vendor. This could take anywhere from 2 to 6 weeks, which became a frustration point for many of our facilities. Given that our facility sizes range from a 25-bed hospital to a 1400-bed hospital, each facility’s returns process requires a different level of attention. By utilizing the mail-in option, returns are packaged and shipped as needed, at the convenience of the site’s schedule. This eliminates the need to pull returns on a quarterly basis; instead, those medications can now remain in inventory longer and are pulled much closer to their expiration date. As medications no longer sit for long periods in the returns bin, there is the added assurance that our medication control is now in line with regulatory requirements.
Waste Reduction and Credit Visibility
With continuous access to accurate data, the health system has improved inventory control, and can now effectively focus on drug waste reduction as one of our cost-saving initiatives. The real-time data inspires practice changes and access to reports allows for the tracking of acceptance and rejection information from vendors that can be shared throughout the health system. Having that transparency provides opportunities to investigate why certain items or partial doses are being returned, and most importantly, because this information is immediately available, we can implement practice changes before a problem arises.
Another benefit of the system is that we have become more aware of our waste. Many of our campuses are now conducting medication waste reduction initiatives, so they are encouraged to utilize the system regularly. Further, our credits from vendors can be tracked, unlike with our previous system, which necessitated going back to the wholesaler to find out if and when credits were issued. With Pharma Logistics, the credits are clearly visible, resulting in clear expectations.
Looking forward, the addition of a push report feature would be helpful. Specifically, the ability to receive an automatic monthly report on a given date reflecting the activity of the previous month would be ideal. Receiving that data regularly would support the reporting process to pharmacy directors on the other campuses as well as the health system administration.
With the Pharma Logistics reverse distribution system, our large health system is able to track waste and credits in detail and in real time. Easy access to this data gives us the information we need to fine-tune inventory management and reduce waste system-wide. The customer service at Pharma Logistics is responsive and the training programs are thorough. Further, the standard quarterly check-ins, regardless of system status, ensure that the program continues to work effectively.
Richard Montgomery, BSPharm, MBA, is the pharmacy contracts and operations manager at Advent Health in Altamonte Springs, Florida.