Pharmacy done differently

We've got technology that overlays that layout and facilitates having pharmacists on the floor at all times maximizing the impact that they can have with their patients. I'm really proud of the model that we've created and I can't wait to have a chat to you about it today. Carlene.

Nobody's really looked at the way that a pharmacy's laid out and gone, oh my gosh, why do we do all of this work all around our dispensaries? And we have all these people working in such a small cramped little space trying to provide counseling to patients. I think one of the challenges is our current environment that we work in.

Another challenge is that our technology, whilst there has been some improvements in the technology space, we haven't really got any enablers to let us work more efficiently and effectively. And then also pharmacies don't really have any private spaces for patients either. So I think that's a big challenge is that we're wanting to do more, but we're trying to do it at a shop counter. So that's not ideal at the moment.

I guess one of the other challenges that we face is that patients are now consuming their information differently and a lot of people are accessing information online and that's probably not the best way to access information. But also there's so many products now that are available in supermarkets, so that's another challenge that we face in the industry.

But the issue is that then there's all these other patients waiting for their prescriptions in that area and they're overhearing all of those private and intimate conversations. And so it's just you go to the doctor and you have an appointment with the GP and it's in a room and it's very professional and it's private and you're talking about sensitive health information. And then we as pharmacists want to talk in our communities at counters and it

just doesn't work very well. So you've got all this hub of activity in one really small space and it makes it really difficult to be productive and effective at our jobs. So I think that's a big challenge. And then you've got other people presenting for all the different things that they might present to a Scripps encounter to say that they're here for an appointment for a vaccination or that they want to access a prescription that was faxed to the pharmacy.

Just the way that we're set up now makes it chaotic in community pharmacy. And I've walked into lots of pharmacies recently and pharmacies that aren't doing large script volumes, but it's just feel like it's chaos. And I feel like a lot of that is owing to the way that our pharmacies were set out and how have we morphed into the way that we practise now.

It's really just morphed into that over time, and we've tacked on a clinic room here and a clinic room there, but just adding something doesn't necessarily solve the problem, if that makes sense.

So when you walk through the door, you don't see a sign that says scripts in, you see a sign that says 'Care starts here' because we want pharmacies to become known for so much more than just prescriptions. We want pharmacists to be known as, I guess the givers of health advice, which we always have done. But so you walk in the door, you see a triage desk, so a triage desk is where we can input the patient into our system

so we can input lots of different things. We can input appointment types, we can input a minor query, we can input any consultation with any type of prescription. And then at that point when you walk into the pharmacy, you'll see that you can't actually visually see a dispensary. So actually the dispensary is sort of hidden away out of the sight of the patient. So that can become the hub of where all the dispensing gets done.

And then there's also little pods, which are basically tiny little consult rooms, much smaller than a traditional bigger clinic room, but they have a chute for dispensing robots so that the pharmacist can take the patient there and directly dispense with the patient. So Complete Care Pharmacy's point of difference is that you've got a triage area, you've got these little pods that medication can be dispensed with the patient, and then you've got a production area.

There's also other little areas of check-in. So we have self-serve check-in areas, and we have pharmacotherapy check-in spaces where patients that are on the pharmacotherapy program can enter themselves in. And I guess all of this is facilitated by our digital workflow solution called Excipient, which we created that overlays this layout. It sounds very complicated when I say it out loud, but in practice it works really well.

pharmacists. So the software we've created is called Excipient, and I must disclose, I'm definitely not the person that wrote the code because I'm pharmacist not in that space, but I know what pharmacists want. And so if I could have mapped out exactly what we needed to

tie everything together, that's what we've done. So essentially what it is, it's a way to triage a patient in whether they are walking into the pharmacy, ringing up, having a phone call, tapping through an order, and then creating a digital basket with that patient that can be seen from anywhere within the store. Now that sounds pretty crazy, but let's just give you a real life example. So the patient walks into the pharmacy, they're greeted by a pharmacist on the floor at the triage area

or a pharmacy assistant. It really doesn't matter who it is. And you ask the patient, what are you here for today? And they say, oh, I've got a prescription on my phone, I've got a digital script. I also have some scripts I want to grab that I keep on file. So Excipient means that you can basically log in.

This is in the middle of the pharmacy. It could be anywhere in the pharmacy, but specifically in complete care out a triage desk, we can look up the patient's script on file and scan in their digital script and create a basket with that patient. You can add in multiple patients, so you could add in mom, dad, grandma, you can add in a consultation type. So they might say, oh, so why I'm here? I want to grab a vaccine so you can create a digital basket.

Now at the point in creating the digital basket, we always said to patient, are you waiting or calling back? So we can indicate if they're waiting or calling back. And if they're calling back, we can actually automate an SMS to them when their prescription is ready. We can see real wait times with Excipients, so it lets you know what's in the system and we can tell the patient there's a five minute wait or a 10 minute wait currently, which allows them to make a decision.

And then once we create a digital basket with them, it fully integrates with Fred Dispense Plus. And so that basket goes into the dispensing program and it queues up the patient's basket electronically in order of the priority that the patient's there. So you might have three patients waiting for prescriptions and they're all timestamped, and so it has all of the work that's in the pharmacy in the order that it's due to be done in, which sounds like, oh, Kristina, why is that helpful?

It's helpful because we have all these inputs into our dispensaries from multiple different sources. So from click and collect from that patient walking in, adding in a prescription in the pharmacy to, I dunno, a prescription being emailed through. And we want to be able to order all of the work that we have to do so that it takes away all of that effort that we have to go to every day going, is that a waiter? Are they calling back? Who's next?

So I can have three or four dispense techs working on baskets and everything is queued up according to the priority that they need to work on it. So if someone's calling back in 15 minutes and then all of a sudden 13 minutes has elapsed, that person's basket goes to the top because you don't want them to come back and their order not be ready. It's very hard to explain over a podcast.

In fact, I feel that a lot of people don't really quite understand it until they come and visit the store and see how easy it is to use. So we wanted to make sure that the software was really simple, really easy, faster than what we're currently doing because you don't want to do something if it's going to make the process more cumbersome. So it's way faster, but also the one benefit is that it splits the baskets into where they need to go.

So what I mean by that is if the person's coming into the pharmacy and they're asking to add that digital script and that script on file and they've had it plenty of times before, they don't need any intervention from the pharmacist, it goes into that production area that I spoke to you about at the start,

which is where our dispen techs do all of the dispensing. But if for example, they come into the pharmacy and it's a new medication or they have a question for the pharmacist, it actually queues up the work for the pod pharmacist and then the pod pharmacist can call the patient in and they see their queue of work. So it kind of splits all the baskets up and sends it to the appropriate person at the pharmacy so that you can become more efficient. Does that make sense?

But it's easy to use that promise.

And then I guess I'd probably want to ask about remuneration and how you make sure that the patients see value in it and want to invest money into the services.

So for example, if a patient walks into the pharmacy and says, my son is struggling with constipation, pharmacy system will add that as a basket and the pharmacist will call the patient into the room, they'll do a consultation with that patient and they will write out a pharmacist prescription pad with recommendations. And it's very different having a consultation for health like that for a minor ailment in a pod opposed to doing it in the middle of the pharmacy in front of

the product. When you're in front of the product and you're recommending for somebody, it almost feels like you're selling to them, if that makes sense. When you're in the pod and you're listening to their symptoms and then you're addressing their symptoms and you're providing health solutions in the room, it feels completely different and patients see value in that.

So when you talk about what's our remuneration like in that situation, people are asking us all the time, what do I owe you for that? Because they see that advice that we've traditionally always given a counter in front of the product as a really valuable thing to them, and they're always asking me to pay. We're starting to charge for some of our minor ailment consultations, so we'll charge $15 for a wound care consultation, for example.

We'll charge for, say for example, we might give advice about plant-based medicine and we recommend particular terpenes or something like that. We will charge for that consultation. So it's a lot easier to charge the patient for health advice when you're doing

it in a really clinical setting. So our pharmacists use those pods, but then you're right, we also do have two larger clinic rooms necessarily, well, they're not connected to our robot, but we do have allied health professionals working in them. So we have a full-time nurse practitioner in our pharmacy as well as lactation consultants that help I guess new moms or moms to be with feeding issues. We've got a continence nurse that works in the pharmacy and we also have a diabetes educator.

But what we found is that we had all of these services in our old model, but what we found was that whilst I love collaborating with allied health professionals, it can become quite laborious when you have to, the patient walks in and says that they've got an appointment and you know that the nurse practitioner's someone with them and you have to say, wait,

she's got someone with her take a seat. So your staff end up doing a lot of the reception work when you're hosting allied health professionals in your clinic rooms with Excipient, which is our software, the patient comes in, they go to that triage area, we can create an appointment with them, and then that appointment goes again into that room with that Allied Health Professional.

Mrs. Jones is here for her appointment with the nurse practitioner at 1:00 PM and that person in that room can see what all her body of work is, and she can then call out the next patient into her room. We are able to use that to communicate notes to them in there. So we don't actually use sticky notes or handwritten notes in our pharmacy at all Now. We use it all electronically through Excipient, but essentially, yeah, I hope that answers the question.

We do so much in the rooms and we look for gaps in our community. So essentially what is it that our community needs? And lactation consultants was one of those examples.

script's in sign. And so we were actually very anxious about it, and I remember we said to each other, we'll work every hour that we're open for the first few weeks to see how it goes and make sure patients are okay. And what we found was it took a lot less time than what we thought for people to

be okay with a new model. They were okay with it from day one, and patients are constantly thanking us for this model, and we get so much more out of, I guess the interactions that we have with the patients because of the way that the pharmacy is operating now. So patients don't get a lot of time with their GPS anymore.

They want to speak to the pharmacist, but pharmacists don't know how they can spend time on the floor interacting with patients during the day because they've always had to be the ones to check the prescriptions. So the way that we've been able to address this with our model is that we have a pharmacist who works in that production space, that checking space, and they stay there for that day.

So they answer the questions on the phone for the pharmacist, they check the prescriptions, they check the Webster packs, and they keep the hub of the bulk of the dispensary going and the dispen text to all the dispensing, and then that allows us to push pharmacists. So we have two pharmacists working on our shop floor doing consultations all

day. So whilst it was scary doing something different and new, I think that if you're always focused on health outcomes for your patients, then it's going to pay off for you because people see the value in it. And I'm really proud of our team for embracing it, but it has been actually a very easy transition, much easier than I thought because it's made the software and the layout and the changes made us more efficient.

We actually felt after a few weeks of being open that we've made a big mistake because the pharmacy felt a lot quieter. But in fact, since we've been open, we've had 20, about 20 to 25% growth in customer numbers had huge growth in our script numbers. Our gross profits up about 35% on what it was year before, so we're much busier.

Our actual services income has gone up over 60% since we opened, and so we're way busier than we were, but we are actually way more efficient and we have more time with our patients, which is pretty exciting.

so we can utilize it. For example, as soon as Tasmania was able to do urinary tract infection consultations, we just added a button on triage, and now if a patient comes in for a UTI, the pharmacy system or pharmacist can just click on that button, you take the patient in, you can do the consultation in the pod, go through all the questions, dispense the medication, do the counseling, and away you go all in one hit. It's good. It's exciting.

The last disruptor that we've had was Chemist Warehouse, and that's driven a low service, high volume model in my opinion. I think it's about time that we flip things upside down and we go, we want to prove that pharmacists are integral to the healthcare system. We can help.

We've got a healthcare crisis at the moment where patients either don't have a GP or they can't get timely access to their gp. So the hope is that there complete care pharmacy out there which can fill that gap in the healthcare system. So in every complete care pharmacy we will have will be registered NDIS agencies, which is helpful for communities.

We'll all have access to a nurse practitioner for every hour that the pharmacy is open, which is also amazing for patients and we'll be operating in this manner. My hope for the future is also that we'll continue to innovate and evolve this model. So what it is right now is sort of the base level entry, which by the way, we think is pretty good, but we want it to always be evolving and getting better.

So this is what we're doing now, but come and look at what we're doing in six months time in another 12 months time, another 18 months time, and we hope that we can be leading the way in the pharmacy industry. We're definitely not scared of change, and we think that the way that we've got it set up now allows us to integrate and add anything that we need to on for our patients, which is exciting. I hope that explained it. Okay. It.

dispensing the pods. But in our production area, it's a dispensed text and we think that pharmacists are sometimes a wasted resource being in the dispensary, just typing away at the computer and printing out labels. So we are upskilling our pharmacy assistants to do more teching roles. Our techs are also being upskilled to do other things like compounding. So we are a compounding pharmacy and our dispense techs do all of the

compounding. It's not done by a pharmacist, obviously everything's checked by a pharmacist, but the tech does that. They run the packing area of the pharmacy. They do all of our claiming, they differ in our prescriptions, they go through the email. So they do a lot of the jobs that previously our pharmacists were doing that pharmacists don't add value by doing that. They add value by having one-on-one consultations with patients and providing health advice. So that's what we did.

We've also upskilled our pharmacy assistance through NDIS training. So what that means is that we can provide patients with medication packing on the NDIS consumables on the NDIS. We can do things like anything that's a private prescription. We actually do a lot medicinal cannabis and compounding on the NDIS, so upskilling our pharmacy assistants in creating service agreements with patients and looking for ways to assist them in that space.

So yeah, definitely a change in roles has been what we did. And that's probably been one of the biggest changes for I guess our pharmacy staff is yes, there was a difference in the layout and a process, but it's a way to handle the patient.

So no longer are our pharmacy assistants going through all of the questions with the patient when they walk through the door, which I know that's quite different to the way we've been doing things in a pharmacy for a long time, but we feel as though the way that we were doing that previously meant that we were double handling everything.

What I mean by that is if the patient came in and requested something for thrush, for example, and a pharmacy assistant goes through all the questioning and then they have to go and relay it to the pharmacist who's standing in the dispensary, and then the pharmacist comes out and asks the questions again, it takes twice as long and the patient gets frustrated because they ask the

questions twice. So now when they come in for something, our pharmacy assistant will triage them in, create a digital basket, and then the pharmacist will see that the patient's there for thrush. They'll call the patient into the pod, they'll do a consultation, write out a pharmacist's prescription pad for them and then go and grab the products for them and away we go. So it's a lot more efficient and it provides much better outcomes.

Our basket size, for example, from a business perspective, has gone from less than $10 to over $20 OTC in this model, and it's been very easy to achieve that because patients are genuinely, they just want help and pharmacists are there perfect people to provide that help and advice.

patients don't know what pharmacists can do already. Number two, pharmacists are going to be able to do a lot more, but if you've got pharmacists standing in a dispensary, checking prescriptions and having their workflow interrupted by pharmacy assistant saying, oh, this person's here for a consult for a UTI, and then having to go into a room that's not connected to a dispensary, do a consultation and then head back to the dispensary to dispense medication,

that sounds very inefficient to me. So the way our model works is that the patient will present, they'll be triaged in for their health need, and then they will be added to the queue for the relevant person, and then they can go in and do the full consultation dispensing everything within a pod. I think it'll be seamless. Well, it is seamless for us already. So I'm actually really excited for what 8CPA is going to bring to community pharmacy.

And I just think that we need something like Excipient and Complete Care to be able to facilitate that easily for pharmacists because pharmacists want to do like oh, far out, we want to do more to help the system. But a lot of pharmacists that I speak to, I just already bogged down in the day-to-day operations and running of their business and their pharmacies that they don't know how they can possibly do more. So hopefully we've got a good solution for pharmacists out there.

our pharmacy assistants. Big training is a big part of it, innovation, and we want to continually evolve the model. And that's really important because that's what we wanted to achieve with Complete Care Pharmacies. If you walk into my pharmacy in Hobart, you get the exact same experience as when you walk into one in Queensland or New South Wales.

So I'm really proud to say that Complete Care Pharmacy is not a brand that's necessarily aligned with a wholesaler, but it's actually a brand that's created by pharmacists for pharmacists and has an amazing team behind it.

So that can sometimes be cost prohibitive for people, but I think that if they want to make a change to the way that they're practising anyway, and if they don't want to do something like Complete Care, the best piece of advice I can have is to connect with your local community and find out what it is that they're needing.

What is it that your local community is after? So the reason, for example, that we've decided to integrate nurse practitioners in Complete Care is because patients were running out of prescriptions and they weren't able to get in to get repeats from their GP in time, or they were coming in for something that was very obvious that, for example, that they might have shingles or that looks like it's an infection that looks

like it's cold sores. And people were saying, well, that's great, but I don't have a GP, so do I need to go to emergency for something that's relatively minor. And so connecting with a nurse practitioner to be able to facilitate that in our pharmacy was important to me. So I think looking out for gaps in your community and then trying to fill those gaps is really important. They could start by becoming registered with the NDIS. I think that that has huge opportunity for community pharmacy as

well. So there's lots of different things that they can do, and I'm actually very happy for people to reach out to me if they want some inspiration within their business, even if they don't want to do this model. Because I personally love seeing people's businesses thrive, and I love seeing people being able to help the patients in their community. So I'd love them to reach out to me regardless of what they want to do with

their business into the future if they need a little bit of inspiration. You might be very busy. I don't mind. I love being busy. I love it. Well, I love community pharmacy and for me, a big reason why we did this is that I've been concerned for community pharmacies longevity. You can see that patients can access so many things online nowadays. They can do their shopping for pharmacy online.

I don't know if you've taken a walk down the pharmacy aisle in the supermarket recently, but there's so many of our products, they're in supermarkets now, OLS there, Voltaran gels are there. It's actually quite scary Zyrtec, it's quite scary to see what's in the supermarket at the moment. We're one step away from having community pharmacy going into supermarkets, and we have to demonstrate, I guess, our wealth of knowledge and demonstrate why it's so important that community pharmacy exists.

One thing that we've got with Excipient is we've got the ability to measure how many consultations we do in a day and what type of consultations we do do. And that has been fascinating. So on average we're taking in around 250 to 300 consultations a day. So patient consultations a day, and we can actually see with our metrics exactly what consultation types they are. So is that minor ailment advice, what type of minor ailment advice is that for a medical certificate?

Is that for a vaccination, is that for a new medication? Is that for a packing query? So we can actually delve down into those sorts of details. We can see exactly how long that consultation type is. So on average, actually I asked last week what our average consultation time was, and it's six and a half minutes per consult at the moment. And we can also see all of the metrics for how long our prescriptions take.

So I can see how long it is from the point of input at triage to the point that it comes out. And at the moment it's six minutes and 25 seconds in our current model. So being able to use Excipient for that is also incredible. Being able to take a patient into the pod and see that it's a new medication and schedule a follow-up consultation with them, there's just so much we can do in pharmacy. We've just never had the ability to do it or to measure it. And so yeah, love that part of it too.

They've just often when they come into a pharmacy, they've had a diagnosis from a doctor or a specialist, and we're that first point of call to pick up that medication. And I think we haven't been set up properly to handle this for patients.

And so what I wanted to mention was even if you don't decide to do a model like this, try and set your pharmacy up in a way that enables you to have more private consultations with patients and try and take them in clinic rooms for counseling and medication advice because patients really need us as pharmacists to be there for them, but they're not going to open up and disclose stuff to you at a counter.

And since we've had our new model, we've realized how impactful these rooms have been for patients to feel like they can chat to us. Probably doesn't make sense what I'm saying, but I think I'm just trying to say that people that come into our pharmacies, they're very vulnerable, they need time with pharmacists, let's try and set up our pharmacy so that we can facilitate that for them. Yeah, hope that makes sense. It.

So I guess what I'd like to say is as you go on your journey and as you continue with the franchises, it would be great still to reach out to you and see how things are going for you in the future and how the ING going, because I think it would be great for the audience to kind of hear with a CPA

coming out, so I'll take it a difference. But with a CPA coming out, I guess people see benefits with compensation and getting remunerated for some of the things they've done in the past, but maybe not looking towards the future and how they can better utilize it or prepare for it now. So I guess that's what my focus was, was interviewing you so that people could kind of think, well, all of these opportunities are coming up. How has someone done it and how can I prepare myself or better put

myself in a position to be able to deliver on these? So I thought.

to your point. But also, we're not as pharmacists. I don't feel like we're really at the moment taking up the opportunities that we already have. We call our front of shopping complete care, our front of practice, because we have all of these things at our fingertips that form our practice. What I'm trying to say is a lot of patients don't already know what pharmacists can do. They don't realize that pharmacists can essentially prescribe for conjunctivitis.

They don't realize that pharmacists can prescribe for head lice or for constipation. So these are things that we are already doing now that a lot of us aren't doing well, in my opinion, that we could do better and we could capitalize on what we've got at the moment. And then 8CPA, just the cherry on top, but you've got to be set up and ready to be able to take those opportunities and then make the most and maximize those opportunities basically. Yeah.