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About SMP Pharmacy Solutions

South Miami Pharmacy (SMP) was founded in 2003 by Dr. Armando Bardisa with a goal to improve the quality of life for their customers and patients through personalized service. In order to provide customized service for their patients, SMP offers hard to find medications, compounding services, one-on-one fertility specialists and medication therapy management for specialty pharmacy patients.

Background

Serving patients in most of the 50 U.S. states and many international countries, South Miami Pharmacy rebranded itself as SMP Pharmacy Solutions in 2015 to better reflect their global services. Considering that they ship approximately 10,000 prescriptions each month from their 2 Miami facilities, many to South America and Caribbean locations, safe shipment of temperature-sensitive products is particularly critical to their focus on patient care and quality.

Fertility treatments are a large segment of SMP’s business and most of these medications require refrigeration. Acknowledging that this is a highly sensitive and emotionally invested treatment for the patients they serve, product integrity is critically important to SMP.

Needs drive indicator evaluation

“Particularly during the summer months, we would receive calls from our patients stating that the ice packs were melted and they were not sure if the medications were still effective and safe to use,” said Brian Brito, Vice President, whose pharmacy expertise and commitment to quality pharmacy services have helped drive SMP’s success. “Plus, we also needed to implement this cold chain procedure for our specialty pharmacy accreditation and state requirements.”

“Temptime had been trying to get us to use their heat indicators for quite some time,” he added. “Quite honestly, we were hesitant when thinking that it might cause more calls and customer confusion. Additional considerations were cost, implementation of a new system to the workflow, and extra time added to the packaging process.”

Shipping studies prove value

Despite those concerns, SMP is completely dedicated to patient safety and satisfaction, so they agreed to work together with Katie Kraverath from Temptime on developing and executing shipping studies. Convinced that gathering solid data on exactly what was going on with their shipments would reveal the answer, SMP worked with Katie and Temptime to set up the temperature-monitored test package shipments to various locations, along with FedEx, who handles SMP’s specialty pharmacy shipping.

“We were surprised to find out how hot the packages got – even with double packing and ice packs,” said Brian. “It opened our eyes to the fact that sometimes the package sits in a truck at 110oF heat, or misses the flight, and sits even longer. Using an indicator shows our patients that we are committed to them.”

“Katie is genuine and always provided true value to our business, introducing us to other specialty pharmacies that were using indicators to improve their processes and patient satisfaction,” he added. “That helped us know that this was the right thing to do – for both our patients and our business.”

Making the choice

SMP evaluated several temperature indicators but landed with LIMITmarker, noting that they knew it would be easy for their customers to read, and reliable at a reasonable price per unit. Brian noted that none of the other options provided the flexibility and technical support they were seeking.

They also liked that LIMITmarker is easily customizable, and have incorporated it into their own indicator card, with their logo, instructions and contact information – further demonstrating their commitment to strong bonds with their customers.

Implementation strategy

Despite their initial concerns, SMP encountered no real significant challenges. They incorporated the new temperature indicator SOP into their workflow at both shipping facilities, and trained staff to respond to patient questions about the indicators. “Role playing was particularly helpful”, explained Brian.

“With every shipment we send a patient letter that explains how the temperature indicator is used, read, and when to call us if the indicator shows the temperature limit was exceeded,” said Brian.

SMP is now including a customized LIMITmarker card and patient instructions with all refrigerated shipments that are sent out via FedEx, and also with their couriers for in-person deliveries.
Return on investment

“The most important return is that the temperature indicator helps us give both our patients and staff peace of mind,” said Brian. “Again, these tools like LIMITmarker support our position on patient safety and commitment to superior quality care.”

The direct ROI for SMP has been savings of thousands of dollars on what would have been spoiled medications and reshipment fees. Also, the increased volume of physician referrals has not been quantified, but SMP has confirmed a positive impact on their business.

Increased prescriber confidence

SMP focuses on educating prescribers about the importance and value of temperature indicators. The outcome has been an increase in prescriber confidence, resulting in more referrals to SMP.

“We have begun to show prescribers how indicators are incorporated into our refrigerated shipments,” he said. “This has become a valuable tool to show our commitment to patient safety. After these presentations where we demonstrate the indicators and packaging, the physicians and their staff thank us for educating them, and helping to provide quality care for their patients. They understand that partnering with a specialty pharmacy that takes these extra measures is key to patient care.”

Key to patient satisfaction & supply chain quality

It’s no surprise to learn that SMP has been awarded “Highest in Customer Satisfaction” by J.D. Power & Associates, among their many other accolades. After implementing temperature indicators, SMP’s reshipments due to temperature concerns have dramatically decreased. Patients have increased peace of mind knowing that their medications were not exposed to excessive heat.

“I would strongly encourage a pharmacy to implement temperature indicators into their business. The advantages I’ve described – and that SMP has experienced – should outweigh any concerns,” said Brian in closing. “The tool (temperature indicator) is critical to a quality supply chain program.”

Focus on Best Practices Increases Patient Satisfaction and Boosts Business Growth

Background

In just over 4 years, Encompass Rx has grown beyond their wildest dreams. What started as a regional specialty pharmacy focused on the greater Atlanta area is now a fully URAC-accredited, 50+ person company licensed in over 30 states. The three owners have over 25 years combined experience in specialty pharmacy. John Olsen, PharmD., attributes this growth and success to utilizing industry best practices.

Challenged by Regulation

“A perfect example of how best practices can truly help us take better care of our patients is how we faced the challenge of Georgia Rule 480-48 in 2014,” said Olsen. In late 2014, the Georgia State Board of Pharmacy issued the rule requiring pharmacies to ensure that any drug requiring storage at “anything other than room temperature” that is being delivered or mailed have packaging with a “USP-recognized method by which the patient can easily detect improper storage or temperature variations.”

“We knew we had to make some changes in how we operated,” he stated. This new regulation came only two years into the young company’s founding, but Encompass Rx faced the challenge head on – as an opportunity.

Finding Opportunity in the Solution

With the introduction of the new regulation, Encompass Rx began to seek out an appropriate temperature indicator. They evaluated several visual temperature indicators, and made a decision to use Temptime’s LIMITmarker®.

“We had not previously investigated temperature indicators, simply because we thought they’d be cost-prohibitive,” said Olsen. “But at the same time, our patients are our number one priority and the last thing we want is to have a patient concerned about their medication.” After investigation, Encompass Rx felt even more strongly that implementing a temperature indicator was the right thing to do, regardless of the regulation.

“We loved the idea, and wanted to make it happen,” he said. “We work hard to make sure our patient’s medications are carefully delivered, in a timely manner, and their peace of mind is important to us. It was almost serendipitous that the rule and our desire to do this happened at the same time.”

Implementing Change

During the evaluation phase of temperature indicators, Encompass Rx focused on minimizing steps.

“We have specific protocols and a fine-tuned shipping process,” John described. “When testing the various indicators, we quickly determined that implementing use of the LIMITmarker indicator added one simple step of sticking the indicator on the product bag before it goes into the cooler.”

Other products required extra steps like pulling a tab for activation, or opportunities for what Olsen described as “more human error.” In the end, they determined that LIMITmarker was more user-friendly and they were more confident about implementing it into their processes.

“Implementation went smoothly for us,” he added. “The Temptime team was great to work with – they helped us understand how the indicators work and where to place them. We had no hiccups at all.”

Addressing Fears

Encompass Rx’s primary “fear of the unknown” was that incorporating temperature indicators could have a negative impact on their business. Instead of improving reliability and shipment integrity, what if there were false indications causing customer complaints and costly reshipments that would negatively affect the bottom line?

“We were honestly concerned that false positives might result in a negative ROI, so we did a range of internal tests of our own,” said Olsen. “Plus, Temptime provided us with white papers and product quality details and in the end, we figured out that LIMITmarker was a safe bet, a good product.”

Expanding Use for Patient Satisfaction

While it’s not mandated, Encompass Rx includes a temperature indicator with every refrigerated product that they send out. Many drugs have extended stability data and are stable at room temperature or even higher temperatures for up to 30 days. Some pharmacies wouldn’t find it necessary to use indicators on these types of drugs, but Encompass Rx has learned that indicators go a long way in helping their patients feel comfortable and confident about their medications.

And, it’s working. Encompass Rx has earned the trust of their patients, with a solid patient satisfaction rating of 97%.

Justifying ROI

“The amount of reshipments has decreased probably ten-fold since we started using indicators,” exclaimed Olsen. “We rarely reship products anymore. Previously during the hot summer months here in the southeast, we would get at least one call a day regarding product integrity due to concerns about heat exposure.”

“The indicators pay for themselves quickly,” he added. With an average shipping cost of $20-$25 plus the average medication product cost of $4000, the elimination of one reshipment pays for an entire quarterly order of indicators.

Olsen described that all patient concern phone calls are monitored closely and reviewed quarterly. With two years of indicator use under their belts, Encompass Rx has deemed the indicator use ”very effective, and incredibly impactful on our business of taking care of patients.” Additional ROI is realized since Encompass employees are taking dramatically fewer patient calls – that in the past consumed resources and increased costs.

Protecting Patients is Good for Business

John and his partners have quickly learned in their 4 fast years of business that manufacturers, payers, healthcare providers and accrediting bodies alike are always looking to see what pharmacies are doing to protect patients.

“Utilizing best practices across the board is our goal and always on our minds – and an absolute necessity,” said Olsen. “Nearly all RFPs ask what we are doing to monitor the integrity, efficacy and safety. Steps like implementing temperature indicators are crucial.”

Encompass Rx has achieved URAC accreditation and is in the process of pursuing three additional certifications. To grow their business with payers and pharmaceutical companies, they have committed to achieving these essential best practices.

“It’s a lot of work and a lot of money. But we want to set the standard – for patients, for providers, for specialty pharmacies like ourselves – and that means taking every step toward top quality,” concluded Olsen. “And that’s why Temptime and LIMITmarker are perfect for us – they’re helping us on our journey.”

View Case Study (pdf):

Pharmacy Advantage implements TransTracker® F temperature indicators and revisits packaging to reduce reships and associated costs, while also improving patient satisfaction

Goals

Pharmacy Advantage’s goals were to:

• Give patients added peace-of-mind and increased confidence in the integrity of specialty pharmaceuticals using an objective, easy-to-understand yet scientific temperature monitoring device
• Mitigate potential health risks resulting from patients taking compromised medicines, and support the ability for patients to take medicine as prescribed
• Reduce costs associated with patient inquiries to pharmacy/manufacturer about the safety of specialty medicines exposed to extreme heat or cold
• Minimize waste resulting from unused medicine and the need to reship due to uncertain temperatures during the “last mile” of transport
• Maintain and improve patient satisfaction and performance ratings to support URAC, Medicare STAR and JCAHO accreditations

Challenge

The Pharmacy Advantage team holds regular Quality Assurance (QA) meetings to review customer feedback. It was during one of these sessions that patient concerns about the temperature of shipments began to emerge.

“We review both positive and negative comments in each meeting,” said Daniel Kus, VP of Ambulatory Services for Pharmacy Advantage. “We noticed that over a six month period, from spring into summer, we were receiving more and more calls from patients wanting to know if their medicine was still good.” The concerns arose, Kus noted, because packages might be delivered later on a hot summer day or left on the doorstep when no one was home. As a result, patients were unsure if the medicine would still be considered effective.

“There seemed to be a gap in the last mile, and we didn’t have the scientific data to make a confident recommendation to the patient,” explained Kus. “There was also no formal process in place to address temperature concerns, so of course we’d end up replacing the product.”

Solution

Based on the findings of the QA meeting, as well as conversations they had recently had with Temptime, Pharmacy Advantage decided to participate in a pilot study along with four other specialty pharmacies. In this study, Temptime’s TransTracker®F temperature indicators were added to the packages of temperature-sensitive medications being delivered to patients with chronic diseases. Patient preferences and insights were then measured and analyzed.

“We want to be proactive, whether that involves making improvements to software, shipping, operations or patient satisfaction,” stated Kus. “We saw the pilot study as an opportunity to find out what more we could be doing – not only to benefit the patients we serve, but also to potentially make an impact on our bottom line.”

Study and Investigation

According to Kus, the results of the pilot study were compelling to Pharmacy Advantage.

• 49% of respondents said they’d been concerned in the past about the temperature of medicine delivered from a specialty pharmacy, whether being too hot or too cold
• 60% reported being worried specifically about heat damage
• Over 95% of patients agreed that a company including a temperature indicator with medicine shipments shows a concern for their safety
• 97% of patients wanted the TransTracker temperature indicator to be included with all of their medicine shipments

“Patients want to know someone is looking out for their best interest,” Kus explained. “Using the TransTracker temperature device just shows our customers that we are committed to their overall health and safety because we are listening to what they are saying and paying close attention to the important details.”

As a result of the study, Pharmacy Advantage did some further investigation into various temperature indicators on the market. They ultimately chose TransTracker based on their experience with the pilot study and patient feedback.

“TransTracker is easy for our patients to read,” Kus noted. “It’s a patient-friendly device, and when we include it with our patient instructions, they can quickly and easily determine the integrity of the shipment on their own. It’s a simple solution to a potentially complicated and expensive problem.”

Packaging

At the same time they began to move forward with implementing Temptime’s temperature indicators, Pharmacy Advantage had an opportunity to meet with Cold Chain Technologies (CCT), a thermal packaging supplier. As a Temptime business partner, CCT provided a complementary evaluation of their packaging, which Kus described as an ancillary benefit of the pilot study and engagement.

“During this process, we learned instantly that many specialty pharmacies use a completely incorrect packing process, putting freeze packs into the shipping container and returning the package to the freezer,” said Kus. “This practice, we discovered, could freeze the product and cause damage before it is even sent out.”

Implementation

In 2013, Pharmacy Advantage began including TransTracker in all heat-sensitive or perishable pharmaceutical items delivered to a patient’s home. Additionally, the company made improvements to their shipping materials and packing processes. “These combined initiatives support Pharmacy Advantage’s goal of best practices in the last mile of shipping,” Kus said.

Results

Not long after implementing the temperature indicator, 450 Pharmacy Advantage medication recipients participated in a survey. A solid 97% said that they prefer a specialty pharmacy that uses the TransTracker indicator in its shipments. They also reported that the indicator enhanced their confidence in the security and effectiveness of their prescription medication. (97% pie chart graphic here)

“Before this implementation, during the spring-summer period, we were sometimes looking at a potential 2% of packages returned and resulting reshipments,” Kus stated. “We’ve more than cut that in half – to less than 1%.”

Kus went on to note that eliminating just one compromised shipment more than covers the cost of temperature indicators for an entire year. With the average specialty pharmacy shipment valued at $2000 per month, and some as high as $5000 to $10,000, the financial payback alone is a significant incentive.

“Beyond the cost of the medication, any disruption in patients taking medicines as they are intended is of major concern to both us and the health plans,” he said. “We don’t want to see clinical outcomes reduce, or ER visits and hospitalizations increase as a result of last mile problems that temperature indicators can simply and effectively address.” In addition to patient safety and cost savings, Kus cited a number of other benefits – including URAC, Medicare STAR and JCAHO accreditation as well as maintaining high levels of patient satisfaction to strengthen relationships with payors and pharmaceutical manufacturers.

Future

Based on the success of adding temperature indicators to shipments and improving packaging, Pharmacy Advantage is planning another study. In this case, they will be including a time and temperature monitor inside a select number of specialty pharmacy shipments that will record and transmit a temperature reading to Pharmacy Advantage every 15 minutes.

“We want to map the journey of shipments over different seasons and with different packing materials to study where freezing or overheating might be occurring,” Kus explained. “Understanding the temperature profile over the entire last mile and then learning what we can do to keep the medication as stable as possible is our next challenge.”

View Case Study (pdf):

Temptime Corporation, the world’s leading provider of time-temperature indicators to the health care industry, announced today that its co-founder and Senior Vice President Ted Prusik has been awarded Inventor of the Year. The New York Intellectual Property Law Association (NYIPLA) honored Dr. Prusik for his work in developing Temptime’s technology that supports the safe storage and distribution of medical products around the world.

“Ted is the true ‘founding father’ of Temptime and personifies our company’s passion and commitment to improving global health,” said Renaat Van den Hooff, president and CEO, Temptime. “His inventions have made a tremendous impact in helping to ensure people around the world are receiving safe, effective vaccinations. We are honored to work with him and look forward to developing the next generation of technology together.”

During his 30-year career with Temptime, Dr. Prusik has been awarded 27 United States patents. His inventions helped create Temptime’s technology that monitors the temperature of vaccines and other biologics to support global health organizations with preventing the administration of vaccines that have been compromised by high levels of heat or cold. Dr. Prusik began his career in physical chemistry in 1977. He received his bachelor’s degree in chemistry from Bucknell University and his master’s and PhD degrees in chemical physics from New York University.

“I will never forget the day I saw Temptime’s devices being applied to vaccines at high speed for global distribution. I got tears in my eyes as I realized our inventions would make a meaningful difference in people’s lives around the world,” said Dr. Prusik. “I would like to thank the many people who helped make the inventions scaleable and affordable, and the thousands of health care workers who use our technology every day to help care for their patients. We are deeply honored to receive this award from NYIPLA.”

About NYIPLA

The New York Intellectual Property Law Association, or NYIPLA as it is known, is a bar association principally composed of lawyers interested in patent, trademark and copyright law who live or work in the jurisdictions of the U.S. Court of Appeals for the Second Circuit, namely New York, Connecticut, Vermont, and the District of New Jersey.

Temptime Corporation, the world’s leading provider of time-temperature indicators to the health care industry, announced today that its board of directors has promoted President Renaat Van den Hooff to chief executive officer. Mr. Van den Hooff, 56, has served as president of Temptime since 2011.

“Renaat deeply values Temptime’s mission of improving global health and has done an outstanding job of expanding Temptime’s products and services to organizations that are saving lives around the world,” said Curt Selquist, chairman, Temptime Corporation. “Renaat leads by example and has cultivated a highly talented team of employees who are focused on delivering results and developing the next generation of technology to meaningfully improve health care.”

Under Mr. Van den Hooff’s leadership, Temptime has expanded its capabilities to the world’s largest health organizations and pharmaceutical corporations. The company has broadened its portfolio of devices that monitor the temperature of vaccines and prescription drugs to blood and other biological products. Mr. Van den Hooff also spearheaded an expansion of Temptime’s operations that has doubled the company’s production capacity. He is currently leading initiatives to develop new technologies and extend Temptime’s presence into China and other markets.

“I am proud of Temptime’s recent accomplishments and performance, and want to thank the executive team and our employees for their continued passion and commitment to our mission,” said Mr. Van den Hooff. “It is exciting to lead Temptime in expanding its services and developing new technologies that will support the safe storage and distribution of a wide range of medical products across the globe.”

Mr. Van den Hooff has more than 30 years of global health care leadership experience. Prior to joining Temptime, he was worldwide president of Johnson & Johnson’s joint venture with Merck. He also held management positions with Johnson & Johnson in Belgium, the United Kingdom and the United States. Mr. Van den Hooff received a degree in economics from VEH – Brussels, Belgium and a master’s degree in marketing from the Vlerick Business School at the University of Ghent, Belgium. He serves as vice chairman of the board of a leading chapter of the National Multiple Sclerosis Foundation.