PharmacyNow Podcast: Medication Safety and Enhanced Clinical Services for Pharmacies

NARRATOR: Helping pharmacists grow themselves, their business, and driving outcomes. This is PharmacyNow. 

SCOTT VONDEYLEN: Welcome back to the PharmacyNow podcast. This is episode number 9. Excited to be here today with all of our listeners. We have another fantastic guest on deck today. But first just want to take a second. We are in the brand new year of 2021, so goodbye to 2020. We are still, though, in the midst of course, of COVID and this global pandemic and helping the pharmacies gear up for the COVID-19 vaccination. So excited to discuss a little bit of that and much, much more today. 

So joined here today with our very special guest. He is the current Chief Sales Officer from Tabula Rasa HealthCare, Mr. Kevin Boesen. Kevin, can you hear me? 

KEVIN BOESEN: I can Scott. Thanks for having me here today. 

SCOTT VONDEYLEN: Absolutely. It is a pleasure. Now, I do want to say to our listeners. Kevin is a pharmacist. As you know we are joined with many of our guests on the PharmacyNow podcast are pharmacists. Kevin has a PharmD. We’ll talk more about his background. But we are excited, Kevin, to have you here today and to talk a little bit more about what you’re doing over there at Tabula Rasa HealthCare. 

But I want to just start the podcast with the same question that I do every time we have a pharmacist on the PharmacyNow podcast before we get into your background. And that is, Kevin, if you can answer, why did you choose to go into the profession of pharmacy? 

KEVIN BOESEN: Yeah, Thanks for that question. I think it’s probably a similar answer to a lot of folks who become pharmacists. My dad was a pharmacist, so my exposure to the field of pharmacy occurred very early in my life. He was a pharmacist, went to Drake University. I went to grade school in Des Moines, Iowa, very progressive state for community pharmacies. My dad worked with a small pharmacy in rural Iowa and had the opportunity when I was younger to go there, 8-10 years old, sweep the floors. And really, that was my first exposure to pharmacy. 

And while I was in high school, I thought about really becoming a physician. I thought that’s what I wanted to do in the health care space, but as I started college and looking at premed, I really saw the value of the pharmacist and my dad’s experience and everything that you do with it. And stuck with it and had a very diverse career so far, myself. 

SCOTT VONDEYLEN: Wow, that’s awesome. So you grew up in the pharmacy, you’re sweeping the floors. You’ve been exposed to that world since a very early age, you’re one of the lucky ones, I think, that knew from a young age, this is what you want to do. I think so many youngsters these days go into college still having no clue what they want to do, but you kind of had that path laid out for you. That’s awesome. 

So let’s talk a little bit about today at TRHC. You’re the Chief Sales Officer there. I’ve done my research, of course, on Tabula Rasa HealthCare. But I wanted to ask, what exactly is TRHC for the listeners. What is TRHC involved with? What are they offering right now to the world pharmacy? 

KEVIN BOESEN: Yeah, it’s a great question, too. Our core products and services are really there to help empower pharmacists to make meaningful impact and provide value in their settings regardless of where they be. We spend a lot of time really developing new tools to help pharmacists practice in different ways. 

And so our mission is really centered around enhancing medication safety, improving medication use through the pharmacist, whatever that practice setting may be. And the problem we’re really trying to tackle is that, there’s been numerous studies that have been published since the mid ’90s that show, for every dollar we spend on medications, we spend another dollar dealing with the problems that medications cause. 

And so in 25 years ago, we were spending about $70 billion on medications and $70 billion dealing with the problems, and as recently as four years ago, those numbers had increased to almost $500 billion or half a trillion dollars. So if you look at the challenges in our health care system, we’re certainly innovative on the pharmacy side and offering more products that really help patients in many different ways. But we still have this problem of making sure that those medications are safe for patients. 

And so we really try to develop tools that help the pharmacists practice in different ways and more effectively. A lot of that really centers around our application that we call MedWise. That is a completely different way to look at medication safety. So not only are we spending more money on medications, patients are taking more in terms of a quantity of medications. 

And the systems that pharmacists have used when I was young helping my dad out in his store, that looked at how two drugs interact with each other was perfectly appropriate 50 years ago. But when you look at the medication usage today, and patients are commonly prescribed 5, 10, 15 different medications, pharmacists just need smarter technology in order to know how do those medications all interact in the body at the same time. 

From the point of, if you take 5 medications in the morning, can your body even absorb those at the same time? How does that impact the individual blood levels when you’re on certain medications that compete with each other at the molecular level? And so we spend a lot of time doing some research and development in trying to create tools that present that information to a pharmacist in an easy way that they can integrate within their practice. 

SCOTT VONDEYLEN: So when you talk about– was it $70 billion, Kevin? 

KEVIN BOESEN: It was $70 billion about 25 years ago. It’s about $500 billion today. 

SCOTT VONDEYLEN: OK, $500 billion today. So just to take a step back for the average listener that isn’t involved in health care, isn’t a pharmacist, when you say we’re spending dollar for dollar on the cleanup of it, is that because of patients being hospitalized, because they’re taking the wrong meds, or because of side effects? Where’s that dollar when you talk about dollar for dollar? Where’s that going in terms of the cleanup portion? 

KEVIN BOESEN: It’s primarily– that’s another good question– it’s primarily related to unintended consequences of the medication. So those could be adverse drug events that lead to hospitalizations or emergency rooms which are very expensive, or they can actually lead to more medication use in terms of prescribing cascades, meaning that if a patient takes one drug and they have a side effect, they might take another drug to manage the side effect of the first drug. 

And sometimes those combinations that result from managing patients’ symptoms that way can then result in falls that can result in emergency room visits, hospital visits, additional diagnostic testing that can be very expensive and cause a lot of– in addition to the cost, a lot of deal of– a lot of stress and anxiety as people try to navigate through that and understand why they’re feeling the way that they’re doing– why they feel. And they might not even realize it’s due to some of the medications that they take. 

SCOTT VONDEYLEN: So you’re saying that the product that Tabula Rasa HealthCare offers today is a software that is offered to pharmacies that can analyze the medications that a patient is on, to avoid some of this potential risk? 

KEVIN BOESEN: That’s the key piece of what that software can do. It gives you that insight into what the medications look like within the patient’s body. So when you take a medication, it first has to be absorbed from the stomach, the intestines. It will go through a process where it’ll be metabolized by the liver first before getting into the bloodstream. It has to make its way to the cells that it’s trying to reach. 

In some cases that might mean getting to brain cells and crossing certain sophisticated membranes within the body that are really designed to protect the body. And then the whole time, while we’re taking these to help us feel better, the body treats them as poison. So the body is trying to eliminate them. 

And so what the technology does is it gives the pharmacist a view of what that looks like. So when all the drugs are taken at once, we create these visual displays to show the pharmacist what’s happening within the body. Are these drugs competing with each other for some of the pathways for absorption and metabolism? Are they complementary? Are they increasing the amount of side effects because of their accumulation of sort of small effects that you wouldn’t notice if a patient was taking one drug at a time? But now that they’re taking five, it’s causing problems with things like memory, heart arrhythmias, sedation, those kinds of things. 

And so it gives the pharmacists insight into a view of multiple medication use that they’ve never really had before. And I think that’s the trick. And so if you’re a pharmacist and the first time that you see this and use these tools, I think it’s almost like it’s intuitive in its information that we all learned in school. But the way it’s presented, it’s almost like you get a completely different view of what medicines look like than you’ve ever had before. 

SCOTT VONDEYLEN: So interesting that you said that there at the end because as I’ve shared with the listeners many of times, I’m not a pharmacist. And a lot of our listeners aren’t pharmacists. And so my question was going to be– and I always give the example of one of my close family members, which is my mom, who has multiple sclerosis, and she’s been on 10 to 15 medications since the early ’90s. 

And I remember helping– going in high school and college going to the pharmacy with her and taking her to the pharmacy to pick up her medications. And we knew the pharmacists on a first name basis. They knew my mom when she walked in the door. 

And as her son, I trusted that the physicians that were writing these medications– because she went to a few specialists for her multiple sclerosis. She, of course, went to her primary care physician. And between those doctors, providers, and the pharmacists who’s handing her these medications over the counter, I just assume that they kind of all worked together and knew exactly what she was taking, and then she was safe to take all of them. 

In what I hear you saying, from the technology that you guys offer and saying that pharmacists have learned a lot of this in school, but it’s just not readily available in front of them when they’re handing 15 medications to a patient, that they could possibly be harmful. Am I kind of on the right track there with that? 

KEVIN BOESEN: Yeah, exactly. I think it’s even being able to consolidate that information in a usable way. So if I were practicing without the tool even 5-10 years ago and I, obviously, have family members, as a pharmacist, you ask me questions about their medications, I need to look up information about each medication. And if someone’s on, let’s say, six medications, then I have to do a drug-drug interaction review of how the first drug interacts with the other five, the second with the other five. And I probably end up, from a research standpoint, with 100-150 pages of data notes. 

And so the information potentially has always been there, and there’s opportunities for me to assimilate that and do that. But what our technology does is it presents that same information, even at potentially additional detail, in a very simple, easy to follow pictorial representation of how everything interacts. And so it formats it in a way that the clinical pharmacist can look at it in ways that they’ve never really had before. 

So drug A might interact with drug B. But when you use our tools and we call sort of the core component, our matrix, that really lines up each drug. What percentage of that drug do we expect the body to absorb and use? Which liver enzymes metabolize it? And we can look at how the drugs compete along just this grid. 

And little changes as far as if two drugs compete but they might be necessary, you might be able to separate them by time of day and take one in the morning and one at night. That might be all you need sometimes to prevent some of the side effects and problems that people have. 

And if you’re sifting through hundreds of pages of available data, those are the challenges. And I think pharmacists have done a really good job managing it, and this sort of gives them just a really another tool in their tool box to help assimilate as the information that’s available becomes more and more abundant, more and more complex. 

SCOTT VONDEYLEN: OK. So through my research– and just to clarify some things, I think, for the listeners because this is fantastic information and I appreciate you sharing this with us. And of course, again, appreciate you being here today as our guest. Tabula Rasa HealthCare has a platform or a software called MedWise which looks at all of the drugs, in what you’re talking about, that a patient may be taking, and then it basically tells the pharmacist if the drugs that the patients are taking or that particular patient is taking are safe, essentially, to take together. 

KEVIN BOESEN: It does. And it’s not always an answer of is it safe or not safe. Sometimes there’s a lot of nuance to that of how could you make them more safe, or what are the things that you have to monitor and watch for. So the building blocks of MedWise are multifactorial. So the first piece of it is looking at side effects that we know are problematic in patients. And one is a side effect that’s called or an effect that’s called an anticholinergic effect. 

And an anticholinergic effect is really dryness. So one way to think about it is if I have allergies, I take Benadryl. And the anticholinergic properties of Benadryl dry my sinuses so that I don’t have that stuffy nose anymore, clears my eyes so I don’t have runny– my eye, I’m not crying, and I can see OK. 

But if you have that impact and you take drugs with chronic anticholinergic use, it can also dry other parts of your body. It can dry your gut. It can actually cause some dryness, so to speak, in the brain, and that some of the brain cells will actually atrophy over prolonged use of drugs that have anticholinergic effect. And so Benadryl is an example of a drug that has a really strong anticholinergic effect, and you take it only when you need it. 

But there’s a number of drugs that may create just a tiny bit of anticholinergic properties. And so one of the things that this platform will do is if you’re taking 10 different drugs, maybe the cumulative effect of those drugs has the same effect of multiple doses of Benadryl or dyphenhydramine. And so being able to sort of aggregate that as an important side effect is one of the pieces of it. 

And then there’s a couple other effects that we do an aggregation of potential risk. The other is sedation. So we all know that if you’re sedated, it’s hard to function, and you’re not at the top of your game. But if you have anticholinergic effects, sort of this brightness atrophy in the brain, and you’re sedated, it can cause a real cognitive impairment, meaning you might not be able to think straight. 

Sedation in the elderly is particularly harmful because that can lead to falls, and falls in the elderly can lead to even worse consequences– fractures and hospital stays. So looking at that anticholinergic use that sedation impact– the other one that we look at is the impact of drugs to create heart problems. 

So there’s a number of medications that can prolong what’s called a QT interval which is part of when you look at an EKG and you have the up and down spikes of the heart rhythm. A portion of that can get expanded, and if it gets expanded too much, it can create a heart arrhythmia and possibly, even sudden death. 

And so we look at the cumulative effect of drugs on that. So that’s really the first piece of it– is what are some core side effects that can be really problematic in patients, and what’s the impact of their particular drug regimen to cause those problems. So that’s really the first piece of it. 

The second, even more in-depth piece, is– I mentioned that the body sees drugs as a toxin, and so it needs to eliminate those from the body. And it does that primarily through metabolism by the liver. And drugs are metabolized primarily through a liver enzyme system called the cytochrome P-450 system. And there are a limited number of cytochrome P-450 enzymes that drugs can go through for metabolism. 

And so if you take 5 drugs and they all would go through that same pathway, the liver doesn’t decide to doing sequentially or do 20% of each, so they’re all metabolized evenly. It picks the drug that it has the highest affinity for, and it metabolizes that first. And then the drug after that would be metabolized second. 

And so sometimes there’s medications that we take that the body can’t even metabolize. They’re going to stay around in the bloodstream longer than we expected, at higher doses than we expected, and they’re going to create side effects at a higher frequency than we expected. And so being able to see all the drugs and all the pathways that they go to in a nice picture, gives you this insight. It’s almost like putting on a special hat, and now you can see things you never got to see before. And that’s, I think, some of the things that makes it really valuable but also really empowers pharmacists in ways that they’ve never been empowered before. 

SCOTT VONDEYLEN: So I love it. This is very fascinating. And so before we dive any further into the cytochrome P-450 and some of the other scientific terminology, I want to look at this on a very basic level for just a moment, from both the pharmacist side of the counter and the patient side of the counter. And so if I’m a pharmacy, I can adopt technology from Tabula Rasa HealthCare. Essentially, that gives me the ability to see if my patients’ medications that they’re taking are safe and if I need to perhaps deliver a medication safety review with that patient, their profile, their medications, through the software, again, offered by Tabula Rasa HealthCare which is MedWise. 

So just to dive into the numbers on the pharmacy side of the counter– so if I’m the pharmacy owner, I have MedWise, just in general number, maybe you have the exact, number how many patients normally qualify or fall into this category where they’re at risk because of the medications that they’re taking? 

KEVIN BOESEN: So we’ll look at– as part of the assessment and part of the technology is we create what’s called a Risk Score. And we call that our MedWise Risk Score because of the MedWise technology. And we generally– that score falls on a scale of 0 to 50. We generally target patients more suggest that we do an in-depth review of their profile if a score is 15 or more. Not to say that anybody below 15 wouldn’t benefit from it, but one of the reasons we pick 15 is we’ve been able to correlate our score with health care spending. 

To the point we were talking earlier is that the real cost of drugs’ side effects is seen in things like hospitalization rates, emergency room visits. So at a score of 15, patients have about 50% higher costs than the general population. At a score of 20, it’s about twice the health care spending as the average population, largely due to increases in adverse drug events. So that scoring gives us an indication of patients that we should really be spending extra time in. 

And depending on the type of patient– generally, if someone is 65 and older, we can see risk scores of 15 to 20 in 20% to 25% of patients. In a younger population, it might depend on other chronic conditions but certainly a smaller number. But probably still, in a population that takes medications, some sort of chronic medication, probably 5% to 10% of patients will have high risk scores. But yeah, it can be one in four, one in five patients who are over 65 that really have risk that pharmacist can manage. 

SCOTT VONDEYLEN: OK. So that makes sense, and I would think for most of our listeners, especially the pharmacies out there, right, no big surprise, probably, when you think about my patients that are on the most medications and that fall into that Medicare population at 65 or over demographic. 

So from the patients side, to kind of maybe walk through an example, if you have one, Kevin, that you guys use a lot over there when explaining this to customers or even patients– I’m a patient walking in. I’m in that category of 65. I’m taking 10, 12, 13 medications, and my pharmacist sees I have a risk score of 22 or 23 or whatever example you want to use. What does that usually look like or most commonly for me, and I’m sure there’s a million examples of after you go through medication safety review. But what’s a common example for those patients that are out there listening, thinking maybe, I need a medication safety review. What would be an example to walk us through on the patient journey side of things and how that’s going to benefit me long term and some of the symptoms that it may alleviate for me as a patient? 

KEVIN BOESEN: Yeah, I would say from the patient perspective, the first part of that question is, if the pharmacist sees that you have a risk score of, let’s say, 22. You probably have a higher risk score because the pharmacist sees your prescription medications. And there’s probably some over-the-counter medications that you take, maybe for your stomach, maybe for any GI symptoms you might have, maybe something to help you sleep, something for pain. 

All of that medication supplements that are over-the-counter, nonprescription are also something that can impact your risk score and interact with your prescription medications. The body certainly doesn’t know if a medicine’s a prescription or an over-the-counter. So that’s probably the first piece of it as it’s really important that your pharmacist knows everything that you’re taking, and you’re cognizant about sharing that information with them. That’s really a critical piece. 

So what the pharmacist will do then is– as the first part of that will ask questions related to other medications that you might take, supplements, over-the-counter, might ask questions about things that could impact drug metabolism. We were talking about that– so some nutrition, smoking, things like that, that can impact the body’s ability to metabolize drugs. So there’s what we call a medication reconciliation and some history questions that the pharmacist will do to really get a full picture before recommending any changes. 

And then at that point, it’s really an assessment of what things look like. And some of it could be if the side effect profiles medications are similar, and so they really accumulate. One of the things we’d be looking at medications that may be taken for diabetes or high blood pressure that don’t have that side effect profile. So you can have different medications that lower your blood pressure, but they can have a different side effect profiles. So that might be something to look at. 

There may be medications that are taken for pain or medications that are taken for other chronic conditions that– it could be problematic because it goes through a pathway that all the other drugs are going through for metabolism. And there might be other drugs that are very similar in what they do from an effects standpoint but potentially use a different pathway. 

And so there could be changing blood pressure medications from one to another, or sometimes the recommendations can be very simple. So sometimes your body can manage all the medications if they’re spread out. So it could be that if you’re taking four or five medications in the morning, it could be that those medications are OK, just not at the same time. So it could be that some should be taken in the morning, and some should be taken at night. 

And so if there’s anything that requires a prescription to be changed, the pharmacist would work with you to follow up with your doctor. They might contact the doctor directly. They might give you some written instructions on questions you can ask your doctor the next time you see them. Or if it’s a once-a-day medication, and it could be within the realm of the pharmacist scope of practice to tell you to take it in the evening instead of the morning and really work with you on making sure that the medications are timed right so that your body can process them in the way that it’s supposed to. 

SCOTT VONDEYLEN: Awesome. Well, I wanted to talk a little bit about– real quickly, we’ve got a couple minutes remaining. What are kind of a– is this the primary focus for Tabula Rasa HealthCare? You guys are a publicly traded company– for those of you who are interested investing in Tabula Rasa out there, the stock ticker is TRHC. But is this the primary focus right now in terms of the strategy with Tabula Rasa HealthCare? Or are you guys planning on other big things– things that you can obviously talk about as an executive with the company in terms of what you guys would get involved with. 

KEVIN BOESEN: Yeah, thanks. Great question. You’re right. Tabula Rasa is a publicly traded company. We are a– stock ticker is TRHC on the NASDAQ. And this is our primary focus. It is our MedWise technology. So the MedWise technology really– like I mentioned, it’s a half a trillion dollar problem annually in the country is problems associated with medication use. 

So our science is something that we’re excited to see utilized by community pharmacies. The PrescribeWellness network of pharmacies is one of the first group of pharmacies to have access to the application. There are other community pharmacies that have access to it as well. So some other relationships that we’re trying to get this in the hands of as many community pharmacists as possible. We really feel the community pharmacist is one of the most underutilized resources in the country, and I, obviously, have seen that, growing up just firsthand and my own professional experience. So it’s a big focus is to make sure that we get this in the hands of community pharmacists. 

We also do a lot of other work to support community pharmacists and in technology that helps them manage things like COVID testing that community pharmacist got involved in early on. And now, the COVID vaccinations where community pharmacists play a key role in making sure that the country gets immunized as fast as possible so that we can all go back to life as we know it and life as we want it. 

So we offer solutions with that, meaning we help with things like pharmacies that are providing the vaccinations and the patients need to register online. We call that contact list. We help the pharmacies with the purporting that they need to do to the States or the Federal government, those types of things. 

But then we also take a look at the MedWise technology and science and think about the other places where it can be valuable. So we have a large group of folks on my sales team that talk to health insurers. You asked about whether patients are paying for it, or their insurance companies are paying for it. 

There’s certainly value. So more insurance companies should be investing in services like this that help prevent problems. So we talked to Medicare plans, we talked to commercial insurers about having this be added as a standard program that they support. 

And then one of the other areas of growth is with employers. So in the United States, employers are responsible for a big portion of health care costs. And so being able to have a service and a tool that’s available that can reduce health care cost spending, we think is something that’s important. So we do a lot of programs that we sell to employers so that employers can implement these services with their own employees. 

And in that same way, the first opportunity would be to have the patients receive the service at their own community pharmacy, or if they don’t have access to one, through a Telehealth solution with some staff that we have that can provide that through a telephonic or some other technology means, remotely. 

SCOTT VONDEYLEN: Yeah. I wanted to ask, Kevin, on that point. I spent a little bit of time in that arena, PAIRs, et cetera. Just hearing what this software, this proprietary technology from Tabula Rasa HealthCare can do for patients and for pharmacies, in pitching that out there to PAIRs or to employers, what’s this– you mentioned some dollars earlier, I think, based on the risk score of every so many points or every point has an associated cost with it, additional costs for patients with higher risk scores. 

What is the ROI, or do you have one for an employer? As you mentioned, they’re responsible for a huge number when it comes to health care costs to their employees. Do you have an ROI or a kind of an average cost savings to a PAIR or to an employer if they were to adopt and offer medication safety reduced to those patients that had a higher risk score? 

KEVIN BOESEN: We do. We’ve got a number of studies. Tabula Rasa has a really large Research and Development and Analytics team that spends a lot of time and energy, and we invest quite a bit in our outcomes, analysis to make sure that the products are achieving the goal that we set out for them. 

So if you target a patient that has– and there’s a couple of ways to do it. But if you look at someone who has a risk score of 20 or more, and we go through the process that I described where we’re doing a medication review, and we would call that a retrospective analysis, meaning that the prescriptions have already been prescribed, the patient has already been taking them, that we can walk back that risk, and we see savings in the patient of $2,000 to $3,000 annually which can be a 4 to 5 to 1 return on investment. So lots of opportunities to save money there. 

The other piece of it is we’ve done a lot of work where if you can employ something like this prospectively, so as prescriptions are written, if a clinical pharmacist can review it for a change in risk score, and make that change before it happens, we see return on investment sometimes of 13 to 1. 

So we really want to continue to advance the technology so that pharmacists can see this in real time and as medications are prescribed so that they’re not dealing with the problems medications cause, but they’re preventing problems that medications can cause as part of their normal practice model. So it’s a huge opportunity to save money on that as between 4 to 13 to 1 from a return on investment standpoint. 

SCOTT VONDEYLEN: So that leads me right up to a nice transition, I think, into one of the final questions that I have for you today, Kevin. Is the future of pharmacy– and as I mentioned earlier, spent basically all of our time here on the PharmacyNow podcast talking to pharmacists, a lot of community pharmacists, executives, other experts within this industry. The future of pharmacy, I think, looks a little different for everyone that I talked to, but it definitely always includes in the conversation, pharmacies getting involved in additional clinical services or offering more clinical services to their patient populations, practicing at the top of their license. 

One of the challenges we discussed at a little bit is getting reimbursed and getting paid. And so what is the future of pharmacy kind of look like for you when you talk about MedWise, you talk about your group of community pharmacies that you’re serving through your PrescribeWellness, acquisition– what is the future of pharmacy look like for you over the next few years in terms of technologies being adopted in different revenue streams for these pharmacies? 

KEVIN BOESEN: I think pharmacists have more and more of an opportunity to play really a primary-care role. And if you look at the numbers of primary-care physicians, nurse practitioners, physician assistants that the country needs versus what we have, it’s a huge void there. And I don’t see that void changing dramatically because it’s challenging. 

There’s not a lot of folks at the University that are studying medicine that are accumulating the amount of debt and skill that they need to go into medicine that are choosing primary care as their practice site. And so I continue to think that primary care will have this void that pharmacists can fill. There’s a lot of things that pharmacists can do relative to general assessment of patients or even ongoing monitoring and management of patients once they have had a chronic diagnosis. 

So I’ve worked with a number of pharmacists that have what are called Collaborative Practice Agreements where if there’s a diagnosis made of high blood pressure, diabetes, respiratory illness, cardiovascular disease, that then the pharmacist can manage those conditions. And so as we’re doing these medication reviews and using our MedWise technology instead of having to go back to the physician to change one blood pressure medication to another, the pharmacists will be the ones able to do that. 

So I think the reimbursement, the practice of pharmacists will continue to become less tied to the medications themselves and more towards their clinical practice model. And then I think as pharmacists evolve to that, we have to stay in tune to what patients need. And no pharmacist is any different than patients. I appreciate that I work, and I’m busy, that the use of technology to be able to have visits like that is important. 

So pharmacists being able to embrace that technology so you can support Telehealth platforms, whether that include just audio or video audio component, I think, it’s part of it, too. So pharmacists will need to evolve with their practice model which many of them have throughout the country, and it’s great to see that. 

And I think the next evolution will be embracing that Telehealth and the convenience that patients really– or people really need to keep up with their lives. And I think that’s consistent with how the post COVID world will work. If you don’t have to go somewhere where there’s other sick people regardless of what the illness they have– I think there’s a heightened sensitivity to spreading viruses or other bacterial infections. And so if you can avoid situations where you’re around other sick people, and you can do it through an app or some sort of Telehealth tool, you’ll choose that. And so I think pharmacists will get more and more involved in applications and in using those. 

SCOTT VONDEYLEN: Yeah, I couldn’t agree more. And all of the guests that we have on the show, the one thing that we all agree on is that pharmacy is on the front line of health care in America, and they are underutilized at this point in time. So I definitely agree. 

Well, Kevin, it’s been an absolute pleasure, sir, having you today here on the PharmacyNow podcast. Fantastic information and amazing technology that quite frankly, I didn’t know all that much about until doing some research and having the pleasure of listening to you explain it to myself, to the listeners. So again, thank you so much for being here today with us. And best of luck to you, Tabula Rasa HealthCare, and to getting MedWise out there to as many patients as possible, lowering health care costs and helping change the outcomes with patients’ lives. That’s fantastic stuff.