ePrescriptions are the Future
Imagine going from your doctor’s office to a pharmacy without a paper prescription, but walking out moments later with the appropriate medicine in hand, tailored exactly to your health needs and medical history. Imagine as well that payment for the prescription is electronic and automatic, and that you, your doctor or pharmacist is able to call up a complete record of all the medicines you have ever obtained, whether from a hospital or another doctor. Welcome to the more efficient and safer world of e-prescriptions facilitated by a seamless medication delivery system. This system may be less than a decade away.
Rx CANADA LEADS THE WAYOne of the leading players working towards this major breakthrough in health care delivery is Rx Canada, a pharmacy-sponsored organization that develops and implements innovative programs to improve patient care—and a recent Bay Consulting Group client. Rx Canada credits Bay Consulting partner Drew Huffman with putting the group on a path that could revolutionize prescription fulfillment in Canada. “Drew expertly led us to a clear mandate with renewed energy,” says Wendy Nelson, president of Rx Canada. “He’s very low-key, but an incredibly effective facilitator.”
Facilitation is central to most of Bay Consulting’s work. It is the process Drew chose to help Rx Canada evaluate its existing business model and develop a strategic path for the future. Explains Nelson: “Rx Canada was approaching 10 years as a company and our Board felt it was the right time to examine our core purpose and develop formal directions for the next decade.”
FIND THE RIGHT CONSULTANTTo help Rx Canada, Nelson looked for outside assistance from a consulting company with private sector experience, an understanding of IT solutions and extensive knowledge of the Canadian health care sector. Bay Consulting scored high on all three counts.
At the same time, Rx Canada had a vision for e-prescriptions that would build on the organization’s current strength in providing electronic chronic disease management programs that pharmacists offer their patients. Some 2,300 pharmacies, accounting for half the prescriptions dispensed in Canada, now offer various Rx Canada adherence programs to patients, but Rx Canada saw a future in which their company could expand their role and serve as the hub or an electronic link for e-prescriptions among patients, pharmacists, physicians, and all payers. Today, such a link normally occurs only in a few small pilot settings.
Drew’s winning proposal was relatively simple. Do extensive research on present stakeholders, develop a business case, present alternatives for the future and facilitate a retreat for critical decisions by the Rx Canada Board of Directors, representing such large drug chains as Shoppers Drug Mart, Loblaws, Canada Safeway and Pharmasave.
RESEARCH, RESEARCH, RESEARCHBut successful facilitation is never simple. “Most people think facilitation is just like waving a wand,” Drew says, “but a huge effort goes into a final performance.”
Drew’s hallmark is research, research and more research. “You never know as much about the subject matter as the client,” he says, “but you need to know enough to provide guidance.” And being fully briefed allows Drew to become an “activist” facilitator and to participate in a discussion when clarification is needed, or if he feels the need to push the discussion in a certain direction. “Drew was a walking encyclopedia,” says Nelson. “And he was able to present controversial material in a constructive way.”
At the same time, Drew believes that one can’t be an effective facilitator without the credibility that comes from his more than two decades of consulting—and facilitating—experience. Simply put, “A facilitation involving senior people can’t be done by a 30-year-old.”
Adds Nelson: “Drew had to work with some individuals with strong opinions. I don’t know how he did it, but he got everyone’s views on the table, including the hidden agendas. At the end of the day, you didn’t feel you were being facilitated.”
ACTIVIST FACILITATION UNLOCKS IDEASAlthough he favours the activist model of facilitation, Drew never loses sight of the essence of effective group decision-making: “It’s about the client. The solution has to work for the group, not for me.”
As for the techniques he employs to help people grapple with tough choices, Drew mentions three. “The most important thing is asking the right questions,” he says. Again, research plays a big part. “Before every meeting, I put together a detailed agenda, and I always develop a list of questions for each item. I may have 20 pages of questions for the one-page agenda that is distributed to the participants.”
Secondly, a good facilitator knows how to listen. “It’s all about listening more and saying less. Let the participants talk, even off topic, because it will loosen them up and spark other discussions that may turn out to be critical.”
Finally, a good facilitator has to know when to cut off the discussion. Before Drew begins, he tells the participants he will invoke closure from time to time and often establishes credibility by giving the hook to the senior person in the room.
UNDERSTAND THE CLIENT AND MARKETFor Rx Canada, Drew wanted to first understand the workings of the organization. What is the present business model of the company and what pharmacies are supporting it? What is the current and future size of the Canadian prescription market? What can we learn from how the e-prescription challenge is being met in each province and internationally?
Only after he found answers to these and other questions did Drew examine such issues as whether the ultimate objective of a national e-prescription hub would be technically, economically and politically feasible,
He established a working group of Rx Canada staff, Board members and experts from the pharmacy chains across the country. Participants were assigned particular research tasks and the group met four times over two months. Information and findings were reviewed, discussed and sometimes challenged. Research led to more research. Simultaneously, Drew met regularly with Nelson, worked with Rx Canada staff and met with all conceivable stakeholders in a potential national e-prescription hub.
DECISIONS COME FROM OPTIONSAt the end, Drew developed an analysis and strategic options that ranged from abandoning the current business model up to and including forging ahead with the vision of an e-prescription hub. When it came time to make the tough choices, there was considerable debate. Drew facilitated the group through the difficult decisions at the retreat. The result: a commitment to move ahead aggressively with the present business model and to continue to resource the pursuit of the e-prescription hub.
Meanwhile, the research and discussion process uncovered other opportunities for Rx Canada. Plans were proposed to grow the business through program enhancement, greater participation by current pharmacies and expanding market share by attracting new pharmacies. Together these measures now constitute the core components of the company’s business plan and are contributing to ongoing renewal of the organization, an unanticipated side benefit of Drew’s work.