In this episode of UnBoxed, host Deb Menter sits down with Bri Robinson of Cleveland Clinic and Aaron Evans from Pitney Bowes as they discuss the evolution and future of pharmaceutical delivery. Bri shares her journey from community pharmacy to managing home delivery at Cleveland Clinic, highlighting how patient expectations have shifted toward a retail-like experience - fast, transparent, and personalized. Aaron discusses his work on the technology side, focusing on improving pharmacist workflows and integrating pharmacy systems to eliminate inefficiencies.

We explore the need to balance automation with human oversight to ensure patient safety, especially when it comes to temperature-sensitive medications or complex patient profiles. The conversation also touches on novel delivery methods like lockers, teleconsultation, and sustainability goals, stressing the importance of equitable access, regulatory compliance, and cost-effective care.

Key Takeaways:

• Accelerated Pharmacy Evolution: The pandemic forced rapid changes in how medications are dispensed and delivered, with patients now expecting healthcare to mirror e-commerce in convenience and transparency.
• Automation Enhances But Doesn’t Replace Humans: Technologies like intelligent routing, dynamic inventory, and AI help streamline processes but must be balanced with pharmacist oversight to ensure safety and personalization.
• Delivery Logistics Are Critical: Weather, geography, and patient circumstances heavily influence delivery strategies and require smart, adaptive logistics systems.
• Locker Delivery Faces Regulatory Challenges: While lockers could increase medication access, especially in underserved areas, varying state laws and concerns over pharmacist oversight complicate implementation.
• Sustainability & Integration Are the Future: There is strong interest in biodegradable, temperature-stable packaging and smart labels, fully integrated with health records to support both environmental goals and real-time clinical decisions.

Guest speaker: Bri Robinson, PharmD., MS, RPh, Pharmaceutical Care Manager, Home Delivery Pharmacy, Cleveland Clinic
Starting a career in community pharmacy, Bri built a strong foundation helping patients understand their medications before moving into the health system space. Over her seven years at Cleveland Clinic, she has focused on integrating logistics, patient care, and technology to enhance medication delivery and improve the patient experience. Bri is passionate about using data and innovation to make healthcare more accessible, efficient, and personalized.

Guest speaker: Aaron Evans, Director, Product Partnerships, Pitney Bowes
Aaron Evans is Director and Product Manager at Pitney Bowes, leading technology partnerships that modernize pharmacy logistics. With extensive ecommerce expertise, he focuses on improving workflows, data integration, and interoperability between pharmacy management systems and healthcare partners to create safer, more efficient experiences for pharmacists and patients.

Host: Deb Menter, Pitney Bowes
Deb is on the Client Lifecycle Team at Pitney Bowes, where she helps clients navigate complex rate changes, mailing system migrations, and greater shipping savings and value. You’ll also find her moderating Pitney Bowes webinars, where she addresses common client concerns and provides actionable solutions.

The material, opinions, and information presented in the podcast are for general information purposes only and is not professional advice. Listeners should consult appropriate professionals for specific advice tailored to your situation. The podcast and its content is provided as-is and any use is at the listener’s own risk. The views, thoughts, and opinions expressed by guests or hosts are their own and do not necessarily reflect the view of any company.

The material, opinions, and information presented in the podcast are for general information purposes only and is not professional advice. Listeners should consult appropriate professionals for specific advice tailored to your situation. The podcast and its content is provided as-is and any use is at the listener’s own risk. The views, thoughts, and opinions expressed by guests or hosts are their own and do not necessarily reflect the view of any company.

Deb Menter
Hi everyone, and welcome to UnBoxed, presented by Pitney Bowes, your source for all things shipping. I'm your host, Deb Menter, and I'm excited today to be joined by Bri Robinson, who is the Pharmaceutical Care Manager of Home Delivery Pharmacy for the Cleveland Clinic, and Aaron Evans, who is the Director and Product Manager at Pitney Bowes, who focuses on pharmaceutical shipping.

So this is a really important topic. I know it's on a lot of people's minds, all the delivery of medication, how it gets there, what happens. There's a lot to talk about. So Let's get into it.

Bri, Aaron, welcome to the podcast. And Bri, I'm going to start with you. If you can give us a little bit of your background and how you got to where you are today at the Cleveland Clinic.

Bri Robinson
Oh, absolutely. So thanks for having me. So I actually started out in the community pharmacy. I was the person behind the counter helping folks understand their medications, the counting and pouring.

That was me. Over time, I realized that I was super passionate about health systems and pharmacies and improving the overall experience for our patients. So that led me to pursue a position inside of a health center.

Thankfully, I'm from Cleveland and we have a pretty well-known health system around here. So I was able to get a position here at the Cleveland Clinic after I've been here for about seven years. And so during that time, i was able to transition into this role where I focus on home delivery pharmacy in the midst of logistics, patient care and technology and marrying all of that.

So I love it here. And that's how pretty much short version of how I got here.

Deb Menter
That's amazing. Thanks. Aaron, how about you?

Aaron Evans
Sure. So I'm based out of Austin, Texas. I'm responsible for product management, but particularly partnerships and ah technology and partnerships with other companies to provide better interoperability with the products that we make and sell.

And I've been here about 11 years. And around the time, a little bit after the kind of the COVID lockdown, I went into this space and we had, we saw a huge gap in this, in this space. Cause that pharmacy space was significantly disrupted and how they can dispense and distribute their medicines to patients. And so, I saw that as an opportunity working with a number of pharmacy management systems like Epic and McKesson and script pro and a number of these players to figure out how to manage and get data into and out of these very secure systems that are you know not they're you know not readily available to integrate to unless you really get connected under the hood.

So it was a journey.

Deb Menter
I love that. So it sounds like you're both really focused on the client/patient experience and how that gets improved. So Bri, can you talk a little about how that's changed over the last few years and how you expect it to develop over the next few? I know Aaron already mentioned COVID. We know that was you know, a big, big thing for all of us. So yeah, can you give us a little detail on that?

Bri Robinson
Yeah, that's a great question. But he's absolutely right, Aaron, you're right. Like COVID was a really big change in how pharmacy operated, how healthcare care in general, but as the part of healthcare care that leads to what people are able to do in their homes, we had to change with that. I think one of the biggest shifts we've seen is patients now expect healthcare care to feel more like retail.

Fast, transparent, personalized. That's what they really wanted. And honestly, I think that's fair. People wanted updates. They wanted to be able to control it. They want it on their terms.

And now that we have the technologies to give some of that, that's really where we were headed. And we, COVID if nothing else, expedited that process for us.

We have better tracking, easier communication, more flexibility in delivery of their medications, whether they're picking it up at a site or we're sending it to their home. So looking ahead, I think their experience will continue to get smarter, more proactive.

Instead of waiting for patients to reach out, we'll use data and automation and AI and anticipation to kind of lead them in that right direction. But yeah, a long way to go, lots of places to go, but I think that's what I'm seeing so far.

Aaron Evans
Bri, I'm not just saying this for your benefit, but I looked at the opportunity focused primarily initially on the pharmacist experience. I think you're, Bri, you're more focused on the patient experience, and I don't touch the patients as much, and I want to give you as much data as you can to provide experiences.

But just an example, this weekend I was picking up medicine and through just like a CVS drive-through, and which is, not a cool move i know it's better for me to get out of my car and come in i was just noticing she was just trying to finish the transaction and she's waiting on that long mile long receipt form to print that CVS gives you that use like Rapunzel we could climb a rope she was just waiting for it and waiting for it and waiting for it and waiting for it and it was like a 10 to 15 second delay and watch and she was touching her touch screen.

And the touch screen was not like your iPhone where it's haptic and it's hyper-responsive glass. It was like, she kept having to push the button until it recognized the screen. And I thought, you know, I can't solve this problem right here, but those sorts of things I internalize and take back to the business because every opportunity to reduce those touches and reduce the time that you spend doing a task and particularly shipping isn' ah is a, is time saved.

And so you know, when, when we really started engaging a number of these pharmacies, I went out and watched workflows and there was a lot of swivel sharing of data between platforms and systems, a lot of copy past information, lot of manual files being pulled in and updated and the people doing the tasks, unlike in e-commerce, you'd have, you know, temp workers or, so or, you know, warehouse workers, but in this, case I've got a pharma tech or a pharmacist actually performing that task, being consumed by pretty menial tasks. And you don't want to say it's menial, that it's not important because if you make a mistake, you know, it's not just a bad experience like an e-commerce someone can die.

So you have to strike a balance between, you know, good processes and efficient workflows that eliminate those opportunities for mistakes without slowing things down.

So, that's kind of me passionate.

Bri Robinson
Yeah, I think that's exactly right. If we're going to use our human capital the best way we can, and we really do need the technology to take care of the things that are more automated, right? And so we have this clinical knowledge that we can pour into our patients and into our work and ensuring that patients are receiving the best healthcare, care the correct healthcare in a timely fashion.

And if I can use my clinical mind and my acumen to do that and the system can take care of the more redundant tasks, then yeah, it should. And that's what we should be kind of pouring our efforts into.

Like I said, that's where the world is going. And so healthcare care has to come along. We have to.

Deb Menter
Yeah, you know you both I think you both mentioned automation to an extent, or at least like integration of platforms, which in a sense, you know breeds automation. So where do you see, how do you see automation fitting into what you do today, Bri. And then, Aaron, I want to understand the technology technological aspect also from the backend, but how do you see that building into what you're doing?

Bri Robinson
Yeah, for sure. So, I want to acknowledge that automation and the pharmacy world specifically has come a long way. We're coming a long way of moving past our conveyor belts and our pill counters.

Now we're looking at intelligent routing, dynamic inventory management, all of these things. And so that's where we're seeing a lot of that automation coming, making like real-time decisions based on patient profiles or delivery risk and things like that. And so I'm seeing a lot of automation move in that space and we're exploring a lot of that.

More than just like unboxed, where before we even get to the box, we are automating processes there as far as what who gets communicated, like what information, who needs to know, and at what point in the service. And so we see a lot of automation there, but even in the delivery process, I said, understanding where something is going. You mentioned delivery risks earlier and you meant in weather, that kind of piqued my interest of what those risks entail.

Yeah, so it's understanding what the weather patterns and some of our delivery spaces look like as our institution specifically delivers to 11 plus states at this time. And so as we know, the weather in Texas right now, even in different parts of Texas is significantly different than what we're seeing in Northeast Ohio, what we're seeing in Florida, we're at the Virgin Islands. So what we're seeing in the Virgin Islands and based off of that, if we can take that off of an individual, like you know taking the time to look up our weather.com forecast with every package, that's a product automation that helps us determine, do we need to deliver this now or can we wait? Based off of this patient's profile, should are they out of their medication or can they wait for a Monday delivery?

Based off of that, do we need to do a higher ah cost and potentially like high touch version of our delivery or delivery method? So automating all of that process with data analytics and all of that, it goes a long way.

Deb Menter
Does it also affect how you package something, knowing all of those weather details and ah temperature controlled and what you need?

Bri Robinson
Absolutely. The Board of Pharmacy for every prospective state respective state, but also the DEA and all of the regulating bodies as human beings care about how these medications are getting to the patient.

And based off of that, different packages, the depth of packages will be needed to ensure that it's getting to the patient in a timely and a safe manner.

Aaron Evans
You know, weather right now here in Texas is very hot. And in the winter, of course, you know you're in Cleveland and your area is kind of notorious for you know ice storms.

Bri Robinson
We're not averse to a lake effect snow.

Aaron Evans
Yeah, yeah exactly. Right.

Now, do you get you get information like that from sources like carriers or platforms like us? Or you have look for third-parties?

Bri Robinson
Yeah, and so we do based off of different relationships with different carriers from our ah procurement teams to even some of the things that we use for temperature monitoring organizations and companies that we use for that. They're able to provide us with information like that to help us make, you know, real-time decisions about how to not only deliver, but whether not we'll have what we need.

And so you know as a native to the area, We know it's coming. It might delay for a week or so, but winter is always coming. Now, spring might not always come, but winter does always come.

And so based off of that, just having a team that understand that, but having that information from our couriers and different ah partners does mean a lot and helps us automate and take some of the pressure off and understanding. So, yeah.

Now we having that integrated into our systems that we readily use is something that we'll continue to explore because anything that's going to make that process easier is really going to improve.

And I know you're focusing on the pharmacist experience, but for me, the patients are my passion. So it's going to improve the patient experience as well.

Aaron Evans
I definitely look at patient experience too. And I don't think there's so much opportunity to make it better. I had another hospital network inquire about, they serve a lot of underprivileged communities and deliverability and access of being able to even deliver to a location can sometimes be challenging. And so they were asking me of their, do we have data sources to say about, you know, deliverability in this neighborhood or at that address? And are there better access points for that patient to pick up their medicine versus, you know, at their door, maybe they're in an urban environment where it's just difficult to deliver or porch piracy, et cetera.

Or maybe it's that the actual patient might be kind of like a transient community or, you know people experiencing homelessness or, heck even that they're in, they're not in their hometown. They're getting you know, they’re at Ronald McDonald house or something and that's their town.

Bri Robinson
Yeah, and that's why I appreciate that there are lots of different tools and projects going on at the same time. I think there are a lot of improvements in novel delivery. We're seeing like in the headlines, drone delivery and different things like that that are really making headlines and are going to be amazing and improving access to rural areas, to just to the patient's home, improving that experience for those patients.

But for patients who though that's not an option for their area, recognizing that there are storage lockers, you know different things like that or different delivery methods that may require some continued conversation with different boards of pharmacies and things like that to ensure that you know the laws are in place to allow us to do those do that for the patient.
I'm glad that these conversations are starting to be had and we have accrediting bodies and advocacy bodies that are really working and pushing those conversations for us.

Deb Menter
Yeah, I had like two things kind of in my mind that, you know, even though Aaron, you're sort of focused on the pharmacist, a little more focused on the pharmacist and Bri you're focused on…

Bri Robinson
That's okay, Aaron. If you focus on me, I'll focus on you.

Deb Menter
I was going to say they're not mutually exclusive. If you give the pharmacist a better experience, the end result for the patient is going to be better. So it's really still that whole journey of you know getting things to the right place at the right time to the right people.

And that's the important part. But, and then secondarily, oh go ahead.

Aaron Evans
My wife is a pharmacist, so that may have answered.

Bri Robinson
Oh, see, you are used to taking care of the pharmacist. That's right. let me get my husband on the line.

Deb Menter
Bri, you know, you touched a little bit on lockers and the regulations that go along with it. And I know this is something, it's really popular. It's becoming very popular for many other types of deliveries across the country. And I think it would be really popular for medication as well, should it be do what it needs to do to for the regulating body. So can you talk a little bit about your journey with that?

Bri Robinson
Absolutely. So one of the things that I kind of speak to is definitely, and when I say we, I'm really blessed to work for organization that is extremely forward thinking.

And while we're looking for always continuous improvement and looking to improve on what we have, it's always what next, how can we continue to drive pharmacy services for the patient experience forward.

Yes, they had Cleveland Clinic Care while they were in the hospital. How do we keep them out of the hospital but still have that amazing experience? And this is all a part of it. So what that means for us as we look at lockers is expanding access.

If I can't physically put a pharmacy in a place, if that is not financially or logistically something that we can do right now, how can I still ensure that these patients have their medications?

And that is something that lockers can help us solve in different areas. We may not be able to keep all pharmacies open 24 hours. As you anyone that an American can see, we have had over half of the community pharmacies that were opened over the last 10 years closed within the last five years.

Like if we look at where we're seeing our retail pharmacies, these chain pharmacies, You can go into any city and see, oh, that used to be, and that used to, be you know, you see everywhere. And so lockers is some way that we can help improve that access and maintain that access.

What we run into there is the legal requirements of every individual state. Where can these lockers be to ensure that medications controlled or, and non-controlled are safe, that the correct patient is the only one that can access these?

Like, how do we do that? How are we stocking these? How are we ensuring, how we dealing with medication changes? One of the things that I find beautiful about working at our health system pharmacy is because we're within the health record, the shared medical record, I can see when the provider makes a change.

If that's in a locker and they make the change, how are we notified? How do we lock down the locker? All of these things kind of go into you know, how do we make this? How do we collect the payment? How do we make changes once that happens? So all of these things go into why it isn't like, why do we didn't do it, you know, yesterday year.

Right. But they're all things that we're exploring. And as we look at the footprints that we have in different states, like Florida is different than Ohio. So we may see something move a little bit quicker in that space than it does here for some things. But knowing then that we can then go talk to the Board of Pharmacy and advocate for the changes that are necessary to say, hey, we have clinically sound pharmacists that are supporting this work.

And we're not replacing the pharmacist. I will never advocate for replacing the pharmacist. As I look at that, that's really what we're seeing. We're seeing advocacy in the spaces to help us better take care of our patients and increase that access in a space where that fast and furious, that retail, that prime model of receiving things is starting to take over.

How do we give the patient the experience that they expect while still actually giving them what they need? And that is where we're seeing this. How do we make ourselves available for real-time counseling?

Sometimes people are like, oh, I know I don't need it, but we know that you do need and so how do I move that? How do I provide for you if I'm not giving this to you anymore?

How do I stick those nuggets in there? And so these are all of the things that we're considering. While we want to make it more convenient, we cannot compromise safety.

Aaron Evans
Absolutely. 

There's so much in that. And it's timely actually, this conversation is boiling up internally as well. And indeed, state by state. So one example, North Carolina does allow lockers and access points as a delivery location for pharmaceuticals.

And the person that sent it to me was in state of Georgia is sort of like, Hey, this is something we can look at as potentially repeatable. There are some, you mentioned so much in there that just gets me curious. I hope I don't get too long winded here, but it's thinking like that consultation thing is a thing that completely goes away. If it's the lockers, the delivery point.

But it doesn't have to for this technology. I mean, the locker, I've seen some locker system have a screen and an actual handset to consult with a pharmacist. Although it looks like it, I don't know if I'd want to touch a handset post COVID anymore, you know. But I do have a, you kind of think there might be telehealth opportunities that, you know, you scan a QR code and it makes a IP video call to the pharmacist who may, might be around the corner or they might be down the street.

The other piece that, that came to mind, you know, about the 24/7, you know, you're not always available 24/7, but patients are being discharged 24/7 from the hospital. And if they can't get their meds, they either have to keep them in the hospital, which means it occupies a bed, which could be available to another patient.

Or they're, they're going home without their medicine and that's not ideal either. So, you know, there are concepts about, you know, using lockers to forward position things that maybe the local doctor or the nurse practitioner or someone is the person that's accessing a locker and not the patient. So there's still some level of consultation.

On the inverse, for certain medications that are maintenance or routine that you take every month, we get those in our mailbox today. And that's a much less secure and there's much less chain of custody. So in a lot of ways, lockers represent an opportunity to have a much tighter chain of custody of who's accessing and touching then your mailbox.

So the legislation is a state by state's case basis, but I think over time experiences are going to rule out. And, you know, every time you stand in line at, at a pharmacy to pick up a very benign, boring I don't think the pharmacist really gets your blood pressure medicine

Bri Robinson
Hey, never boring

Deb Menter
Maybe routine

Bri Robinson
Routine maybe but never boring

Deb Menter
No, I think you make a really good point, Aaron, that like i don't get any of my medications delivered now, but I used to because also that that is also a function of the cost of delivering the medication, which I know, Bri, you are very familiar with as well. And who's absorbing the cost of that delivery? Is it the consumer? Is it the pharmacy? Is it the medical health facility? Who is it?
And, so, you know, can you actually talk a little about how your team handles that?

Bri Robinson
Yeah, for sure. So i think that's something that comes up in any place as the cost of medications rise, as different legislators like legislature leads to changes in the cost of medications, the cost of delivery and things like that.

Every organization, and every team is looking to manage costs. And so where that cost lies, I know that there are some organizations that pass it directly on to the patient, right? But our organization has chosen to go with strategies that helps not let that be a burden that is housed by the patient. like So there are no differences for us if a patient picks their medication up at the local pharmacy or if they have it delivered, we do not create a change in their copay based off of that.

And so based off of that, that is something that we've been able to create contracts and like pricing to help support that for the patient here. But I definitely do understand, like as we I think it's almost like I am empathetic to the organizations and to the entities that are not able to absorb it in that way.
Real quick, I'm going to take a step back and then come back. Aaron, you did mention ah the lockers and who can access them. I think there's something that you brought up to just clarify that there are two very distinct different locker designs or delivery methods there are discussed.

There's the patient specific, which fewer boards of pharmacy have an issue with that. Big time, absolutely. This is for a particular patient and then we'll get, you know, a patient can pick it up. What more states have an issue with is having something that's more like a vending machine, more of that vending machine model where it's not patient specific.

And so the drug is there and then you get a special code and you just go in and check it because now you have a particular. This is where more boards of pharmacy have an issue with that because you didn't put it in there for a particular person.

But now based off of information that is not being reviewed by a pharmacist against a particular patient profile, you're allowing someone to access that. And so while I do see the benefit of it, we then do have to have a take a step back and consider that's what that is today.

But if we approve this, then what is there to stop them from saying, I don't need the pharmacist. I don't need the pharmacy team to review this.
I was able to review it with this. And so I think those are the questions are pushing back against.

Aaron Evans
I can give a specific example of where that that's going to come up. So I take antibiotics ah like daily, a very small dose just from like an injury when I was a kid of my kidney and occasionally it doesn't work. And so I have to go get something prescribed that's different.

And every time, which is a good thing, the pharmacist will get a flag and them come up like, hey you know, you can't take two antibiotics at the same time. Like what's up with this? And I'll explain to them, well, how is that going to work in an automated?

Maybe be the dispensing thing can have some kind of exception, but how is it going be able to take a human judgment call to say, okay, this patient knows what they're talking about and they're not going to do one or the other.

A machine's not going to be able to do that. And that, that requires you know, somebody that knows A, what they're talking about and B understands the patient. You have to have a human in the mix. Anytime there's like human lives at stake, you know?

Bri Robinson
And so I think that's one of the things that we're seeing that there are still decisions that need to be made. And so while we use it automation and we want to implement all of this and there's so much benefit for it, we do need to weigh it against, like I said, we never want to sacrifice safety.

There's just certain things that artificial intelligence hasn't mastered, can't master as it relates to the relationships that pharmacists are building yeah with the patients and able to see and review in real time.

Data and circumstances change ever so quickly and ever so lightly. And so something that could be a calculated small risk based over overall data that can be absorbed into a system might be a larger risk for a particular patient.
And that's something only a human can view and you know assess based off of time spent in that chart in real life experience. So it's it's a balancing act, but yeah, we see that in so many cases.

Aaron Evans
Bri, you said something earlier that brought a memory back that's just worth discussing, I think, about you're absorbing the costs of the delivery.

What I was surprised by in in meeting a lot of pharmacy leaders is that they were using the exact same language. They had become experts.

Maybe they always were. But my perception is the COVID changed a lot of that. And so they had become pretty impressive experts at all things delivery, whether, you know, regardless of carrier or a courier, they were using the language, they understood zones.

You mentioned weather and concerns that no one thinks about in their day-to-day activity. And, you know, I would imagine normally in a pharmacy and suddenly you're considering weather considerations and how the medication gets dispensed and delivered.

Those were eye-opening.

Bri Robinson
I think that's something that we see. Like it's something that we've seen happen. COVID, did a lot to healthcare care and healthcare providers in the health system.

Some people who were extremely patient focused, like somebody had to rise and be concerned about the costs and be concerned about how we can create sustainable models so that we can continue to take care of the largest number of patients in excellent way.

And so I think that's what's facing everyone, which is why I'm saying I'm so empathetic to that. But where I see my role, particularly as a pharmacy leader, is freeing up that thought process from my caregivers.

If I'm thinking in that language, if I'm able to build strong relationships, me and the procurement team and supply chain are able to build strong relationships with dependable third parties who can take that care off of us, then we can spend less time talking about shipping rates and right-size packaging and the weather patterns and the cost of shipments for you know this versus that, or whether or not we should add this value added you know service line.

If I can take that away from my team, then that frees up my team to be able to say, you need it, you need it. And so I'm going to get it to you. And so I'll have the conversations in the background. If that means that a group of caregivers who are passionate about a patient care still can have those meaningful conversations and move that into the patient's hands, but figuring out the best way to balance it and how to make it a part of receiving and providing excellent care.

Deb Menter
That makes a lot of sense and you want your people doing what they do best. And yeah, someone's got to talk about box sizes and rate shopping and all of that other stuff that is part of the shipping journey, but you know, those people have to be focused on the right piece of the puzzle or each person has to be focused on their piece of the puzzle.

Bri Robinson
Their piece of the pie.

Deb Menter
Yeah.

Aaron Evans
How much of your time is spent updating patients on where is their package? This is another part of where automation in this process is really important.

Bri Robinson
Once a prescription or order is prepared here, a message is sent back, tracking information is sent back to the patient automatically through our electronic health record.

And so that patient can log in and track it along that journey. And so that frees up a phone call worry from the patient of wondering like, is it, did it get done?
Like, think is it on its way? And so that patient is receiving those real time updates. They're also able to coordinate with those third parties or their couriers to set up additional delivery methods.

Do you want to you know get a notification as soon as it's dropped you know at your door? Do you not want it dropped at your door anymore? So those are things that those relationships and strong relationships with those third parties and increase like creating relationships with the right third parties frees us up the pharmacy staff up from worrying about what happened after it left our door.

And so we don't really spend a lot of time updating patients on that because automation and strong third party relationships have taken that burden off of the pharmacy team.

Deb Menter
That's great. I think what you said about making sure it's the right third party is so critical. And that's across all industries, you have to make sure you have the right partner to meet your needs and your, in your case, patient's needs.

Most people these days, and you, Bri, mentioned also like the Prime model that everyone is kind of adhering to. And we all have become so attuned to like, as soon as something, as soon as I order something, I want to know as soon as it has shipped. In this case, like if it is an auto renewal, like I want to make sure that it's coming. Are you finding that your patients are adhering to that model of like, I want to know all of this information immediately?|

Bri Robinson
I think just like the workforce, like just like everything, it really depends on the patient, their experience, the patient demographic, you know. If that patient is also a Prime user, then they tend to be relatively more. And so making sure that for the patients that want it like it's available. You have a lot of interest for that.

And it's not just the patient accrediting bodies. especially working with mail order in specialty pharmacies. These high-priced medications for really important or really specific disease states.

And so the accrediting bodies and the insurance are wanting to know, like, did you really send it? When did you send it? We need to understand how long it took for to get to the patient.

So, because this is information that is needed for a number of stakeholders, that's information that we do need to be able and ready to provide in several different formats. And so, you like you said, partnering with the right third party allows us to do that and be able to pull the data when we need to.

Aaron Evans
Everyone is asking for and still asking for the “pizza tracker experience”. That was the phrase. And in a lot of spaces here, with especially with the mainstream carriers, we don't really have those experiences yet. You have a very traditional chain of custody experience, you can only see the last place someone touched it. You can't watch the good move, but especially for these higher dollar therapies, the there are other experiences. We notice when you do an analysis and this isn't case by, I mean, you have 11 states that you serve, but quite a lot of the delivery area radius that a pharmacy is serving is their local community.

So it's a very tight grouping, which carriers love because they don't have to go very far. But I mean, we even have a product for this where you can kind of put the, the, you know, the, the pizza hut sign on the top of your car and have an employee do the deliveries. And you know, the platform, the software gives you the device. It gives you the trackability. So people can watch you on your route and that you can scan a delivery scan and take a picture of it in the, and propagate that back into the health, the HR system.

And down the road, surely enough, nine and a half years later in a payer audits at trying to claw back their money that you're able to produce that delivery, you know, not just the, you know, I can envision not too distant future that they're not, that a signature is not going to be sufficient proof of delivery. They're going to want to see a picture. Maybe, maybe you take a selfie with the person. I don't know, but, that kind of data, it's data rich, but those are the the demands that I'm hearing from, and those demands can't all be met by every technology player yet. But that's what people and patients already experience from like an Amazon and other newer delivery experiences.

Bri Robinson
And I think this is where it comes into looking at where, of course, I'm always going to be on the side of health system pharmacy. So, please understand that.

A little biased in that area, but this is where looking at these delivery options and these relationships and the cost of the delivery and the cost of providing this healthcare is going to come into play. If we can save or save money in different areas, not by cutting the quality of care, but automating processes, build better relationships with some of our robust health like systems, and then you know integrate with better relationships with these other smaller contracts and third parties, then we can splurge, if you will, on some of these newer technologies or figure out ways to optimize that. How can we get this experience and provide an experience, number one, that we need, one that the patients want, and then one that is affordable for us to continue to provide it consistently.

I think a big thing for us is we don't want to provide excellent care for two patients, but terrible care for eight. We value the lives of every single life that we are monitoring that we're caring for. 

And so it's about creating consistent relationships and like producibility. Like, can I produce or reproduce this model consistently for every patient that needs it? And what will that cost us? And to provide that, what will I have to give up? And so needing to understand, you know, all of that. Obviously a very specific thing in the healthcare care space because of what you're providing.

Deb Menter
But I feel like so many different industries have that same feeling. You want to serve the many and you want to make everything consistent.

One last question, I think, just to wrap this up, because we talked about a lot of different things, a lot of different technology, and which is amazing. And so I just wanted to get a sense, you know, we touched on sort of the locker piece of what that may look like in the future, but are there other things that you're looking for, looking towards for the future of ah you know pharmaceutical delivery?

Bri Robinson
So if I had a magic wand, if I had all of the things, the stars aligned everything. I want a cooler packaging that's biodegradable and temperature stable.

I want smart labels that change color if a med is outside of the range. So that we don't have to worry about like there's consistency and knowing we're not worrying what a patient was like, it feels warm-ish. And you're like, well like do you have neuropathy? Like, we don't know. Is it warm? Does it feel warm to you? So that the patient doesn't even have to read it. Like, what are you seeing?

I want that fully integrated into the patient's health record so everything is connected. And so if that reports back, then I know before the patient even knows that that was an error or if temperature monitors can then be connected to us, but I want it costly. So it needs to be biodegradable.
It needs to be something or a technology that the patient doesn't need to return to me because that increases shipping costs.

Aaron Evans
I saw this person that had this like much nicer corrugate box that once it was delivered, you could fold it up as a flat and ship it for like 50 to a dollar, 50 cents to a dollar back to. You still have to do some work, but it's reusable asset that's durable.

I don't know about temperature control, but there are some concepts of biodegradable makes sense logistically. People don't want to have to if they don't want, they would prefer to just discard it.

Deb Menter
I think the biodegradable conversation and just like sustainable packaging is such a, I mean, I've already had a podcast at least one, and I think there are more coming on that topic because it's not just about what even what we want, but there are now laws being implemented across different states about the type of packaging to use, how much void pack, like there are so many things that people are focused on. So that is absolutely the future.

But I think it's such a vital part of all the whole shipping conversation is how do we make it more efficient and lowering our carbon footprint? Because if the packaging is smaller, we can ship more things and it can fit we can fit more things into the same ah you know on a pallet. And just though the way it's viewed, is…there's it has a lot of legs.

Aaron Evans
There's a sound out of my window right now, Debra. I can hear the garbage man collecting my bin. So there are already people going through every neighborhood, picking something up right now. They're just taking it to a landfill, but if it could be reusable assets or things of that nature, it's almost to me seems like at some point it needs to be become something. the way you look at trash collection, like a utility that you just pay for as part of living.

Bri Robinson
And then that's creating, like that would require, sorry, see now all of us have the magic want. Look at this. Now that will require some communication and consistency across fields.

I think the thing is, as we start talking about temperature control, pharmacy is not the only area that is focusing on that and thinking about that. There's grocery, there's retail in other areas.

And so in order for something like that to work and to be built into our infrastructure, it's going to have to pick up traction in different areas. But that ends up just being that thing, creating the new normal.

Deb Menter
I think we're going to end the conversation there. This was so insightful. Thank you both Bri, Aaron. Thank you for your time, your expertise, your insight. It was amazing. So if you like what you heard, please listen and subscribe and we'll see you on the next episode of UnBoxed.