This article is sponsored by PointClickCare. In this Voices interview, Senior Housing News sits down with PointClickCare Vice President & General Manager of Pharmacy Andy Brigant to learn how senior living made medication management more efficient and safe in the immediate wake of the pandemic. Brigant also takes us back in time to the start of PointClickCare two decades ago, back to the days when it was “a scrappy little company.”–
Senior Housing News: You came to PointClickCare in November of 2000. Show us what the company looked like through your eyes then. What were the early days like?
Andy Brigant: PointClickCare was a really different place back then from what it is today. When I joined the company, it was a small organization. There were 12 people. We were doing something that wasn’t the original focus but became the primary mission, which was electronic health records for all of long-term care.
Our two founders got to the decision point where they were either going to leave long-term care because it was a really difficult market, or they were going to need to change the way they approached the challenges so they could make a difference and be proud of what they were creating.
That made the company very interesting to me. While I was used to working for a well established Fortune 500-type of company, this small company was prepared to look at things differently, and try a different approach. They didn’t want to just stick with the status quo and make incremental improvements — they wanted to try to change the game and do something exciting. Long-term care was a little bit of a niche market where a lot of the bigger hospital players didn’t really spend a lot of time, and didn’t understand how to approach it in a cost-effective way, because it’s a market that is actually tough to make money in.
At the time it was a scrappy little company, with people who had all worked in some way or another in long-term care before, and were looking to come together to create something special. It was nice in that respect, having a common mission.
What did PointClickCare’s senior living customer base look like at that point?
When I joined the company there weren’t really any customers on board. When you think about what customers were trying to do and trying to solve at that time, they weren’t investing in technology at all. They saw electronic health record systems, if you could even call them that, as a basic compliance system that sat in the back office or behind a desk somewhere.
It wasn’t something that was in the hands of the caregivers trying to change how they interact with people and trying to change their workflow — picture most systems being managed by a kid from high school down the road. They weren’t leveraging systems in a way that could bring value. They thought it was secondary to their business as opposed to something that was going to change the way they did business.
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How has your role evolved at the company and is there any parallel track that you can paint between the evolution of PointClickCare and the evolution that you’ve gone through professionally?
I’ve been in a lot of different roles at PointClickCare. When I joined the company, I was on the engineering side. I was part of the first iteration of a product team where we designed new product and we started to figure out how we wanted to interact with customers. I’ve always gravitated toward wanting to understand our customers and get tightly engaged with problems that they’re trying to solve.
I think there are parallels between that and what it actually takes to make good products, and bring good products to market. One thing that is really important is learning how to get feedback early and fail fast. If you’re building something and you haven’t talked to a customer early in the process, you’re going to end up investing in something that, six months to eight months down the road, if you realize that it’s not hitting the mark, it’s really hard to change course and change direction.
Take us back to several months ago when the pandemic hit. What were the most pressing medication management needs that you were hearing about from both the senior living side and the pharmacy side? How did PointClickCare address those needs?
When the pandemic hit and people first realized how it was going to impact them, our customers were obviously dealing with a lot of challenges. You hear the heartbreaking stories about people with dementia who lose all their family contact, and staff are trying to stretch to be there for them where they can be. Those staff members are also having to deal with cleaning protocols and getting different guidance from people like the CDC and what’s coming down from the state, dealing with staffing issues and trying to sort it all out all the time.
All of this was frustrating and draining on our customers. When we tried to look at how we could help in the short term, it was really working with pharmacies and customers through operational challenges. We had customers where when they got through the testing, they realized the situation was really bad. Maybe 80% of both their residents and their staff were infected. We had facilities that just needed to completely shut down and move people to other facilities overnight. Working closely with our pharmacy partners we were able to help our customers with those big challenges.
To do that safely with resident information we needed to find a way to electronically move all their charts and all their information over to the new facility so that plan of care could remain in place when they got to their new location. It was a lot of scrambling, a lot of coordination working with the pharmacy partner, as well as the providers to make sure everything happened in a coordinated manner. Then, when they woke up the next day, they could resume operation. That’s where we found we could be the most helpful in the first couple of months.
What were some of the most creative, innovative solutions that operators were creating to address those needs?
On the medication side, there were a few things. Most people are thinking about how to reduce the number of single touch points when managing medications. Especially the way medications are usually given in a typical facility, there may be a med cart, or perhaps the way that medications are packaged leads to multiple people touching it across different shifts, which increases the transmissions risk.
One approach that we see people using to try to innovate and change their process to reduce the potential contact points is having meds stored in the room. It’s easier to sanitize when you get into the room, and when you leave, that medication supply stays in the room. You see other people changing the type of packaging on medications so it’s not a card or a bottle of pills that gets used repeatedly over a month — instead, it’s a compliance-style multi-dose packaging model where all meds for a pass time are packaged together.
Some are working with our pharmacy partners to not have deliveries come directly into the building, but rather have them dropped at the door. We’ve seen pharmacies introduce a grace period where staff can see if there are any issues with the delivery and still return it to the pharmacy after the driver has left. There are a lot of procedural things that people have found to be advantageous on the med management side.
Which of PointClickCare technological innovations this year were most exciting to you under these unprecedented circumstances and conditions?
One that I think our customers were really happy to see when it came out the other side was infection prevention and control. We were very fortunate that right about the time when COVID hit, we were in development of an infection management product and we were able to divert resources to get it out to our customers more quickly. We got that into the hands of all of our customers almost immediately when we realized the pandemic was going to be as big as it was.
We got tons of great feedback from our customers on that. We were glad that we could help them in an area that they needed, in a time when they had to put new protocols in place for effectively managing infections.
How do you advise senior living operators to select a strategic pharmacy partner, specifically as they look ahead to next year?
There’s always a choice to be made between working with local retail pharmacies and working with a pharmacy that specializes in long-term care. There are pros and cons, trade-offs to that. In some areas, it’s not in the jurisdiction of the community to decide on which pharmacy will supply a resident’s meds, but sometimes they can influence that decision. A community working with a long-term care specialized pharmacy gets a lot of advantages.
They know they can have systems in place that are specifically designed around long-term care workflows, and that are designed to speak with the community’s electronic health record system to make sure information flows back and forth. That is something that just can’t happen to the same level with a retail pharmacy system.
Even if someone is choosing between one long-term care pharmacy and another long-term care pharmacy, I would advise them to evaluate how well they can support things like integrating the EHR with their pharmacy system. Ask questions about how they currently support facilities that are integrated with their pharmacy. Look for referrals, and a track record that the pharmacy can speak to, and find other customers to speak to that they’re already supporting well.
What are you excited about for 2021?
In general, I think we’re all excited about trying to get back to some level of normalcy. I think everyone is sick of talking about things like PPE and regulations and sanitation and testing and wondering when vaccines are coming out. Hopefully we get to a good place with maybe some reasonable protection on things like litigation for facilities, where they’re not going to be worried if there are more lawsuits coming. They want to just focus on trying to keep their communities healthy and the residents safe.
Editor’s note: This interview has been edited for length and clarity.
The long-term care data you collect on a daily basis needs to be accurate, accessible and actionable. To learn how PointClickCare can help you improve your medication management during and after COVID-19, visit pointclickcare.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact firstname.lastname@example.org.