How BMC’s Mail-Order Pharmacy Operation Scaled and Continues to Thrive During Pandemic?

By Sebastian Hamilton, Associate Chief Pharmacy Officer Outpatient Pharmacy Services, Boston Medical Center

As the COVID-19 pandemic began to spread across the United States, Massachusetts started to experience some of the nation’s highest infection rates. Similar to other states, state leaders established mandatory quarantine measures that essentially shut down the state.  Residents of the Commonwealth were asked to shelter-in-place to reduce the risk of exposure.

Boston Medical Center and many other healthcare organizations had to quickly pivot in many areas to ensure that care continued for all, especially our most impacted patients. Fortunately, our pharmacy department has always been at the forefront of innovation, which prepared us to remain agile as overall operations were immensely impacted throughout the pandemic. Using data-driven models to constantly raise quality expectations, the department continuously improves operations and patient experience.

When the pandemic forced our on-campus, community health center, and health plan patients home to remain safe, impacting thousands of patients and over tens of thousands of prescriptions a month, we were ready.

Our mail-order operations thrived during the pandemic. When the pandemic forced our on-campus, community health center, and health plan patients home to remain safe, impacting thousands of patients and over tens of thousands of prescriptions a month, we were ready.

Ever since the 7,000 sq. ft. mail-order operation, with an additional 10,000 sq. ft. of administrative space moved online in 2017, we have constantly sought ways to increase efficiencies and consolidate productivity while establishing the infrastructure to up-scale operations to a goal of 10,000 prescriptions a day for when the opportunity arises.

One of our first actions at the onset of the pandemic was to make intentional efforts to reach out to our patients, especially those with a higher risk of health complications should they experience interruptions in their prescribed medication regimen. This outreach effort required pharmacists, pharmacy interns, and pharmacy technicians to call patients daily and recommend our mail order program as a viable option to avoid medication delays. Patients expressed appreciation for us offering this option and diminishing the worry about how they would continue getting their prescriptions during the pandemic.

Our efforts resulted in prescription volume increasing 3-fold in a matter of days to weeks without any appreciable decrease in service key performance indicators. We were forced to quickly determine how to effectively and efficiently utilize our physical space to meet the growing demand. To keep our most valuable assets – our amazing team – safe, we immediately moved to a work-from-home model for the aspects of the operational process that could be performed away from the pharmacy.

Over the years, as our prescription volume continues to grow within a finite footprint at our on-campus pharmacies, we know we cannot sustain a model to simply add new team members to support operations. We will need to consider relocating specific prescription processing steps out of the physical pharmacy space to keep pace with efficiency while safely keeping quality intact.

Today, some of the best-in-class pharmacies leverage this strategy. Key steps such as prescription order transcriptions, pharmacist verification of transcribed prescription orders, along with compliance refill and return-to-stock calls can be performed away from the physical pharmacy space. This initiative requires a conducive and honest work environment that is supportive and efficient to ensure patient privacy and safety.

Thanks to several State emergency regulations permitting pharmacy interns and pharmacy technicians to work remotely while still under a pharmacist’s supervision, patient support outreach efforts like mail-order delivery for prescriptions was possible.

The pharmacy operations team knew before the pandemic what was precisely needed for a work from home model. Historically working closely with BMC’s IT department equipped the team with detailed specifications from data, computers, phones, and other hardware and software-related peripherals to safely perform tasks outside of the pharmacy, ensuring system integrity to maintain patient privacy. Such a valuable ongoing collaboration and partnership made securing and distributing these items relatively seamless, thereby allowing our team to move towards a work from home design in a matter of days.

The COVID-19 pandemic has challenged us in many ways and hastened changes in the way we think about and provide services to meet our patients’ expectations. With prescription volume continuing to grow and thriving despite the pandemic, we met and continue to meet our targets with a fraction of the team on-site. Our results demonstrated the importance of how ongoing proactive planning can help improve operations and prepare a team for the unknown or unknown opportunistic challenges that may be present.

We are embracing and adjusting to our “new normal” quite well. I am not sure we will ever go back to the old pre-COVID operational environment. While not entirely out of the woods just yet, we can take solace in the fact that we successfully served our patients when needed the most.


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