The Efficient Immunizer

Four Lessons from a Master of Productivity

By Dale Dauten, Syndicated Columnist

Spend some time talking with Josh Howland and you’ll find yourself getting excited about being more productive: How can we use our time better? How can we eliminate time spent “staring at a blank wall”? How can we accomplish more with our resources?

Josh, who works with independent pharmacies at PioneerRX, says, “We don’t sell pharmacy systems, we sell profitable pharmacies.” And while many of us don’t get measured by profits, we all share the same goal at work: The most profitable use of our time. So let’s get right to some ideas from a master of productivity…

  1. WORK THE CLOCK, or How can you do more in a day?

My favorite idea from Josh and his colleagues at PioneerRX is what they call Med Sync. This is where they coordinate a customer-patient’s prescriptions so that the refills all fall on the same day of the month. This is a clear convenience for the patient, but it has a profound advantage for the efficient vaccinator. Josh explains:

The pharmacist calls the patient the week before the prescriptions are to be picked up and this is where pharmacists can add value. For instance, they can say, ‘I see you need your flu vaccination. Why don’t you come at three next Tuesday and we’ll get that taken care of.’ The pharmacist picks a time when it’s not rushed for the patient or the pharmacist, so there will be time for a meaningful interaction.” He adds, “Adherence rates go up and the pharmacy can manage the inventory peaks and valleys.”

Notice that this doesn’t just smooth out inventory peaks and valleys but time peaks and valleys. The pharmacist takes the slowest part of the day — what Josh calls “time staring at blank walls” — and puts in highly productive tasks.

The lesson for all of us: Identify the least productive hour of your day and look for people/tasks that can be rescheduled into that hour.

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Another advantage of the Med Sync program is that it allows the pharmacist to have a real conversation while going over multiple prescriptions and administering vaccines. This is an opportunity to reinforce the pharmacist as the patient’s ally and medical expert. This is especially true when the pharmacist accesses bi-directional vaccination data. PioneerRX works with STC’s ImmsLink to allow the pharmacist to see the patient’s vax history.

“It’s our goal,” Josh adds, “to provide the right information to the right person at the right time. This is where software can add a ton of value. The bi-directional look-up of data is something we are proud of because we can send action items back to the store. We can create custom alerts, like all the patients who need vaccinations.”

The lesson for us all: If you want to have better conversations, have better information (especially data the other person needs to know and doesn’t know they need to know). Have a ready answer for “What’s new?”


We are eager to see PioneerRX’s next innovation: their new Pharmacy Finder mapping software. This will list all pharmacies (not just their clients) and will include what services each offers, including vaccinations. As Josh puts it, “It will be a way for customers to find the closet pharmacy that suits all their needs.”

Once again, there is an efficiency advantage as this automates the customer’s search, reducing the number of wasted calls or visits.

The lesson for all of us. We all need to know our FAQs and do something more creative than putting out a FAQ list. If you keep track of the questions asked, then you can play the game of finding creative ways to pre-answer those questions – Signage? Better instructions? Better design? The goal is to have a regular review of FAQs to see which are becoming less frequent.


One of the features of PioneerRX’s service is what they refer to as “success calls.” Josh explains how they work: “This is where we reach out to our pharmacies. We analyze their business and are able to tell them something like ‘We see that you’re losing money every time you fill the following prescriptions.’ Or we look at their inventory and tell them where they are wasting money – ‘The drugs you have sitting on a shelf are cash that you don’t have to do something else with.’”

Josh summarized the goal of the program by saying, “We call before there’s a problem.”

The lesson for all of us. Look for trouble. It’s the nature of immunizations to prevent disease, but not everyone takes time to anticipate problems with workflow or programs. For instance, is possible to foresee anti-vaccination efforts? Is there a way to have a “success call” to minimize them? (In a recent issue of IINews, we heard from one of the leaders of the Italian vax movement who told us that they’d created a counseling service for concerned parents as a defense against negative publicity around new vax laws.)

Our thanks to Josh Howland and PioneerRX for our efficiency lessons. Here’s more background about them:

PioneerRX has co-headquarters, in Shreveport and Dallas. They now work with over 3000 clients and Josh tells us that, “It’s the fastest growing system in the country. Of those pharmacies converting from one system to another, 38% pick us.”

Josh Howland has the ideal background for his work as a pharmacy profitability expert. He did his Doctor of Pharmacy degree at the University of Texas before going to work as a pharmacy manager for Walgreen’s. He eventually decided he “didn’t want a traditional retail pharmacy role.” Instead, he chose to follow his fascination with healthcare process improvement, taking on roles at CVS and then DaVita Kidney Care. He says of his work in those years, “I kept finding software getting in the way of good clinical care, and I discovered that I like working with the data folks.” So, in 2016, when the folks at PioneerRX came calling, he was ready to take on a role that included creating “a better pharmacy experience for patients, pharmacies, physicians and the entire healthcare team.”

We also asked Brent Holbrook of STC to tell us how PioneerRX client interact with STC ImmsLink: “The pharmacist signs up through PioneerRX, then gets an onboarding guide from STC that takes them through the process of turning on the interface with the state’s immunization registry. It’s very straightforward and we’re there to hold their hand if any problems pop up.”



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