The Bottom Line Pharmacy Podcast: Layering the Medication Adherence Cake with Jennifer Whalen, Medsense and Matthew Gilbert, RxSafe

Pill bottles don’t talk…but what if they could? Now you can know exactly how (and when) patients take their meds.

That’s the power of Remote Therapeutic Monitoring! And on this week’s episode of The Bottom Line Pharmacy Podcast, we’re diving into the mechanics of Remote Therapeutic Monitoring.

Bonnie Bond, CPA, and Austin Murray sit down with Jen Whalen, Director of Clinical Operations at MedSense, and Matt Gilbert, VP of Business Transformation at RxSafe/Eyecon to explore:

• Remote Therapeutic Monitoring as a New, Billable Revenue Stream
• How real-time adherence tracking works with any packaging
• Long-term Care Layering and How MedSense Fits right in
• Reducing Workload While Increasing Patient Insight

Join the discussion with us!

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If you prefer to read this content, the video transcript is below:

Bonnie Bond, CPA, MBA: Welcome everybody to another episode of The Sykes Bottom Line Pharmacy Podcast. We have great guests with us today. Very excited. Jen Whalen, from Medsense. She’s the Director of Clinical Operations. She’s going to talk to us about MedSense and what that is. If you haven’t heard about that, you definitely need to stay and tune in for the remainder of this podcast. And then we have Matt Gilbert from RxSafe Eyecon. We appreciate both of your time today. Jen, let’s go right into MedSense. What is MedSense for those who have not heard about this? 

Jen Whalen, MBA: Yeah, absolutely. Well, first of all, thanks for having me today. We’re here at MedSense. We’re essentially an end-to-end solution for pharmacies to help address some of the medication adherence concerns and challenges that you guys are facing. With MedSense, we have everything. We have the partnerships with our nationwide network of physician providers. We have the hardware software that tracks medication adherence, collects that data, and puts it out to our pharmacy partners so that they can take action on it and really work with the patient from an adherence side. I work with our pharmacy providers and then we do everything all the way down to medical billing for that. When we talk a lot about Remote Therapeutic Monitoring, which is the program we work through here at MedSense, one of the biggest concerns our pharmacies have is how do I have this service and how do I get paid for it because it’s on the medical side of the offerings and our service solves that. it’s a great way that we work with pharmacies to provide those services and generate revenue to go with it. 

Bonnie E. Bond, CPA, MBA: Yeah, and that’s huge right now. We preach to our clients, just filling scripts these days is not gonna cut it the way things are right now with PBMs. So we have to do things like this outside of the box, obviously, to generate extra revenue, especially when you’re sort of already doing some of these things. And we all know that adherence is so huge. It can make such a big difference. I was just having that conversation this morning with a client, just for one person, just one extra fill a year. And obviously, patient health is the most important thing. That’s what we’re, that goes without saying. But on the business side of things, keeping people adhering to their medication and then making sure you’re getting that full amount of scripts is important. So, it’s a big deal. actually, thought about my husband takes two medications. I was thinking about that this morning. I love the caps that tell you if they’re adhering to their medication or not because we just got in a fight last night that he needed a refill of his of one of them, he was out. He’s supposed to be taking them both every day. So while one has half of the pills left and one does not, he swears he’s been taking them both. And I’m like, well, obviously you haven’t. And then I can’t get the other one filled yet because it’s not time and I’m like so now I have to go twice so anyway I would love to have this just for my the argument that we were having last night.  

Matt Gilbert RxSafe/Eyecon: Sounds like he needs some pouch packaging too, Bonnie. 

Jen Whalen, MBA: Absolutely. Absolutely. And you brought up a really unique point too, because you were talking about like the caps, right? And the bottles and Matt mentioned like the pouch packaging, et cetera. That’s one of the things with MedSense is it doesn’t matter what container you have, whether we have solutions for a pouch packaging, whether it’s caps, whether it’s inhalers, you name it, whatever container you have, we have solutions for. So, it works really, really well along a lot of different angles that fit kind of what those pharmacies are using with their patients and with their clients. 

Bonnie E. Bond, CPA, MBA: Yeah, and this is just another step beyond what you’re gonna get in a big box store. It’s patient care. It’s awesome. So, tell me about that, Jen, when a pharmacist has monitored some of these things for a certain period of time, is it something that just, when they come in again, it’s a conversation, it’s a report you get? 

Jen Whalen, MBA: Absolutely. So, the way that it works is, know, when we work with a pharmacy under Remote Therapeutic Monitoring, that program covers two, like ranges of conditions. And CMS says that that’s respiratory or muscular skeletal. We’re primarily are working with those senior patients, that senior population. So, while it’s two, you know, segments, there’s a lot that falls under that, right? So it can be, you know, arthritis, it can be respiratory, COPD, everything. So, when a pharmacy works with MedSense for that, we provide the, you know, the sensors or if they’re getting pouch packaging, which Matt works with, we have a box that it goes in and it senses the motion on that. So, it recognizes if they pull the packet, if they open the cap, et cetera. So that data gets fed into a like platform and software that the pharmacy has access to. So typically, in pharmacies, you have an idea about how adherent a patient might be just by, do they fill it on time? Are they early? Are they late? But then it’s more of a conversation. The cool thing about MedSense is it actually shows you the data, like up to the time that they took it or open that cap, right, for the prediction that they took it.  

Bonnie E. Bond, CPA, MBA: Nice. 

Jen Whalen, MBA: So, they have that information and that’s the really cool baseline data that now they can have a lot more in-depth conversation with those patients. So, the pharmacists, the technicians, they see that information. And now when they’re having that conversation around adherence, it’s not just, you taking, are you not taking your meds? Are you taking them on time? Right? Is that medication, a medication that should be taken in the morning? And we’ve seen patients that they’re taking it in the afternoon. And now suddenly they have a whole host of side effects, right? That no one may have identified, but the fact that you can actually see that type of information, you can have a whole different level of conversation with your patients and make a completely different impact from an adherence standpoint and build that relationship with your patients. They’re not going to get that anywhere else. 

Bonnie E. Bond, CPA, MBA: Right. So that’s very interesting. I haven’t even considered that. So, it could be someone that actually took their pill every day, but you could actually, and so they actually checked that box, but they didn’t take it at the right time. The fact that you can see that, I guess, hour by hour, minute by minute, is very interesting. So that’s, wow, that’s really digging down into the, you know, the root cause of what may be there’s some other issues are. Yeah, that’s awesome. 

Jen Whalen, MBA: Yep, and we’ve seen it, we actually had it. I said, we’ve seen it, where we had a family that said, we’re getting notifications that he’s not taking his meds. But when I go to the house, the meds are gone. And he’s telling us that he’s taking it. Well, what we found out was he was taking it in the afternoon, not in the morning. And it was a certain type of medication. Then now suddenly it explained everything. They said, you know, dads irritable. He’s not sleeping. We’re having all of these issues. And once they identified that and realized he’s taking it at the wrong time, because they could, we could see the data, and kind of told them what was going on with it, it was a complete game changer. 

Bonnie E. Bond, CPA, MBA: That’s great. 

Matt Gilbert RxSafe/Eyecon: I think one of the interesting things, I was actually with one of our rapid pack customers yesterday in Ohio and we were taking them as part of our package. We show them how to sell not only pouch packaging but go and get into new business lines. And we went out to, I think we hit probably 15 or 20 home health agencies. And one of the huge things that we promoted as part of the pouch along with MedSense was not only is the pharmacy tracking this, but we can give access to those apps to a family member and or a caregiver. So, if you’ve got, you know, two, three lines of oversight over a patient’s medication, the adherence is just going to go through the roof. And that was a huge selling point that these home health nurses were buying into because nobody else was offering this in the area. You know, some people were offering pouch packaging, but it didn’t take it to that next step of really monitoring the adherence in real. 

Bonnie E. Bond, CPA, MBA: Yeah. Wow. 

Austin Murray: Yeah, that’s really interesting. That leads right into the long-term care piece that I know we wanted to, long-term care home piece that I know we wanted to talk a little bit about. So how does a long-term care pharmacy layer this into what they’re already doing for patients? 

Jen Whalen, MBA: Yeah, it fits really well. I think layering is the exact word for it. I think we called it layering the cake at the Atrium conference. With those long-term care patients, the pharmacy already has a whole process and a whole communication cadence with those patients. And they have to be in some kind of compliance packaging. So, where they have those strip packaging, what MedSense does is it provides the opportunity for them to work through Remote Therapeutic Monitoring and that program it’s simply making sure they have a call with, the patient has a call with the physician that confirms their eligibility, essentially prescribes them the RTM program. And then when they’re using that strip packaging, we provide a permanent box that those strips go in that has the sensors in it and recognizes when they’re pulling those packets. So, the pharmacy is already having that monthly communication with them. They’re already getting the medication out in the strip packaging. At that point, MedSense can provide the equipment for it. It gives them more insights and data. And when they’re already on the phone with that patient to have that monthly check-in, to have those points of contact, they simply work in that clinical discussion around their conditions, which they’re probably already doing. So. You know, in that case, they’re not adding any extra work into their process. They’re just using those channels that they’ve already established through long-term care and adding a Remote Therapeutic Monitoring program for that patient and getting the data back from an adherence standpoint. 

Bonnie E. Bond, CPA, MBA: Perfect. Yeah. It’s a no brainer, right?  

Matt Gilbert RxSafe/Eyecon: Get paid for those services you’re already doing for free. That’s my motto. 

Bonnie E. Bond, CPA, MBA: Exactly. Yeah, exactly. Yeah. It’s like, you know, pharmacists are now becoming insurance salesmen because they’re already having to do the work in the, you know, December timeframe. You might as well get paid. We’re doing it. 

Matt Gilbert RxSafe/Eyecon: Right. And all that gets built into this ecosystem too. It’s like the more things that a pharmacy can offer and make a turnkey solution, the easier it’s going to be. And the more, honestly, the more financial gain that the pharmacy has. I mean, regular dispensing just doesn’t cut it anymore. Margins are way too thin or negative margins in a lot of these aspects on the retail side. So, you’ve got to branch out and diversify. 

Bonnie E. Bond, CPA, MBA: Absolutely. That’s the name of the game right now, Matt. I mean, there’s no way around it. We see it every day. Well, Jen, how would one get started with something like this if they were interested? 

Jen Whalen, MBA: Yeah. So pretty simple and straightforward. What we do is if you have interest in it, reach out to us and I’m sure we’ll get you the contact information or you can go on our website, Medsense.health and there’s some links to get some additional information. But really what we start with is, know, once we have the BAA and we have those legal agreements in place, then what we can do is we can establish and check how many of your patient population would be eligible. And when I say eligible, what we’ll do is we’ll do the insurance review and insurance discovery because when talking with pharmacies, we have to remind them this is a medical service. So, it isn’t their prescription insurance. It’s the medical insurance. And we have ways that we can just based off of their patient demographic information, we can go out and we can do the insurance discovery and determine what patients have what medical insurance. And then what MedSense does, we go one step further and we then go and check to make sure, okay, will the insurance fully cover RTM services? So, we check that individual by individual so that then we can tell a pharmacy, hey, based off of your patient population, here’s what you’re seeing as far as the number of folks that would be eligible and fully covered for the service. Because one thing that’s really important, we understand that the cost of medication is a big thing for patients, right? So, what we’re looking to do and what we find is there are certain groups of patients that are eligible, typically dual eligible, dual patients, and then patients that have Medicare supplement insurance, that’s typically fully covered. So that service is essentially free to the patient. So, we can go we’ll go through we’ll go through that data with a pharmacy. And then what MedSense does is we have an entire like end-to-end onboarding program where we’ll get everything set up. We will you know get the pharmacy educated on the platform. But then what we do, and our goal is to take as much work off the pharmacy as possible. So, we have a team that does all of the outreach. These are US based agents that they do nothing but call and explain the MedSense service and talk with the patients and get them interested in it. They do all of the scheduling because those patients would have to, they have a quick telehealth consultation with our physician. So, they do all of the scheduling for that. And then MedSense actually ships the equipment generally directly to the patient. And we will do the assist; we’ll do the setup with the patient. So, our goal is at that point, everything’s done by MedSense. We’re not asking the pharmacy to do any additional work. The one piece that we ask the pharmacy and that we require from the pharmacy is to do one check-in with a patient a month. And that’s just making sure that, the whole program of RTM is to help keep patients’ adherent. So that would be the pharmacy quickly reviewing the report that we have and the data on their medication adherence, and then doing that check-in to make sure that the patient is doing well on their medication regime, that the meds are working as they need to be working, and they’re answering any clinical questions to make sure that they’re getting the most out of  their medication to maintain and help those conditions for them. So really quick, easy setup. We’ll get you the data. We’ll walk through the numbers with you. We do all of the setup and all the outreach for the patient on the back end and get them onto the platform. And then once a month, we just ask for that check-in. And it could be something where the patient’s already in the pharmacy. So, they’re just doing that check-in when they’re picking up the medications, or it’s simply picking up the phone and having a quick phone conversation with the patients. 

Bonnie E. Bond, CPA, MBA: Great. I love it. 

Matt Gilbert RxSafe/Eyecon: Yeah, I think one of the key things about MedSense, I mean, we went down the RTM path about two years ago, looking for a good strategic partner in the space. And the thing I can say about MedSense is they really created a turnkey solution with no device cost, which is huge. You know, there’s probably four or five, six other big device companies out there. 

Jen Whalen, MBA: Super easy. 

Matt Gilbert RxSafe/Eyecon: And the problem with all of them is one, they usually involve a cell phone or a computer component, where you have to teach the patient how to use it. You have to go and do a hard setup process. And there’s a big cost, you know, in the hundreds, if not thousands of dollars. So, with MedSense, the box cost is already baked into the contract. So, there’s no upfront cost for not only the pharmacy, but also the patient. So, getting that device into their home, like Jen was talking about, they drop ship it. It’s literally plug a hub into a wall and set the box on the counter. No setup other than that. So, it’s really just a simple solution.  

Bonnie E. Bond, CPA, MBA: Right. So, you really don’t have to train the patient at all. But you just try to do it. Yeah. 

Matt Gilbert RxSafe/Eyecon: Yeah. Well, and you know, thinking, putting my pharmacy operations cap hat on, you know, into some of these discussions I’ve been having with some of our strip pouch packaging customers, you know, saving the box cost because it’s a reusable box. So even if you save $1, $2, $3 per dispense, now you’re adding in onto that bottom line, you know, getting back to The Bottom Line Podcast. If you’re looking for some more revenue, save on that box cost. 

Bonnie E. Bond, CPA, MBA: Mm-hmm. I was about to ask for a bottom line, but that’s a good one. It’s the bottom line. Yeah. Again, just echoing what you said before. I mean, you’ve got to look outside of the box for things like this constantly in pharmacy these days. And this is just one great example. To me, this is a no brainer, Austin, right? 

Austin Murray: Yeah, yeah, absolutely. Yeah. Yeah. 

Bonnie E. Bond, CPA, MBA: But we definitely appreciate you guys spending a few minutes with us today. This is great information as always, passing that along to our pharmacy friends out there in the world. 

Jen Whalen, MBA: So, you know, we’ve talked a little bit about the RTM program, but it is a recurring revenue for you on a monthly basis. Bonnie, as I mentioned before, we do all of the billing, so you don’t have to worry about that. We handle everything from that standpoint. And then we pay the pharmacies a fee every month for their active patients and for essentially for the time that they’re the clinical time that they’re spending with those patients. So, it’s that opportunity to get paid for the clinical work that you’re doing besides just filling the prescription. So, and you know, even if they’re on an LTC at home program, there’s no conflict there. You can simply add an RTM program right on top of it. 

Bonnie E. Bond, CPA, MBA: Right. 

Austin Murray: Yeah, Jenn, one of the things you mentioned earlier that I absolutely love about this program is that there’s little lift on the pharmacy side. They don’t really have to do, you know they don’t have to like to hire a tech and they don’t have to train tech to do all that. So, you guys do all that for them, which I think is fantastic. 

Jen Whalen, MBA: We do. It’s interesting you say that Austin we’ve evolved, right? Even over the last year, when I think about MedSense a year ago versus MedSense today, you know, it started where our pharmacies were doing a lot of that work, right? We would partner with them for some of the outreach, but they were doing a lot of, they were helping with the setups, people were coming into the pharmacy, et cetera. And we just recognized that pharmacies just don’t have that capacity, right? They’re busy. They’ve got patients in front of them all the time. And it’s really evolved into that’s our goal is we don’t want to add a bunch of lift to the pharmacy. Our goal is: let’s take that off your plate. The only thing that we say is we just want you to do what you do best. You’re our clinical experts. So, make sure you have that once a month check in with our patients. We have a whole team of medical assistants that are watching behind the scenes. So, we’re looking for if, you know, if they happen to unplug that hub, right? That’s transmitting to that box. We have medical assistants, they’ll call on that. If we notice that, suddenly the adherence, that was great, but we haven’t seen anything in a couple of days, we’ll call on that for the pharmacy and find out that, hey, maybe they went on vacation or something happened, right? That we didn’t get the data to come through. But if we see something and our medical assistants talk to those patients and we hear, I’m not taking it because of the side effects or my doctor changed that prescription, or they have questions about their medication, that’s where we’ll just contact the pharmacy directly, say, hey, we spoke with your patient. Here’s what we learned. I think this would be a great patient to do some outreach on. So, we have a whole team of trained medical assistants in the background that watches that, again, with a whole intent and purpose of, we want this to be turnkey. We want this to be easy for the pharmacy. You guys are doing so much out there for your patients. And I know every day is really, really busy for you. So, our goal is, let’s give you an option to add some services, take care of your patients, generate revenue while you’re doing it, but add very little to no added activity on your plate. 

Bonnie E. Bond, CPA, MBA: Yeah, that’s perfect. That is a great bottom line. Matt, any last words?  

Matt Gilbert RxSafe/Eyecon: Just diversify your portfolio. Think outside of the box. Do stuff like MedSense. Use our Pouch technology. It’s world class. And be efficient. The number one thing I’m sure Sykes and Co. and RxSafe hear, and MedSense hear is that every trade show is DIR fees. I’m not making as much money as I used to. The margins are thin. Well, here’s a way to triage that. And really the lift is very, very minimal for you in a pharmacy. So go and get them. 

Bonnie E. Bond, CPA, MBA: Yep, great. Thank you guys so much for your time. We certainly appreciate it.