Pod Insights Pharmacy Podcast Network More Patients, Same Pharmacists: Preparing Independent Pharmacy for the Next Era of MTM | Outcomes: Insights Beyond the Counter About this episode As MTM evolves and pharmacies prepare for increased demand, what does success look like from both the technology side and the pharmacy operations side? Ross brings the perspective of innovation, workflow transformation, and MTM Intelligence. Jon brings the perspective of an independent pharmacy owner and operator who understands the realities of staffing shortages, prescription volume, patient expectations, and limited resources. The result is a conversation that feels less like a product discussion and more like an industry discussion about helping independent pharmacies thrive.
Guests: Jon Grice and Ross Frei
Transcript 0:05 Speaker 00 You are listening to the global network of podcasters dedicated to the pharmacy profession. Welcome to the pharmacy podcast network.
0:28 Speaker 01 Outcomes Insights Beyond the Counter.
0:32 Speaker 01 My name is Todd. You're a proud founder of the nation's largest podcast network. And subject matter expertise from my favorite providers are pharmacists as well as people out there who are running specialty and long-term care and community pharmacies. We are so excited to be working with outcomes, digging in to the insights beyond the counter. Today's episode, more patients, same pharmacists were preparing for independent pharmacy for the next era of medication therapy management. Up next on Insights Beyond the Counter.
1:09 Speaker 01 Hey, welcome to Insights Beyond the Counter. I want to bring in our guest. Excited to have you here. Two nerds, two nerds like me from the world of pharmacy technology, because that's my roots. Ross Gray and John Greis, welcome to the show.
1:27 Speaker 02 Good to see you.
1:29 Speaker 01 If, if you weren't both good looking, I wouldn't have said nerds, but good looking nerds didn't suffer like the bad looking nerds did. And, and I grew into my look. So I remember the big head and I needed to grow into my head and needed some style. I still need style. My wife always makes fun of me, but we definitely were three nerds here talking about pharmacy technology.
1:51 Speaker 02 That's right. Yeah, I'm in for it.
1:55 Speaker 01 John, you and I have done these shows before. Lots has, has changed since you were, you were first on and back to the, to the network. I kind of want to open up with you and that is, you know, MTM, just like the state of the nation of pharmacy, there's plate tectonics happening. This market's changing. We are seeing drastic changes in how things are getting paid for and what is being paid for. And I think as MTM evolves and the pharmacies are preparing for increased demand and shifts and, and how many pharmacists are on staff or what, and what disease states are being managed, what are they communicating to their pharmacy, to their communities? What are they communicating to physicians?
2:40 Speaker 01 So what does success look like from both the technology side and the operation side at this point?
2:46 Speaker 03 Oh, man, they got to work well together. You know, Todd, I was, I went back to our conversation a year ago. We met out at Thought Spot and did one out there. And man, it was, it was interesting to say, I know I believed it then, the things we talked about, the changes that were coming and the, the new developments that outcomes was making. But we could go back, re-listen to that and then just kind of like highlight the different things that have come out of outcomes in the last 12 months since that podcast and how that points forward to 2027. You're right. Tectonics is a great way to describe it. The shifts that are happening, some, in some ways are settling out of COVID, but are shifting in a new way.
3:31 Speaker 03 And it's almost like a fresh beginning that pharmacy is just heading into. It's pretty exciting. So I, I think your question was around the technology, the success. I think you've got to, in a pharmacy, have your technology dialed in for efficiency and then have your strategy really solid on clinical matters. And here's how I'm going to attack it. And if I don't have one, here's how I'm going to build it. Or if I've already got it or got a framework of clinical operations, clinical services going, here's how I'm just going to continue to level up every year. That would be my, my short snippet on, yeah, what success is going to look like as every pharmacy goes into 27.
4:11 Speaker 01 Ross, same question about operations, about the technology side, supporting the new age of pharmacy where pharmacists are being much more hands-on, clinical to the disease state, clinical to the treatment management. You have 14 years, just bravo to you for the, the technology experience you have out outcomes and, and the vestedness in your career. But give us your insights. What, what do you think?
4:39 Speaker 02 Yeah, well, I know Todd, as we're kind of preparing for today's conversation, we talked about how in the, in just the 14 years I've been in outcomes, you know, I've been able to see submission of a clinical service to outcomes go from sending a fax document to outcomes and then putting that into a system. And then the release of a platform enabled, enabling that documentation and then seeing that platform continue to evolve, new services, new ways to continue to engage pharmacies into clinical services and the care that that can really, you know, create within that community pharmacy. And, and I think, you know, to, to John's point, it comes back to the technology needs to complement and enhance the workflow and the work of the pharmacy.
5:25 Speaker 02 It, you know, we kind of joked at the beginning here of kind of that workflow term being kind of one of those fun phrases that's been thrown around for ages and ages. But I do think that there is a lot of grit to that as well, because as you go out and you sit in pharmacy and you, you are in that space, you can tell that if the technology is not meeting you where you are, the technology is not going to work. And so I think that's been the key driver for us for sure at outcomes of, you know, continually just driving towards building technology that meets people where they are in their community. We're in a really unique position where our platform is used by, you know, the local pharmacy as well as large national chain.
6:11 Speaker 02 Doesn't matter the PSAO, it really doesn't matter where you're coming from. Our technology is sitting back there, allowing for clinical services to be documented. And because of that, we got a lot of different users that are coming in with different expectations of how things are expected to operate and flow and how that works into their own systems. So that brings a lot of fun challenges for us to really help support the masses with the, you know, 60,000 pharmacists that are coming into our platform, 120,000 monthly active users coming into our platform. That's a lot of folks that are coming in with different expectations of how, again, to use that term workflow, but how that fits into that puzzle piece of what things look like behind the counter in the pharmacy.
6:57 Speaker 01 So I'm thinking, you know, you design this intelligence system. You continue to see it evolve based on what's necessary, based on how payment systems are changing, based on where we know pharmacists' expertise and understanding and knowledge could actually make some money beyond a dispensing fee. So let's talk about that. John, I'm going to ask you, what is the change? What is that change that needs to happen in today's like MTM environment that an independent community pharmacy owner really needs to understand?
7:31 Speaker 03 What is the one change?
7:33 Speaker 01 Yeah.
7:35 Speaker 03 Probably in mindset, you know, because there's so many different ways I could take that question to Ross's point, there are 60,000 pharmacies out there. Now, maybe not every chain is uniquely different from its counterpart, you know, other chain down the road, but every independent is different. And man, so, so to do or to kind of put an underline on what he said, they have, in the clinical, clinical product workspace, been able to make a product that is usable by very big and by independents and see success at all different levels. So I would say for the folks who are thinking that, well, that's something that only other
8:19 Speaker 03 pharmacists do, or, or that's not something we do here, they got to change their mindset. Maybe start talking to a different group of peers. I know that if you're in a circle that sort of reinforces that, you just really believe that, that, well, no, we're not really doing that work. But I don't, I don't think that can continue going forward. I think this is going to be a continually growing bucket of revenue. And right now we're seeing the unengaged just stay unengaged and the ones that are engaged just keep growing in it. And so for every, every pharmacist who's maybe not quite crossed that mindset, this is like the immunizations of 20 years ago, where there were a few that held out and held
9:04 Speaker 03 out for a while, but eventually it was, it was not going to slow down. It was only going to keep expanding. So it's probably a mindset thing if I've got to go, sorry that that's sort of broad, maybe 50,000 foot level, not as tactical as I'd love to be able to be. But it really is, we're talking about a diverse group of people, a whole bunch of different ways to run pharmacy, and yet there is that one unifying thing that's got to change.
9:30 Speaker 01 Mindset, the leadership. So we're talking about the, the top of the food chain within your pharmacy, the owners, the executive board. And those are literally the people that are going to help to change the mindset of not only management, but more importantly, your, your work team, your team that is expected to manage workflow. And that workflow, Ross and I, before we started recording, talking about getting, we're starting to be the old guys. And workflow was like a, was like a buzzword from, I don't know, 2020, 2012 to maybe 2018. And now it is what it is. But workflow has to change. So mindset, starting
10:15 Speaker 01 with mindset, but now workflows have to change. We have to be thinking of phone call changes, getting away from the dreaded fax machine, fragmented systems and disconnected information sources, staffing uncertainty about which patient intervention should be prioritized. I mean, there's, there's this whole kind of head scratcher that Outcomes is standing in the background saying, we're ready for this. Like, we've already, we've already done this. John, or actually, John or Ross, really, Ross, actually, it should be for Ross. You mentioned a sector of pharmacy, and you're like, hey, we have large chain
10:55 Speaker 01 organizations, we have individual pharmacies, specialty, long-term care pharmacy. So where is medication therapy management the hottest right now? What sector of pharmacy are you seeing, you know, some of the, the best success stories?
11:09 Speaker 02 I'm going to take that question, Todd, and I'm going to kind of augment it a little bit into where I feel like there is the greatest opportunity as I look ahead to 2027. And so kind of to paint that picture for you, Todd, as we look into 2027, we've kind of been dancing around it a little bit here. But to kind of hit the nail on the head, as we move into 2027, we're going to see a dramatic increase in the number of CMR opportunities and the number of CMRs that need to get completed in the Outcomes platform. We're talking about a three to four X increase. So millions more CMRs. And of course, that means the revenue that we know pharmacies are in dire need of coming from these clinical
11:50 Speaker 02 services. So at Outcomes, we've been really laser focused on how do we get after those things that we've time and time again, heard from pharmacies as some of those barriers to really getting in deep, like John was describing of like, creating that workflow that allows them to take MTM and just clinical service provision in the pharmacy to that next level. And not surprisingly, those barriers are generally, I don't have the time, or you're not, I don't have enough opportunity, right? The pie isn't big enough for me to make this into something that really matters in my pharmacy. And let me tell you, the
12:30 Speaker 02 first part about time you hit on earlier, we've got amazing new efficiencies that we're deploying into our platform this year that are going to bring the time down dramatically for documenting and completing CMRs. And then for that pie, like I just said, the pie's getting bigger next year. So not only is the time barrier going to be going away, but the opportunity barrier is going to be going away as well. And back to your original question, Todd, on where is that opportunity and what part of the pharmacy, you know, landscape has that opportunity? It's your local community independent pharmacy that really has that huge opportunity to step up and show that they can be the ones to
13:11 Speaker 02 lead the way. So to John's point on the immunization wave of 20 years ago, and seeing who jumped in first, and who took maybe a longer time to adopt and get into that space. The MTM space right now, it's a huge opportunity for independent local pharmacies to show up, to show that they have those local relationships that really change that healthcare experience for the patient at the end of the day. I'll tell you really quick, I've got, you know, younger kiddos, one of which has long-term disability, just went through a heart surgery two years ago. So a lot of complex medical needs. And it's your local pharmacist that at the end of the day is the person that can help you to navigate all the complex
13:54 Speaker 02 medications that come with, with healthcare. And so it's a really amazing and exciting time. I get really passionate about, of what I think we can see next year with all those opportunities and those increased efficiencies coming into play.
14:09 Speaker 01 I think of the opportunity from what you're saying, almost as the ground level, the comprehensive medication review, setting the stage, and now having a patient for life who might be experiencing something with their disease state, they're going to need your assistance for the remainder of their time. They got eight medications that they're juggling, they're not quite sure, no one's really taking time to check up on them. The world of telehealth is coming, you know, full force now, remote patient monitoring's full force now, long-term care pharmacy at home is kind of the buzzword today that we're going to continue to see expanding. You guys are ready for it. So, John, let's
14:54 Speaker 01 talk about that. Let's talk about expanding the role, the workflow, some of the things that, that Outcomes has experienced and prepared for. Talk to us a little bit about the inside the pharmacy, what's happening.
15:08 Speaker 03 Sure. You know, inside the pharmacy, I think the way we have developed automated data entry is a huge thing towards prepping for 27. Our team has gone through, and just me talking about it, feels like I need to be giving all the credit to this other group of folks, but they have built a way that our system automates data entry on over 90% of the scripts. You know, every e-script that's coming in, there's very few exceptions that can't be automated. And all the rest are going right from receipt into being a billable claim. That's amazing. You know, that cuts down so much tech time of putting in the, the script manually. So automating data entry is a big piece of making the pharmacy
15:51 Speaker 03 efficient enough to now take that excuse away. You know, I think one of the questions that I would pose to independent pharmacists is what's on your second monitor? Everybody's usually got two monitors up, one's running their pharmacy system, and the complaint as well. It's cumbersome to move, move out of that and into a website to do more work. But they've probably got something up, and it might be email or something else. But if, if you're not managing the PMS, you know, your, your script flow, as well as your clinical stuff, that's where now we're efficient enough to be able to do that. So anyways, back to the automated data entry, I just can't highlight that enough as really saving time in the
16:34 Speaker 03 pharmacy. And if our folks don't have it turned on yet, at least Outcomes system, that's what we've done to be able to enable our pharmacies to, to really get that time back. But it's not just in the, the dispensing process where efficiency is coming. I want to kick this back over to Ross, if you don't mind. Ross, tell them about the CMR process, how the MTM intelligence is actually faster.
17:00 Speaker 02 Yeah, yeah. No, thanks, John. I mean, I totally agree with what you're sharing on automated data entry. That is a huge jump forward in just helping to unlock additional time in the pharmacy. Like I was saying, you know, we keep hearing that as we talk about clinical service opportunities. So a great, great call out there. Yeah, when it comes to comprehensive medication reviews in an MTM program, we, we know from kind of being the market leader in comprehensive medication reviews, that a CMR typically today looks like a whole lot of data curation, getting the data ready, preparing to talk
17:41 Speaker 02 with the patient or the caregiver for that comprehensive medication review. And that shouldn't be the case. We really want to help support pharmacists and pharmacy staff to not need to be the, the data curators, the archivist of all of that information, but instead lead with their clinical expertise. So with our MTM intelligence capabilities that we will be releasing into the comprehensive medication review workflow in the Outcomes platform here in 2026, those capabilities are going to help to automatically pre-fill content with inferred medication directions, inferred medication conditions, help to auto
18:23 Speaker 02 sort and prioritize active versus non-active medications, help to even infer potential action items that the patient can be taking in follow-up to that comprehensive medication review. So really trying to help support that conversation, help the, again, the pharmacist to not feel like they open up a comprehensive medication review, and they just opened up a blank file folder, and now they need to fill that in with all the patient's data. We really want to get past that and allow pharmacists to, again, step up to the plate, ready to go to hit that homerun with that CMR.
18:59 Speaker 01 All right, let's talk about measurement of success. We all love data. We want to be able to take what we've done and be able to track, be able to improve, be able to make some adjustments. The completed intervention, the patient engagement, how well the patients are understanding, medication adherence, quality measurement, performance, even staff efficiency. Talk to us about measuring MTM success.
19:29 Speaker 02 Yeah, I've spent a lot of time on this over my years at Outcomes, of course, Todd, and specifically as we think about comprehensive medication reviews, a lot of that, like I said, comes down to how much total time does it take to complete that comprehensive medication review for the patient, not just in that, like I said, the patient conversation itself, but the full journey, the total time. And then even when you get into that journey, we get down and talk about how many clicks does it take you to get from start to finish, right? We want to get really gritty and tactile in that full process to make sure that, again, we're sitting down and we're thinking through what it means to embed these workflows into
20:13 Speaker 02 the practice behind that counter in the pharmacy. Because as we said earlier on, if you're not thinking through that methodology, if you're not thinking through that lens, it's not gonna fly. It's not going to fit. So you really need to take that full breadth view, not just thinking about one aspect, but thinking about how much time does it take? Where am I, you know, creating U-turns or process loops that are not necessary or successful? So that's where we've really come in and we've tried to deploy features here with our MTM intelligence suite that help to bring in that curated data, like I said, to support and
20:56 Speaker 02 take away all of that burden of documentation. And then alongside of that, we're also releasing a documentation quality review. So what we're doing is we're not only infusing data to help to support, to bring you and that data to full readiness state as you're going in and completing that CMR, but then as you're documenting and completing the CMR, we're also automating and bringing forward to you all sorts of information that helps you to understand what's the quality of the data you've just documented. Because the last thing we also want you to do is go through that and recognize that, hey, what I've documented, you know, there's an opportunity for me to make that even of a higher quality. So we
21:38 Speaker 02 really want to help to bring forward as much insight and information as possible, but do it in a way that we're aware of and recognizing things like notification fatigue and presenting the user with the right information at the right time. We have a phenomenal user experience team here at Outcomes that does amazing work to sit with pharmacists as they're in our platform, hands on, seeing how they're interacting. And man, is it fun to be able to sit with that team and sit with pharmacists and do those shadowing opportunities to really get your feet planted into that experience? Because if you're not doing that, you're not participating in the exercise that is supporting pharmacy.
22:22 Speaker 03 Todd, that's a big thing. I'm serious. As a pharmacist who's used the system before, knowing how Ross and the team, the UX team he's talking about can watch basically the path of clicks that a pharmacist is taking through the system as they do a CMR, and then break down, all right, which clicks were redundant? Or where did they get stuck most? Or, like he was saying, like, at moments, we just need to supply some extra information for them. It's amazing. Like, okay, as a pharmacist, my brain goes from having information presented to me, you know, 200, 300 times a day, and all I've got to do is verify it,
23:04 Speaker 03 to then changing over to the other side of my brain and going, oh, I have to not only think, all right, that's cool, and I'm glad I get to think, but I've got to generate the text now. Whereas it used to be 300 times a day, text is coming to me to double check.
23:20 Speaker 03 They've been able to kind of bring the two halves of a pharmacist's brain together and go, okay, well, if that's how you're used to thinking, and this is the way that clicks seem the most logical in order for your process to flow better, we're going to design it that way. We're going to put the information that you might want right over here. It's amazing. Like, I was impressed. I got a glimpse of how they are really getting inside and making sure that it works with a pharmacist's mind.
23:49 Speaker 01 All right, so I'm listening. I'm a pharmacy owner. Maybe I'm on the knife's edge where I really want to do something to prepare for 2027, to come out with an MTM program that's tied into my pharmacy management system. It's definitely getting billed correctly. My workflow has been designed. My staff, my pharmacy technicians, everybody's on the same page, prepared, ready to go. Let's talk about real quick, because I want to hear from both of you on this, educating the patient base, educating the community that this is even available to them because of how this could really help their ongoing health, assuring that they're taking medication, assuring that they understand their medication. It's
24:34 Speaker 01 that engagement. It's bringing, it's bringing patients back to how close they were with their pharmacist, you know, 20, 30 years ago. And I think it's returning to that intimacy of being a consultative pharmacist. So talk to us about that communication between the pharmacist and the patient.
24:55 Speaker 02 Yeah, I'll jump on it first here, John. Thanks for the question, Todd. Yeah, I think that's a good way that you, you kind of frame that question in terms of the timeline around that question, too, and just the history of what pharmacy has looked like and how, I think we've used the term so far, of just kind of this like tectonic shift that's happening in pharmacy, especially with this opportunity that MTM and CMRs presents in 2027, where it does allow for that consultative pharmacist role to really come back to the surface and really shine, you know, within your local pharmacy. It's, it's something that we know
25:40 Speaker 02 as Outcomes, as we've sat there and worked with pharmacies across the country to support them to become best in class pharmacies documenting MTM and CMR and comprehensive medication review services, is that it's, it's generally, it's not something that's going to happen overnight. Let's be clear. It's something that is a shift in what a pharmacy looks like, but we've got the best practices here to help you through that shift. I will say, you know, my history at Outcomes, I started on our help desk, fielding calls from our pharmacies. So I will tell you right now, we have the best help desk out there to help you with our platform and with supporting you in your questions that you have as you're
26:23 Speaker 02 navigating our platform. We really want to be there with you and alongside of you as you're going through this journey of helping your patients with clinical services that are available on our platform. So it's something that I'm really passionate about. And again, to the point John was making around how we're, you know, studying and looking at and aware of how, you know, users in our platform are documenting and working, we're also very aware of just the feedback and the information we're gathering from things like our help desk, what are folks calling in about, what are the themes that we're hearing from those, those conversations, and really making sure that we're hitting on those opportunities
27:07 Speaker 02 to continue to meet the pharmacist and our users where they are. So I think we've hit on that in many ways, talking about getting the right data into the right place at the right time. There's a lot of different ways that you can describe and talk about that. But definitely, it's not a shift that happens overnight, but it's an opportunity for you to really, to John's earlier point, kind of take up the torch with this great opportunity in front of us and lead, lead that charge towards becoming that clinical center of excellence as a pharmacy in your local community.
27:42 Speaker 01 Clinical Center of Excellence, that is amazing terminology that could really bring a lot of attention from your community if you're communicating that, if you're putting that out on your Facebook, or you're putting that in your literature, or something that you're able to get in front of someone that's taking care of their mother, or someone that's taking care of their great aunt or their dad, and letting them know, hey, there's a lot of confusion stuff. Your dad is breaking tablets in half, he doesn't exactly sure what to be taking, adherence issues here, something happening there. And then ultimately, that
28:23 Speaker 01 communication to the patient, the description, the education, and then kicking all of that back to say to the physician in the primary care, hey, we got it figured out, we got it under control, look what we did, look what we implemented, here's how we're helping to move forward in the treatment that you kind of as the quarterback, you know, put out there. And that would be, if I'm the physician, I'm relieved that there's a pharmacy out there prepared for it, has invested in infrastructure. So there's multiple stories. As an independent community pharmacy owner, you have multiple stories to be telling. You have the story to tell internally to your staff and get them ready. You have the story to tell the public in your community who doesn't know that you're doing this, and they would love
29:06 Speaker 01 to take advantage of it. You have to tell the story to the physician, and you definitely have to tell the story to the payer, because the payer wants to know that you're prepared for this as well. So, John, in wrapping up, let's talk about that last one. Talk to me about the payer environment and medication therapy management.
29:22 Speaker 03 Man, the payer environment is one where I think, I don't think as a pharmacist, I thought about my customer the right way. I always thought about the number of patients walking in the door, but I wasn't thinking about the insurance plan behind them. And so, you know, the best analogy I can think of as we go into 2027 is, all right, if I knew that I was going to have three times the amount of scripts walking in my door in 2027, I would get ready. I would extend the counter, I would add an extra terminal, a whole nother bin of vials. I'd be prepped for better volume of script count going across the counter, right? Well, if I wasn't, what would happen? Well, I'd still take care of
30:06 Speaker 03 the same amount of people I did last year, and all the rest would be a little frustrated, and take that script and leave and go down the road. And I would just probably kick myself for having missed that big opportunity. The same thing's happening. Our customers, at least in this sense, and in your question, our payers are coming to us with three times the volume that they've had before, saying, okay, we need you, can you do this? And some of us are stepping up. And it's going to be cool, and it's going to be fun, and they're going to be ready for it, and they're going to take full advantage. And then there's others who are going, I don't know, we'll see. And I'm just going to wait until it gets here. And then they'll maybe do the same amount they did the year before, and wonder, all
30:47 Speaker 03 right, why am I not keeping up with the rest of my peers, the ones that did prepare, that saw that big influx of, in my example, scripts walking in the door? It's just volume of business coming into you. Are you preparing for it? So back to Ross's, the storyteller. The pharmacy has to be the storyteller on this one. You know, it's not for Outcomes to go market to the public. People don't know Outcomes' name, and that's okay. The customers, the patients, they don't, they don't need to know our name. They want, we want, everybody wants them to know the pharmacy's name. And so it's really up to them. I'd love to be able to drive down the road and see in front of pharmacies, not just flu shot, COVID shot here, but get your CMR here. Don't know what that is? Stop in and ask, you know?
31:32 Speaker 03 Those sorts of little message board readers that get people going, yeah, what is a comprehensive med review? Stop in, ask. You're probably eligible. Let's sit down and talk about it. Because if our pharmacists aren't the ones telling the story, there's still the customer, the payer on the backside going, I got to get these done somewhere. And so they will get filled. And I hope as many pharmacies as can see it come and take advantage of it.
32:02 Speaker 01 Pharmacy owners, pharmacy operators, management teams out there, the expansion of nutraceuticals and grocery stores getting involved, and small micro chains, you are not in this alone. There are people out there, John Greis and Ross Frei, you guys are passionate, your minds are on fire for this. This is which we live, we breathe. Reach out to this Outcomes team. The Outcomes, the Insights Beyond the Counter, part of the Pharmacy Podcast Network. Gentlemen, thank you so much for your time today. This was an awesome conversation, and cannot wait to have you back.
32:41 Speaker 03 Our pleasure.
32:42 Speaker 02 Thanks a lot. Great to be here.
Previous Inventory, AI and Automation, R&D Tax Credits, Peptides, and Basis | The Bottom Line Rewind Next Beyond Dispensing: Building a Pharmacy Around Medication Management and Community Care | SuiteCast Page updated November 14, 2026 · transcript and summary are machine-generated
