Queuing Customers? There’s an App for That

The COVID-19 Pandemic Accelerated the Inevitable

Remember late winter and early spring 2020? Do you remember where you were and what you were doing when the National Basketball Association canceled its season or when celebrities announced they had COVID-19? For pharmacy staff, do you remember when you heard that physician clinics were closing and patients started calling in a panic over prescription refills and access to care? Nearly overnight, telemedicine took off, restaurants closed their doors, and patients and consumers were forced to look toward the future.

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Fast Food, Retail, and the DMV Experimented With Plan-Ahead Queuing

I was picking up my daughter’s order at Starbucks recently (nearly 3 years after those fateful moments), and I was struck by the number of orders sitting on the counter lined up alphabetically by the name submitted. Yes, the drive-through had a few cars and, yes, there was the traditional (smallish) crowd early in the day making the establishment their temporary remote work office, but the largest huddle of caffeine-dependent customers (by far) had ordered ahead on the app and were anxiously waiting, expecting to walk in, pick up their 8 AM caffeine, and get their fix on the road to work, or school, or their kid’s soccer practice. Retailers are experiencing more of the same, and even the Department of Motor Vehicles tried (unsuccessfully, I might add^*) to schedule driving tests and renewals during the pandemic.

Pharmacies Have Been Queuing Patients Based on Preferences for Decades

That Starbucks visit is seared into my memory because my enlightened service experience felt uncannily like most retail pharmacies. The only difference was that Starbucks dispensed 1 stimulant drug. Whether Chipotle, Shake Shack, or Walmart, the pickup location is strangely similar to the pharmacy’s will-call bin, with all of the same advantages and challenges, including using interactive voice response (IVR) or new apps so the business has time to prepare the order. Even the inevitable “I don’t want that one” or “I didn’t order that” or “Why am I waiting? I ordered ahead” complaints are the same. For those not using the order-ahead functions provided by the business, it feels like standing in the 2-hour line at Orlando International Airport while the TSA PreCheck and Clear patrons are walking right up to the front and spending less than 10 minutes in the security line. Pharmacies have been asking for refills, authorizations, and call-aheads and queuing patient-consumers into different lines, with different patient-expressed priorities and dual call-in, walk-up operations for decades.

Will Consumer Expectations of Pharmacy Queuing Improve With Increased Adoption in Other Service Sectors?

Now that the rest of the world deals with waiting in line despite ordering ahead, maybe the pharmacy doesn’t seem like such a dysfunctional arena, with only a few people in the lobby but 200-plus orders in the queue being worked on. Yes, it isn’t likely that your chai latte will require a prior authorization or have an expired prescription ingredient, but patients can make common mistakes like ordering the wrong refill, sending it to the wrong location, and not intending to pick it up.

Will Pharmacy Queuing Evolve to Multiple, More Sophisticated Queues Based on Patient Profiling and Eligibility?

What can we learn from the rest of the service and retail sectors adopting queuing strategies that pharmacy has had in place formally and informally for decades? Most likely, pharmacy will need to focus on segregating patient-consumers into categories of queuing and workflows based on 2 vectors: (1) desire for a service beyond standard counseling and (2) complexity of condition and care delivery. Increasingly, patients may become homebound or need and want remote assistance. On the opposite side of the spectrum, others will not want to interact with a person at all but desire to stop by at any hour of the day and grab their prescription out of the kiosk. Still others will want to spend 30 minutes scheduled with the pharmaco-geneticist or will queue for test-and-treat services, or get their vaccinations up-to-date when they pick up all the medications for their household.

For pharmacies that synchronize medications to a single day each month, an entirely different workflow and queuing system will be necessary, with monthly plans of care documented and delivered to patients and care team members alike. As pay-for-performance and gap-closure opportunities grow, queuing patients for screenings and blood pressure readings or counseling on nondrug services such as the need for a colonoscopy will also need to be built into IVR, apps, and standard operating procedures for queuing and scripted patient interactions.

COVID-19 forced the rest of the world to catch up to pharmacy, but the new economics and expectations for pharmacy post pandemic will cause the industry to become a leader in queuing for product and service delivery once again.

^*As it turns out, for certain services, the public is exceptionally unequipped to keep appointments.

About the Author

Troy Trygstad, PharmD, PhD, MBA, is the executive director of CPESN USA, a clinically integrated network of more than 3500 participating pharmacies. He received his PharmD and MBA degrees from Drake University and a PhD in pharmaceutical outcomes and policy from the University of North Carolina. He recently served on the board of directors for the Pharmacy Quality Alliance and the American Pharmacists Association Foundation.