When Ed Mercadante saw the news that pharmaceutical giant Merck & Co. Inc. was recalling its popular arthritis drug Vioxx, he knew he was in for a challenge.
Mercadante, the CEO of Familymeds Inc., an 80-store pharmacy chain based in Farmington, Conn., needed to get the word out to his customers in a hurry. In the past, the practice for this sort of thing would be to have pharmacists call each of their customers who used the drug and inform them of the recall, and then see if they had questions or needed more information. But this could take weeks.
Fortunately, the 14-state chain, based mostly in the east, was already using an IVR (Interactive Voice Response) application from Silverlink Communications Inc., a Burlington, Mass.-based application service provider. Until the recall, the primary use for Silverlinks service was HIPAA (Health Insurance Portability and Accountability Act) compliance.
According to Rees Pinney, senior vice president of sales and marketing for Familymeds, the automated system had received high marks from customers. But now came the challenge. Could Silverlink be set up to call every one of the pharmacys Vioxx users and alert them to the recall? In addition, could it provide them with the information they needed to make an informed decision about their medication?
They only had hours to find out. Pinney said that Familymeds managers take their responsibility to their customers very seriously and felt that it was necessary to get the word about the recall out as soon as possible, both to help manage the customers health care and to make sure that any concerns were dealt with. So they turned to Silverlink.
By 6 p.m. Friday—the day of the recall—phone calls were already being made to inform patients who had been taking Vioxx. Those calls would be completed in just a couple of hours.
The key to this fast turnaround is Silverlinks ability to set up the calling scripts from their Web site. "We called Silverlink to let them know," explained Pinney. Together the companies developed a script that the IVR application would use, and then, once Familymeds approved the script, Silverlink recorded it. Then it was time to make calls.
Silverlink designed the calls so that they would inform each patient of the Vioxx recall, and then ask them if they wanted their primary care physician to contact them to determine an alternate means of treatment. But first, the application had to deal with HIPAA.
Since the calls involved protected medical information, the first task was to authenticate the person on the phone. According to president and CEO Stan Nowak, this was accomplished by confirming that the person was the patient in question and by having the person enter a private code, such as the last four digits of their social security number.
Once Silverlinks IVR software authenticated the user, the next step was to alert them to the Vioxx recall, explain what the recall meant and then ask for responses. The primary question the users were asked to respond to was whether they wanted their physician to contact them. The application also provided sources for additional information, including Mercks toll-free number explaining the recall.
Because Silverlink can make thousands of calls in an hour, the recall notices were completed very quickly—in less than two hours, in fact. According to Pinney, Familymeds had between 2,000 and 3,000 Vioxx patients. The calls reached about 1,900 of them, and about 300 of those asked to have their doctors contact them. The physicians for those patients have also already been called. Doing it the old way would mean that pharmacists would still be calling patients for days or weeks to come.
The success of the Familymeds recall effort has resulted in three more pharmacy chains using the same procedure. While the details of the script vary with each, the level of effectiveness apparently does not. Calls to those pharmacy customers are ongoing, but progressing very quickly, according to Nowak.
The scale and speed of the notification effort was unprecedented, Nowak said. Within five hours of the notice by Merck, the calls were completed and the patients informed. Nowak said the speed of the calls and their interactive nature did a lot to reduce the confusion that was already spreading about the recall.