white medication pill on orange plastic container

I’ve always said that the best way to keep up with a refill synchronization program was to keep it simple. I’ve been part of the feedback team for a corporate refill synchronization program, went through getting bought and learned another refill sync program, and have used the sync program used by Outcomes MTM. None of them are ideal. Introducing: SYNC.

In all cases the corporate version seeks to “overcomplicate” things by taking control away from the pharmacy. The software tries to make it fancy by integrating into the dispensing software (which is nice…if it would work) or using some fancy algorithm to “cushion” the fill dates. Nothing substitutes for the experience of a well-trained pharmacy staff.

Now, you’re going to hear refill synchronization increases adherence. It improves outcomes. It may be all BS. It’s a mixed bag. A motivated patient may have increased adherence. But…the vast majority of patients will not change behaviors. Your program has to be flexible enough to recognize this. Studies show increases in adherence of 3% to 10%. So… nothing to something. That’s just one study, but a review of the literature (and its fairly limited when it comes to good studies) produces results all over the board. But…it is the right thing to do.

What is SYNC

SYNC is simply a paper-based method for synchronizing refills and managing a pharmacy’s synchronized patients. I hate paper, but if it is organized, I can be friends with paper. SYNC only has one core binder. After all, you should be targeting your complex patients, not the patients with only a few medications. But, for those that like that, it will work for everybody.

Prefer digital management? You can still manage your fully synced patients digitally. But the monthly worksheets and active SYNC plans require the binder. Some computer literacy is required.

Introducing: SYNC Core Tools

The program uses three core documents to organize and manage SYNC patients:

Master Sheet
SYNC Worksheet

Master Sheet

SYNC Master Sheet
SYNC Master Sheet

The SYNC Master Sheet is the patient’s main medication list. It includes all medications, including PRN medications and medications not included in the SYNC program. Why? Because SYNC is also designed to work in tandem with MTM.

Patients on SYNC are most likely good CMR candidates. Because the pharmacy is collecting a complete medication list from these patients, it only makes sense to identify and action MTM patients while completing a SYNC list.

The pharmacy will work from the Master Sheet each month, updating it as necessary.

The Plan


The SYNC Plan is the path to synchronization. While a patient is in a SYNC plan, the Master Sheet follows the SYNC plan until the patient is synchronized.

The key to a successful SYNC plan is accurate information from the patient regarding remaining medication, and an experienced pharmacy team that is able to action and follow-up on active SYNC plans efficiently.

Monthly Worksheet

SYNC Monthly Worksheet
SYNC Monthly Worksheet

The monthly worksheet is the workhorse of the group. When a patient order gets worked, the monthly worksheet follows that order to ensure completion.

How does SYNC work?

It’s a binder with 31 tabs, an active worksheet tab, and an exception tab. Either kept physically or a hybrid electronic/physical system. That’s it. When coming up with the system, I kept a few things in mind:

Simplicity is needed, but it has to be flexible enough to meet the complexities of managing multiple SYNC orders and all the moving parts associated with synchronization
It had to be repeatable and scalable. By that I mean it should work for a handful of patients, or a hundred patients.
Consistency. Most pharmacies have multiple people that work throughout a week; there is not a guarantee that the SYNC champion is going to be there every day. Keeping in line with simplicity, it had to be able to easily be used by multiple people. Even if it is only “pull all the active works orders and fill them”.

SYNC in a nutshell

So, here’s how SYNC works in a nutshell.

  1. Going out 5 days, start working the SYNC orders. If today is 11/5, start on patients behind 11/10.
  2. 3 days out, review active worksheets for any high-value items that need ordered.
  3. 2 days out, fill all active worksheets. If your pharmacy uses a mail/parcel service for delivery, mail out completed orders.
  4. 1 day out, review active order exceptions.
  5. SYNC date, sell the order.

That is a very high-level overview, but it gets the basic point across. The master sheet has the med list, from which you will work create and work a monthly worksheet each month (or each quarter, depending on the patient).

Introducing: SYNC

Alright. Thats the bare bones. Now, head over to the SYNC section of the website to learn more. You get the documents. I may throw in the spreadsheet. You get a few calculators (eventually). No, its not new. But, it’s taking everything I’ve seen in a few years, combined the good, thrown out the bad, and actually listens to feedback. SYNC it up.

Author: Zack

Pharmacist, tech guy, pianist, lover of beer, gamer, beach bum. Probably missed something. Just assume I'm into a little bit of everything.



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