What is SYNC?

SYNC is simply a pen and paper method for synchronizing refills. It was built around years of experience working with corporate programs that took control and complexity to the next level and doing it poorly trying to predict every possible patient problem. The best way to synchronize refills is to keep it simple and not try to remove human experience and intuition from the equation.

SYNC binder

It’s the one book required to have a synchronization program.  All synchronized patients will be worked out of the binder.

SYNC master sheet

Exactly that: a master list of medications for a specific patient, from which the pharmacy will work to keep them synchronized.

sync worksheet

A monthly worksheet for completing orders so that there is consistency and communication between what often is multiple orders and people working a SYNC patient.

sync plan

The worksheet used to synchronize refills, and the workhorse of the program.  In my experience, visually seeing the SYNC plan makes it simple.

Core Components

Several key points were kept in mind when designing SYNC. First, it had to be a repeatable process that any team member could learn quickly. Second, it had to be simple enough that it could be quickly worked on a daily basis. Third, it had to be able to clearly communicate completeness of an order regardless of which individual was working it.  And fourth, it had to provide value to the pharmacy (obviously) rather than become another complex task.

SYNC Master Sheet

The SYNC Master Sheet is the core component of SYNC. From this worksheet orders are filled. Think of it as a CMR worksheet.  Monthly worksheets are generated from the master sheet to start off a SYNC order.

SYNC Worksheet

The SYNC worksheet is the monthly order form.  Think of it like an invoice that stays with the order until it is complete.  This form communicates order status, including short fills, out of stocks, out of refills, etc.


The SYNC plan kicks off the synchronization process.  This sheet will follow the master sheet until a patient’s medications are synchronized.  Once synchronized, the SYNC plan goes away unless a patient’s medications get misaligned.

How it works

Let’s look at a very high-level overview of how this works:

  • A patient is identified and enrolled in SYNC by completing a CMR to generate the SYNC master sheet.
  • A SYNC plan is developed and attached to the master sheet as well as communicated to the patient. The combined SYNC Plan and Master Sheet are placed in the SYNC binder, behind the numbered tab corresponding to the date of the first SYNC fill.
  • The SYNC binder is worked daily, identifying upcoming SYNC fills 5 days in advance to generate a monthly worksheet. The patient is called to verify any changes, additions, or holds and to communicate the expected pickup date. Refills are requested, and worksheets are moved to the “Active” tab until 2 days before the SYNC date.
  • 2 days prior to the SYNC date, active worksheets for that day are removed from the binder and prescriptions are filled. Any exceptions are notated on the worksheet and the patient is called. The patient, ideally, picks up their completed order anytime over the next 3 days.

ZIP file containing all program documents.

Core components (worksheet, master sheet, and SYNC plan

SYNC Guide

SYNC Master Sheet

SYNC Worksheet


Get the program

Grab the entire package from the links.  Don’t need the entire file?  Grab each component separately.



You have questions. wE have answers.

I get it. Refill synchronization isn’t everyone’s cup of tea. I’ve got techs that pick it up in no time. I’ve also got techs that just can’t wrap their heads around it. So… let’s hit the F.A.Q.  It’s a new program, so the F.A.Q. is updated as I run across more issues and questions.  

I’ve got a patient that has no clue what their meds are, and can’t tell me anything. What now?

First answer: this patient is not a good candidate for refill sync. Straight up. Gonna be honest, in the 8 years I’ve been working with synchronization, the best patients are those that are interested and engaged in their healthcare.  But wait…there’s more.

Second answer: this patient is in need of refill sync. While they may not be engaged, for various reasons, this patient, if they display interest, may be a good candidate. Why? Because by engaging them every month, communicating and building a relationship with them, and educating them, we can slowly improve their healthcare position. But…we’ve got to have that honest conversation to figure out why they are not engaged.  If they are willing to commit to at least a monthly (or quarterly for 90 day fills) conversation, they may be a good candidate.

Here’s the third answer. And it is the answer corporate pharmacy and insurance companies don’t want to hear. If you’ve got a patient that absolutely doesn’t want to hear about their medications and just wants an autopilot program, then they are not a candidate.  I do not care if they absolutely demand they pick up all their medications on one single day per month.  It is absolutely not the responsibility of the pharmacy to ensure that happens.  There must be a two-way conversation between the patient and the pharmacy each month that reconciles medication changes, recognizes and addresses adherence problems, and adjusts the regimen based on responses.  If the patient cannot commit to that, then cut them loose until they are ready.

Oops, my patient picked up a medication in the middle the cycle, what next?

That’s easy.  Fill out a new SYNC plan, attach it to the Master Sheet and put it on the fill date, and follow the plan.  Ideally, if a patient is flagged in the dispensing software as a SYNC patient, any technician should be able to recognize when to check the master sheet for changes.  But if missed, the simple answer is to create a new SYNC plan and follow it.