Transcript: Accessible Prescription Labeling

HadleyAccessible Prescription LabelingPresented by Amanda TolsonDate January 14th, 2015

Larry MuffettWelcome to seminars at Hadley. My name is Larry Muffett. I am a member of Hadley seminars team, and I also work in curricular affairs. Today’s seminar topic is Accessible Prescription Labeling. Our presenter today is Amanda Tolson. Amanda is the Pharmacy Relations Manager for En-Vision America Incorporated. After working in insurance for several years at State Farm and Clemens & Associates.

Amanda was immersed in the blind and low vision community in 2006 when her grandmother lost her sight. Since joining En-Vision America, Amanda has worked with national and local pharmacies, Hadley.edu | 800.323.4238 Page 1 of 56

legislative bodies, and support agencies to further prescription label accessibility for the low vision and blind community. Amanda will be sharing some information with you on some exciting happenings in this particular field. So, let me get underway. Let me welcome Amanda, and we’ll get started. Amanda welcome. Glad to have you in here Winnetka.

Amanda TolsonThank you. Glad to be here. Like Larry said, this is Amanda with En-Vision America, and I have a bit of information that I’m going to share with you today. What we’re going to do is we’re going to first get started with talking about some of the legislation background of accessible prescription. What has happened, what hasn’t happened, what is currently happening, and what we hope to see happen. And then we’ll stop for a short break, and we can do some question and answering for that piece of our seminar today. After that, we will then discuss what products are available and where those products are available and how you can find a pharmacy that offers some accessible prescription solutions for you.

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We’ll start with slide one. On our first slide, we put some images of some prescription bottles, and those bottles have blurred out information as text, and then pills in front of them. And the title’s Which One Should You Take. Well we’re trying to prove a point that for many many people in the U.S., they don’t know which one to take, and we want the sighted community to understand this topic better, and to know exactly what we’re talking about and why it’s such an important topic.

So we’ll start with why it’s important. Over 285 million blind and visually impaired people worldwide, and those numbers are growing. So we have so many people that really need a solution on how to take their medication, and be able to identify, and safely take the appropriate dosage. We know that assisted technology can be costly. Many people can’t afford to come in their home and set up a pill box for them, and some of them don’t want to do that. They want to be independent.

We also know that 82% of people that are living with blindness are 50 and over. The elderly are the highest rated individuals taking medications. So

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you’re going to see statistically that anybody over 50 is more than likely going to be on some medication regimen, and we need to make sure that those individuals are safely taking those.

Some of the current solutions what are people doing right now with no assisted technology and are managing things on their own. We do see that we do have people come in their home. You have a neighbor, a friend, a family member, or a nurse that can come in your home and set pills up for you.

In 2012, the World Health Organization’s study on the challenges faced by visually disabled people knew that 71% of the participants wanted to be independent in their medicine use, and that 79%, in spite of the difficulties, still self-administered with nothing. It’s extremely dangerous to do that. I know those of you who are taking multiple medications are using some system in your home.

Some pharmacies offer blister packing. For those of you that aren’t familiar with that term, it’s a cardboard paper that has each day segmented and

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your pills for that date put into a pouch. On the back it’s sealed with foil, so you can punch through the pouch, and the pills can come out. They can also go by day, so you can have three different times of the day, and each of those have your morning medication, your noon medication, your evening medication.

Those are great if they’re available from your pharmacist, but sometimes they can be difficult to open, especially with those who are having a hard time controlling their hand movements. And it doesn’t really solve the problem of you know what pill’s what, and you being aware of how to take your medication properly. It’s just another band aid to the problem.

Some people use the tried and true rubber band method. I hear this one a lot where for certain medications, they’ll use one rubber band, two, three, and so on. The dangers of that are if you’re doing that on your own, you’re still trying to identify what’s what to put the rubber band on. Rubber bands can fall off. And then also, if you have somebody come into the home to help you,

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you’re still relying on assistance with your medication, so you can’t take it independently.

Some individuals with low vision will take Sharpie markers, and use different color coding methods, and write on the caps or use a black method to write on the cap. Again, you’re relying on yourself to be able to properly identify, and to make sure there’s been no changes in the dosage or the pill type. Then we have some individuals that will take pills, and to tell themselves they took it for the day, they’ll turn the bottle upside down. Or when they’re storing bottles, if they’re taking two medications, they’ll store one upside down and one right side up. And then they say this is my blood pressure, and this is my antianxiety med.

We know the problem with that. What if you pick it up, you take it, you get busy, you put it down. You go to put it back, and you’re like oh no which medication did I just have? So now, you’re left in a position that you’re not sure what’s in front of you, and a critical mistake can be made. 60% of medication errors result in serious injury. So that’s why it’s so important that we find solutions that

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are healthy and safe, and allow the blind and low vision community to be independent.

That will take us to some legislations that’s went on. There are organizations and individuals in the community who have been stressing the importance of independent medication taking for some time. Some large organizations that have worked with government agencies to discuss what needs to change and how that needs to change. But it all goes right back to the ADA. Initially, in 1990 we have the ADA, and it serves a wide range of civil rights low. Specific to accessible prescriptions we would be looking at title three of that. And what it says is that, “No individual may be discriminated against on the basis of disability with regards to the full and equal enjoyment of the goods, services, facilities or accommodations of any place.” So vague, but it also says, “As long as such changes are achievable.” That means with the ADA their definition of, “readily achievable, easily accomplishable, and able to be carried out without much difficulty or expense.” So that’s the ADA’s definition of that term, and it leaves public entities a way to not have to provide

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something. Which don’t get me wrong, the ADA was great, so we’re happy that we have that on our side. We’ll go to the next slide.

In 2004, there was a Medicare Prescription Drug Improvement and Modernization Act. That particular act said that The Department of Health and Human Services were required to research how to make prescription information accessible to the visually impaired. So what had happened is the Department of Health and Human Services formulated study questions, and then they asked the AFB which is the American Foundation of the Blind to respond with information. So they did.

They further studied it, and they gave those answers back to the Department of Health and Human Services. And the final recommendation was that they educate the public entities, private entities, and individuals about what needed to change.

Whatever happened with that? Back in 2004, we’re like well we probably should have gotten somewhere. There were people saying it needed to

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change. There was an organization saying yes it does, and this is why, and here’s what we can do about that. And then, made a recommendation to educate. There was no funding, so they did nothing. So, it sat, and it never really followed through. And that can be a problem with the government, and funding and those issues, and unfortunately it did affect this piece of the law where they’re asking that accessible prescription information was then educated to the public.

This is one of the biggest jumps and bounds that we’ve had with making accessible prescriptions available to everybody everywhere. And it’s the Food and Drug Administration’s Safety and Initiative Act. There was a senator Mark Hay who initiated a campaign and a bill to make accessible prescriptions available to everybody. And a part of his bill was then put into this Food and Drug Administration Safety and Initiative Act.

Within that they had to create the United States Access Board had to create a working group to determine what the best practice is for medication labeling is. As we know ADA says it needs to be provided, and so there was no clarification on what

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exactly needed to be provided. So that’s what this working group’s job was. Their job was to get together and determine what the best practices are. So individuals that were a part of that working group were pharmacies, organizations that work with the low vision and the blind population, and some other government agencies.

While that working group got together, they came up with specific guidelines and recommendations as to what should be offered. They broke it down to audible, braille, and large print. And within each one of those segments, they broke those down further and said, “If you offer audible labels, you should offer this,” and so for that particular section they said, “For a dedicated equipment, select devices that provide independent, easy to use, start, stop operations with volume control and earbud access. If using a voice recorder, speak in a clear voice, record information in a setting that minimizes background noise and maintains patient privacy. And then offer to show the patient how to operate the audible prescription drug container label.”

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That was the specific recommendations for an audible solution. Then they went to braille, and they said for braille, “Electronic delivery method, acquire an electronic delivery method using RFID tags, QR codes, or other processes to provide electronic text of the prescription drug container label upon request. Consumers with electronic braille equipment may then access electronic text in a braille format. So just to kind of sum that up a little bit, they wanted a label to be provided on the bottle that you could access from home and use your own braille display to get all that information on the outside of your label.

And then, it said that, “Note that as required the working group considered significant challenges that pharmacies may face in producing drug labels in accessible formats. Such as hard copy braille. The working group recognizes that mail order and online pharmacies, because of their centralized structure, large volume, and mail delivery process may be better equipped than local stores to provide hard copy Braille prescription drug container labels. Many mail order and online pharmacies have established a unit with the necessary computer software and braille embosser

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to produce hard copy braille labels and protocol to developed process proficiency in printing accurate braille labels.

So with that piece, they’re saying a lot of centralized mail order pharmacies currently offer braille. Then they talked some more, and they said they wanted them to use contracted grade two braille that if they were providing a label on the bottle, the embossed braille labels needed to be transparent. So if an individual came into your home, they still had access to the printed text information. But then you still as the user have access to the braille, and you can get the same information.

The next piece is the large print, and they said, “If you’re offering large print, you need to offer 18 point bold font, to use nonglossy paper or other material that is durable, and the size that is easy to manipulate. Use print with highest possible contrasts between text and background color. Ideally, black text on white or pale yellow background. If printing on both sides, use material that does not allow print bleed through from one side to the other. Use sensitive case with the initial

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capital letter followed by lower case. To use non condensed, and then they talked about different fonts. So Arial was one of the ones they had suggested. They also suggested to use one and a half line spacing, and to use horizontal text only.

With all of that, they wanted that large print label to be affixed to the bottle, so they wanted to make sure you weren’t just getting a sheet of paper with a prescription that was in large print, and it not be connected. And then in that case, you could end up with five prescriptions at home, five pieces of large print paper, and still not be able to properly read the small print to match up that large print paper.

They really did a good job. I was really impressed with what the working group came up with. They left all kind of questions out, and they said, well here’s three options, and whichever option they broke down and said what it should look like.

That report was published, and it was made public that those were the recommendations and from there where do we stand? The National Council on Disability will conduct an informal and education

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campaign in cooperation with the stakeholder working group to inform the public, including people with disabilities and pharmacists of the best practices. So again, we got back to an education campaign just like we did in the last bill.

Unfortunately, I can tell you right now today, there has not been an education campaign done. There’s been some limited blogs that have been posted about the issue, and some organizations have shared the information. But there’s really not been anything done formally to educate the pharmacies and the different pharmacists on what they should be offering.

Again, I want you to keep in mind that the title of this is Recommended Best Practices, so if you get a chance, and there’s some links we can provide. When you go to read it within the first few paragraphs it says that, “This is not a requirement.” That the pharmacy does not have to do any of this, but that it’s recommended that, if they provide one of these solutions, this is what they should provide.

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So unfortunately, there’s no teeth behind what’s been done. And that’s why an education campaign is so important, so that the sighted community that work with these products understand that there’s this need. And then they also understand what the best thing to do is about it and how to provide that. Most recently what has happened I think that has come close to an education campaign. It’s not really an education campaign, but the Senator Mark Hay who initiated all of this.

On January 7th I got a link in my inbox that he had actually sent out letters to the top ten pharmacies throughout the U.S. And what he did was he addressed each one of them and asked them what they’re doing. What kind of solutions have they currently implemented, what are they working on to implement, if they have a future plan for implementation, and the he asked them to please respond to him by the end of January. I’m very interested to see what that looks like when it comes back. I think that it’s a great stepping ground for us to keep moving forward with accessible prescription options we have.

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So I just gave everybody a lot of information. Does anybody have questions for me right now regarding the legislation and what’s gone on and what’s currently happening?

Larry MuffettI’m going to release the microphone, so if you want to cue up and ask a question of Amanda, you can do that. You can also do that by means of the text box, so I’m going to turn loose then microphone. Those of you who have a question go ahead and jump in.

ChristyThis is Christy. I was just curious years and years ago, I was told that Walgreens offered braille prescription labeling. I don’t take prescriptions, but I was wondering. It seems like braille would have to be smaller than the standard braille. It would have to be I don’t know. Real tiny, tinier than what it is to actually fit it on the bottle, because prescription bottles aren’t that big. I was wondering how that actually worked. And the large print too, because it’s bigger.

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Amanda TolsonAs we move forward, actually our next part of this is going to be me talking about what options are currently available and where those are available. So I can get you guys some really good information on that.

Larry MuffettWe do have a question. Rita says, “How do we get the word out to everyone.”

Amanda TolsonThat’s a great question. I like that question. If you are a part of a local chapter of your American Council of the Blind or your National Federation of the Blind, it’s great to share this information. If you’re on any social networking groups with individuals, share the information. If you are using a pharmacy that doesn’t have anything, share the information with your pharmacist. Word of mouth is best, and always talking about it. And keeping individuals educated then what’s going on.

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I think it’s also important to remember to educate your sighted family, friends, and educate them on that. When you have individuals in the sighted community, they don’t know that this issue exists. It’s not something that they have a problem with, and when you tell them, they kind of look at you with wonder, and they’re like, “Oh I never thought about that. That is a problem. What do you do?” So getting everybody behind you and understanding the problem and educating everybody is the most important.

Larry MuffettSome other questions for Amanda? I’m going to turn the microphone loose.

AllenHi Amanda, this is Allen. Just so that I’m on the same page. Ultimately for this kind of stuff to happen, there’s got to be some kind of enforcement that’s over this, and I assume it’s the FDA for it to have teeth to get people to volunteer or businesses to fix something, kicking and screaming usually. Is that where this rests in terms of any kind of enforcement and any kind of

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centralization of authority to get something like this done?

Amanda TolsonWe’re hoping. But still a part of the Food and Drug Administration Safety Act, the comptroller has to file a report. So Senator Mark Hay has sent those letters out asking those questions. I’m sure he’s going to gather that information and then provide it to the appropriate person that then is going to look at everything and say, okay what has been done? What is being done? What isn’t being done? And then make some decisions.

But again, I think you’re right in the sense that for anybody to be forced to do anything like this, people above me and you are really going to have to get behind it and regulate it, and say it’s not acceptable anymore to provide print to the low vision and blind community when they can’t use it. So each state has regulation as to what that label looks like for the sighted community, and it says that you have to provide certain information. And it has to be in certain font size, and everything that it needs to include.

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You cannot just hand a bottle with no label on it to an individual. I think it’s important for people to use that analogy that you wouldn’t hand a bottle to a sighted person with nothing on it, because you’re not allowed. And handing a print bottle to somebody who’s not able to use it is kind of the same thing. You’re not really giving them an option to access the information that they need and know what’s in front of them to take it, to know how to take it, and get all the information about the warnings associated with that drug that are available to them.

So yes, eventually it’s going to take a larger entity to make things mandated. I think it’s up to us right now to keep educating and pushing your local government, your local pharmacist to understand the problem, and to be on your side and want to work with us in a solution for accessible prescriptions.

Larry MuffettI think we’ve got time for one more question, so I’m going to release the microphone again.

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IgnacioThis is Ignacio. As far as all these labels, and the audio technology, if I was to get it from a pharmacy where does it come from? Who pays for that? My insurance that would pay the pharmacy, or does the pharmacy itself pays for this like the audible cellular and audible machine. Who pays for this?

Amanda TolsonCurrently the pharmacy absorbs the cost of services like this. Your insurance company does not pay extra for any special labeling. They do not cover the cost of a reader that could read specific types of audible labels. And so really the pharmacies are absorbing that cost right now. Hopefully, one day we see that the insurance companies are going to pick up this cost like they did with the glucose monitors. I know that we have some of those readers out there that are audible, and you can check your blood with. And those are covered by your insurance company. So we hope to see that something like this will become covered by insurance companies as well. But currently, they’re not.

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Larry MuffettAny more questions? Alright, hearing none, we’ll move onto the second portion of the seminar.

Amanda TolsonI think this is what was the much anticipated part of this conversation. What’s available? I’m going to be really honest that I’m with En-Vision America, so I’m very well versed on what my products are. I can give you general information on other products that I know are available, and provide you with as much data as I can, and I’ll try to answer questions. But again, I’m not well versed in those products, but I can tell you what I know is available.

Let’s start with Walgreens. What they’ve done, they have a talking pill reminder that they’ve actually had on the shelf for I think a couple of years. You can go in and buy it for $10. I think it’s $9.99. Again, don’t quote me on that price. But you could go and you could buy it on your own, and it’s a 30 second audio recording. And it has adhesive on it, so you can stick it on a bottled top. It also has a reminder that’s built in that would ping at you.

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Walgreens recently had a press release saying that you can get that at any one of their brick and mortar locations, and that they also offer it through their mail order. So what are some pros to that one? It’s available, and you can get it. You can make the recording at home if you buy one on your own, or you can have a caregiver do that for you. Its battery operated, and Walgreens does operate in the store. So it’s available to you at the brick and mortar locations.

Some of the cons to that option for you are that it does have short recording times, you’re limited to 30 seconds. So you’re not going to get the full label information. You could probably talk really fast, and you’re still not going to get it all. And then you won’t understand anything. It’s limited, and you’re going to have to choose what information they give you. It doesn’t have a volume control on it, so the volume is what it is. It doesn’t have an earphone jack for privacy, and it does leave room for human error during that recording. So that’s some of the cons to that one.

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We can go to the next solution. There’s a product now called AccessaMed, and again, I have limited information about these products. But I want to say that they’ve been around for a couple of years now maybe one or two, and just recently entered this accessible prescription arena. They have a product that connects to a bottle with adhesive, and it is a digital recording, so you press a button, and you’re still hearing digital voice whereas with Walgreens you’re hearing a recorded voice. With this one is a digital voice.

Some of the pros to this one is it attaches to the bottle which is definitely a must. It’s easy to use. It has one button on it with a speaker, and its battery powered as well. Some of the cons to that one are there’s no volume adjustment. You can’t move up and down through the information. You can just start and then stop it and then start again. And then, there’s no headphone jack on that one either. And I think it’s limited to the container or dispensing package that it’s put on. I don’t know that you would be able to get every package that your prescription is dispensed on.

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We’ll go over En-Vision America’s products and these other ones that I am well versed in. So I’ll give you lots of great information. What En-Vision America has done is we have ScripAbility, and what that is is it’s an umbrella. And under that umbrella it houses three label styles audible, large print, and braille. So we current offer three different label styles.

The three that the United States Access Board recommends our products meet or exceed all of those recommendations. So we did pay close attention to what they were saying, the working group, as far as what should be offered and how it should be offered. And we made sure that we provided all of those options and either met or exceeded what they were asking for.

The other nice thing about ScripAbility is that you have multiple options for smartphone use. If you use our audible option where we provide you with a device, we provide that device on loan to the customer, so there’s no cost to the customer. All of our products are easy to use, and we are currently available in over 100 independent pharmacies in the U.S., and we are available in some very known

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large name brands companies in the U.S. and Canada.

We’ll go to the next slide. I’ll start with our ScripView options. This is our large print option. And what we did was we created a booklet style label that attaches to the bottle, so it cannot come off. The font can range anywhere from twelve point font to 26 point font. And the pharmacist has the ability to choose font styles, so they can customize it to your needs. We also offer contrasting, so if you like black on white you can get that. If you prefer white on black, you can get that as well.

This label completely mimics exactly what the legal label has on it. You would be getting everything that’s on the legal label in a large print format. ScripView is one of the products that offer a smartphone solution as well. There is a 2D barcode printed on the large print label, and you can use an iOS product and download the ScripView app for free. You can scan that 2D barcode, and then the label becomes audible. So not only can our large print be large print, but it can also serve as an audible label.

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So we know we have an attached large print label for our ScripView, but I think a lot of people ask the question, “Every time I pick up my prescriptions I get a pamphlet that’s stapled to the bag, and it’s all in text and little. And I can’t read it. What does that say?” We call those patient monograph sheets, and that’s all the extra information associated with that drug. In most cases, individuals who are blind or low vision don’t have access to that. But with our products you do.

You’re provided a phone number and a four digit code. When you call the number and enter the code, you are then given that entire sheet in an audible format. So there’s a lot of information that’s available on those sheets, and unfortunately, putting those in a large print format was not an option unless you literally wanted a book, like a hundred page book attached to your bottle. And so we felt that we wanted to make it available, and we needed a way to do that. This audible phone solution was the way that we could do that.

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So with your app when you scan it, and you get the audible solution on the label information, you can also with an app get the additional information. So there’s actually two ways to get that additional information on our large print solution. So we talked a little bit more about the 2D barcode and how you can scan it. I’m going to see if we can get them to down load an audio example of the app being scanned for you guys, so you can hear that. But again, you’re using your Siri device, so it’s going to be with voiceover on, and reading through the information.

So now that we’re offering a braille solution, braille printers are very expensive, and we wanted to find a solution that was affordable, usable, small, and easy for a pharmacist. And we came up with our braille solution which are clear adhesive strips that can go on the bottle. It is great to contract as braille, and the pharmacist has the ability to choose what information they provide on your bottle.

Most of know that braille is braille. We can’t shrink it. We can’t expand it. It is what it is, and we are limited by the amount of space we have on a

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dispensing package. Most people don’t want a milk gallon jug for their prescriptions or a 30 day supply. We would need something quite large like that to get all of the legal information available to you in braille. What we like to suggest to our pharmacies is if they provide our braille that they also provide ScripTalk our audible solution. Then that way they can provide you with some clear identification pieces as to what that prescription is, and the keep the lines short that they’re using and have enough space on their package. But then, giving you that audible solution, so you can still get the clear picture of what that drug is and all the information that’s associated with it. So it’s a limited solution, but it’s a solution, and it is clear and adhesive, so it does meet those recommendations.

And then next I’d like to go over our audible solution, and ScripTalk is our audible solution. ScripTalk’s been around for over a decade. Most people have heard of it and know about it. We have over 15,000 users in the U.S, using it, and we have now expanded the market to Canada. And so we do have a lot of users coming on in Canada using it as well.

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ScripTalk is a really neat technology, and the way that it works is with RFID which is Radio Frequency Identification. And what we have done is we’ve embedded a small microchip in a label that can be placed on any packaging product. So bottle, boxes, tubes, whatever. It can be placed on, and then using an RFID reader in your home you can pull that information off of that microchip and get all of that label information spoken to you.

The neat thing about ScripTalk is those of you that don’t have a smartphone in the home, or can’t afford technology like that, we provide you with that reader. So again, there’s no cost, and we’re making that reader available to you. You can use a smartphone. Really any NFC enabled phone can read those. Unfortunately, Apple products do not have NFC, so you’d be looking more to android market. I know with the iPhone 6 and 6 Plus, they started doing Apple Pay, and that does use Radio Frequency Identification, so we’re hoping they open that up to our production team, so we can create that app for you for an iOS device. But currently, it is available on the android apps with NFC. And again, you

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would hold it close to your phone and read it, and we do have an app available for free with that as well.

The nice thing about ScripTalk is it has adjustable volume. It has an earphone jack for privacy. You do have the ability to move forward and backward through the information. So maybe the first time you get the medication you want to listen to it all the way through. But after that, you just want to know what it is or how to take it, or you just want your pharmacies phone number and your prescription number so you can reorder it.

The nice thing about ScripTalk is you can get to that information quickly with an up and down arrow, and you don’t have to listen to the whole label to get to it. It does run on AA batteries or a wall adapter, so it’s your choice on how you’d like to do that. And the pharmacists program [inaudible 0:41:58] for you. And it’s an automated text to speech voice, so you don’t have to worry about somebody’s voice recording on it. And I can do a sample of that for you guys right now. I’ll turn it on. I have one here with me.

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ScripTalk station ready. Patient John J. Smith medication. Amoxicillin 250 milligrams. Instructions take one capsule three times daily. Quantity 30 capsule. Prescription date August 1, 2013. Use by July 31, 2014. Refills remaining zero. Prescriber Ben Casey. ScripAbility. To reorder this prescription dial area code three, zero, nine, five, five, five, one, two, one, two. Prescription number one, two, three, five, four, six.

Warning, Important. Finish all this medication unless otherwise directed by prescriber. Warning this medicine maybe taken with or without food. Warning may cause diarrhea during treatment. If it persists or becomes severe tell your doctor or pharmacist. Warning persistent due to colitis may rarely occur weeks or months after using antibiotics. If this occurs notify your doctor or pharmacist promptly. Other information take for infection. Other information take for infection.

So this particular label didn’t have the phone number and the four digit code for you to call, but that would be available to you. And like I said, we

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just listened to that whole label. That’s a lot of information, and I know that every time you pick up your prescriptions, you don’t want to hear that. And that’s again why you had the ability to move up and down through the information. The other thing that I didn’t mention is you do have the ability to slow down or speed up that talking. So if you like to listen to your talking devices really fast, because I know some of you do, you can. If you want it slowed down, because you have a hard time hearing it, and you need it slower, you can do that as well.

For those tricky drug names that you have no idea how to spell, and half the time they’re really hard to pronounce there is a spell mode available for you. So you can go to spell mode and have that information spelled to you. So it reordering a little easier, and it helps you understand your prescription drug names better, and gives you more information and keeps you educated.

So the biggest question that we have is where can I find accessible prescription labels, and how do I get them? There’s a lot of pharmacies. Over 100 independent pharmacies throughout the U.S. offer

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ScripTalk, and you can go onto En-Vision’s website to get that information. You can call the office, and we can provide you with that information.

When we start talking about the name brand pharmacies that we know. Walmart does offer ScripTalk. Walmart offers ScripTalk through their mail order, and then they also offer it through their brick and mortar locations as well. Right now I want to say we’re at around 60 Walmart locations that are offering it. And if you use your current Wal-Mart you can go into your Walmart and ask your pharmacist for it, and they can get that installed for you there at your hometown location.

CVS I don’t know if anybody’s seen some new press releases that have come out, but www.cvs.com which is a way to get your prescriptions mailed to you but be billed as a brick and mortar location, you would use CVS dotcom. They do mail your prescriptions to your home, or they bill your insurance like you walked into your local CVS and picked it up. They offer ScripTalk. And again, that’s mail order. And then, CVS Caremark which is their real mail order facility, and that’s based on your insurance.

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So if Caremark is your required mail order place, you can use them. And you can now get ScripTalk through them. But what’s also nice is not only can you get ScripTalk through Caremark, but you can also get large print and braille. And again, you have those smartphone options. So we’re really excited. They just recently did their press release announcing that that offer that.

OptumRX is another mail order pharmacy that offers it. So if your insurance is that OptumRx is your PBM which is Pharmacy Benefit Management Company, you can get through them as well. They have ScripTalk and large print and braille as well. So they have all three options through them as well. We touched on the Walgreens solution. Walgreens offers their solution at their locations. So they don’t have any of En-Vision America’s. They have theirs, and you should be able to go in and talk to your pharmacist, and they should be able to help you out. So our website again you can go to our website www.envisionamerica.com, or you can go to www.scripability.com. Our phone number is also available. You can call our office, and here’s what we’ll do.

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When you call in and you say you’re interested in it, we’ll look it up by zip code for you. We’ll let you know what options are available locally to you, and then we’ll let you know what mail options are available to you. If there’s an option that you want that’s not available, we’ll add you to our database and mark you as such. So when that option becomes available we can call you and let you know how to get it. I encourage everybody to do that, because we are working with a lot of companies right now. And as information becomes available, and rollouts happen, you would be the first to know. And we can get you going right away.

We do not sell your information. It’s strictly for us, and we only contact you when the solution that you’re interested in is available. So our phone number is 1-800-890-1180. And that was made available in the text field for you guys. Also, you can dial 855SPEAKRX for those of you that’s easier for you remember words, you can dial that number. And we can provide you with all the information as far as solutions that are available in your area.

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I know that when we’re going to get to the question and answers, the biggest question that we have is I don’t want to switch my pharmacy. I want to stay where I am. How do I get my pharmacy to carry it? We do have recommendations on how you can do that. You can call us, and we can help and call your pharmacy and work with them. But we also recommend that you work with your local blind and low vision support groups in your area and to invite one of your local pharmacists into a meeting, so you guys can show them the acceptable prescription options, and you can demonstrate it for them.

Also, if you approach your pharmacy as a united front, and you say here’s my group, and you’re local, and there’s X amount of us looking for a solution would you help us out? You’re more likely to get the pharmacy to offer that and make that available to you, because then they see a need for it in the community. And then again I always recommend that you talk to your pharmacist. Use this to establish a relationship with them. And so, when you go in, and you if they don’t already know that you’re having trouble, and you make the solution know to them, in most cases, they want to

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help you. And so they want to offer a solution. And just letting them know that this technology’s available could be enough. And then you can have it at your local store.

The other thing is some organizations apply for a grant, because it cost the pharmacy to implement the solutions. So sometimes organizations will get grant money, and they’ll cover the cost of implementing a solution like that. And then it’s available to the whole community, so sometimes that’s an option for individuals as well. And again, if you call us at En-Vision America, we can help with whatever solution or avenue you would like to take, and you feel comfortable doing and work with you to get you some solutions in your area.

I’m going to open it up for questions and answers, and I think we’ll have quite a few of those.

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Larry MuffettI’m going to release the microphone. I already see some people cuing up.

Janice CrosbyHi this is Janice Crosby in Columbia, South Carolina, and I was talking with you before Amanda, and my husband used to when he was living he had the ScipTalk and it was provided through the VA. And I’m now a beneficiary, and I receive my prescriptions through the CHAMPVA Meds by Mail, and I’ve called them before to see if they offer that, do they have that since I’m blind, and they didn’t. And I was wanting to know if you know whether they provide that now, or if now what is it that I can do to get them to do that for me. Because I really get confused with my medication.

Amanda TolsonIt’s nice speaking to you again. Yes, and I have a lot of veterans spouses that use CHAMP’s, and we’ve reached out to them. They do not currently offer it. What I would recommend is if you are working with a specific person at the VA for your services, you reach out to that person and see if

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they can help you, or what options would be available to you.

The nice thing is that if you are a veteran you get ScripTalk. Any veteran in the U.S. that needs it can get it. And then in this situation with the spouse, I know the majority of spouses are using CHAMP’s. They do not currently have it. I have spoken to them, and I don’t think I’ve spoke to the right people. But we keep trying to get somebody over there, so if you have an individual that you’re working with at the VA that can help you and help us get those services going, we can work together. Give me a call at En-Vision, and we’ll keep moving forward with that.

MaleThanks Amanda for all this outstanding information you’ve presented. I guess I’m most encouraged by the ScripView option, and the use of iDevices simply, because I know the way the business world works when it comes to finance and this kind of stuff. If they can put the monkey on the back of an individual to have to come up with e funding, it’s a lot more likely to happen.

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With that in mind, who controls this is the QR code I assume with the ScripView app. Who controls the underlying database that’s being accessed when your phone reads those QR codes? Is that something that En-Vision America controls, or is that turned over to the pharmacy? How does that work? The second question is is the app set up, so once you go into that, you just it’s set up in real time to scan the thing? You don’t like take a picture?

You don’t have to find the code on the prescription and then take a picture of it. Does it just scan it in real time and then present the information. And finally, I get my meds through OptumRX which I think you mentioned. Do they make a QR code that works with ScripView available? Do I just have to call them up to do that, or is it only ScripTalk that I can get? Thanks.

Amanda TolsonThat was a great question. I’m going to start with your last question first about OptumRX. Yes, they have ScripView. Yes, they have the QR code, and

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yes, just call them, and tell them you want the large print script view on your prescriptions, and they will get it so you now moving forward will receive that.

The ScripView technology when it creates a QR code uses our software. And in that QR code is all that prescription data. So there’s not an outside database that is being accessed. All of your personal information to that prescription, and we did it this way for HIPPA. All of that information is available in the QR code itself. So it’s not like with most QR codes where it takes you to a website and brings back information, it’s not doing that here. It’s actually reading the data embedded in the QR code itself. So that’s great news. One, it’s HIPPA. It’s private. It’s right on the label, so there’s no databases being accessed. The pharmacy has our software that creates that QR code.

Your next question about the app. You would launch the app, and it immediately opens to the scanner. So then you would scan the barcode and then pop, all of your information comes up. You use your same key strokes that you’re going to use with voiceover is what you’re using through our

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app. And each piece of information is line itemed. So it’s you’re going to scroll down through the information by tapping and swiping.

And then your final piece of information at the end of that is going to be, “For more information click.” That piece you do click on, and it opens a browser with additional prescription information. So that information is specific to the drug not specific to you. So that is a general database of information. And En-Vision America, we are the ones that house that database and take care of that information. And you’re actually pulled to our website to get that information. SO hopefully, I answered all those questions, because they were great questions.

Larry MuffettWe’ve got a couple in the text box I’m going to pass along, and then we’ll turn the microphone loose again. Robin says, “What does it cost for an individual pharmacy to get started using this?”

Amanda Tolson

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It depends if they’re an independent retail location, just a mom and pop style pharmacy. You’re looking around $1,000 startup, so it’s not ask high as some people think. I think some people when you hear this technology it sounds very expensive. But we do keep that affordable, so that independent mom and pop style pharmacies can provide that.

And then the other thing is there’s a tax credit available to pharmacies that are smaller, and they actually get 50% back on anything they spend on this program. It’s called the Disabled Access Credit, so not only do we keep the cost low, we also get the tax credit with it as well. So I think it’s a pretty good price point for them to get started.

Larry MuffettSecond question. Ann says, “Was Caremark the one that provides script reader?

Amanda TolsonNo, En-Vision America will provide you with your ScripTalk reader. So what happens is when you get

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signed up for a participating pharmacy, that pharmacy sends En-Vision America a form, and they say John Smith is using our pharmacy for ScripTalk. Here’s his address and phone number. Please send him a device. En-Vision America then will call you, verify your address, and then we’re going to ship that ScripTalk station out to you.

En-Vision America handles everything with the ScripTalk reader. Because we put it on loan to you, we take care of all the maintenance of it. If anything were to go wrong, we call and follow up with you every six months to make sure everything’s still fine. If in between that time you have a problem, and you need assistance, you would call us, and we would help you.

And when I say, “loan,” what we mean is as long as you’re using a participating pharmacy, you’re keeping that ScripTalk in your home. If you stop using a participating pharmacy, you would then return it. We would provide you with that kit to do so. So there’s no cost associated for returning it either. And the main reason is, because that ScripTalk doesn’t work unless you use a pharmacy that offers the special labels with the microchip

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embedded in them. So if you do go to another pharmacy that doesn’t offer the special labels, your ScripTalk won’t work. So we like to make sure that we can provide those to users that are at pharmacies getting those microchips.

Larry MuffettWe’ve got some other questions here. So Ann wants to follow up. She says, “Is CVS Caremark they are a pharmacy that offers this, right?”

Amanda TolsonCorrect, in the sense only through mail order. So you cannot go into your brick and mortar CVS location to get it. You have to get it through mail order. So either it’s through CVS dotcom mail order, or it’s through CVS Caremark mail order. They’re two separate companies, and CVS likes to say think of us as Coke, Diet Coke, and Coke Zero.” So they’re all Coke but different types, and that’s kind of like the CVS dotcom, the Caremark, and then their brick and mortar locations. And again, En-Vision America can get you the right phone numbers to call and make it a very simple process

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for you to get switched into using one of those options.

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Larry MoffettA couple more questions. Does Kaiser HMO offer this, and does Safeway offer it?

Amanda TolsonYes, there are some Kaiser locations. There’s Colorado Kaiser that offers it. Oregon offers it, but it’s through mail order. So anybody in that region can get it, and then Colorado region can get it. The way that Kaiser work is it’s broke off by region, so not all Kaiser Locations offer it. Just certain locations.

Larry MuffettAnd Safeway?

Amanda TolsonSafeway does not offer it, unfortunately.

Larry MuffettWe’re going to go back to the microphone now.

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IgnacioThis is Ignacio from Houston, Texas. I wanted to know if you can repeat the phone number you gave out earlier, and just to understand correctly did you say Walgreens does that also, offer ScripTalk? Because I was in an Abilities Expo in the past, and they had some type of booth where they had a machine that talked, but I wasn’t sure if it was the ScripTalk that you’re talking about, or it was something different.

Wayne My name is Wayne Vindinen, and does Express Trip offer the ScripTalk, and secondly could you repeat the email address again please?

JaniceHi this is Janice again, and I understand you said that these ScripTalk’s were on loans. Does that mean that I needed to mail my husband’s ScripTalk back in once he passed away?

Ellen

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Hi there. It’s Ellen. I’m a Canadian resident, and I was wondering if the ScripTalk is available and for Canadian residents and how to go about doing that.

Amanda TolsonOkay, so you have a lot of questions here. I’m going to try and make sure I touch on all of them.

Larry MuffettTelephone number and email address were two of them.

Amanda TolsonOkay so telephone number again 1-800-890-1180, and that’s being entered into the text field again for you guys. The other phone number if you want that one is 855SPEAKRX. So either one of those numbers will get you to En-Vision America. Our website is www.envisionamerica.com, and that is also being put into the text field for you.

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Canada question. Right now in British Columbia there are some Canadian options available. Overwaitea Food Group offers it at any one of their locations. London Drugs offers it at any of their locations, and there’s a Peoples Drug Mart in Vancouver that offers it that you can get it at.

Larry MuffettWalgreens.

Amanda TolsonWalgreens does not offer ScripTalk. Walgreens offers a recorded solution of their own. So if you are interested in just Walgreens, you would have to go speak to your pharmacist for more information on that one. But it is not ScripTalk. That is not the solution that they have. And then I think there was an Express Scripts question. And I would highly encourage anyone that uses Express Scripts to call En-Vision America and provide your information and that you are an Express Scripts user, so that when it comes available or if, we can call you and let you know what to do to get set up with it.

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Larry MuffettGood. I think we handled most of those. If we didn’t, if we skipped something, or if we missed something, please ask again. I’m going to release the microphone.

Janice Hi. Again, this is Janice, and I wanted to know if I needed to mail my husband’s ScripTalk back to En-Vision America once he passed, and that’s been ever since ’08.

Amanda TolsonI’m making sure I’m making myself clear. Veterans do not have their put on loan. And En-Vision America does not provide veterans with their device. The VA provides veterans with their device, and so veteran’s devices are not on loan. And those don’t have to be returned. The VA supplies those to the veterans, so those are not on loan, and they don’t have to be returned.

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JaniceOkay thank you.

Larry MuffettWe’ve got time for about one more question here, so who wants to jump in?

IgnacioDo you know if WellCare offers ScripTalk?

Amanda TolsonI think WellCare is part of an insurance provider. Off of the top of my head, I couldn’t give you specific information, but give us a call at Envision, and I can make sure that we get that, the correct information for you with them.

Larry MuffettThis has been a wonderful sharing of information today, and I want to let everyone know that this seminar like all of our seminars will be recorded and archived on our website and available for your use anytime around the clock. Also, each Hadley

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seminar is now made available for podcast that you can download to your computer or mobile device. If today’s seminar got you interested in this particular topic or others please check out the seminar archives and Hadley’s course list.

We thank you all for your participation. Your questions were outstanding and really added a lot to the value of this seminar. Hadley values your feedback. Please let us know what you thought about today’s seminar and please give us suggestions for future topics. One way you can do that is by dropping us an email to feedback@hadley.edu. Another way to share is by completing a short onscreen survey outpost as we conclude today. I’m going to turn the microphone back over to Amanda for a few minutes and ask her if she’d like to make any closing comments.

Amanda TolsonOkay guys, it was so nice to be here and be able to provide you all with this information. I hope that you’ve learned a lot about accessible prescriptions and what you can do to get them, where you can go. Most importantly, remember that En-Vision

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America is happy to answer these questions for you, and you can call us or get ahold of us on our website. So if you do come up with questions after, please feel free to call us. We’re there to help and answer those questions, and hopefully if you’re looking for a local blind or low vision group to team up with we can point you in that direction, and get you some contact information for them. Again, if you have any questions, you can please feel free to call us, and thank you for having me.

Larry MuffettThank you Amanda this has been wonderful, and I want to thank all of you for taking the time to be a part of this and asking a number of really great questions that the people that listen to this on podcast or the recorded archives are going to get a lot of value out of that from the questions that you asked. So thank you for that. Again, I want to thank you for taking the time to participate. I want to thank you for all the great questions, and goodbye for now.

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