Founded in 2003 by Dr Armando Bardisa, South Miami Pharmacy (SMP) aims to improve the quality of life for its customers and patients through personalised service.

To provide this individual service, SMP offers hard-to-find medications, compounding services, one-on-one fertility specialists, and medication therapy management for specialty pharmacy patients.

Serving patients in most of the 50 US states and many international countries, South Miami Pharmacy rebranded itself as SMP Pharmacy Solutions in 2015 to better reflect its global services. The company ships approximately 10,000 prescriptions each month from two Miami facilities and safe shipment of temperature-sensitive products is particularly critical to their focus on patient care and quality.

Fertility treatments are also a large segment of SMP’s business and most of these medications require refrigeration. Acknowledging that this is a highly sensitive and emotionally invested treatment for the patients they serve, product integrity is critically important to SMP.

Vice-president of SMP Pharmacy Solutions Brian Brito said: "Particularly during the summer months, we would receive calls from our patients stating that the ice packs were melted and they were not sure if the medications were still effective and safe to use.

"Plus, we also needed to implement this cold chain procedure for our specialty pharmacy accreditation and state requirements.

"Temptime had been trying to get us to use their heat indicators for quite some time.

"Quite honestly, we were hesitant when thinking that it might cause more calls and customer confusion. Additional considerations were cost, implementation of a new system to the workflow, and extra time added to the packaging process."

Being completely dedicated to patient safety and satisfaction, SMP agreed to work together with Katie Kraverath from Temptime to develop and execute shipping studies. Convinced that gathering solid data on exactly what was going on with their shipments would reveal the answer, SMP worked to set up the temperature-monitored test package shipments to various locations, along with FedEx, who handles SMP’s specialty pharmacy shipping.

Brian added: "We were surprised to find out how hot the packages got, even with double packing and ice packs.
"It opened our eyes to the fact that sometimes the package sits in a truck at 110°F heat, or misses the flight and sits even longer. Using an indicator shows our patients that we are committed to them.

"Katie is genuine and always provided true value to our business, introducing us to other specialty pharmacies that were using indicators to improve their processes and patient satisfaction.

"That helped us know that this was the right thing to do, for both our patients and our business."

SMP evaluated several temperature indicators but landed with LIMITmarker, noting reliability at a reasonable price per unit. Brian also noted that none of the other options provided the flexibility and technical support SMP were seeking.

The company also liked that LIMITmarker is easily customisable and has incorporated it into their own indicator card, with a logo, instructions, and contact information further demonstrating its commitment to strong bonds with its customers.

Despite initial concerns, SMP encountered no real significant challenges. It incorporated the new temperature indicator standard operating procedure (SOP) into its workflow at both shipping facilities and trained staff to respond to patient questions about the indicators.

Brian said: "With every shipment, we send a patient letter that explains how the temperature indicator is used, read, and when to call us if the indicator shows the temperature limit was exceeded."

SMP is now including a customised LIMITmarker card and patient instructions for all refrigerated shipments sent via FedEx or couriers for in-person deliveries.

Brian said: "The most important return is that the temperature indicator helps us give both our patients and staff peace of mind.

"Again, these tools like LIMITmarker support our position on patient safety and commitment to superior quality care."

The direct return on investment (ROI) for SMP has been savings of thousands of dollars on what would have been spoiled medications and reshipment fees. Also, the increased volume of physician referrals has not been quantified, but SMP has confirmed a positive impact on its business.

SMP focuses on educating prescribers about the importance and value of temperature indicators. The outcome has been an increase in prescriber confidence, resulting in more referrals to SMP.

Brian added: "We have begun to show prescribers how indicators are incorporated into our refrigerated shipments.

"This has become a valuable tool to show our commitment to patient safety. After these presentations where we demonstrate the indicators and packaging, the physicians and their staff thank us for educating them and helping to provide quality care for their patients. They understand that partnering with a specialty pharmacy that takes these extra measures is key to patient care."

SMP has been awarded Highest in Customer Satisfaction by J.D. Power and Associates. After implementing temperature indicators, SMP’s reshipments due to temperature concerns have dramatically decreased. Patients have increased peace of mind knowing that medications were not exposed to excessive heat.

Brian said: "I would strongly encourage a pharmacy to implement temperature indicators into their business. The advantages I’ve described – and that SMP has experienced – should outweigh any concerns.

"The tool (temperature indicator) is critical to a quality supply chain programme."