As demand for fast, affordable shipping solutions continues growing year-over-year, vendors are experimenting with new ways to drive efficiency.¹ But with new innovations come new challenges, especially for businesses that service rural locations, where demand is comparatively low but the need remains just as urgent. 

Rural patient populations present unique challenges for pharmacies that are exacerbated by limited transportation options.² Those complications multiply when looking at patients in the criminal justice system.

Incarcerated patients tend to be high risk for many health outcomes. Race, gender, age, and class health outcomes among the general populace are reflected in the disproportionately older, male, nonwhite, and economically disadvantaged demographics of incarcerated populations.³ Carceral demographics are further confounded by high turnover and differences from one institution to the next, all of which makes for a complex patient base with wide-ranging healthcare needs.

The challenge

Independent Health Services, Inc. (IHS Pharmacy) is a family-owned business in northeast Alabama that
provides medication and pharmaceutical services to city, county, and private correctional facilities. What started as a small, specialized healthcare distributor has grown to encompass more than 400 correctional facilities across 20+ states and counting. Their clients rage from small community jails to large prison and detention facilities, some with populations of over 1500 inmates.

As a Triose customer of seven years, IHS manages approximately 70,000 annual shipments from their Rainsville, Alabama processing location, running the gamut of medical needs for patient communities who are reliant on them for a full range of pharmacy services.

While many IHS clients manage pharmaceutical needs for large patient bases typically associated with urban hubs, correctional facilities are concentrated, by and large, away from population centers almost
by definition. Because of this, IHS is uniquely dependent on shipping partners to ensure their clients can deliver essential medications in a timely, reliable manner.

In October 2023, UPS implemented a Rural Deferral Program that significantly impacted IHS's delivery capabilities. The program reduced delivery frequency to rural areas from 5–6 days to just 2–3 days per week.4 With 18 affected zip codes and most of their customers located in rural areas, this change threatened to disrupt both regular medication refills and delivery dates for time-sensitive orders, in addition to general patient orders.

The Triose solution

When the changes were announced, the Triose team met with IHS to establish priorities, assess options, and come up with a plan to preserve the integrity of their delivery schedules.

Triose proposed enrollment in the relatively new UPS Premier Gold program. An innovative expansion of existing white glove shipping and monitoring services specially designed for healthcare, the new offering “supports the complex needs of our laboratory, medical, and pharmaceutical customers around the world,” according to Kate Gutmann, EVP and President International, Healthcare and Supply Chain Solutions for UPS.⁴

Implementation of the program would provide a tidy solution for IHS to deliver medication at the right time through access to Next Day Air. But, as a healthcare- focused service, it would also provide increased visibility to their customers on the location and expected arrival times of individual packages. “Visibility and traceability are essential to prioritizing the life-saving medications our customers ship and their customers need,” said UPS Healthcare President Wes Wheeler. “The difference between life and death for patients often hinges on the ability to quickly ship and precisely track, monitor, and locate medications.”⁵

“For us, the end priority is always the patient,” said Triose Account Executive Emily Evans, “making sure we’re offering a solution that’s simple and visible for the customer, but ultimately knowing that it will positively impact the patient.” According to Evans, IHS was piloting the Triose real time tracking platform around the same time. “Maybe a cold chain package is delayed and you need to know it’s being refrigerated,” said Evans, “or a patient is running out of medication on Sunday that they need to take on Monday.” With additional geoscanning from UPS, “you can pinpoint exactly where a package is in a warehouse, or on a truck.”

Not only would this solve the immediate issue at hand, but it would set IHS up with robust technology-driven capabilities to expand tracking and monitoring for their customers, and more tools to address shipping disruptions when they occur.

The outcome

The implementation process, completed in early March 2024, involved a streamlined rapid onboarding with coordination between Triose, IHS, and UPS. Leveraging our unique strategic carrier partnerships, we were able to escalate the priority of implementation for IHS, and work with the UPS hub manager to quickly evaluate problems and identify tailored solutions.

As a UPS Premier Gold member, IHS is now able to:

• Bypass rural deferral restrictions now and in the future through Next Day Air
• Access advanced package tracking through RFID-enabled mesh sensors integrated directly into packaging materials
• Track the precise location of individual packages within warehouses and hubs
• Use the advanced tracking and location capabilities to effectively dispatch emergency courier services for time-critical deliveries that are delayed for any number of reasons
• Ensure temperature-controlled storage for delayed refrigerated packages

Nine months after implementation, IHS Pharmacy has reported positive outcomes. They have maintained consistent medication delivery schedules despite rural location challenges, and enhanced visibility into shipment status and location. They
are now able to predict delivery timing for critical medications with much greater accuracy, and when shipping delays do arise, they know when and where so they can plan accordingly.

As part of our ongoing partnership, we continue to monitor program effectiveness through monthly
check-ins and internal tracking to ensure a sustained level of high-quality service for IHS and their customers.

References:

¹ Johnson, Gabriela. New UPS program limits deliveries to rural areas. WTVM, ABC 9 News. 7 September 2023. Accessed on 10 December 2024. Available online at: https://www.wtvm.com/2023/09/07/new-ups-program-limits-deliveries-rural-areas/
² Martin SL, Baker RP, Piper BJ. Evaluation of urban-rural differences in pharmacy practice needs in Maine with the MaPPNA. Pharm Pract (Granada). October–December 2015. Accessed on 10 December 2024. Available online at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4696125/
³ Dumont DM, Brockmann B, Dickman S, Alexander N, Rich JD. Public health and the epidemic of incarceration. Annu Rev Public Health. April 2012. Accessed on 10 December 2024. Avalaible online at: https://pmc.ncbi.nlm.nih.gov/articles/PMC3329888/
⁴ Based on internal data from March 2024, UPS Healthcare. UPS Healthcare Revolutionizes Prioritized Shipping with Enhancements to UPS® Premier. 13 July 2022. Accessed on 10 December 2024. Available online at: https://www.ups.com/us/en/healthcare/news/press-releases/ups-premier-expansion.page
⁵ Ibid.