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No industry is immune to burnout, including pharmacy. At many traditional retail pharmacies, individual pharmacists are often asked to do more than is possible on any given workday. Not only does this deprive talented and extensively trained health professionals of a manageable working environment, it deprives patients of the exceptional care they deserve.

pharmacists-spotlight-roni-hein

The better pharmacy model we’ve created at Alto makes life easier for everyone involved in the prescription process: patients, physicians, and pharmacists. And in restructuring how pharmacists work, we haven’t just separated fulfillment and patient care responsibilities into different roles — we’ve ensured that there’s ample support for each specialization, as there should be in any profession.

To wrap up our series of pharmacist profiles in celebration of American Pharmacist Month, we spoke to Roni Hein, a patient care pharmacist lead who takes care of her team so that they can in turn care for patients.

What motivated you to pursue a career in pharmacy?

It all began with my high school and college job at Target. I interacted a lot with the pharmacy team while working in the health and beauty section and eventually moved into that department.

I never expected it to be more than a college job, but it turned into the beginning of my professional path. As I worked there, I was able to see the impact pharmacists made in customers’ lives each day. It really struck me that in many communities, including mine, pharmacists were the most accessible healthcare providers. That accessibility is so impactful on a person’s well-being.

What challenges have you encountered as a pharmacist?

Limited time and isolation behind the counter, without question. In retail pharmacy, more and more responsibilities were added to my job description, with fewer resources to accomplish them.

All pharmacists value the personal connections we make with patients. I think many of us would say that making an impact through patient counseling is the best part of our day, but that is often what gets lost when pharmacists are asked to do more. Our primary driver for entering the profession is the first thing to go. I found a very refreshing change at Alto.

Everyone at Alto, no matter their department or role, has the same shared goal of improving patient lives by transforming the pharmacy model. As a patient care pharmacist lead, I do that by supporting my people. I create the space for our pharmacists to do their best work. They are able to have better interactions with patients because they are taken care of.

The pandemic has been a trying time for many companies and teams, including mine. I am constantly looking for new ways to ward off burnout and maintain a sense of camaraderie, not only for the pharmacists I manage, but for the benefit of our customers as well.

The individual locations of many retail pharmacies can feel very separate from each other. Each one often serves a single population.

The centralization of Alto’s patient care team is a contrast to that model. We have a cohesive, unified team serving all patients. That means there’s a depth of resources available to each pharmacist, which is also really important for retaining great talent.

Our pharmacists have a great support system in their colleagues. There’s other smart, driven pharmacists to bounce ideas off of. Unfortunately, you don’t always get that in our profession.

It also means that you don’t have to worry about anything falling through the cracks if something comes up outside of work. It's a game changer to be able to take time to grieve a loved one or to care for your child if they’re sick while knowing that your patients are still in expert hands. I never had that in retail pharmacy.

Finally, what is one thing people would be surprised to know about life as a pharmacist?

At a tech-oriented pharmacy like Alto where there’s so much innovation, you’re constantly thinking of new and creative ways to problem solve. It’s challenging in the best possible way. There isn’t a day when I don’t have to put my critical thinking skills to use.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. Meet the other pharmacists featured in this series: patient care pharmacist Travis Allison, specialty patient care pharmacist Gabrielle Kaplan, and medication therapy management pharmacist Wei-Lin Chang.

National Pharmacists Month Spotlight: Roni Hein

For many Americans living with a chronic health condition, prescription medications are necessary to manage symptoms and prevent complications. But following a treatment plan can be easier said than done. There are many considerations involved, from managing medication interactions and side effects to staying on track with related testing and follow-up appointments. And of the 66% of U.S. adults who are prescribed medication, only half take their medication as prescribed.

National Pharmacists Month Spotlight: Wei-Lin Chang

At Alto, medication therapy management pharmacists like Wei-Lin Chang help patients navigate all the complexities of managing a chronic disease. As part of our coverage of American Pharmacist Month 2022, we spoke to Wei-Lin about her professional path, the challenges of retail pharmacy, and the importance of medication education.

I honestly didn’t know what I wanted to do when I first entered college. My parents encouraged me to pursue a career in healthcare, but I knew I was a bit too squeamish around needles to become a doctor or nurse.

I took a chemistry class that I really enjoyed and decided to do all the pharmacy prereqs. I then did an internship with the head of pharmacy at Cook County Hospital in Chicago. Through that experience, I saw firsthand that pharmacists were a critical liaison between patients and doctors, with so much valuable information about medication strength, directions, dosing, and administration.

After that, I pretty much knew that pharmacy was for me. I’ve been practicing since 2002.

Before Alto, I worked in traditional retail pharmacy. In that setting, you’re so busy as a pharmacist — it’s one customer after another after another.

I worked both daytime and night shifts, and it was during the night shift, when the store was much more quiet, that I could really counsel patients without feeling so pressed for time. During the day, I simply didn’t have the free minutes to always answer patient questions or give recommendations.

Another challenge I faced was the perception of our profession. At the beginning of my career, in the early 2000s, many people I encountered didn’t know a pharmacist did much beyond putting pills in bottles and handing them off to customers. Not only did this lead to frustration from my customers, who would wonder what we were doing and why it was taking so long, it led to missed opportunities to more actively participate in a patient’s health journey. 

More medication education for patients is an urgent need within American healthcare. People taking multiple medications have to be mindful of potential side effects and medication interactions.

The growing field of medication therapy management is an opportunity for pharmacists to play an even bigger role in patient health, and I’m very proud to work for a company that prioritizes this particular area of pharmacy.

As a medication therapy management (MTM) pharmacist, I contact patients who take multiple medications — often multiple heart medications — and review their entire regimen over the phone. I make sure that they understand the purpose of each medication they’re taking and are on track with related testing.

For example, it’s important to get your liver function checked every 6-12 months if you’re taking cholesterol-lowering medications that are processed by the liver, or to get your A1C levels checked every 3-6 months if you’re taking diabetes medication.

We also discuss side effects, interactions, when to take medication, and what food to take it with. Too often, there isn’t the space for these conversations between pharmacists and patients, but they are so essential to a patient’s overall health. 

I love our pharmacy specializations. It’s unique to have a team that focuses solely on patients and another team that focuses on fulfillment. Not all pharmacies have a medication therapy management program, and it’s possible at Alto in part because of our smart allocation of resources.

Being able to use all of my time to focus on my core job functions is such a contrast to retail pharmacy, where you’re constantly bombarded from all sides at once.

As a pharmacist, what does “care” mean to you?

Care to me means going above and beyond for your patients and making sure all loose ends are tied. As an example, I recently initiated a transfer for one of the heart medications a patient takes. At Alto, we always complete every single step of the prescription transfer process on the patient’s behalf. He was so appreciative, and when I got off the phone, I could tell from his voice that he was smiling ear to ear. That’s the experience I want all of my patients to have.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison and specialty patient care pharmacist Gabrielle Kaplan.

Each October, American Pharmacist Month is an opportunity to not only celebrate the dedication of pharmacists and pharmacy technicians, but also to shine a light on all that they do.

National Pharmacists Month Spotlight: Gabrielle Kaplan

The average American visits a pharmacy 35 times a year, and the availability of pharmacists has the potential to address many gaps within healthcare, like access to the underutilized HIV prevention medication PrEP.

Many people who could benefit from the medication are unable to get a prescription from their primary care provider, whether it’s because they live too far from the doctor’s office or aren’t comfortable speaking about their sexual health. There's growing recognition that expanding the role of pharmacists in HIV prevention can help increase PrEP usage.

At Alto, we’re committed to maximizing the possibilities of pharmacy care. Not only do we divide our pharmacy roles into fulfillment and patient advocacy — we have numerous specializations under the umbrella of patient advocacy that allow our pharmacists to be part of the solution to precisely these healthcare challenges.

As part of our coverage of American Pharmacist Month, we spoke with Gabrielle Kaplan, a specialty patient care pharmacist who makes HIV prevention medication and treatment for complex chronic conditions more manageable for patients.

I’m a patient care pharmacist in our specialty department. We oversee medications that aren’t as common and which often have more side effects — or more serious side effects — including HIV medications, PrEP for HIV prevention, and injectable medications used to treat chronic conditions like psoriasis, rheumatoid arthritis, and high cholesterol.

The side effects associated with these medications can keep people from continuing with them. Since there’s a team of us whose sole focus is serving the patients who take these medications, they don’t just stop treatment. And they don’t have to worry about reaching out to us — we proactively check in. If anything is bothering them, we’ll take the initiative to call their provider and discuss their concerns.

What motivated you to focus on specialty pharmacy, specifically HIV treatment and prevention?

I was very interested in learning more about HIV treatment back in pharmacy school since a family member had passed away from it. The medications available today have drastically transformed what a diagnosis even means. I was excited by the possibilities, and it was always on my radar as a potential interest for the future. Working at Alto is the first time that I’ve been able to completely immerse myself in this specialization.

It’s a rapidly evolving area of both medicine and pharmacy, and there continues to be so much opportunity for pharmacists to take on a bigger role. In my state of Colorado, pharmacists can prescribe the HIV prevention medications PrEP and PEP. At Alto, we’re always discussing these updates and trying to expand the scope of what we offer patients and how we support their treatment.

By far the biggest pain point I experienced in retail pharmacy was staffing and having the number of pharmacists needed to execute all the day’s tasks while still providing great patient care.

Everyone working in a pharmacy is doing their very best, but there’s only so much we can do in an allotted time. It’s a disservice to patients and to those who work in the field — trying to balance the demands with your own mental well-being becomes nearly impossible.How do Alto’s pharmacy specializations make a difference for you and your patients?

Having a specific focus on patient care allows us to actually deliver quality patient care. At retail pharmacies where one pharmacist is doing it all, you’re trying to fill a prescription while on the phone and with someone yelling at you from across the room.

With fulfillment and patient advocacy separated at Alto, we are each able to focus on what’s in front of us at any given moment. For me, that means I can give patients my full and undivided attention and spend as much time with them as possible.

We have such a great team and plenty of support, so there’s no need to worry about other people’s tasks. We can each do the jobs that we’ve been specifically trained and are uniquely equipped to do.

What else is unique about Alto’s model?

The digital model makes it so that geography is less of an obstacle to care, and that each patient in our service areas has access to all of our resources. This is particularly relevant to my division of specialty pharmacy.

Many traditional retail pharmacies don’t have a specialty pharmacy in every physical location. Sometimes the specialty pharmacy is one centralized location from which everything is mailed. That means you won’t necessarily have a pharmacist in your local store who’s familiar with your medications and able to counsel you.

The medication used to treat or prevent HIV is complex, and it can be difficult to stay on track with treatment. The fact that any Alto customer taking these medications can talk to a pharmacist with deep expertise in that area of pharmacy makes a world of difference.

It means always putting patients first — thinking about the care you would want a family member or friend to receive and delivering just that.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison.

Pharmacists are one of the most accessible healthcare professionals, seeing people 5 to 8 times more frequently per year than primary care providers. Their role has become more expansive than ever, and many people don’t realize just how integral they are to a patient’s health and well-being.

National Pharmacists Month Spotlight: Travis Allison

At Alto, fulfillment pharmacists focus on dispensing medication — ensuring that the entire process is carefully monitored every step of the way — while patient advocacy pharmacists tackle anything related to a patient’s wellness, from provider communication and insurance coordination to guidance on managing chronic health conditions.

These specializations have opened up entirely new possibilities for the patient-pharmacist relationship at Alto. And this October, as we celebrate American Pharmacist Month, we’re spotlighting a few of the extraordinary Alto pharmacists who focus on patient advocacy.

To kick things off, we’re pleased to introduce Travis Allison, a patient care pharmacist based in Dallas, Texas.

I took the long and winding road here. I didn’t always know this was what I wanted to do. In college, I started off as an English major but had a change of heart after a semester or two. I went on to study agriculture, and those experiences made me believe that I could pursue a path grounded in science.

My childhood memories of visiting the pharmacist were always in the back of my mind. As a kid, I hated going to the doctor. When those dreaded appointments were over and done with, I knew I’d get to see a guy in a white coat who would give me something to feel better. I always saw pharmacists as a comfort in the often scary world of healthcare.

At any chain pharmacy — which is where I spent my career before Alto — pharmacists are inundated with so many tasks. It isn’t that these tasks are unrelated to pharmacy, but they interfere with our ability to deliver patient care.

On a typical day, I would give 100 Covid shots and fill 200 prescriptions by myself while also coordinating billing and calling doctors’ offices. We also had to think about corporate metrics. I was frequently asked to get more people signed up for text message alerts and hit specific quotas.

Patient care is always the priority, for any pharmacist, but the reality of my job made it extremely difficult, and often impossible, to give patients the time they deserved.

The first thing I noticed when I started at Alto were the specializations. We have many different team members to handle all the responsibilities that fall on a single person’s shoulders at a traditional retail pharmacy.

I’m a patient care pharmacist, which is distinct from fulfillment pharmacists who process prescriptions.

I review prescriptions for accuracy and initiate medication transfers, and I interact with both patients and doctors. I’m here to answer any questions a patient has about their medication.

In a way, I feel like I’m on the frontlines the same way that I was when I worked in a pharmacy chain. It’s all of what I liked about retail pharmacy without the distractions of retail. We’re able to practice our most important functions as pharmacists without the noise.

We’re utilizing technology in a way no other pharmacy does, which allows us to communicate with patients and providers in so many different ways — without having to rush through interactions.

And the wheels of change turn much more quickly at a tech-oriented company than they do at a massive corporation. At my previous job, you could have conversations all day about what improvements were needed, but nothing ever happened. Alto was founded by software engineers, and we’re able to easily make changes in real time.

As a digital pharmacy, we serve so many patients that only we can serve. I talk to many who are homebound without a caretaker. Because of Alto’s model, I’m able to communicate with them, and we’re often their only point of contact within the healthcare system. I don’t know of another way these patients could get pharmacy care.

The digital model also allows us to get a broader view of healthcare, and to make an impact on a larger scale. Alto was one of few places where New Yorkers could get the Covid medication Paxlovid when it was first introduced.

It was incredible to be sitting here in Texas, getting prescriptions out in New York City just as a new variant came out that was really devastating to the city. At no other pharmacy would I have been able to help out my neighbors in New York.

Those moments where you can tell in a patient’s voice that you seriously helped them. To me, that’s an indication of how well I’m doing my job, much more so than the number of prescriptions processed or dollars generated.

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

Some degree of anxiety is natural. In fact, it can even be beneficial in certain contexts, like pre-interview butterflies. Other times, however, anxiety can become so debilitating that it interferes with daily life. Frequent and intense feelings of nervousness may be indicative of an underlying mental health disorder.

Anxiety disorders are the most common type of mental health disorder in the U.S., affecting more than 40 million adults, or about 19%. It is also estimated that 7% of children and adolescents between the ages of 3-17 struggle with symptoms of anxiety.

Over the past few years, as Covid-19 brings much upheaval and change, the number of Americans suffering from anxiety disorders and depression continues to increase. As a result, the U.S. Preventive Services Task Force is now recommending that all adults under the age of 65 be screened for anxiety. 

For many of those with an anxiety disorder, treatment — in the form of medication, psychotherapy, or both — is necessary to manage symptoms and maintain an active and fulfilling life. Below, we explain more about some of the most common treatment options.

Many factors can contribute to anxiety, including genetics, environment, behaviors, and situations. Common causes and risk factors include:

Having another mental health disorder such as depression

Genetics - having a relative with an anxiety disorder is considered a risk factor

Certain personality traits such as shyness

Individual experiences of anxiety can vary, so your anxiety symptoms may be different from those of a friend or family member with the condition. Anxiety can cause physical sensations like butterflies in your stomach or a racing heart. It can also bring an overall feeling of fear or unwanted thoughts.

Digestive issues, stomach pain, or nausea

Thoughts or flashbacks of a traumatic experience

Anxiety disorders are highly treatable with medication and therapy. (A combination of both is necessary for many people with an anxiety disorder.) While it can be difficult to share your feelings with a healthcare provider, it’s an important first step in managing symptoms.

These are some indications that you may benefit from treatment for anxiety:

Anxiety, fear, or worry has interfered with work and relationships

You find it difficult to control your anxiety, fear, or worry

You are concerned about your use of alcohol or other substances

There are many options for medication to treat anxiety. Some are used on a short-term basis or as needed while others are taken daily in the long term. Your provider will make recommendations based on your specific symptoms.

Though it can be frustrating, finding the right medication for your anxiety symptoms can take some trial and error.

There are several types of medications commonly used to treat anxiety disorders.

Benzodiazepines are sedatives that induce a feeling of calm. They amplify the effects of certain chemicals that act as a messenger between brain cells.

Benzodiazepines commonly prescribed for anxiety include:

These medications are typically used for short-term treatment of acute symptoms and may be prescribed on an as-needed basis. They often cause side effects like drowsiness and difficulty with balance and memory.

While benzodiazepines are effective, they have the potential for dependence and misuse. As a controlled substance under the U.S. Drug Enforcement Administration’s guidelines, there are tight regulations for prescribing and dispensing benzodiazepines.

Benzodiazepines are not safe to abruptly discontinue. If you have been taking a benzodiazepine for longer than two weeks, speak with your doctor about slowly tapering off to avoid withdrawal symptoms and lower the risk of seizure.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) increase a person’s levels of serotonin, a chemical in the brain that affects mood. Increased serotonin levels can alleviate symptoms of anxiety. These medications are considered a frontline treatment option for anxiety disorders and are also used to treat depression.

SSRIs commonly prescribed for anxiety include:

While SSRIs are very effective for many people with anxiety, it typically takes several weeks to experience their benefits. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you still have concerns several weeks into treatment, speak with your doctor.

Always consult your doctor before stopping an SSRI. It is not recommended to frequently start and stop SSRIs, and they should not be taken on an as-needed basis.

SSRIs have been linked to the following side effects, though they are mild in the majority of cases. Speak with your doctor about any concerns.

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin — just like SSRIs — but they also increase norepinephrine, which boosts energy and focus. These medications may increase your energy levels in addition to alleviating symptoms of anxiety.

SNRIs commonly prescribed for anxiety include:

Venlafaxine extended-release (Effexor® XR)

There are additional medications used to treat anxiety that do not belong to the medication classes above.

The antihistamine hydroxyzine (Atarax®, Vistaril®) blocks histamine and boosts the effects of serotonin. As the only antihistamine that offers this effect, it is the only antihistamine used to treat anxiety. This is typically an option for those who experience side effects with SSRIs or SNRIs, or who have concerns about the addictive potential of benzodiazepines.

Buspirone (Buspar®) is another alternative to SSRIs and SNRIs. While it isn’t entirely understood how buspirone works, the medication likely activates certain areas of the brain to make serotonin more active.

Each person metabolizes medications differently. Open communication with your provider can help identify the medication that works best for you. Your doctor should know:

Any other medications you are prescribed and their dosages

Your experience of anxiety symptoms after taking the prescribed medication — do you feel like it’s working?

Medication for anxiety disorders is often combined with psychotherapy, which helps you understand and manage your emotional and behavioral responses to sources of anxiety.

Cognitive behavioral therapy (CBT) is considered one of the most effective types of therapy for anxiety disorders. It helps you recognize the underlying thoughts and behaviors that fuel uncomfortable or debilitating emotions. Shifting your thoughts and behaviors then alleviates symptoms of anxiety.

Finding the right therapist can take time. If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point. You can also look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator. Some therapists offer sliding scale fees to make sessions more affordable.

Maintaining good mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

We’re thrilled to congratulate Munashe Kaseke, Senior Director of Business Operations, on the release of her debut short story collection, Send Her Back and Other Stories, last month. We recently sat down with Munashe to learn more about her writing journey, the book’s inspiration, and how her time at Alto has impacted her creative process.

Meet Munashe Kaseke, Senior Director of Business Operations and Debut Author

We’re thrilled to congratulate Munashe Kaseke, Senior Director of Business Operations, on the release of her debut short story collection, Send Her Back and Other Stories, last month.

Munashe began the project nearly three years ago as a creative outlet and continued to develop this beautiful collection of short stories during her time at Alto. We recently sat down with Munashe to learn more about her writing journey, the book’s inspiration, and how her time at Alto has impacted her creative process.

Can you tell us more about the book and what inspired you to write it? 

The book is titled Send Her Back and Other Stories. It's a short story collection featuring sixteen distinct Black women, all immigrants from Zimbabwe. It's an intimate, fresh telling of the immigrant experience of Black women in the United States. The stories are varied, awash with both the joys and challenges of discovering a new world.

My characters range from those who are unsure of themselves and struggling with various aspects of the immigration system, to those who are well established, thriving, and in control of their own destiny. I was inspired to write these stories because of not only my own experiences but also those of my friends and immigrant community. The publishing world lacks diversity, and as a Black Zimbabwean immigrant, I felt these stories deserved to be told.

Who did you write the book for and what do you hope people take away from it?  

I dedicated this book to immigrants, women, and people of color because I hoped they would feel seen in this collection. I also hope that those who don't identify with one or more of these categories become more empathetic from reading this book. Ultimately though, I write for myself first and foremost. I enjoy the process of world-building and character development. I believe the best writers initially write for an audience of one, and when they're satisfied with their work, then they can begin considering how to share it with the world. 

What did you learn when writing the book? 

I had a group of beta readers throughout the writing process and it was cool to learn — through these readers — that many of my characters’ particular struggles and joys are much more universal, reflecting the experiences of immigrants and people of color around the world.

I also learned that there are many aspects of the U.S. immigration system that I assume are common knowledge, as well as many immigrants’ struggle of belonging and search for identity. I was astonished to learn how much of this was new to my American friends.

I wrote the first story almost three years ago. I didn't intend for these stories to become a book —  I was simply writing about whatever was on my mind at the time, with no timeline to completion. After the fifth story, I noticed an emerging theme, and that's when I first considered that these works might belong in a collection. Editing was the longest part of the process. From developmental edits to copy edits, it probably took a good year and half to get these stories publishing-ready

How did working at Alto impact your writing process?

When you love your job, it fuels creativity outside of work. It's hard to be creative or passionate about a hobby when you're burned out. I'm certain that had I not been at a company and in a role that provided great work-life balance, there is no way I would've been able to dedicate my weekends and evenings to writing and editing.

Some of my biggest supporters have been Altoids. When I released the book, I received multiple messages from Altoids telling me what their favorite stories were. Both Matt and Jamie (our founders) have been incredibly supportive as well — from the time they first learned about my creative writing passion almost a year ago, they have cheered me on and checked in on the book’s progress. 

Anything else you'd like to leave us with? 

I hope that more Americans engage with multicultural and Own Voice fiction. This is such a rich space full of promising emerging voices that I believe will help shift the country's conscience for good. I challenge you to intentionally seek out and add a few books by diverse authors to your reading list every year — don't leave it to chance.

Munashe’s book is available here. Learn more about the author at munashekaseke.com.

We’re thrilled to congratulate Munashe Kaseke, Senior Director of Business Operations, on the release of her debut short story collection, Send Her Back and Other Stories. We recently sat down with Munashe to learn more about her writing journey, the book’s inspiration, and how her time at Alto has impacted her creative process.

When Jake Moffatt says he loves building things, he means it — sometimes literally. A construction project manager turned engineer, Jake has spent the past decade building software at mission-driven organizations. Today, as Engineering Manager of Alto Assistant, he leads the team that’s bringing wizard-like support to Alto’s customer-facing app.

Get to know Jake Moffatt, Engineering Manager on the Alto Assistant Team

When Jake Moffatt says he loves building things, he means it — sometimes literally. A construction project manager turned engineer, Jake has spent the past decade building software at mission-driven organizations. Today, as Engineering Manager of Alto Assistant, he leads the team that’s bringing wizard-like support to Alto’s customer-facing app.
Below, Jake chats with fellow engineering manager Mike Riess and recruiter Braden Hanlon about the work ahead for Alto Assistant.

I’d love to learn more about your background to get us started. How did you end up in software engineering?

When I was twelve, I started learning to code in QBASIC because I wanted to make video games. Once I wrote my first program, I was hooked! I loved computers and the creative power they gave to anyone willing to invest the time and energy to learn. Since then, I’ve built games, personal tools and projects, desktop software, and a number of apps and services — I love building things. My career has gone back and forth between construction and software engineering, but it’s been firmly in the software industry for the last ten years or so.

My favorite place to be in a company is working on something new that has a big impact or addresses an important problem. In a previous role, I built an app that helped people find roommates in a city where housing is prohibitively expensive. At that same company, I led the team responsible for creating a new vertical that eventually split off into its own company.

The goal of Alto Assistant is to help customers help themselves before reaching out to support. Our first project is introducing a wizard-like support “assistant” (hence the team name!) that guides the customer through a series of questions to narrow down the area of support. We’ve already identified a few tasks the assistant can help customers complete on their own, including making changes to upcoming deliveries or scheduling new orders.

In cases where we can’t help them just yet, our new tool generates data to help us to learn exactly what customers need help with. It’s a top priority to bake analytics into every new feature we build; even though we have years of experience supporting our customers — and we know intuitively which problems they frequently experience — we don’t have conclusive data to draw upon just yet.

We plan to start with a couple of frequent use cases and measure how often customers reach out to us for support. Then, we’ll chip away at the problem until we’ve seen a substantial improvement in the user experience. From there, we’ll move on to the next biggest problem and repeat the cycle. There’s a reason “Chip away it” is an Alto value: It’s the playbook that we’ve used to automate other critical parts of the pharmacy value stream like intake, billing, and fulfillment.

What opportunities are you most excited about?

Support drives much of the cost of every shipment today, so this is a high-impact area for our business. A year from now, it would be a stellar outcome if the Assistant team could reduce the number of issues that customers need support on by half.

We’re also thinking about the user experience beyond the app. We plan to improve the tooling that our care specialists use to provide support as well. We’ve already discussed some promising ideas like creating the concept of a conversation in support communications rather than an infinite stream of messages and building out enriched communications. We also intend to develop a custom tool that can expedite a customer’s prescription when they need their medication ASAP.

The possibilities are many, and it will take a team of determined, passionate, empathetic people to solve these challenging problems. I’m super excited to see what the Assistant team will do together.

Any lessons learned from previous experience that you’re applying to your role at Alto?

There’s always the temptation to tackle everything at once with new business initiatives. My experience leading new verticals at Apartment List and Snapdocs taught me the importance of being laser-focused on one or two key metrics instead of trying to build out a fully-realized product from the beginning. That’s exactly what we’re doing on the Alto Assistant Team with our clear focus on reducing communications per shipment — how often customers reach out for help because they could not find what they needed in our app.

It’s also important to recognize that we won’t have all the answers right out of the gate! I like to think of product development as a three-step sequence: learning, growth, and maintenance. Alto Assistant is so young that we’re very much still in the learning phase. We maintain a tight iteration loop with everything we ship: launch, measure the impact, and use the results to iterate and refine our hypotheses about what our users want. Our final product could be anything from a customer support wizard to an AI chatbot to a ticketing system — we have to rely on our key metric of communications per shipment, experimentation, and user feedback to shape the direction.

What got you excited to join Alto? What would you pass on to an engineer thinking about applying to the company?

I was impressed by the Altoids I met during the interview process. I knew I would be working with people from whom I could learn a lot, like Elnaz, who started as an individual contributor and went on to become Director of Engineering and, now, Alto’s first Head of Strategy & Operations. I was also impressed by the quality of the interview process itself — a good sign that the company was well-organized internally. Finally, the pitch for the role was extremely clear, with already-established key metrics that would directly contribute to the company’s bottom line and help Alto become more profitable.

For engineers, I think Alto is a great place for both technical challenges and career growth. We’re still small enough that every individual gets exposure to a broad portfolio of high-impact projects. It’s also a great environment for learning about how a business works — the Product & Technology organization does a great job of sharing information and presenting problems in a way that gets to the root business problem we’re trying to solve. There’s a clear line between any project a team is working on and a foundational business metric. Most importantly, we’re a company that makes a truly positive impact on our users’ lives.

Interested in learning more about engineering at Alto? Follow us on LinkedIn.

Alto’s board of advisors was formed in 2020 to deliver strategic guidance as we work toward a better healthcare system for all. With diverse leadership experience in the industry, our board of advisor members ensure that our efforts are both impactful and efficient, with services grounded in the highest standards of operational excellence.

Meet the Newest Members of our Advisory Board | Alto Pharmacy

Today we’re thrilled to welcome three new members to the board of advisors: Adam J. Fein, Harry Leider, and Brad Fluegel. Their passion and expertise will no doubt be an asset as we focus on reaching even more patients — and delivering even more comprehensive care — in service of our mission.

Read on to learn more about their backgrounds in the industry and join us in giving them a warm welcome!

Adam J. Fein, PhD, is the CEO of Drug Channels Institute, a leading source of industry research about pharmaceutical economics and the drug distribution system. Widely published in academic and industry publications, he also heads the Drug Channels website, praised by readers for its comprehensive and witty coverage of pharmacy benefit managers (PBMs), medication pricing, and other industry topics.

Delivering medications to our patients at the lowest price possible is central to our mission. Dr. Fein’s deep expertise in pharmacy economics supports our ongoing commitment to improve adherence rates by way of more affordable medication options and total price transparency.

“The pharmacy industry has entered a period of structural change. There’s a tremendous need for the cost transparency, efficiency, and commitment to patient well-being that Alto delivers. I’m thrilled to support Alto in building innovative solutions to foundational issues within the industry,” Dr. Fein said.

Dr. Fein holds a doctoral degree in managerial science and applied economics from the University of Pennsylvania’s Wharton School of Business.

Harry L. Leider, MD, MBA brings more than 25 years of experience as a senior healthcare executive to our board of advisors. Since 2018, he’s served as Chief Medical Officer and Executive Vice President of Gelesis, an innovative biopharmaceutical company.

In addition to his current leadership in the biotherapeutic space, Dr. Leider has broad experience in telemedicine, retail healthcare, laboratory medicine, and payor strategies, as former Chief Medical Officer of Walgreens Boots Alliance, Ameritox, and Care Improvement Plus.

Dr. Leider shares Alto’s commitment to driving lasting change within the healthcare system for better patient health. With both clinical expertise and executive experience, he’s spent his career designing programs, services, and intellectual property that improve health outcomes.

“Alto’s pharmacy model brings us closer to a future where everyone can receive the highest standard of care and is equipped to manage their health. I’m personally inspired by Alto’s bold vision for healthcare and look forward to what we can accomplish together,” Dr. Leider said.

Dr. Leider has served on the faculty of Harvard Medical School and the Johns Hopkins Carey School of Business and holds five patents in laboratory medicine.

Drawing on more than three decades of healthcare experience, Brad Fluegel is a strategic advisor to organizations, entrepreneurs, and other industry participants. Most recently he served as Senior Vice President and Chief Healthcare Commercial Market Development Officer for Walgreen Co, where he managed all commercial healthcare activities, from sales and contracting to biopharma relationships and market planning.

Previously, Brad oversaw Walgreens’ corporate strategy and business development as Chief Strategy and Business Development Officer. He also led Elevance (then Wellpoint)’s strategic planning and corporate communications as Executive Vice President and Chief Strategy and External Affairs Officer.

His expertise in strategic planning and operations will allow us to deliver an exceptional patient experience as we continue to grow.

“Since 2015, Alto has proven itself to be a leader in the rapidly evolving digital pharmacy space. It’s a privilege to support their efforts to redefine what’s possible in healthcare, and together we can deliver industry-leading care to more patients,” he said.

Brad earned a master’s degree in public policy from Harvard University’s Kennedy School of Government and a bachelor of arts in business administration from the University of Washington. He also serves as a lecturer at the Wharton School of Business.

Dr. Fein, Dr. Leider, and Brad join three other advisory board members: Dr. James Hildreth, the President and Chief Executive Officer of Meharry Medical College; Jennifer Kent, previously the Director for the California Department of Health Care Services; and Ajay Khatri, previously Alto’s Chief Strategy Officer. 

Dr. Hildreth, Jennifer, and Ajay have offered invaluable guidance as we’ve grown throughout the past two years, and we couldn’t be more grateful for their partnership and support.

Learn more about Dr. Hildreth and Jennifer’s healthcare experience.

Visit alto.com/careers to learn more about our open roles and join us in delivering industry-leading pharmacy care.

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