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One of the first non-traditional ways to fund a startup came through Kickstarter. With the introduction of crowdfunding, anyone can now back a project or campaign in exchange for early access, or a product discount. Crowdfunding gives anyone a chance to fund a successful startup, but doesn't provide much return for the investor. It did open the door to the "average Joe" investor who could sort through various ideas and determine which was deserving of a small personal investment.

But, before May 2016, only accredited investors earning $200,000 or more a year or having a net worth of $1 million (excluding your primary place of residence) were given the opportunity to invest in private companies for equity return.

Title III of the JOBS Act eradicated this requirement, making it possible for anyone with some spare cash to invest in a startup. The JOBS Act really stepped up the stakes for the everyday investor and changed the playing field for startups on the hunt for funding.

Related: 7 Quick Ways to Make Money Investing $1,000

In exchange for equity, now anyone can invest as much or as little as desired, which could result in some big bucks if the investment succeeds. But, because that option is now available, doesn't mean it's right for everyone.

Here are my tips for investing in startups in the 21st century:

Invest in founders.

The idea of investing is exciting and daunting all at the same time. As a first time investor, how do you know where to start? How do you make a savvy investment that keeps the roof over your head and makes money in the long run?

Seems like a gamble -- and it can be if you're not smart about where you put your money. Remember that about 90 percent of startups eventually fail, which means your investment might have the same trajectory. It's easy to get excited about a cool, innovative new idea. But, who are the people steering the ship?

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A cryptocurrency is a digital currency that is created and managed through the use of advanced encryption techniques known as cryptography. Cryptocurrency made the leap from being an academic concept to (virtual) reality with the creation of Bitcoin in 2009. While Bitcoin attracted a growing following in subsequent years, it captured significant investor and media attention in April 2013 when it peaked at a record $266 per bitcoin after surging 10-fold in the preceding two months. Bitcoin sported a market value of over $2 billion at its peak, but a 50% plunge shortly thereafter sparked a raging debate about the future of cryptocurrencies in general and Bitcoin in particular. So, will these alternative currencies eventually supplant conventional currencies and become as ubiquitous as dollars and euros someday? Or are cryptocurrencies a passing fad that will flame out before long? The answer lies with Bitcoin.

The Future of Cryptocurrency

Some economic analysts predict a big change in crypto is forthcoming as institutional money enters the market. Moreover, there is the possibility that crypto will be floated on the Nasdaq, which would further add credibility to blockchain and its uses as an alternative to conventional currencies. Some predict that all that crypto needs is a verified exchange traded fund (ETF). An ETF would definitely make it easier for people to invest in Bitcoin, but there still needs to be the demand to want to invest in crypto, which some say may not automatically be generated with a fun.

Understanding Bitcoin

Bitcoin is a decentralized currency that uses peer-to-peer technology, which enables all functions such as currency issuance, transaction processing and verification to be carried out collectively by the network. While this decentralization renders Bitcoin free from government manipulation or interference, the flipside is that there is no central authority to ensure that things run smoothly or to back the value of a Bitcoin. Bitcoins are created digitally through a “mining” process that requires powerful computers to solve complex algorithms and crunch numbers. They are currently created at the rate of 25 Bitcoins every 10 minutes and will be capped at 21 million, a level that is expected to be reached in 2140.

These characteristics make Bitcoin fundamentally different from a fiat currency, which is backed by the full faith and credit of its government. Fiat currency issuance is a highly centralized activity supervised by a nation’s central bank. While the bank regulates the amount of currency issued in accordance with its monetary policy objectives, there is theoretically no upper limit to the amount of such currency issuance. In addition, local currency deposits are generally insured against bank failures by a government body. Bitcoin, on the other hand, has no such support mechanisms. The value of a Bitcoin is wholly dependent on what investors are willing to pay for it at a point in time. As well, if a Bitcoin exchange folds up, clients with Bitcoin balances have no recourse to get them back.

Bitcoin Future Outlook

The future outlook for bitcoin is the subject of much debate. While the financial media is proliferated by so-called crypto-evangelists, Harvard University Professor of Economics and Public Policy Kenneth Rogoff suggests that the “overwhelming sentiment” among crypto advocates is that the total “market capitalisation of cryptocurrencies could explode over the next five years, rising to $5-10 [trillion].”

The historic volatility of the asset class is “no reason to panic,” he says. Still, he tempered his optimism and that of the “crypto evangelist” view of Bitcoin as digital gold, calling it “nutty,” stating its long-term value is “more likely to be $100 than $100,000.”

Rogoff argues that unlike physical gold, Bitcoin’s use is limited to transactions, which makes it more vulnerable to a bubble-like collapse. Additionally, the cryptocurrency’s energy-intensive verification process is “vastly less efficient” than systems that rely on “a trusted central authority like a central bank.”

Increasing Scrutiny

Bitcoin’s main benefits of decentralization and transaction anonymity have also made it a favored currency for a host of illegal activities including money laundering, drug peddling, smuggling and weapons procurement. This has attracted the attention of powerful regulatory and other government agencies such as the Financial Crimes Enforcement Network (FinCEN), the SEC, and even the FBI and Department of Homeland Security (DHS). In March 2013, FinCEN issued rules that defined virtual currency exchanges and administrators as money service businesses, bringing them within the ambit of government regulation. In May that year, the DHS froze an account of Mt. Gox – the largest Bitcoin exchange – that was held at Wells Fargo, alleging that it broke anti-money laundering laws. And in August, New York’s Department of Financial Services issued subpoenas to 22 emerging payment companies, many of which handled Bitcoin, asking about their measures to prevent money laundering and ensure consumer protection.  

Alternatives to Bitcoin

Despite its recent issues, Bitcoin’s success and growing visibility since its launch has resulted in a number of companies unveiling alternative cryptocurrencies, such as:

  • Litecoin – Litecoin is regarded as Bitcoin's leading rival at present, and it is designed for processing smaller transactions faster. It was founded in October 2011 as "a coin that is silver to Bitcoin’s gold,” according to founder Charles Lee. Unlike the heavy computer horsepower required for Bitcoin mining, Litecoins can be mined by a normal desktop computer. Litecoin’s maximum limit is 84 million – four times Bitcoin’s 21-million limit – and it has a transaction processing time of about 2.5 minutes, about one-fourth that of Bitcoin.
  • Ripple – Ripple was launched by OpenCoin, a company founded by technology entrepreneur Chris Larsen in 2012. Like Bitcoin, Ripple is both a currency and a payment system. The currency component is XRP, which has a mathematical foundation like Bitcoin. The payment mechanism enables the transfer of funds in any currency to another user on the Ripple network within seconds, in contrast to Bitcoin transactions, which can take as long as 10 minutes to confirm.
  • MintChip – Unlike most cryptocurrencies, MintChip is actually the creation of a government institution, specifically the Royal Canadian Mint. MintChip is a smartcard that holds electronic value and can transfer it securely from one chip to another. Like Bitcoin, MintChip does not need personal identification; unlike Bitcoin, it is backed by a physical currency, the Canadian dollar.

The Future

Some of the limitations that cryptocurrencies presently face – such as the fact that one’s digital fortune can be erased by a computer crash, or that a virtual vault may be ransacked by a hacker – may be overcome in time through technological advances. What will be harder to surmount is the basic paradox that bedevils cryptocurrencies – the more popular they become, the more regulation and government scrutiny they are likely to attract, which erodes the fundamental premise for their existence.

While the number of merchants who accept cryptocurrencies has steadily increased, they are still very much in the minority. For cryptocurrencies to become more widely used, they have to first gain widespread acceptance among consumers. However, their relative complexity compared to conventional currencies will likely deter most people, except for the technologically adept.

A cryptocurrency that aspires to become part of the mainstream financial system may have to satisfy widely divergent criteria. It would need to be mathematically complex (to avoid fraud and hacker attacks) but easy for consumers to understand; decentralized but with adequate consumer safeguards and protection; and preserve user anonymity without being a conduit for tax evasion, money laundering and other nefarious activities. Since these are formidable criteria to satisfy, is it possible that the most popular cryptocurrency in a few years’ time could have attributes that fall in between heavily-regulated fiat currencies and today’s cryptocurrencies? While that possibility looks remote, there is little doubt that as the leading cryptocurrency at present, Bitcoin’s success (or lack thereof) in dealing with the challenges it faces may determine the fortunes of other cryptocurrencies in the years ahead

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Future of Pharmacies

Pharmacy has a problem: One of the traditional core tasks for most pharmacists is getting medications to patients. Getting the right medication to the right patient at the right time carries the potential for direct interventions that improve patient outcomes. But the mechanics of medication dispensing are mind numbingly tedious, repetitive, and nearly impossible to perform without error. 

Pharmacy also has a solution: Automation. Dispensing robots never get bored, never get distracted, and make far fewer mistakes than their human counterparts. And in this era of ever-shrinking prescription margins, dispensing robots free up pharmacists and technicians for more profitable clinical services that require human judgment. 

In 2016, Tom Gierwatoski, RPh, installed a ScriptPro dispensing robot in his Platte Valley Pharmacy in Brighton, CO. Automation allowed him to boost prescription volume by 50%, freeing up time to expand compounding and grow nonprescription services such as durable medical equipment and diabetic shoe fitting while halving his dispensing staff.

“We were able to reallocate staff to things that require more human attention,” Gierwatoski says. “And because the robot cut our average wait time to five minutes, I have more time to talk with patients because I’m not backlogged waiting for prescriptions to get to me.”

Automation has long been a fixture in central fill facilities, large health systems, and other settings that count their daily prescription volume by the thousands. Newer generations of community pharmacy automation have made dispensing robots cost-effective for pharmacies with prescription volumes as low as 150 per day, says Bill Lockwood, executive director of the American Society for Automation in Pharmacy.

“Automation is making pharmacies more efficient, no question about it,” he says. “Increased efficiency is giving pharmacies the opportunity to offer more services and to provide more drug safety.”

One thing robotics isn’t doing is reducing pharmacy employment. Robots are more efficient, more reliable, and less expensive than technicians or pharmacists. Pharmacy owners typically redeploy staff who are no longer needed in dispensing rather than letting them go.

“Dispensing medications will eventually become fully automated using various types of robotics,” predicted Al Babbington, CEO of PrescribeWellness, a Tabula Rasa HealthCare company. “Clinical work—the education, motivations, and support that pharmacists provide to patients to enact behavioral change—will be the new foundational service.”

In his prerobot days, Gierwatoski filled about 200 scripts per day at Platte Valley pharmacy. The operation is located in a hospital, handling hospital outpatient needs and discharge prescriptions as well as serving patients from two dozen physician offices in an attached medical building. About 70% of his prescription volume was, and is, new scripts.

“The volume of new prescriptions meant I had to have two technicians all the time inputting, handling insurance, and everything else associated with new scripts,” he says. “With the robot we are averaging 300 scripts per day and just one technician doing all the inputting. There are plenty of more rewarding and more profitable things we can do versus counting pills on a tray.”

Robotic Numbers

Dispensing automation comes in a variety of sizes, shapes, capacities, and capabilities, from simple pill counters to robots that spit out a stream of filled, labeled, and capped vials. But robots can’t fill every script.

“Our robots normally cover at least 45% of pharmacy scripts,” says Mike Coughlin, president of ScriptPro. “But we have seen it go as high as 80% or 90%. It depends on the mix of business.”

Gierwatoski says his robot fills about half of his daily prescription volume. Most of the rest are filled using pill counters.

“We might have five scripts a day that we count out by hand” he says.

The key to maximizing robot use is selecting the right drugs for robotic dispensing. The most common method is to track the top 100 to 200 products dispensed at the pharmacy and load the most common into the robot. 

Local regulation may play a role, too. Gierwatoski points out that Colorado prohibits controlled substances in dispensing robots. So, all of his controlled substance scripts must be filled manually or using pill counters.

Coughlin says the largest ScriptPro robot has 225 cells, which means 225 different drugs or drug dosages can be stored in the system and dispensed. Some customers use multiple robots to keep up with their prescription volume, but the top 200 drugs cover the bulk of products dispensed in most community pharmacies.

Comparing the cost of technician labor to robotic labor is easy. Robots cost about $12 per hour, Coughlin says. Technician salaries average a bit over $18 per hour nationwide. Add in the costs of benefits, hiring, training, and absences and robots look even more financially attractive. 

Right Business, Right Robot

Unfortunately, there is no one-size-fits-all automation system. Every manufacturer approaches automation from a different perspective with different types and sizes of practices in mind. Gierwatoski settled on ScriptPro after talking with other pharmacists and spending hours with different automation makers at pharmacy conferences. 

It can be tough to choose the right system for a specific pharmacy, says Kurt Proctor, PhD, RPh, senior vice president of strategic initiatives for the NCPA and President of the NCPA Innovation Center. The good news is there are appropriate systems for most pharmacies. 

“You can overextend on automation technology and bring in more robotics than your business warrants,” Proctor cautioned. “That’s just a purchasing mistake. But assuming you bring the right automation into your pharmacy, there is no real downside.”

Script volume is only part of the picture when it comes to selecting a dispensing robot. The local labor situation is just as important. 

“The robot is doing something that a person would have to do otherwise,” Coughlin says. “If labor is tight, a robot may be the best alternative. We have sites that might not need a robot based on other factors, but have a hard time getting reliable technicians. There is a lot of financial modeling involved in deciding whether or not a robot could be cost-effective and then choosing the right model for your specific practice.”

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Each month, we do our best to share practical insights that can help your pharmacy succeed. We also try to pay attention to what resonates with you the most.

Some of our most popular blogs over the past few months have looked at how you can do more for patients and prepare for the future of pharmacy. Read on to make sure you didn’t miss out on any of these expert insights from our most-read pharmacy blogs.

1. Anticipate changing patient needs

Changing patient needs are changing the pharmacy game. And if your pharmacy can respond to those needs, both your patients and your business will benefit. William George helps you do just that in “The Pharmacy of the Future Will Focus on Personalized Care.” George is the vice president of retail transformation for McKesson Canada. He suggests several ways to better meet evolving patient needs.

  • Make pharmacy services more convenient. Increasingly, patients are craving a more convenient pharmacy experience. People are short on time and don’t want to have to wait in line or explain their issues more than one time to more than one person. You can remedy this by offering programs like medication synchronization, or med sync. This allows patients to pick up all their medications at the same time.
  • Show patients that you care. You’re not just there to dispense medication. Help make things easier for patients. For example, if a patient has arthritis, note that they may need an easier-to-open packaging option. It’s the little things that help patients feel cared for and seen—and these steps can also help them take their medication.
  • Go the extra mile for your patients’ health. Patients want more than just a transaction when they go to pick up their medication. They want you to remember their name and to help them tackle their health problems. Help patients address additional health concerns by offering one-on-one counseling or medication therapy management. If they have a question about a prescription or a health issue they’re managing, you might be able to suggest further treatments, tests or even supplements to help their condition.

When you’re invested in what your patients need now and in the future, you ensure your pharmacy stays both clinically and financially successful.

2. Prioritize preventive medicine

Chris Dimos expands on the need to put patients first in “The Future of Pharmacy Is About the Patient Experience.” Dimos is the president of retail solutions for McKesson Pharmaceutical Solutions and Services. He explains that your pharmacy shouldn’t just be a solution center for the sick. It should be a destination for the healthy, too. He suggests you offer services and products that can help keep patients healthy, such as:

  • Immunization programs. Beyond the typical flu shot, consider offering other vaccines, such as pneumonia or shingles.
  • Face-to-face counseling. Your pharmacists can counsel patients on topics such as smoking cessation, nutrition or disease management.
  • Health information. Think of how you can deliver preventive health information through written materials, mobile apps or other omni-channel experiences.

As pharmacists start to function more as providers, patients want to see you as their allies in better health. The strategies in Dimos’ post can help keep your patients healthy for the long haul.

3. Stay on top of pharmacy trends

Keeping up with pharmacy trends isn’t always easy—especially when the world of healthcare is evolving so quickly. Eyad Farah rounds up several key trends to pay attention to in “Top 5 Independent Pharmacy Trends for 2019.” Farah is the vice president and general manager for Health Mart Atlas. Here are three key trends he mentions in his post:

  • Continued downward reimbursement pressure. The downward pressure you’re feeling on reimbursement rates will likely continue. Despite this, align your pharmacy with the networks that pharmacy benefit managers (PBMs) have created so you don’t lose access to the patients within those networks.
  • Increased need for technology to improve patient care. With new healthcare disruptors entering the market all the time, your pharmacy needs to stay on top of the latest technology to stay competitive. Find methods that work best for you. For example, introduce a mobile app that lets your patients fill their prescriptions or reminds them to take their drugs.
  • More emphasis on health outcomes. Value-based care will continue to change performance metrics for your pharmacy. For example, it’s not enough that you fill a prescription and then your patient takes it. You’ll be judged on those two factors and whether or not the drug has improved your patient’s health.

When watching the latest pharmacy trends, prioritize the ones that will affect your patients the most. When you can deliver better care, they’ll see better outcomes—and so will your business.

4. Optimize inventory management

If your pharmacy is still performing manual cycle counts, our blog on “How to Optimize Inventory Cycle Counts Using Technology” may inspire you to make a change. In it, Jody Harvey explains that manual cycle counts are not only time-consuming but more prone to inaccuracies, too. Harvey is the vice president of sales and account management for Supplylogix. She notes that doing cycle counts manually also means doing them less frequently—as infrequently as once a year. By using technology within your pharmacy management system (PMS), you can optimize your cycle counts. Doing so has several benefits, including:

  • Reduces the risk of treatment delays for patients
  • Improves accuracy in your inventory management
  • Increases the time your staff gets to spend with patients

All of these byproducts of optimizing your cycle counts can help your pharmacy stay competitive in the future.

5. Branch out by buying your own pharmacy

When looking to the future, you might want to buy an independent pharmacy of your own, if you don’t own one already. If you’ve been on the fence about that decision, Christopher Cella offers some tips on how to succeed in “How to Buy Your Own Independent Pharmacy.” Cella is the national vice president for RxOwnership. He recommends starting with a checklist of who you’ll need on your team throughout the process, such as an accountant, financial advisor, lawyer and more. He then outlines several key questions you should ask when thinking of buying a pharmacy. Before you sign on the dotted line, you should ask yourself the following questions:

  • How profitable is the business?
  • Is revenue trending up or down?
  • What is the potential for growing the business?
  • What is the volume and mix of prescriptions?
  • What is the payer mix of the pharmacy’s patients?
  • Which long-term care contracts are in place, expiring or need to be renewed?

When you ask yourself these questions, you can evaluate whether or not a potential pharmacy can be successful under your ownership. You should also go through financial statements line by line so you know exactly what you’re buying—and be sure to enlist your financial advisors and legal team during this process.

Whether you’re looking for new services to offer patients, trying to keep up with trends or want solid business advice on how to strike out on your own, stay tuned for more insights on how to keep up with the future of pharmacy—and keep delivering better care to your patients.

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