At ASCP 2026, consultant pharmacists kept coming back to three medication regimen review (MRR) workflow themes. First, most of the effort sits in the manual work around each review. Second, an automated flag only helps if the pharmacist can see how it was reached. Third, carry-forward between reviews has to balance continuity against stale information. These are qualitative notes from booth and hallway conversations, not survey findings. We are treating them as questions to test, not as conclusions.
Medication regimen review is a licensed pharmacist's clinical review of each resident's drug regimen, including the medical chart. The federal regulation at 42 CFR 483.45(c) calls it the drug regimen review (DRR), and CMS guidance calls it the medication regimen review. For the regulatory detail, see our F756 drug regimen review explainer and the consultant pharmacy glossary.
Why Pharmacore went to ASCP 2026
We had two goals. The first was to show consultant pharmacists what modern software for long-term care consultant pharmacy can look like when it is designed in this decade. The second goal, and the more valuable one, was to listen.
Who we spoke with
The people we spoke with covered a good cross-section of the work:
- Consultant pharmacists reviewing residents in skilled nursing and assisted living
- LTC pharmacy owners running teams of reviewers
- Directors of nursing who receive the recommendations
- Prospective partners
Some run solo practices. Some manage dozens of facilities.
How to read these themes
We did not run a formal study and we did not count responses. Nothing below should be read as a measured finding. It is what we heard, written down honestly, so that we can be held to what we do with it.
Theme 1: the hidden work behind medication regimen review
What consultant pharmacists described
Pharmacists did not complain about the clinical judgment. That is the part they trained for and the part they enjoy. What came up again and again was everything wrapped around it.
We heard the same pattern from many people. We describe it here as a composite, with no person, facility or resident identified:
- Pull the month's medication administration records (MARs).
- Chase the physician orders that do not match.
- Reconcile against labs that arrived in a different format.
- Retype the same resident details into a tracking spreadsheet.
- Rebuild context from scratch next month, because none of it carried forward in a usable shape.
Several people said the review itself was the short part of the day. We explore this pattern further in the hidden work in medication regimen review and why consultant pharmacy workflow fragments.
The product question it raises
We are leaving this as a question, not a conclusion. If the system took over the reconciliation and re-keying work, would review quality improve, or would pharmacists just spend the time elsewhere? Pharmacore brings MARs, physician orders and laboratory results together in one review workflow, so we can test that question instead of arguing about it.
Theme 2: pharmacists want to see how a recommendation was reached
What consultant pharmacists described
The second theme was more pointed. Pharmacists were not skeptical of software flagging problems. They were skeptical of flags they could not question.
The request we kept hearing, in their words, was some version of this: show me the evidence, show me what you looked at, and let me override you. A flag with no trail becomes one more thing to check by hand, so it adds work instead of removing it. A flag with visible reasoning works like a second opinion.
The product question it raises
This shapes how we build. Pharmacore's AI is designed to support the pharmacist's clinical judgment, and the pharmacist stays the decision-maker. Pharmacore provides tools for the review. It does not perform the review.
ASCP strengthened our belief that the thing to optimize is making flags easy to inspect, not making them more autonomous. We plan to test this by watching how pharmacists accept, edit and reject flags during real review cycles in product evaluations. We will also ask what information they wanted at the moment they hesitated. For our wider view, read decision support that strengthens judgment and how pharmacists should review AI recommendations.
Theme 3: continuity versus stale carry-forward in resident charts
What consultant pharmacists described
The third theme was the most interesting, because nobody had a clean answer, including us.
Pharmacists want continuity. They do not want to rebuild a resident's story every month, and they want last period's rationale in view when they revisit a recommendation. But several people also described what goes wrong when information stays past its shelf life:
- A note that was true in March is still sitting in the chart in September.
- A discontinued medication is still shaping the picture.
The open design question
The question has three parts:
- What should come back automatically at the next review?
- What should only come forward when the pharmacist explicitly chooses to bring it?
- How does the reason for any carry-forward stay visible on the page, rather than buried in history?
We are still working through this, and we would rather say so than pretend it is settled. Related reading: pharmacist coverage and review continuity.
What Pharmacore is changing because of these conversations
The first concrete change prompted by the meeting is [SPECIFIC CHANGE, to be confirmed internally before publication]. We are also adding a research question to our next evaluation cycle: [RESEARCH QUESTION, to be confirmed internally before publication].
We can make one commitment without qualification. Anything not yet built stays labeled In Development or Planned in our materials, and we will not call it available until it ships. If something you saw at the booth was clearly a direction rather than a product, we said so then and we are saying so here.
Where MRR software stands today
It is worth stating the obvious gently. Consultant pharmacists have been using software built specifically for medication reviews since the mid-1990s. In our view, the category has changed little in structure since then. That is not a knock on anyone. Software that lasts thirty years solved a real problem.
But the constraints have changed. Software can now read documents automatically, keep context attached to a specific resident, and send evidence along with each handoff between a pharmacist, a facility and a prescriber. We would rather compare on workflow and outcomes than make claims about any competitor that we cannot verify. If you are weighing options, see what matters in consultant pharmacist software and switching consultant pharmacy software.
We want Pharmacore judged by practicing consultant pharmacists, using their own workflows. That is the only test we care about.
What happens next after ASCP 2026
We are sending follow-up based on the type of conversation:
- Prospective customers: demonstration and evaluation details.
- Practice leaders: a workflow summary based on these themes.
- Partners: the specific next step we agreed on.
- Media contacts: background material where appropriate.
Maybe you spoke with us and have not heard back. Or maybe you missed the meeting but recognize your own workflow in the themes above. Either way, we would like to keep the conversation going. You can book a Pharmacore demo or browse our resources for consultant pharmacists.
Thank you
Thank you to everyone who walked us through a painful workflow, challenged an assumption we had not examined closely enough, or offered to stay in touch and keep pushing. Several conversations changed how we think about carry-forward in particular.
What was said at the booth is not the measure of ASCP 2026. The measure is what changes afterward.
Frequently asked questions
What were the main themes consultant pharmacists raised at ASCP 2026?
Three themes kept coming up in Pharmacore's conversations. The first was the hidden manual work around each medication regimen review. The second was the need to see how an automated flag was reached. The third was the pull between continuity and stale carry-forward in resident charts.
Was this ASCP 2026 recap based on a formal survey?
No. The three themes are qualitative notes from booth and hallway conversations at ASCP 2026. We used no survey, counted no responses and make no statistical claims. Pharmacore is treating each theme as a question to test through product evaluations, not as an established finding.
What is a medication regimen review?
A medication regimen review is a licensed pharmacist's clinical review of each resident's drug regimen, including the medical chart. The regulation at 42 CFR 483.45(c) calls it the drug regimen review, and CMS guidance calls it the medication regimen review.
Does Pharmacore make recommendations without pharmacist review?
No. Pharmacore's AI is designed to support the pharmacist's clinical judgment, and the pharmacist stays the decision-maker. Pharmacore provides tools for the review but does not perform it. Conversations at ASCP 2026 confirmed that pharmacists want to inspect and check how a flag was reached before relying on it.
Which features discussed at ASCP 2026 are available today?
Pharmacore calls a capability available only once it is built and released. Anything still being designed or evaluated is labeled In Development or Planned, both in our materials and in demonstrations. The fastest way to see what is shipping now is a live demo.
How can a consultant pharmacist follow up after reading this recap?
Whether or not you spoke with the Pharmacore team at ASCP 2026, you can continue the conversation or book a demo on the Pharmacore website. We especially want to hear from pharmacists whose experience contradicts the themes above.
About the author
Tim Merritt is a co-founder of Pharmacore. He founded and built the company with Adam Brown and Dave Robbins.
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