How Alto Pharmacy aligned 537 pharmacy team members and saved 29,804 hours annually

Alto Pharmacy is a digital-first, full-service pharmacy serving more than 500,000 patients across all 50 states. Behind the seamless patient experience is a widely dispersed team managing prescription intake, clinical documentation, and complex care coordination at high volume, every day.

Maintaining consistency with high-volume, highly-regulated cases

At Alto, the care operations team processes 700-800 patient charts daily, with each requiring individualized, compliant documentation. Some medications alone require 12 or more note variations to account for patient-specific factors, while errors in Medicare documentation carry regulatory risks. Getting the language wrong can mean both regulatory and financial consequences. 

For Pharmacy Care Operations Manager Roni Hein, the challenge of standardized communication is amplified because Alto’s workforce doesn’t share a building, floor, or time zone. As a fully distributed team working across several systems, updates that occur in one tool but not another can lead to errors and compliance risks.

“Our internal communication between teams happens in Slack, then we have our proprietary pharmacy operating system for communicating with patients and documenting patient information and future care recommendations,” explained Hein.

“In an organization like Alto, standardization becomes vital because of our dispersed workforce. Unlike a traditional pharmacy team, we’re not all working and existing in a single space.”

Before TextExpander, Alto had no formal text expansion system. And at the volumes they operate, that wasn’t sustainable.

The Solution: Standardized language across every touchpoint

Alto has been a TextExpander customer since 2019, long enough that for Hein, there’s no frame of reference for working without it. “I’ve been on board since 2019, so I haven’t worked at Alto without TextExpander,” she explains.

The first year of the program was a ramp-up period, amassing 8,200 hours saved (or 1,000+ working days) in 2019. By 2020, both the team and tool usage had more than doubled. The team saved 21,900 hours, or 2,730+ working days, on typing and documentation in the calendar year.

Whether it’s a compliance note, a patient instruction, or a team handoff, every message can be standardized and deployed consistently across the organization.

“Having these processes already documented and presented in a standardized way aligns the team and ultimately helps us provide better service to our patients,” said Hein.

Snippet governance is tiered to match the stakes. Patient-facing content goes through a centralized approval process to ensure Alto’s tone, compliance language, and clinical accuracy are maintained. Internal snippets are managed by team leads like Hein, who tailor them for their specific workflows.

How Alto uses TextExpander

Clinical documentation and compliance
At 700–800 charts per day, there’s no margin for improvisation. Snippets covering medications like morphine include variations tailored to specific patient conditions. Using fill-ins and optional sections within their Snippet library ensures the right language reaches the right patient profile every time.

Internal team handoffs
TextExpander keeps Slack-based handoffs clean and complete because it houses Alto’s standard operating procedures (SOPs). This makes Hein’s and other leaders’ roles easier by instructing the team with “all the information they need to prevent rework.”

Partnership programs
Alto’s partnership programs involve high-touch patient communications like onboarding, prior authorizations, and medication adherence outreach across a wide range of healthcare partners. Standardized Snippets ensure every patient-facing message reflects the same clinical accuracy and brand voice, regardless of which team member sends it. 

New hire onboarding
New hires receive a snippet suite that teaches Alto-specific processes and embeds company culture, letting them get started in the tool and Alto’s systems on day one.

The results: A team that speaks with one voice and 3,725 working days saved

Between April 2025 and 2026, Alto’s team expanded 2.2 million snippets and saved 29,804 hours, one of their highest usage years to-date. It’s the equivalent of giving each team member 7 working days back in their year, and time not spent rewriting noncompliant notes, correcting handoffs, or individually coaching team members on messaging standards.

For Hein, that last point matters as much as the time savings. TextExpander changed how quality control works at Alto. The team shifted from a reactive, person-by-person process to a proactive, system-level one.

“It’s a lot easier to manage using a standardized set of information versus individually providing feedback to every single team member about the particular deficiencies in their message,” explains Hein.

The impact shows up in KPIs too. Message response times and contact resolution rates have improved, particularly in the partnership programs where snippet usage is highest.

Ask Hein to sum up what TextExpander does for Alto, and she doesn’t hesitate.

“In a word, alignment. TextExpander helps quickly align a team to a particular function or a message, even processes. We have some complicated processes to manage, and they require a ton of attention to detail. Having these processes already documented and presented in a standardized way aligns the team and ultimately helps us provide better service to our patients.” 

The results after one year

• 2.2M snippets expanded
• 29,804 hours saved across the team
• 3,725 working days saved across the team (7 days per user)
• 700–800 patient charts processed per day
• 537 team members aligned on language, process, and tone