Latest / Becker’s Healthcare Podcast / Shawn Myers, Vice President of Pharmacy and Ancillary Clinical Services at Encompass Health

Transcript

Shawn Myers, Vice President of Pharmacy and Ancillary Clinical Services at Encompass Health · Becker’s Healthcare Podcast

0:00
This is Laura Dierda with Becker's Healthcare podcast.
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I'm thrilled today to be joined by Sean
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Myers,
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who is the vice president of pharmacy and
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ancillary clinical services at Encompass Health. Sean, it's
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a pleasure to have you on the podcast
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today.
0:13
Yeah. Thanks. I'm excited to be here.
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Absolutely. Well, I'm looking forward to our discussion
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and learning more about some of the great
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things you've been doing at Encompass as well
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as how you're thinking about the future. But
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before we dive in, can you tell us
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a little bit more about yourself and Encompass
0:27
Health?
0:28
Yes. Sure.
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So, my background, I'm a pharmacist by training.
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I
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received a bachelor's in pharmacy degree from University
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of Georgia and
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went on from there to get a master's
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in business directly out of pharmacy school. You
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You know, at that point, I felt like
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I wanted to track into sort of an
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administrative role.
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After leaving the University of Georgia, really, my
0:49
entire
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early to mid to mid late career was
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all in
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hospital management at
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a director
0:57
slash regional director level in two different organizations.
1:02
I came to Encompass Health ten years ago.
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Actually, January
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this month is my ten year anniversary with
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Encompass Health, and
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I lead,
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from a home office standpoint,
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our pharmacy services line. And then in the
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last four years, I have assumed responsibility of
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respiratory therapy, and that's sort of where the
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ancillary clinical services part of my title comes
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from.
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Fantastic to hear. Well, you know, great that
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you've had such,
1:30
fantastic experience in the field. And, you know,
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I'm curious from the last year or so,
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what was the most important initiative that you
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led? What did you do, and what were
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the results?
1:40
There's a I I guess there's a couple
1:41
that come to mind.
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I'll start with,
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you know, really the one
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sort of area of pharmacy that has been
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a a bit of a passion of mine.
1:50
I feel like I've been working on it
1:52
the entire ten years I'm here, and that
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has to do with medication reconciliation for our
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patients. It's a patient safety driven initiative.
2:01
You know, Encompass Health is a post acute
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care inpatient rehab
2:05
hospital company, and so we are uniquely
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positioned in the patient's health care journey where
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they're
2:12
most commonly
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transitioning from an acute care stay, having some
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kind of event that then requires them to
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have intensive inpatient rehab.
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And then we are
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performing that rehab
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and our goal certainly to prepare them to
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return to their community setting and be independently
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functional. That's the goal. So, you know, one
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of the things I think that's just worth
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pointing out about our setting
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compared it to, let's say, an acute care
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setting,
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our length of stay is much longer. So
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we average somewhere around thirteen days length of
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stay, meaning
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our ability to kinda have interaction and interface
2:51
with our patients is a little bit
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longer, than what we would see in a
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traditional acute care setting. And the other thing
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is our patients are a little bit less
2:59
acute. They've already had their acute issues managed,
3:03
and they're there for rehab. So,
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yes, they still have medical issues and complexities
3:08
that need management, but
3:10
oftentimes,
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they're in a sort of a different place
3:14
in their journey that allows us to have
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more impact on things like medication education and
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preparing for discharge.
3:20
On the med rec piece,
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the the one thing that is still a
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challenge, and I think it's a challenge,
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institutionally for health care is
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trying to get a patient's
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medication regimen, what they should be on
3:35
accurate from the beginning of a stay, whether
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that's a hospital stay or, in our case,
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an inpatient rehab stay.
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You know, we don't
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have great interoperability
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between systems. We still rely heavily
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on some electronic data transfer, but a lot
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of paper data transfer when we see a
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patient moving from one side of care to
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another.
3:55
And
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oftentimes,
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the information that we might see,
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can conflict.
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We might look at multiple sources of information
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like a discharge summary, then we might see,
4:06
information in the physician progress note that is
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a little bit different. We might look at
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their external pharmacy health fill history through their
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claims data and see, hey. They're on a
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medication that is at a different dose than
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what we saw on the discharge instructions. So
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all of these complexities, I think that is,
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in my mind, from a patient safety standpoint,
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the biggest challenge. We want to get it
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right.
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And so when you ask what was sort
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of the biggest initiative, it was continuing
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to advance
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all of the systems and processes that are
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related to admission med rec.
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Really in the last,
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year and a half, we've implemented
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an admission a patient medication interview
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where pharmacists,
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within the first, say, forty eight hours post
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admission,
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once the medication orders have been written or
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entered by the physicians,
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we'll go to the patient,
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sit down with them, review that list.
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We found that to be really a just
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another
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way
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to try and catch erroneous information. We found
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so many
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things that would have otherwise been discrepancies or
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errors just by talking to the patient, sharing
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what was ordered for them, making sure nothing
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was omitted,
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making sure that all the meds sounded correct
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based on their knowledge of
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their medication regimen.
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And then
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this year, we had a a performance improvement
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project team that,
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initiated a project around an admission checklist,
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which is pretty interesting idea. We we sort
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of know, and we we have policies that
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direct us on
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what the effective
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steps,
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of an admission
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medication reconciliation should be. We know
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we want to review the discharge summary. We
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know we'd love to see the final day
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MAR for the patient. We know we're gonna
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look at external fill.
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All those things,
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need to be done, in my opinion,
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completely and in every single admission to give
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us the best chance
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of not,
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having an error carry forward. And so the
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checklist idea was,
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something that this team built. They did some
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piloting. The results were really good,
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and we have implemented that checklist into our
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EHR.
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And then I think really what it does,
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it's not new workflow. It's not new process.
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But what it does is it requires our
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staff members to actively check off that they
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completed
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each step of the process. It's almost like
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a reminder, a confirmation,
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and,
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we've seen some really good success. I mean,
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in the early months of launching it, our
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reported rate of serious MET errors has gone
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down. Now I'm interested in continuing to track
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that longitudinally to see if we think that
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we can attribute that to checklist launch. But
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that was probably
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the the most work,
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in terms of organizing that, communicating it, continuing
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to create,
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ways for us to assess in an organization
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our size, which is, you know, a 170
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plus hospitals in, you know, over 40 states.
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Communicating,
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coordinating is a big challenge.
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So that that was that's probably top of
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the list.
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That's amazing to hear. You know, what a
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huge initiative to undertake and and project to
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do and build out, but then to see
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those results, really makes a big difference for
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patients.
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You know, it has been cool to see.
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How did you put all that together? What
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were, you know, who are the the leaders
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involved, and,
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how did you, I guess, roll out to
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make sure it was accepted and implemented by
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all?
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Yeah. I mean so probably worth mentioning a
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little bit about our organizational
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structure. So we are,
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segmented into eight operating regions.
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All of our hospitals
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belong to one of those eight operating regions,
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And each operating region has a regional director
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of pharmacy. So that's really sort of my
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primary contact when it comes to rolling out
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operational
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or workflow based,
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initiatives such as this one.
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So we also have a pharmacy leadership board,
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which is not just the
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the pharmacy leaders in the company, but it's
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a multidisciplinary
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governance board and a guidance board that includes,
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hospital CEOs, regional vice presidents, nursing leadership, medical
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staff leadership,
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and and and some others.
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And so, you know, I look at it
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to say that the the pharmacy leadership board
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is really the strategic arm that helps guide
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what are important initiatives and projects to be
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worked on. This was one of them that
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was identified.
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And then once that's done,
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a lot of really the
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the legwork is done by our regional directors.
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They're very involved
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in the hospitals in their region. They're,
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you know, they're traveling quite a bit. They're
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they're boots on the ground in these hospitals
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in addition to having routine calls amongst their
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region. So, you know, in addition to, I
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think, the standard things, you know, doing,
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Zoom calls or Webex calls, recording those, making
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them available,
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also having those regional directors continue to reinforce
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that. And then I guess the other thing
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that's always important is if you have a
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way to create
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visibility through metrics, and we and and I
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I think we're very fortunate in encompass that
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we have an an exceptionally
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strong
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information technology group, particularly
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when it comes to data.
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And they have provided us with some really
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awesome,
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tools for us to be able to gather
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data. And this is one example where it's
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pretty easy to run a report
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on things like what percent of patients had
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the admission interview
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completed within forty eight hours of their stay,
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what percentage of patients had the admission checklist
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completed.
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And we can run that at a individual
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hospital level and simply use that as feedback
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to the hospitals on what their performance is,
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where their opportunities are. So I think it's
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really sort of all of those things
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that we pull together in order to make
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something like this possible.
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I love it. And, you know, makes a
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lot of sense. Thank you for digging a
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little bit deeper there and just explaining the
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structure and how you're able to get it
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all done. Now looking ahead, what are some
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of your big priorities and headwinds for 2026?
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Yeah. Probably all of the folks that are
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involved in the pharmacy space are keenly aware
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of the fact that in late twenty twenty
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five, we had the
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the implementation or the go live data, the
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last element of what is known as the
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drug supply chain security act, which is a
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multiyear
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piece of legislation
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all aimed at reducing,
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the likelihood or the ability for counterfeit drugs
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to make it into our supply chain. And
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in this last element of go live, it's
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really taken
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all of these
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transactions
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that occur between what they define as trading
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partners into the electronic
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age. And not only into the electronic age,
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but
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they have created,
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some some serialization
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of data
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that's very detailed that allows
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tracking
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not only of what the drug is,
11:25
the indications, but also all the different trading
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partners that it has moved hands from into.
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And so there was a lot of work
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involved in preparing an organization
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to be ready to comply with those standards.
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The implementation date was the November 27,
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and, we're probably very similar to others. It
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takes
11:47
really concerted effort between our wholesalers,
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any other vendors we use, like repackagers.
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In our case, we're using a third party
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vendor to, you know, house all of this
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information on an Internet based web portal.
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It did require some changes
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to hospital workflow where staff now have to
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scan all these items, confirm that all of
12:10
that
12:11
required serialized data is,
12:13
there with the transaction.
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So
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I think we're gonna continue to spend a
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lot of time,
12:21
fine tuning and continuing to work through all
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of the processes.
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I would say that it's gone better than
12:28
expected, but
12:29
with anything this scale and scope, you're always
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gonna have some things that you didn't anticipate.
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And, so we continue to work on just
12:38
really back end,
12:40
informational and IT things to make sure we're
12:42
in full compliance with that standard. So, I
12:45
mean, I think that's certainly a a big
12:47
area that we will focus on. And, you
12:50
know, the other thing is that
12:52
we're spending some more time on is in
12:54
the space of virtual pharmacy or remote pharmacy.
12:57
It's called sort of different things depending on
13:00
the organization. But,
13:02
we are similar to others where we use
13:04
pharmacists that are in a remote site to
13:07
perform
13:08
certain functions largely,
13:10
medication order verification
13:13
is the probably the most common thing that
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they do.
13:16
And that's an important component for us because
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our pharmacies,
13:20
you know, don't have on-site staff twenty four
13:23
seven like maybe a big acute care,
13:26
hospital system might. And so we are
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passing off some of this verification work at
13:32
some point in the evening from on-site staff
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to remote staff. I think we have real
13:37
opportunity to continue to,
13:40
make that remote workflow just workflow
13:43
just more and more efficient. We've already
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started some work with our IT on some
13:49
database building that just allows them to
13:52
research information about an individual hospital.
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I'll give you an example.
13:57
All of our hospitals don't have the same
13:59
interchange policies. We may hospital a may convert
14:02
drug a to drug b. Another hospital may
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convert drug a to drug c,
14:07
and those things are all locally determined through
14:10
their medical staff committees and governing body.
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It's important for a remote pharmacy to be
14:16
aware of any of those kind of interchanges,
14:19
or or or processes while they're doing order
14:22
verification
14:23
to make sure they get it right for
14:25
each individual hospital.
14:26
Today, it's difficult. A lot of that is,
14:30
research they have to do by going out
14:32
and referencing
14:33
a document
14:35
or a spreadsheet, and they have to do
14:36
that for each individual hospital. So,
14:38
we're working on a consolidated database that is
14:42
queryable that's gonna allow remote staff to quickly
14:45
identify if there should be an interchange at
14:48
a specific hospital for for a specific drug.
14:51
We think that's gonna be, saving a lot
14:53
of time and certainly make sure that we
14:55
get those interchanges processed correctly. So that that's
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another big area of focus for us that
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we'll be working on in 2026.
15:04
I love it. That, you know, really makes
15:07
a lot of sense and is great to
15:08
have a better understanding of, you know, some
15:10
of those things you're doing, the implementation, and
15:12
and certainly
15:13
making sure,
15:15
you know, you're you're able to
15:17
have the right drugs in the right places
15:19
and getting the patients at the right times,
15:21
which is so, so helpful.
15:22
I I'm curious. You know, what do you
15:24
think the hardest thing you'll have to do
15:25
in the coming year will be?
15:27
Yeah. I mean, I think for me, I'll
15:29
always say the hardest thing is just communication
15:31
and coordination. And it goes back to
15:34
really the organizational
15:36
scale and scope.
15:37
And,
15:38
you know, when you're when you're managing,
15:42
across so many different sites of practice in
15:44
so many different locations in so many different
15:46
states,
15:48
it's one thing to have really good ideas
15:50
that are born from, let's say, a pharmacy
15:52
leadership board or a group of regional directors
15:55
who are part of an operational pharmacy
15:58
work work group.
15:59
But
16:00
taking that and,
16:02
you know, turning that into
16:04
meaningful workflow and then having that workflow,
16:08
shared
16:10
with the hospitals
16:11
so that they understand it. They they kinda
16:15
get where what is expected of them, and
16:17
they're able to execute on that. I I
16:19
always find that super challenging.
16:21
And, you know, I think,
16:23
for me, specifically, I still do quite a
16:25
few,
16:26
visits to our hospitals every year. It's always
16:29
it's important for me to go out and
16:31
connect with the folks and talk to them
16:33
about initiatives and get their feedback.
16:36
And I always find a few examples of
16:39
things where I have felt like,
16:42
if you were to ask me, I thought
16:44
we did a really good job explaining
16:47
a certain initiative, what we expected,
16:49
how it should be executed.
16:51
But I I always find things that
16:54
weren't necessarily
16:57
heard the same way that we thought it
16:59
was told
17:00
and for no other reason than communication is
17:03
difficult.
17:04
And so,
17:05
that's
17:06
something that's just inherent into the, you know,
17:09
the way that we go about trying to
17:11
roll these things out. And I just think
17:12
that's always gonna be a challenge. I'm always
17:14
open to and interested in,
17:17
you know, new and better ways
17:19
to communicate
17:20
across this diverse, dispersed,
17:24
organization that we have.
17:26
Helpful to understand. And, definitely, you know, always
17:29
great to have the open communication and be
17:31
able to figure out how you can have
17:33
that information flow,
17:35
to work as efficiently and effectively as possible.
17:38
Before we wrap up here, I just wanted
17:40
to have one more question or ask you
17:42
about,
17:42
some of the things you're excited about or
17:44
how you're looking at continuing to grow and
17:47
evolve in the the next year. Is there
17:49
anything that you're looking forward to in 2026?
17:52
I mean, there's always a whole host of
17:54
things that are exciting. One, you know, one
17:56
of the things that is nice about Encompass
17:58
Health is we're still in a a growth
18:00
mode, and we are adding new hospitals to
18:04
the tune of six to eight every year.
18:06
We've done that for the last few years,
18:07
and I think the next few years, we'll
18:10
continue with that growth rate.
18:12
And there's something unique about standing up a
18:15
brand new hospital from from every aspect. Right?
18:18
But speaking specifically of the pharmacy piece,
18:21
it's, it's interesting and it's exciting to
18:24
sort of go from the ground up. And
18:27
and what we learned as we went into
18:30
late twenty twenty five is,
18:33
you know, there's some opportunities there for us
18:35
as well. There's some organizational,
18:38
we talked you mentioned organizational growth. This is
18:40
truly a a growing pain
18:43
in that,
18:44
we want to,
18:47
take a hospital from,
18:49
you know, just the shell of a building
18:51
to an operating functional hospital as efficiently as
18:54
we can.
18:55
Understanding that in many cases, we have all
18:58
new staff, many of them unfamiliar with Encompass
19:01
Health. There's a huge educational and onboarding challenge
19:05
there.
19:06
And so
19:07
what can we do as an organization
19:11
to make it as turnkey as possible? I
19:13
know things are never gonna be quite turnkey,
19:15
but what kind of back end things can
19:17
we do in the beginning of a hospital
19:19
setup so that, you know, that
19:21
potentially new leader who comes into a pharmacy
19:24
leadership role has less independent decisions to have
19:28
to make in an environment where they're it's
19:30
new to them, where things that we can
19:33
predetermine
19:34
and set up and have ready and working,
19:36
will simply benefit
19:38
them and their organization. So,
19:41
that from a growth standpoint is is one
19:43
area where we wanna get better, and I
19:46
think we've got some plans to do that
19:47
in 2026.
19:50
I love it, Sean. Thank you so much
19:51
for joining us on the podcast today. This
19:53
has been such a fascinating conversation. We covered
19:56
ground and, you know, really appreciate your time
19:58
and look forward to seeing you as well
20:00
at our, twenty twenty six chief pharmacy summit,
20:03
in April. I I think there'll be a
20:05
great opportunity to connect with so many pharmacy
20:07
leaders across the country and continue this conversation
20:09
and spotlighting the things you're doing at Compass.
20:13
Well, thank you very much. And, yeah, I'm
20:14
excited to see you and all my colleagues
20:16
in Chicago a little bit later this year.
20:18
So,
20:19
thanks for the invite. I really appreciate it.