Latest / Becker’s Healthcare - Clinical Leadership Podcast / Regina Schomberg, System Director Pharmacy II at Atrium Health

Transcript

Regina Schomberg, System Director Pharmacy II at Atrium Health · Becker’s Healthcare - Clinical Leadership Podcast

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  - This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Regina Schaumberg,
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  system Director of Pharmacy, retail,
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  and specialty pharmacy at Atrium Health.
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  Regina, it's a pleasure to have you on the podcast today.
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  - Thank you for inviting me.
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  - Now, I know we have a lot to talk about.
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  There's so much happening in the healthcare space
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  and in particular, I'm excited to learn more about
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  what you do at Atrium.
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  I, I know one of the, um,
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  most well-respected health systems in the country,
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  so that'll be great to hear more from you.
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  But before we dive into that discussion,
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  can you tell me a little bit more
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  about yourself and your background?
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  - Um, absolutely. I, I am Regina Schaumberg, as you said,
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  and assistant director for our retail
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  and specialty pharmacies, um,
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  at Atrium Health at Wake Forest Baptist,
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  and some responsibilities in the Charlotte market.
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  Um, but that's not all I've done in,
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  in my professional career.
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  Um, I've been a licensed pharmacist for close
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  to 32 years now,
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  and throughout that, back throughout that time,
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  I've had numerous opportunities, uh,
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  with the healthcare system
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  to learn about all aspects of patient care.
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  So training from University
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  of North Carolina at Chapel Hill,
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  and then started working in, in direct, um, hospital
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  practice soon after that.
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  So, worked with providers in internal medicine.
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  I've worked as a specialist with kidney pancreas
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  and solid organ transplant.
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  Been a clinical manager for the department, um, as well
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  as heavily involved in student and residency training.
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  I was a residency coordinator
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  for our PGY one pharmacy practice program for close
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  to 14 years, and then started a PGY one community-based
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  residency program where I served as the RPD for eight years.
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  So a lot of investment in learning
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  and preparing those pharmacists in the future.
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  Um, over 10 years ago, I made the transition to the retail
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  and specialty area.
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  It was beginning to, uh, just take off, um,
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  especially pharmacy at the time.
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  We needed a lot of focus with accreditation
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  and really growing that business that we know has become,
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  um, even a greater, uh, growth volume
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  through throughout the years.
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  So I think my training and background's quite interesting
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  because I have seen all transitions
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  of patient care from the acute care space
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  to starting a transitions of care program in a meds
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  to beds program, and now looking more in the ambulatory
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  space and retail specialty pharmacy.
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  So really seeing the, the patient management
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  and the patient life cycle full circle.
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  Um, from a professional standpoint,
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  been involved in a SHP committees
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  and work for numerous years,
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  and in 2010, I also served as the president
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  of our North Carolina Association of Pharmacists.
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  So a, a lot of, a lot of different opportunities came
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  through, um, my ability to say yes
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  and discern what really drives me in my pharmacy career.
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  - Fascinating. And it seems like you've got such an amazing
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  background in pharmacy as well as connecting with patients
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  and really being able to learn the continuum of care.
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  So I can imagine that is really helpful.
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  In your current role, um, in, in, in that vein,
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  what are some of the top trends you're
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  following in healthcare right now?
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  What's really top of mind for you?
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  - Oh, wow. That, you know, a loaded question.
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  Um, there's a lot of internal drivers, external drivers, um,
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  and headwinds and tailwinds that we're having
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  to, to keep track of.
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  But if I could narrow that down to a few, uh,
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  one would be pharmacy workforce or,
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  or healthcare workforce for that matter.
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  Um, covid has changed a lot of the ways that we practice,
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  um, allowed us to leverage different opportunities
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  and different ways to meet the patients where they are.
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  Um, but with also, with, with those changes,
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  we've become competitors, um, with other, um, different
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  for our, for our same talent pool.
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  So we are really trying to figure out
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  what does pharmacy look like now and in the future,
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  and what does our workforce demand, um, to,
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  to remain within the profession.
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  So retaining that great talent that we already have,
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  and then learning about training opportunities
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  and pharmacy school enrollment is down
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  for the first time in decades, so what is
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  that gonna look like in the next 20 to 30 years?
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  Um, how are different AI technologies going
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  to assist pharmacists, not replace pharmacists,
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  but assist pharmacists in our role?
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  And then take thinking about the heavy impact
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  on pharmacy technicians.
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  The pharmacy technician workforce is a growing workforce,
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  um, but it also is one
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  that's being shared across multiple types of care.
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  Um, so learning about how we can train,
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  how we can start from perhaps you, the middle school,
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  the high school area, for folks to start to understand
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  that pharmacy technicians should be a career
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  path, not just a job.
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  And, and we want that great talent so we can continue
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  to provide you the best care.
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  So pharmacy workforce is something
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  that we think about daily.
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  Um, we can't grow without, without people.
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  The second would be technology
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  and really the race for healthcare to keep up
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  with the private sector, uh,
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  and along with technology comes data.
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  And so what does that data look like?
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  You know, you can, you can look at data,
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  but what does it mean and how do we discern that data
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  to make great decisions, um, from how we take care
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  of our patients to
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  how well we're performing when we take care of our patients?
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  So I think in healthcare, we need to be open, um,
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  to using data open to what technology is out there, um,
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  and realizing that maybe it doesn't look like we thought it
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  would with technology,
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  but just be open to that, to that growth mindset.
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  And one of the last things I I think about a lot would be in
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  specialty pharmacy, particular,
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  the pipeline that's out there.
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  You know, when I graduated pharmacy school, there weren't
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  as many medications as there are now.
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  And really it's keeping up with that pipeline.
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  With the pipeline comes the treatment strategies
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  and even the access to the medications.
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  You know, if we're doing the research on the,
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  these medications with our patients in our facilities,
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  then we want to, we want to ensure that we have the ability
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  to provide those medications from a specialty pharmacy
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  standpoint and not just joint patient care
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  by sending those patients elsewhere.
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  So we need to align closely with their manufacturers.
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  We need to tell our story better of how we take care
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  of our patients and
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  how we can contribute to positive outcomes.
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  - I love that. I, I think it makes so much sense,
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  and certainly just fascinating to kind of think through all
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  of those trends, whether it's looking at the workforce,
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  having a strong pipeline in place to continue to grow
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  and develop, and then adding that technology
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  and integrating it into your current
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  operational flows and systems.
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  I, I really appreciate you talking about the growth mindset
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  because I think so many aspects
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  of healthcare today really need to, uh, embrace that
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  and figure out how, um,
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  to do things differently than they ever have
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  before to solve big problems.
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  When you look at your teams
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  and, um, how you're trying to innovate and grow and develop
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  and embrace that growth mindset, what does it take to
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  change the culture, whether a little bit
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  or a lot in order to really, um,
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  get yourself into a position that everybody is, um,
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  thinking in the same way
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  and really excited about the future?
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  - Well, I would say that's a loaded question,
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  but change doesn't happen overnight.
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  Um, you know, it's, it's, uh, small turns.
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  Um, it's just developing a sense of community where we have
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  that open mindset where all ideas are welcome,
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  where we challenge the, the norm to, to your point, uh,
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  when you say, you know, healthcare is changing
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  and we need to be open to those technologies
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  that may not have been ones
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  that we would've considered in the past.
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  Um, but we, we know we're either gonna be limited on, on,
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  um, teammates, limited on resources,
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  and we need to design a way to do that.
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  I think that open mindset starts from the top down.
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  We have to have leadership that recognizes
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  that change is inevitable,
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  and we need to be a positive part of
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  that change versus driving against that change.
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  Looking at our frontline staff,
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  looking at their suggestions.
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  They're the ones that are, are interacting
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  with those patients on a day-to-day basis.
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  We need to recognize that they're the experts in those
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  fields and we need to support them as leaders
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  for the technology that they might need,
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  the additional support they might
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  need as well as our patients.
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  We need to listen to our patients.
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  Um, I think providers have done a good job
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  for years having patient advocacy groups, um,
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  inviting patients, um,
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  or patients, um, caregivers to be part of, of those groups.
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  And we need to do the same in pharmacy.
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  We need to listen to our patients, meet them
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  where they are at providing what they need
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  because it just might not be what was needed 10 years ago.
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  - That's such an excellent point,
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  and, you know, fascinating to think about.
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  Now, along those lines,
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  how has your pharmacy program evolved over
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  the last two to three years?
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  What's really different today than, um, it ever has been?
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  - Oh, wow. Um, well, for specialty pharmacy in particular,
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  that term or concept 10 years ago did not exist.
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  Um, and to, to, um,
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  the conversation earlier about my background, you know,
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  I had been a clinical pharmacist
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  with a solid organ transplant team where I would interact
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  with just one or two specialty pharmacies, you know,
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  15 years ago that would provide those immunosuppressants
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  and those medications for those newly transplanted patients.
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  And if you think about how
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  that has evolved in the past 10 years is over 50%
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  of the medications that are prescribed now are
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  deemed specialty medications.
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  Um, and so there's a lot of opportunity for those patients
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  for rare disease, um, for oral oncolytics,
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  you think about medi, uh, treatments for patients that used
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  to only be in infusion centers or in an acute care bed
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  or facility have now moved
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  to the outpatient outpatient setting.
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  And that is absolutely wonderful if you do not have
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  to go into a hospital
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  or into an infusion suite to receive your therapy and, and,
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  and heal at home and,
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  and be seen at home even with some
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  of our hospital at home opportunities.
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  But really it's the volume growth.
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  Um, over the past two to three years in our retail
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  and specialty pharmacies, we're seeing, you know,
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  double digit growth in volume, not just prescription volume,
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  that this is an incredibly lucrative revenue stream.
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  So inter hospital enterprises are looking
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  to expand those health system specialty pharmacies
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  because they understand not only do they prevent
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  fragmentation of care for the patient
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  that they're seeing all under the same providers, um,
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  pharmacy, et cetera, within that same locale.
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  Um, but they're also generating that revenue that gives back
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  to other patients in the facility that helps sustain, um,
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  enterprises in a, in a positive financial manner.
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  That in addition to immunizations, if,
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  if you think about the covid vaccine response,
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  there were very limited folks who could give vaccines,
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  but pharmacists were one of them.
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  So we were really called to, to service immediately.
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  We had to be creative with how we were providing vaccines,
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  how we were getting medications to patients, um,
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  a little bit unorthodox, a little bit, a little bit,
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  it felt unusual or might might not be something we were
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  accustomed to, but those dire times calls for, called
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  for creative measures and we were able to do that.
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  Um, you know, and the shifting the patient care into the
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  ambulatory setting is, is something that's really evolved.
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  And we, in the specialty and the,
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  and the retail pharmacy are beginning more so to be involved
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  with those provider discussions, even as far as looking at
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  where providers need to be hired,
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  what specialties do we need to have?
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  Because if you don't have clinic opportunities for patients
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  to be seen for six to nine months,
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  then they can start therapy
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  and they, they cannot, um,
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  resolve the issues that they're having.
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  So again, I think the background, um, I have in acute care
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  positions me greatly and my team, it provides them
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  that support and that comfort level
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  that we can have those conversations with providers as well
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  as conversations with hospital, um, c-suite type leadership,
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  um, that what we,
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  what we say in our knowledge is very important
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  to the entire spectrum of patient care.
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  - That's truly fascinating
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  and definitely I love kind of that story of
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  how things have evolved so quickly
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  and then embracing the change and innovation
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  and, um, really, you know, moving to in a direction that is
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  so impactful and important to continue
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  to care for communities.
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  Now, before we wrap up here, I'm wondering
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  where do you see some of the best opportunities for growth
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  and adding value to the system overall?
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  I know you talked a a little bit about, um, just how,
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  you know, having that specialty pharmacy focus can really
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  make a difference and be impactful.
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  And I would just love to hear from your perspective
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  where you see all that headed.
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  - Oh, sure. I, I think it's going to be even more impactful,
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  um, moving forward in the next three to five years.
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  Many integrated delivery network opportunities.
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  I know I've said several times use the term preventing the
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  fracturing of patient care,
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  but it really is important to adherence and compliance.
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  And you, you think about if you have five
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  or six medications, you're seeing three
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  to four different providers
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  and maybe your healthcare insurance is mandating you use two
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  or three different pharmacies.
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  I mean, even if you don't have many medications,
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  that's still difficult to keep up with.
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  So for some of our patients that have a plethora
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  of medications with multiple disease states,
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  that's even more confusing.
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  So we need to understand that we don't need
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  to contribute to that confusion.
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  We need to augment that with ease for patient care, um,
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  one stop shop, if you will, and make that possible.
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  I think there's, there's no limit to
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  what we can do from a health system
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  to provide the best care to those patients.
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  It's really telling our story to those outside the,
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  the walls or the confines of the IDN
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  or a health, a health system network.
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  Those are the payers, those are the manufacturers.
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  Um, I, I think we, we need
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  to tell our story, we need to tell it better.
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  We need to tell it more often,
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  and we need to tell it to anyone who will listen about
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  what we do it, it's quote, the elevator speech,
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  the executive summary, what whatever term you wanna use.
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  Um, pharmacy in itself has not been a great advocate for it
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  for themselves over the years.
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  And, and I know just during my time in the career, um,
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  if there's a, if there's a news story, what do they show?
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  They show a pharmacist counting pills on it
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  or tablets on a tray.
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  Um, but that's not what pharmacy is anymore.
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  And we're responsible for marketing who we are
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  and what we can do, um, to the, those payers,
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  those manufacturers, to those executives
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  as well as to the patients.
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  Um, patients know that pharmacy is a reliable profession.
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  They, they ask us many, many different questions.
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  We can provide more time with them than
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  unfortunately their providers can.
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  Um, so we just need to continue to advocate through those,
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  those different types of forums about what we can do.
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  And I think we've done a good job.
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  I mentioned immunizations previously.
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  There's, um, there's support in different states.
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  There's, um, certified pharmacy practitioners that can serve
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  as mid-level practitioners.
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  There's the ability for pharmacists to prescribe.
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  Um, there's ability for pharmacists
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  to administer long-acting injectables.
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  So we're getting out there.
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  Um, but we're having to do a little bit slowly
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  and we're facing some political pushback,
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  but I think just we continue to, to push forward.
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  We can do, do some amazing things for the system overall.
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  - That's fascinating to hear.
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  Regina, thank you so much
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  for joining us on the podcast today.
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  This has been a really fun and interesting conversation
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  and I look forward to connecting with you again soon.
• 15:03
  - You're very welcome. Thank you so much.