Latest / Pharmacy Podcast Network / AI in Pharmacy Standards and Drug Supply Chain Upgrades | TWIRx

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AI in Pharmacy Standards and Drug Supply Chain Upgrades | TWIRx · Pharmacy Podcast Network

• 0:04
  Speaker 1: Coming up. On the next episode of This Week in Pharmacy,
• 0:08
  Speaker 1: sponsored by GoodRx, we sit down with David Graziano, head
• 0:12
  Speaker 1: of retail network at GoodRx, and Tom to Petro, independent
• 0:15
  Speaker 1: pharmacy owner at to Petro's Pharmacy for a timely conversation
• 0:19
  Speaker 1: about the future of independent pharmacy. We'll discuss reimbursement pressures,
• 0:23
  Speaker 1: the rise of cash pay patients, growing demand for high
• 0:26
  Speaker 1: cost brand medications like GLP one therapies, and how independent
• 0:30
  Speaker 1: pharmacies can compete in a rapidly changing marketplace. David will
• 0:34
  Speaker 1: share how GoodRx Community Link is designed to provide predictable
• 0:37
  Speaker 1: pricing and favorable economics for brands and generics, while Tom
• 0:41
  Speaker 1: brings the real world pharmacy owner perspective on sustainability, patient access,
• 0:45
  Speaker 1: and community care.
• 0:47
  Speaker 2: Don't miss this important discussion on how transparent pricing and
• 0:51
  Speaker 2: stronger pharmacy economics can help independent pharmacies serve patients with confidence.
• 0:56
  Speaker 2: To learn more, visit GoodRx dot com slash community Link.
• 1:01
  Speaker 1: Good rx is not insurance.
• 1:29
  Speaker 3: About twenty twenty six, We've done a lot of work around,
• 1:32
  Speaker 3: taking some customer feedback and really making thoughts spot a
• 1:36
  Speaker 3: new and reimagined event this year, We've got a lot
• 1:40
  Speaker 3: of great programming, a lot of good ces, a lot
• 1:43
  Speaker 3: of just really cool things for our pharmacies to come
• 1:47
  Speaker 3: in and realize and look for things that we're going
• 1:49
  Speaker 3: to increase their efficiency so they can really spend time
• 1:53
  Speaker 3: with the patients, caring for patients, working on clinical services,
• 1:57
  Speaker 3: activating some knowledge. We've got a lot of industry experts
• 1:59
  Speaker 3: that will be they're a lot of thought leaders. They're
• 2:01
  Speaker 3: creating some opportunities for pharmacies to come in and just
• 2:04
  Speaker 3: talk to one another, some space for just pharmacies to network,
• 2:07
  Speaker 3: and then we're really focused on helping them diversify the revenue.
• 2:11
  Speaker 3: We know the pharmacies, the distribution and economics are what
• 2:15
  Speaker 3: they are, and how do we help them diversify their
• 2:18
  Speaker 3: revenue so they can continue to be here well into
• 2:21
  Speaker 3: the future.
• 2:25
  Speaker 4: Hey, starting off on twerks today, we're jumping right into
• 2:29
  Speaker 4: the business of pharmacy. I want to welcome Brent Wilhelm.
• 2:33
  Speaker 4: He's senior vice president of Global Supply Chain and tim
• 2:36
  Speaker 4: Weber Pharmacy Operations and Regulatory Executives, a team from Sincora
• 2:43
  Speaker 4: on twerks.
• 2:44
  Speaker 5: Gentlemen, it's so good to have you.
• 2:47
  Speaker 6: Good to be to be here. Thank you.
• 2:50
  Speaker 4: We are in a stage and everyone that's talking on
• 2:56
  Speaker 4: twerks right now is old enough to remember the way
• 3:00
  Speaker 4: that supply chain worked twenty years ago and how things
• 3:04
  Speaker 4: have shifted and changed, and some of it for the good.
• 3:08
  Speaker 4: Some of it seems like it creates confusion. But people
• 3:12
  Speaker 4: that have a pedigree in veterans who understand where we
• 3:15
  Speaker 4: are today and making accessible making drugs more accessible through
• 3:22
  Speaker 4: their source, whether they want to go to their independent
• 3:25
  Speaker 4: community pharmacy or they want to go to a friendly
• 3:29
  Speaker 4: neighborhood chain pharmacy or grocery store or whatever.
• 3:34
  Speaker 5: That sounds so.
• 3:36
  Speaker 4: Insignificant to the consumer, but people listening to the show
• 3:40
  Speaker 4: right now know how delicate of a system that it
• 3:43
  Speaker 4: really is. I'm going to open up with Brent Senior
• 3:47
  Speaker 4: vice president Global Supply Chain there at Saquora. Just give
• 3:50
  Speaker 4: us an overview of what you think of where we are.
• 3:53
  Speaker 4: What's the state of the nation right now with drug
• 3:56
  Speaker 4: supply chain.
• 3:57
  Speaker 7: Yeah, well, thank you for the time today, Todd and
• 4:02
  Speaker 7: the questions. I would say it's a healthy supply chain,
• 4:08
  Speaker 7: but it comes with challenges the way that we think
• 4:12
  Speaker 7: about healthcare and the way we position ourselves from Sincora's
• 4:17
  Speaker 7: it's always the patient first.
• 4:18
  Speaker 5: For us.
• 4:19
  Speaker 7: Patient care is foremost and what we think about and
• 4:21
  Speaker 7: how we approach our supply chain and how we support
• 4:26
  Speaker 7: manufacturer partners and points of care. And so we've got
• 4:29
  Speaker 7: a robust network that is positioned to get product within
• 4:33
  Speaker 7: hours when a practitioner needs it for patient care to
• 4:37
  Speaker 7: the customer. But that brings challenges within itself. That creates
• 4:41
  Speaker 7: speed and agility for the practitioner to get product for
• 4:45
  Speaker 7: patient care, which is important. But because of that network
• 4:49
  Speaker 7: and the way that we set things up, we are
• 4:51
  Speaker 7: putting inventory and supply at each of those forward distribution
• 4:56
  Speaker 7: locations closest to the customer. So we're really relying on
• 5:00
  Speaker 7: how we look at customer demand, the demand they give us,
• 5:03
  Speaker 7: the demand signals that we see to make sure that
• 5:06
  Speaker 7: we've got the right inventory at the right place for
• 5:08
  Speaker 7: the right time. I think historically that's been good enough.
• 5:14
  Speaker 7: As we think about access to drugs, the cost of drugs,
• 5:18
  Speaker 7: and everybody's looking for pharmaceuticals in really real time, the
• 5:23
  Speaker 7: way that we plan our network and using data becomes
• 5:26
  Speaker 7: even more important. And so there's a gap today and
• 5:31
  Speaker 7: what we see in how we think about demand planning.
• 5:33
  Speaker 7: We use demand that's been pulled over a period of time,
• 5:37
  Speaker 7: what did you buy yesterday, what did you buy last week?
• 5:39
  Speaker 7: And then we demand forecast plan against that for the future.
• 5:44
  Speaker 7: We need to lean we're leaning in more to how
• 5:46
  Speaker 7: do we think about an integrated supply chain where we
• 5:48
  Speaker 7: get data from customers that's more forecasting. How do we
• 5:51
  Speaker 7: use AI to look at past seasons and conditions and
• 5:55
  Speaker 7: disease states and think about how we factor in with
• 5:58
  Speaker 7: AI and the data that we have, and leaning into
• 6:01
  Speaker 7: how do we integrate a supply chain with data closer
• 6:03
  Speaker 7: to the point of care to how do we forecast
• 6:06
  Speaker 7: where that inventory needs to be so that we make
• 6:09
  Speaker 7: sure we always have the right inventory at the right time.
• 6:11
  Speaker 7: There have been times in the past, and we've seen
• 6:14
  Speaker 7: this with RSV a couple of years ago, where there's
• 6:17
  Speaker 7: disease spikes, and when we have those and we're placing
• 6:21
  Speaker 7: inventory in the forward DCS, our ability to react to
• 6:24
  Speaker 7: that isn't as fast is what you would expect it
• 6:27
  Speaker 7: to be. So there could be inventory in the supply,
• 6:30
  Speaker 7: but it's not in the right place at the right time.
• 6:32
  Speaker 7: So I think as we look to patient care and
• 6:36
  Speaker 7: what practitioners are needing. We need to think differently about
• 6:39
  Speaker 7: how we leverage technology to make sure that we've got
• 6:43
  Speaker 7: supply where it needs to be.
• 6:46
  Speaker 4: Thank you for that, Tim. Your understanding of this subject
• 6:51
  Speaker 4: is extremely close to your heart. The work that you
• 6:56
  Speaker 4: put in in community pharmacy directly through throughth pharmacy back
• 7:00
  Speaker 4: in the day, and then the time that you've spent
• 7:03
  Speaker 4: with Sincora in the field understanding the pressures, understanding the
• 7:08
  Speaker 4: challenges of our independent community pharmacies. Talk to us about
• 7:12
  Speaker 4: what availability means in comparison to accessibility for providers, pharmacies
• 7:18
  Speaker 4: and patients.
• 7:19
  Speaker 3: Yeah, that's a great question, Talt. You look at supply
• 7:23
  Speaker 3: in the network, it's yes, it's in the network, but
• 7:25
  Speaker 3: so Brent was saying, it's in a forward d C.
• 7:27
  Speaker 3: It may not be in the forward DC that's closest
• 7:29
  Speaker 3: to the place that pharmacy that needs that product. And
• 7:32
  Speaker 3: I think as Brent was talking talk about how we
• 7:36
  Speaker 3: need more data to make the supply chain more resilient
• 7:39
  Speaker 3: and more forecat being able to see the future a
• 7:41
  Speaker 3: little bit easier than we can today. That's critical for
• 7:45
  Speaker 3: independent pharmacies, particularly even in some small chain pharmacies that
• 7:49
  Speaker 3: are operating in our very rural locations where you know,
• 7:53
  Speaker 3: in a lot of cases they are the only healthcare
• 7:55
  Speaker 3: entity within miles for some of these patients and really
• 7:59
  Speaker 3: the only place the patients can seek care. And you know,
• 8:02
  Speaker 3: the opportunity for the for us to be to get
• 8:05
  Speaker 3: a better supply chain so that that product can be
• 8:07
  Speaker 3: in the right place at the right time when the
• 8:09
  Speaker 3: patient and the provider need it. It's it's critical for
• 8:13
  Speaker 3: patient outcomes.
• 8:16
  Speaker 4: So I think of if we were to draw a
• 8:19
  Speaker 4: circle and try to fill it in with the supply
• 8:22
  Speaker 4: chain and the and the actual cycle that it follows.
• 8:26
  Speaker 4: One of the places where we see barriers to access
• 8:30
  Speaker 4: to these medications is reimbursement barriers prior authorization, certain pay
• 8:36
  Speaker 4: rules PBMs. Sometimes their process is getting in the way
• 8:40
  Speaker 4: and they may not be doing it purposely, but it's
• 8:42
  Speaker 4: just systems that are set up, algorithms that are set
• 8:45
  Speaker 4: up that that prevent the accessibility. So how does that
• 8:49
  Speaker 4: play into it to brand? How does how does that
• 8:52
  Speaker 4: side of the supply chain work?
• 8:56
  Speaker 7: Yeah, certainly reimbursement it can play a factor, and access
• 9:03
  Speaker 7: to pharmaceuticals and the cost of those and what that
• 9:07
  Speaker 7: means from a financial perspective for points of care when
• 9:11
  Speaker 7: I think about, you know, the supply chain as far
• 9:14
  Speaker 7: as access to the drugs, and we talk about having
• 9:18
  Speaker 7: there's different dosages. Uh, there's you know, a variety of
• 9:23
  Speaker 7: you could have a formulary that a patient needs. And
• 9:27
  Speaker 7: I talked about previously how we're looking at connecting data
• 9:32
  Speaker 7: when we think about making sure that we're getting access
• 9:35
  Speaker 7: to those pharmacies. Tim talked about, you know, ural we
• 9:39
  Speaker 7: have independence that are the only point of care for
• 9:42
  Speaker 7: some of these rural markets. We've we at Scura have
• 9:46
  Speaker 7: made a billion dollars worth of investments into our network
• 9:50
  Speaker 7: strategically where we see growth and coal chain, but also
• 9:54
  Speaker 7: to create more nimbleness or agile in the way that
• 9:57
  Speaker 7: we're supplying our forward distribution sites and connecting our network
• 10:01
  Speaker 7: to our manufacturer partners.
• 10:03
  Speaker 5: And so.
• 10:06
  Speaker 7: One of those investments is creating a single point of
• 10:12
  Speaker 7: entry from manufacturers into the Secora network. But what that'll
• 10:16
  Speaker 7: do for us is also allows us to hold a
• 10:19
  Speaker 7: certain amount of inventory centrally where we can dynamically replenish
• 10:23
  Speaker 7: those forward dcs closest to those customers when we see
• 10:27
  Speaker 7: variations in demand due to external factors. Could be business
• 10:34
  Speaker 7: continuity scenarios where we've got weather events like fern where
• 10:40
  Speaker 7: we're moving customers across the network and that's creating larger
• 10:43
  Speaker 7: demand in certain pockets than what we typically would see.
• 10:46
  Speaker 5: This allows us.
• 10:47
  Speaker 7: To flex to that to make sure that we've got
• 10:49
  Speaker 7: the right product at the right time for what customers
• 10:51
  Speaker 7: need to serve patients. So outside of those barriers when
• 10:54
  Speaker 7: it comes to reimbursement, which I can't solve, what I
• 10:58
  Speaker 7: do need to make sure from microspective and my role
• 11:00
  Speaker 7: at S and COREA is that we've got a network
• 11:02
  Speaker 7: that's robust enough to make sure that we're meeting the
• 11:05
  Speaker 7: demands of the customer for that patient and flexing it
• 11:08
  Speaker 7: in a way that we're agile to the changing conditions
• 11:11
  Speaker 7: that we're seeing within the supply chain space.
• 11:16
  Speaker 4: What a significant investment I read about that when you
• 11:19
  Speaker 4: mentioned that later last year drug distributor Sincora to invest
• 11:24
  Speaker 4: one billion in a US supply chain upgrade, and that
• 11:27
  Speaker 4: just shows the staging and the investment being made for
• 11:31
  Speaker 4: the future of what's going to be happening to pharmacy
• 11:35
  Speaker 4: care and how it is. It's changing and we just
• 11:37
  Speaker 4: have to keep up with it. I want to come
• 11:39
  Speaker 4: back to the data point. I want to want to
• 11:42
  Speaker 4: ask about accessing that data, getting getting connected and then
• 11:51
  Speaker 4: not slowing down the providers in giving you that data.
• 11:55
  Speaker 4: So Tim, tell me about the world of data accessibility
• 11:59
  Speaker 4: and what that means for predictability, what it means for
• 12:04
  Speaker 4: transparency and pricing, what that means for the the end
• 12:10
  Speaker 4: the end user, which is the our pharmacist out there
• 12:12
  Speaker 4: that need their patients to get their medication.
• 12:16
  Speaker 7: Yeah, I think there's.
• 12:17
  Speaker 3: Brent probably can hit on a lot of other data
• 12:19
  Speaker 3: points that than I can. But from a you know,
• 12:22
  Speaker 3: just the data. The world of data and the interconnectness
• 12:25
  Speaker 3: of pharmacy data is continue to grow, and I look
• 12:28
  Speaker 3: at things that are evolving. It's like NCPDP is creating
• 12:32
  Speaker 3: a standard for pharmacists to be able to share their
• 12:35
  Speaker 3: in stock data with providers and hopefully someday with patients,
• 12:38
  Speaker 3: and just allowing that transparency around where product sits inside
• 12:44
  Speaker 3: of the supply chain today so that patients and providers
• 12:47
  Speaker 3: can access it at the time they need to. Brent,
• 12:50
  Speaker 3: I allow you to elaborate on some of the data
• 12:53
  Speaker 3: maybe that we're bringing into the network to help forecast
• 12:56
  Speaker 3: the supply chain better.
• 12:59
  Speaker 7: Yeah, I think you know we're data rich, we have
• 13:02
  Speaker 7: been for a long time, and so with the evolution
• 13:06
  Speaker 7: of AI, what's exciting is we're able to take the
• 13:08
  Speaker 7: data insights that we get from manufacturers because that's where
• 13:12
  Speaker 7: the supply chain starts, So understanding where there's health in
• 13:15
  Speaker 7: the supply chain or where there's risk, and then what
• 13:18
  Speaker 7: does that mean being able to assess that for our
• 13:22
  Speaker 7: customers and what does that mean for patients if there
• 13:25
  Speaker 7: needs to be a discussion around alternate formulas for care
• 13:30
  Speaker 7: that they can plan around and be prepared for, and
• 13:32
  Speaker 7: then how do we make sure that we're planning for
• 13:34
  Speaker 7: that within the supply chain.
• 13:35
  Speaker 6: So we have lots of data today.
• 13:39
  Speaker 7: We're excited about what we're doing with AI and how
• 13:41
  Speaker 7: we use AI to be able to digest that data
• 13:44
  Speaker 7: quickly and make data driven insights. But also leading in
• 13:49
  Speaker 7: then to how do we think about agentic AI where
• 13:51
  Speaker 7: we can make then decisions faster so we can digest
• 13:54
  Speaker 7: it quicker, but how do we then make decisions quicker
• 13:58
  Speaker 7: across our network execute faster so they're not we're not
• 14:03
  Speaker 7: delaying Because these things, these insights that we get on
• 14:06
  Speaker 7: the supply and the health of the network, if ours
• 14:11
  Speaker 7: can mean not having a product within a DC for
• 14:15
  Speaker 7: a customer, for that patient, for cancer treatment or whatever
• 14:18
  Speaker 7: it may be. So trying to cut out the time
• 14:21
  Speaker 7: it takes to analyze the data and then quickly making decisions.
• 14:25
  Speaker 7: AI is really the future for both of that, understanding
• 14:30
  Speaker 7: the insights and then how do we execute.
• 14:32
  Speaker 4: All you have to do is look at the news
• 14:34
  Speaker 4: and see some of the changes that are happening in
• 14:37
  Speaker 4: supply chain. There was a feature article from Sincora's Matt
• 14:43
  Speaker 4: Sample that we're talking about the FDA making a landmark
• 14:46
  Speaker 4: change and how that pharmaceutical products are going to be
• 14:49
  Speaker 4: tracked with the new twelve digit NDC code going from
• 14:53
  Speaker 4: ten digits to twelve digits, and once again it's just
• 14:57
  Speaker 4: telling to the world of new coming medications, new coming treatments,
• 15:03
  Speaker 4: transitional treatments from one cancer medication to the next, and
• 15:07
  Speaker 4: how the NDC is going to be key in tracking
• 15:11
  Speaker 4: and starting to tie things back to even DSCSA and
• 15:15
  Speaker 4: management and then reporting back to manufacturers.
• 15:19
  Speaker 5: There's a lot to that.
• 15:20
  Speaker 4: Can you speak to a little bit about that change
• 15:23
  Speaker 4: and your insights on that.
• 15:26
  Speaker 7: Yeah, Todd, I'm not really the NDC twelve experts, so
• 15:29
  Speaker 7: that's not an area of my expertise, so I'll defer
• 15:33
  Speaker 7: to Tim if he's got something to add to that topic.
• 15:36
  Speaker 3: Now, I just I mean from an NDC twelve standpoint,
• 15:38
  Speaker 3: just from a pharmacy standpoint, right, it's a new operational
• 15:41
  Speaker 3: challenge that now pharmacies also have to overcome, right, supply
• 15:45
  Speaker 3: chain has to overcome. But the pharmacies operationally do as well,
• 15:47
  Speaker 3: and so do the payers, and so it'll be it'll
• 15:50
  Speaker 3: be interesting to see how that NBC twelve helps, either
• 15:54
  Speaker 3: operationally or just from a data standpoint in the future.
• 15:59
  Speaker 5: Yeah, I think it.
• 16:00
  Speaker 4: I don't think it is going to help with tracking
• 16:01
  Speaker 4: and then substitution the world expansion of biosimilars. I think
• 16:07
  Speaker 4: I think they're doing it. I'm obviously on purpose. And
• 16:11
  Speaker 4: we heard a little bit about that from the NCPDP
• 16:13
  Speaker 4: who updated us about four weeks ago, and it was
• 16:18
  Speaker 4: just on the the ending of another one of our
• 16:23
  Speaker 4: press coverage events that we do, which is quite exciting
• 16:28
  Speaker 4: that we are on the eve. It's Friday today and
• 16:32
  Speaker 4: in less than two weeks it'll be the Sincora's super
• 16:37
  Speaker 4: Bowl of Independent Community Pharmacy thought Spot in Orlando.
• 16:40
  Speaker 5: So are either of you going to Thought Spot we'll
• 16:44
  Speaker 5: be there.
• 16:44
  Speaker 7: Yeah, we'll both be there.
• 16:46
  Speaker 4: That's incredible. So we'll have a podcast press booth set up.
• 16:50
  Speaker 4: I'm going to reach out to your press team to
• 16:51
  Speaker 4: see if we can't get one or even both of
• 16:53
  Speaker 4: you back on the show and just talking about what
• 16:55
  Speaker 4: you're most passionate about. That's what we love here on
• 16:58
  Speaker 4: twerks anyway, is the the passion from people in the
• 17:01
  Speaker 4: business of pharmacy. And this has been awesome. I really
• 17:04
  Speaker 4: appreciate the both the insights that you bring to us
• 17:06
  Speaker 4: and our listeners. Technicians, pharmacy technicians. You guys, you're transforming
• 17:12
  Speaker 4: the world of the business of pharmacy and specialty and
• 17:15
  Speaker 4: long term care in community pharmacy. We want you to
• 17:19
  Speaker 4: be a part of this. Make sure you reach out
• 17:21
  Speaker 4: to me, schedule some time with me in Orlando at
• 17:23
  Speaker 4: Thoughts about twenty twenty six. Pharmacists, you're my favorite providers.
• 17:27
  Speaker 4: Thank you so much for listening and all the work
• 17:30
  Speaker 4: that you put in this week in pharmacy, and we'll
• 17:33
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  Speaker 4: Hey, welcome back to this week in Pharmacy IRAQ.
• 19:00
  Speaker 5: You are AC.
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  Speaker 6: Todd, thank you for letting us come and talk for
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  Speaker 6: a while.
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  Speaker 4: Absolutely excited that you're here. Sean, So, as a former
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  Speaker 4: medicine physician, health system executive, you provided leadership with other organizations.
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• 20:02
  Speaker 4: we talk about AI and is this weird for you and
• 20:05
  Speaker 4: I because we're old enough to remember, goodness, gracious, the
• 20:09
  Speaker 4: Commodore sixty four and close systems and pharmacy software that
• 20:14
  Speaker 4: you couldn't do anything with but print a label.
• 20:17
  Speaker 5: And now we're talking about AI.
• 20:20
  Speaker 4: In healthcare and someone that remembers the dot com gold
• 20:24
  Speaker 4: Rush and so much of this technology boom. As excited
• 20:29
  Speaker 4: as I am, I'm also like apprehensive a pull back
• 20:32
  Speaker 4: a little bit. I want to talk about the governance
• 20:34
  Speaker 4: and the challenges that kind of come in with that,
• 20:36
  Speaker 4: and what better organization that has kind of written the
• 20:41
  Speaker 4: standards of accreditation in governance?
• 20:43
  Speaker 5: But talk to us a little bit about that.
• 20:46
  Speaker 6: So, you know, Todd, just if we're sharing credibility here.
• 20:49
  Speaker 6: You know, I remember the Commodore sixty four. I also
• 20:51
  Speaker 6: was in the bunker on y two K. So I
• 20:54
  Speaker 6: mean that tells you how far back I go.
• 20:56
  Speaker 7: Yeah.
• 20:57
  Speaker 6: So you know, as we think about about these things,
• 21:01
  Speaker 6: you know, technology and healthcare have been dancing for decades,
• 21:05
  Speaker 6: and as we think about AI, we say what's different
• 21:08
  Speaker 6: about AI and what's the same about AI? And there's
• 21:11
  Speaker 6: people who act like AI is just completely new, there's nothing,
• 21:15
  Speaker 6: nothing ever been done before like this. And I'll say,
• 21:18
  Speaker 6: you know, how many times have I heard that this
• 21:20
  Speaker 6: is brand new? There's nothing like this that's ever been
• 21:22
  Speaker 6: done before. And it was an echo of something that
• 21:24
  Speaker 6: had been done before. And so I spent a few
• 21:27
  Speaker 6: decades as a chief medical information officer. So it was
• 21:30
  Speaker 6: bringing technology into healthcare and finding the right balance. And
• 21:34
  Speaker 6: I always say the thing about AI is that if
• 21:36
  Speaker 6: I put in an order set into an electronic medical
• 21:40
  Speaker 6: record back in two thousand and three, the order set
• 21:43
  Speaker 6: I put in in January was the same order set
• 21:45
  Speaker 6: that was sitting there in June if I didn't touch it.
• 21:48
  Speaker 6: And now we have things that are going into healthcare
• 21:51
  Speaker 6: where it's not the same this afternoon as when you
• 21:54
  Speaker 6: last looked at it this morning. And so I think
• 21:56
  Speaker 6: that that with AI and when we talk about governance,
• 21:58
  Speaker 6: when we talk about best practices. I actually spoke on
• 22:02
  Speaker 6: AI and healthcare in twenty eighteen, and there was really
• 22:06
  Speaker 6: nothing there at the time. It was a talk to
• 22:08
  Speaker 6: a bunch of new chief Medical Information officers and it
• 22:10
  Speaker 6: was about AI and machine learning and the possible impact
• 22:13
  Speaker 6: you could have down the road. But there weren't even
• 22:15
  Speaker 6: the chips to do it back then. And now we
• 22:18
  Speaker 6: have these things where you're having a brand new version
• 22:20
  Speaker 6: of an AI tool every two weeks, and it's just overwhelming.
• 22:25
  Speaker 6: And our role in pharmacy at IRAQ has been here
• 22:27
  Speaker 6: for a couple of decades. We helped build specialty pharmacy
• 22:30
  Speaker 6: as its own area, and all the organizations that we
• 22:33
  Speaker 6: work with, you know, being that gold standard as people
• 22:36
  Speaker 6: so often talked about what URAC does, and we said,
• 22:39
  Speaker 6: you know, AI, what's good governance, what's good oversight, what's
• 22:43
  Speaker 6: good monitoring for AI? And it's built upon stuff we've
• 22:47
  Speaker 6: done before about good oversight, quality management principles, regulatory compliance
• 22:52
  Speaker 6: and those things. But what was different and so, you know,
• 22:55
  Speaker 6: we convened a group that include pharmacists, that include academic
• 22:58
  Speaker 6: medical centers, that included at the SYST, that included lawyers,
• 23:02
  Speaker 6: and we built a program from scratch, but it sits
• 23:05
  Speaker 6: on the foundation of quality principles that we've had for decades.
• 23:10
  Speaker 4: I'm glad you kind of opened up with that healthcare
• 23:14
  Speaker 4: is increasingly treating AI, like you had referenced, as clinical
• 23:18
  Speaker 4: risk management issue rather than simply a technology issue. I
• 23:23
  Speaker 4: think it's blended and I think that I think that
• 23:28
  Speaker 4: it's the physician and the pharmacist and the nurses who
• 23:31
  Speaker 4: are the protectors of our patient and that also includes
• 23:36
  Speaker 4: data leakage and other things that are happening go into that.
• 23:41
  Speaker 4: With increasingly treating AI as a clinical risk management issue, well.
• 23:46
  Speaker 6: I think that as I've said the thing about AI
• 23:49
  Speaker 6: and this mainly in medical areas, I say it's an
• 23:52
  Speaker 6: overconfident third year medical student. It has a whole ton
• 23:55
  Speaker 6: of information, but it has no background to really put
• 23:57
  Speaker 6: it into context, and it says everything with the highest confidence.
• 24:01
  Speaker 6: I mean, it sounds very convincing, but then you check
• 24:04
  Speaker 6: on it, it's like, you know, by the way, one
• 24:06
  Speaker 6: of the things you cited doesn't exist. And honestly, if
• 24:10
  Speaker 6: we had a peer who hallucinated like AI sometimes does,
• 24:13
  Speaker 6: we'd probably run a drug test. And so, so how
• 24:17
  Speaker 6: do you keep an eye on this and how do
• 24:18
  Speaker 6: you make it earn the trust as opposed to just
• 24:21
  Speaker 6: giving it the trust the day that it shows up.
• 24:24
  Speaker 6: And so one of the analogies I've drawn for it's
• 24:26
  Speaker 6: like credentialing in some respects. You know, where'd the AI
• 24:29
  Speaker 6: come from, who trained it, what did they build it
• 24:31
  Speaker 6: to do? What does it know to do? And when
• 24:33
  Speaker 6: I bring it into my system, I got to keep
• 24:35
  Speaker 6: an eye on it for a while before I turn
• 24:37
  Speaker 6: it loose. And even when I turn it loose, I
• 24:39
  Speaker 6: got to keep an eye on it because it's had
• 24:41
  Speaker 6: some behavior issues that we heard about it in its
• 24:43
  Speaker 6: last job. And so I think in the pharmacy space there,
• 24:48
  Speaker 6: you know, one of the things that comes into our
• 24:49
  Speaker 6: accreditation and we were the first to launch an AI
• 24:51
  Speaker 6: in healthcare accreditation and people looked at and they're like, oh,
• 24:54
  Speaker 6: this would be great for hospitals. And I said, it's
• 24:56
  Speaker 6: not just for hospitals, you know, it's for hospitals, it's
• 24:59
  Speaker 6: for independent clint, it's for the FQHC down on the corner.
• 25:02
  Speaker 6: It's the little pharmacy, it's the the PBM. You know,
• 25:06
  Speaker 6: we all need to have some trusted rules of the road,
• 25:08
  Speaker 6: and it needs to come from an independent organization who's
• 25:11
  Speaker 6: audited these things for years. You can't have the foxes
• 25:15
  Speaker 6: guarding the chickens. And there's so much money wrapped up
• 25:18
  Speaker 6: in this right now. I mean just trillions of dollars
• 25:21
  Speaker 6: of money that's being spent on these models, and eventually
• 25:24
  Speaker 6: the people who are building these models are going to
• 25:27
  Speaker 6: want their money back out of it. And a lot
• 25:29
  Speaker 6: of that is going into healthcare where there's just a
• 25:31
  Speaker 6: lot of money involved. And so how do you do this?
• 25:34
  Speaker 6: How do you keep an eye on it? And it's governance,
• 25:36
  Speaker 6: it's monitoring, it's it's risk evaluation, it's a plan before
• 25:40
  Speaker 6: an implementation. It's training your people, it's you know, recognizing
• 25:45
  Speaker 6: if you're using an AI tool to man your phones, Okay,
• 25:49
  Speaker 6: that's one thing. If you're using an AI tool to
• 25:53
  Speaker 6: deal with prior authorizations and clinical information, that's another thing.
• 25:57
  Speaker 6: If you're using AI for you know, drug discovery and
• 26:01
  Speaker 6: you're a pharma company, that's a whole different level of
• 26:04
  Speaker 6: risk that's involved. And let's make sure that we have
• 26:08
  Speaker 6: the right tool for the job when it comes to
• 26:10
  Speaker 6: monitoring these programs.
• 26:13
  Speaker 4: Pharmacists that I talk with all the time, my favorite
• 26:16
  Speaker 4: providers have always known, regardless of how shiny the new
• 26:22
  Speaker 4: software system is or the data analysts to report, that
• 26:26
  Speaker 4: it's their license that's on the line, it's their credibility,
• 26:29
  Speaker 4: it's their patient that they're taking care of. And pharmacists
• 26:34
  Speaker 4: that I talk with don't even use this as a
• 26:37
  Speaker 4: speed bump. They're like, listen, AI, this is cool. This
• 26:40
  Speaker 4: is amazing that it can tap into MediSpan, or it
• 26:43
  Speaker 4: can tap into an EHR, and it can access and
• 26:46
  Speaker 4: do all this coupling of information from the patient's record
• 26:51
  Speaker 4: from ten twenty years ago. And that's great, but I'm
• 26:55
  Speaker 4: always going to double and triple check it, just like
• 26:57
  Speaker 4: I would anything, just like I do when a prescription
• 27:01
  Speaker 4: came through our system ten and twenty years ago. So
• 27:05
  Speaker 4: I think that of itself helps us to understand the
• 27:08
  Speaker 4: growing role of the independent standards and the third party
• 27:12
  Speaker 4: validation and how building trust around AI is part of
• 27:17
  Speaker 4: the ecosystem of what it means to be a pharmacist.
• 27:20
  Speaker 4: The most trusted healthcare professional out there by different reports
• 27:27
  Speaker 4: that have come out over the years. But talk to
• 27:29
  Speaker 4: us about that, the role of the independent standard.
• 27:31
  Speaker 6: Yeah, so you know, you talk about licensure and you
• 27:34
  Speaker 6: talk about liability and those sort of things. I mean,
• 27:36
  Speaker 6: when I was practicing as a physician, I remember going
• 27:39
  Speaker 6: to the hospital medical records department when I was new
• 27:41
  Speaker 6: on staff, and they said, hey, we want to make
• 27:43
  Speaker 6: a stamp of your signature so we can just sign
• 27:45
  Speaker 6: your charts for you. And I said nope, I said no,
• 27:49
  Speaker 6: I worked way too long to get this license to
• 27:53
  Speaker 6: get you a rubber stamp that looks like I signed something.
• 27:56
  Speaker 6: One of the things that we do at year AC
• 27:59
  Speaker 6: is if you look at your certificates, every single certificate
• 28:02
  Speaker 6: for your AC accreditation, I hand sign here in my
• 28:04
  Speaker 6: office and and that's because that's me putting my name
• 28:08
  Speaker 6: down and my credentials down. And that's the model that
• 28:12
  Speaker 6: we've always had in healthcare is that there's there's a
• 28:14
  Speaker 6: licensed provider who is responsible for this and has the
• 28:17
  Speaker 6: final say. Our standards actually reinforce that. You know, we
• 28:21
  Speaker 6: actually we actually say it's not about a human being
• 28:24
  Speaker 6: involved in the design. It's a human being involved in
• 28:27
  Speaker 6: the design, in the training, in the rollout, in the monitoring,
• 28:31
  Speaker 6: in the program overview, in the quality monitoring, all of
• 28:34
  Speaker 6: those things. And you know, we're seeing AI tools getting
• 28:38
  Speaker 6: pushed out to organizations where the liability is all pushed
• 28:42
  Speaker 6: on the provider, but none of the information needed to
• 28:45
  Speaker 6: understand that liability goes along with it. And so that's why,
• 28:49
  Speaker 6: you know, we when we chose to build a program,
• 28:51
  Speaker 6: we were originally going to build a program that was
• 28:52
  Speaker 6: just for the users of AI in healthcare. And we
• 28:55
  Speaker 6: got the users together and they said, yes, we need that.
• 28:57
  Speaker 6: Please give us some guidance and some standards and some
• 29:01
  Speaker 6: monitoring of that. But we also need something for the manufacturers.
• 29:04
  Speaker 6: We need somebody to check on the manufacturers because we can't.
• 29:07
  Speaker 6: They're not giving us the information that we need to
• 29:09
  Speaker 6: know if they're if they've looked at data bias, if
• 29:11
  Speaker 6: they looked at protection of health information if they're clear
• 29:15
  Speaker 6: in their contracting about who has the liability and how
• 29:18
  Speaker 6: they're going to keep us on updates. And the other
• 29:20
  Speaker 6: thing that's really kind of funny is, you know, if
• 29:23
  Speaker 6: you buy a tool and you roll it into your
• 29:25
  Speaker 6: workforce and that business is actually you know, sort of
• 29:28
  Speaker 6: four guys in a garage and they go out of business,
• 29:32
  Speaker 6: where does that leave you hanging? And so we talk about,
• 29:35
  Speaker 6: you know, the liability and the responsibility and the business
• 29:38
  Speaker 6: continuity for those developers. Also, so if I were shopping
• 29:42
  Speaker 6: these days and I were looking for for somebody who
• 29:44
  Speaker 6: supplies me with an AI tool, I'd say, are you
• 29:47
  Speaker 6: accredited by your AQ as a developer? And if they are,
• 29:52
  Speaker 6: then that's going to support you to be accredited by
• 29:55
  Speaker 6: IRAQ as a user. And those those things work together,
• 29:59
  Speaker 6: and they're meant to work together other to protect the
• 30:01
  Speaker 6: providers and the pharmacists and the patients for doing things
• 30:04
  Speaker 6: in the right way in this world that's running six
• 30:07
  Speaker 6: thousand miles an hour.
• 30:09
  Speaker 5: I love it.
• 30:10
  Speaker 4: I love this discussion. I love that it's the evidence
• 30:14
  Speaker 4: based foot forward that pharmacists becoming a pharmacists studying in school,
• 30:21
  Speaker 4: all of these years of practice has always come back
• 30:25
  Speaker 4: to that assurance that their decision making is based on
• 30:30
  Speaker 4: the information, the evidence, the studies, the journals. There's nothing
• 30:34
  Speaker 4: different here, and it's good to hear an organization like
• 30:39
  Speaker 4: your AQ that's building those standards and helping us to
• 30:42
  Speaker 4: understand it so that it's demystifies AI and pharmacy and
• 30:46
  Speaker 4: it's just another it's another tool that we're going to
• 30:49
  Speaker 4: continue to mature. I have got to have you back,
• 30:53
  Speaker 4: doctor Griffin on this Week in Pharmacy.
• 30:55
  Speaker 5: This has been so much fun. Thank you so much
• 30:57
  Speaker 5: for being here today DOT.
• 31:00
  Speaker 6: I appreciate the invite and always happy to speak with
• 31:02
  Speaker 6: people who have the ear of pharmacists.