Latest / Pharmacy Podcast Network / Clearway Health, John Nosta, Perigon 360, and Psychedelics in Practice | TWIRx

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Clearway Health, John Nosta, Perigon 360, and Psychedelics in Practice | TWIRx · Pharmacy Podcast Network

0:05
Speaker 1: You are listening to the global network of podcasters dedicated
0:09
Speaker 1: to the pharmacy profession. Welcome to the Pharmacy podcast Network.
0:35
Speaker 2: This Week in Pharmacy April seventeenth, twenty twenty six. We
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Speaker 2: have four interviews for you today. It's a big one.
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Speaker 2: Starting out with Alison Aaron a rant Rant. I'm on
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Speaker 2: a rant right now on Specialty Pharmacysembia twenty twenty six.
1:10
Speaker 3: How Excited is coming.
1:14
Speaker 2: And we're gonna go over to Chris Antipas, the Doctor
1:17
Speaker 2: Antipass and Ted Mills with Paragon. Then we're gonna talk
1:25
Speaker 2: with John Nosta, my digital health godfather. He's graduated to
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Speaker 2: large language models, but the philosophy of artificial intelligence. We're
1:36
Speaker 2: gonna be talking about his book. It's gonna be great.
1:40
Speaker 2: And then finally doctor Crute Andy Krute is coming in.
1:48
Speaker 2: He's gonna be talking about psychedelics, what's the future of
1:52
Speaker 2: psychedelics and pharmacists. I'm not gonna want to miss today's
1:58
Speaker 2: This Week in Pharmacy. Hey, welcome to This Week in Pharmacy.
2:35
Speaker 2: I am your host of Tworks. We are Tworks in
2:40
Speaker 2: Tworks and it's Friday. It's a great day to be Friday.
2:43
Speaker 2: I need a weekend. I need to get prepared for
2:47
Speaker 2: the super Bowl of Specialty Pharmacy coming up of the
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Speaker 2: ASSEMBIA twenty twenty six The Access to Pharmacy. Access to
2:53
Speaker 2: Specialty Pharmacy one of my most favorite conferences of the year.
2:58
Speaker 2: If you're going, please take time to reach out to me,
3:02
Speaker 2: let me know that you're there, get involved in our
3:05
Speaker 2: press coverage. We absolutely, I absolutely love talking with people
3:10
Speaker 2: in specialty pharmacy and just game changers. I just I
3:18
Speaker 2: love people who are passionate about changing things and making
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Speaker 2: things better. And that's why I'm excited to have Paragon
3:27
Speaker 2: Health today on the show. And today's Toorks episode is
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Speaker 2: brought to you by Paragon Pharmacy three sixty and a
3:36
Speaker 2: shout out to clear Way Health. I don't know if
3:40
Speaker 2: anybody saw my videos drinking my new Clearway Health drink.
3:45
Speaker 2: We will have some Clearway Health aluminum container drinks. These
3:52
Speaker 2: things are awesome. I like I said, it tasted a
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Speaker 2: lot like Fresco, but absolutely love what they're doing doing.
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Speaker 2: Can't wait to talk with Alison a Rant and it's
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Speaker 2: just a It's an exciting time in pharmacy. I think
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Speaker 2: that the news upcoming and the expansion of specialty, the
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Speaker 2: expansion of pharmacy consultants.
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Speaker 3: I think this is a.
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Speaker 2: Big move for our pharmacy industry and I see specialties
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Speaker 2: coming out of pharmacists consulting on different things that isn't
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Speaker 2: getting enough attention. At the ASSEMBI event, it's going to
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Speaker 2: be AI and specialty pharmacy, the impact of that, very
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Speaker 2: specifically about how AI is impacting workflow, technology, drug development,
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Speaker 2: and we're going to be talking about cell and gene therapy.
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Speaker 2: We're going to be talking about women's health. Can't wait
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Speaker 2: to the event. Excited about the event, Excited about the future,
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Speaker 2: especially pharmacy. We're kind of honed into that.
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Speaker 4: Today.
5:06
Speaker 2: However, we have twerques news that I really want to
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Speaker 2: jump into because first out the FDA.
5:18
Speaker 3: According to JD.
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Speaker 2: Supra, the FDA announced it will remove twelve peptide bulk
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Speaker 2: drug substances from Category two of the Section five O
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Speaker 2: three A compounding list after their nominations were withdrawn. It
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Speaker 2: goes on to say that the agency also scheduled Pharmacy
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Speaker 2: Compounding Advisor Committee meetings for July twenty third through twenty fourth,
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Speaker 2: this summer twenty twenty six, and again before the end
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Speaker 2: of February twenty twenty seven to consider whether these peptides
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Speaker 2: should be added to the five five three A bulk
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Speaker 2: list goes on to say, the important takeaway for compounders
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Speaker 2: is that removal from category two does not automatically authorize compounding,
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Speaker 2: so pharmacy still face regulatory risk until the FDA takes
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Speaker 2: further action. I'd like to hear from our compounding pharmacist
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Speaker 2: experts on this. I'd like to do a follow up,
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Speaker 2: so shout out to the a PC Scott Brunner and
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Speaker 2: his team keeping us all safe in the pharmacy compounding sector.
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Speaker 2: But you will find this information on JD Supra once
6:48
Speaker 2: again JD Supra s U p r A Supra dot com.
6:53
Speaker 2: The news just came out this week in pharmacy. Hey,
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Speaker 2: next up, xan X maker recalls a batch of cont
7:04
Speaker 2: the common anxiety drug. Big news out of the Seattle
7:08
Speaker 2: Times reporting this is a big news for mental health. Also,
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Speaker 2: I can only imagine what pharmacists are going through in
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Speaker 2: some of the issues that this is going to cause,
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Speaker 2: and strife that it's going to cause, and her hyper
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Speaker 2: hyperboil and hyperbole that it's going to cause. A recalled
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Speaker 2: batch of xan x x rs drawing attention. Nationwide. Reporting
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Speaker 2: is tied to the Seattle Times story to confirm by
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Speaker 2: additional information regarding the FDA classified a Class two recall
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Speaker 2: for xan x x R three milligram tablets in sixty
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Speaker 2: count bottles. It even gives the lot. I'm going to
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Speaker 2: put this in our show notes. It's lot eight one
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Speaker 2: seven seven one five six. That's eight one seven seven one.
8:02
Speaker 2: After the product failed dissolution specifications. The recall product was
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Speaker 2: distributed nationwide by viatrists, Specialty LLC, and pharmacists are being
8:18
Speaker 2: advised to identify and quarantine affected inventory, while warning patients
8:25
Speaker 2: not too abruptly discontinue benzo diazepine therapy without clinical guidance.
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Speaker 2: Something for pharmacists to be aware of. I'm sure you
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Speaker 2: already know and you know it's it's big news. We've
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Speaker 2: heard it on we've heard it, we've heard it through
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Speaker 2: the instagram sphere and.
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Speaker 3: Being paid attention.
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Speaker 2: I learned so much from social media from credible sources.
8:55
Speaker 2: Most of my sources on social media are pharmacists. But
9:00
Speaker 2: to be able to listen to some news story from
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Speaker 2: a pharmacist perspective is really special and then to be
9:13
Speaker 2: able to trust that source is really special. Hey, our
9:19
Speaker 2: last story comes from Pharmacy Times Pharmacy fifty Influencer.
9:25
Speaker 3: The winner of the of last year's.
9:32
Speaker 2: Pharmacy fifty Most Influential doctor Nadia Ahmad. She's making waves
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Speaker 2: in pharmacy. It all started with her concern with her
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Speaker 2: patients specifically and how she's dialing in. She is a
9:45
Speaker 2: pharmacist for Walgreens. Let's listen in.
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Speaker 5: In the United States, about ninety percent of American live
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Speaker 5: within five miles, so for community pharmacy see and studies
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Speaker 5: shows that patients often seeing their pharmacists far more frequently
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Speaker 5: than their primary care providers, and because of that accessibility,
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Speaker 5: pharmacists are often the first healthcare professionals patients turned to
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Speaker 5: when something unexpected happens, including wood care situations. In my
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Speaker 5: practice as a community pharmacy I see this very often.
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Speaker 2: So shout out to Nadilla and her work drug Topics
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Speaker 2: is highlighting.
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Speaker 3: A growing role. The growing role of.
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Speaker 2: Community pharmacy in wound care absolutely makes sense. You're seeing
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Speaker 2: patients all the time, You're seeing people all the time,
10:43
Speaker 2: emphasizing that pharmacies can serve as an accessible first stop
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Speaker 2: for patients with everyday wounds. This piece really drives into
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Speaker 2: the ability to become more woond care expert and having
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Speaker 2: that expertise answering a lot of questions for OTC care
11:02
Speaker 2: as well as anything that's needed in the prescription realm
11:06
Speaker 2: and even compounding. Just another example of Pharmaci's expanding role
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Speaker 2: in frontline clinical value and the business of pharmacy and
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Speaker 2: how our community pharmacies can step up, our independence can
11:23
Speaker 2: step up and start providing new, different, different services and
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Speaker 2: hopefully tie that back into more cash based systems or
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Speaker 2: something that you can work with the patient and step
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Speaker 2: outside of that the clutch of the PBM per se.
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Speaker 2: But services are going to definitely increase in our pharmacies,
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Speaker 2: especially those places that are pharmacy deserts.
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Speaker 3: We just don't have enough coverage.
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Speaker 2: Hey, clear Way Health coming up next right after this
11:54
Speaker 2: special message from our sponsor.
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13:06
Speaker 2: Hey, welcome back to this week in Pharmacy. This week
13:11
Speaker 2: in Pharmacy is hot. This week there's so much going on.
13:15
Speaker 2: I wanted to say thank you so much to Chris
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Speaker 2: for coming down to the studio from I think South
13:22
Speaker 2: Hills Astes pharmacy area. It's probably like a forty five
13:27
Speaker 2: forty five minute drive. It's my dream to build a
13:31
Speaker 2: studio north of Jupiter, Florida. If you guys are know
13:35
Speaker 2: where Jupiter is. My family lives up in Vero Beach.
13:39
Speaker 2: I want a studio on a one A which is
13:42
Speaker 2: right on the coast, and we'll have to have some
13:45
Speaker 2: twerks parties there too.
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Speaker 3: I guarantee it.
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Speaker 2: Hey, I'm throwing a party here at twerks today because
13:51
Speaker 2: this next segment is literally happening this week in pharmacy.
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Speaker 2: On Wednesday of this week in pharmacy, med Center Health
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Speaker 2: partners with Clearway Health to establish a specialty pharmacy program.
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Speaker 2: The stock of Fresca is going to go up this
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Speaker 2: week because of that partnership. Just getting a reference to
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Speaker 2: our Instagram and Fresca. It's probably my favorite drink right now.
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Speaker 2: And I was drinking out of my Clearway Health mug
14:22
Speaker 2: and absolutely love the mug. And I want to welcome
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Speaker 2: back my friend from Clearway Health, Alison A.
14:30
Speaker 3: Rant. It is so good to have you back on twerqus.
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Speaker 7: Hey Todd, it's good to be here and thanks for
14:37
Speaker 7: having me.
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Speaker 3: It's good to see you. Good to be back.
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Speaker 2: Last time you were here was December of twenty twenty five,
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Speaker 2: and all of a sudden, we blink, and now it's
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Speaker 2: second quarter of twenty twenty six. It's almost time for
14:50
Speaker 2: assembia crazy fast. I don't understand what's going on. Why
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Speaker 2: time seems like it's speeding.
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Speaker 7: Up crazy fast.
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Speaker 8: If time goes by that fast and you have your
15:00
Speaker 8: Vera Leach Studio, next time, I'm here.
15:03
Speaker 7: I will happily you come visit.
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Speaker 3: You there please, that would be so much fun.
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Speaker 2: Congratulations on this week in pharmacy and the success that
15:13
Speaker 2: you're having.
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Speaker 3: And what I'm most excited.
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Speaker 2: About is these rural areas of America which are suffering
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Speaker 2: with pharmacy desert pressures and there's no access to the care.
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Speaker 2: Now we come to a hospital system and we insert
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Speaker 2: a designed program to pull out the needs of that
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Speaker 2: community through that hospital system.
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Speaker 3: I absolutely love this story.
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Speaker 2: I'm always leaning towards the independent pharmacist out there, also
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Speaker 2: the independent health systems that are just trying to serve
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Speaker 2: their community, and you guys step in as the specialists
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Speaker 2: in specialty pharmacy to share with our listeners about that.
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Speaker 8: Thank you, thanks for the congrats. We are so excited
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Speaker 8: to announce our partnership with Mediciner Health. But I have
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Speaker 8: to say it's truly congratulations to Mediciner Health for choosing
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Speaker 8: to build a specialty pharmacy program to support their patients
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Speaker 8: and their care teams and their communities. We are thrilled
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Speaker 8: that they chose clear Way Health as their partner. They
16:14
Speaker 8: are in Bowling Green, Kentucky and have done incredible work there.
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Speaker 8: They're actually celebrating their one hundred year anniversary this year
16:22
Speaker 8: in twenty twenty six, and so they've been serving Bowling
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Speaker 8: Green in the surrounding areas for a century and we
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Speaker 8: are thrilled to go into the next century offering specialty
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Speaker 8: pharmacy services to them. You know, they have long provided
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Speaker 8: in patient pharmacy services and some retail services that had
16:41
Speaker 8: never made the jump into specialty, and they realized over
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Speaker 8: the last several years there's just incredible opportunity to serve
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Speaker 8: their patients better, to provide better services to their clinicians,
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Speaker 8: and then to provide a really strong financial engine for
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Speaker 8: the system through specialty pharmacy. So they have a lot
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Speaker 8: of considerations when they were choosing a partner, and truly
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Speaker 8: truly grateful that they chose their way health and commend
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Speaker 8: them through their decision to explore specialty pharmacy.
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Speaker 2: It makes sense back to when Chris was here just left,
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Speaker 2: he and I were talking about the trust that's built
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Speaker 2: in complex disease states and how if you had your
17:26
Speaker 2: hospital system, or you're in the hospital system, you're in
17:29
Speaker 2: therapy and then all of a sudden, now it's time
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Speaker 2: to start your treatment in your specialty medication to the patient.
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Speaker 2: It still feels like that they're part of their local hospital.
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Speaker 3: It still feels like.
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Speaker 2: I know my physician and I know other people that
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Speaker 2: are supporting me. There's an element in the in the
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Speaker 2: ecosystem of care, the psychology of care, the mental health
17:52
Speaker 2: of care. I think this is a huge win for
17:55
Speaker 2: bulling Grain and keeping that local feel of the patients.
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Speaker 8: You're exactly right, you know, we talk so much about
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Speaker 8: the impact that a specialty therapy has on a patient,
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Speaker 8: whether it's a therapy that they have been on for
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Speaker 8: weeks or months or years, or whether it's a new
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Speaker 8: diagnosis that they're hearing for the first time and they're
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Speaker 8: starting a therapy journey that will truly be life changing
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Speaker 8: or life saving. We actually a few weeks ago were
18:24
Speaker 8: together as a leadership team at Clearway Health and had
18:28
Speaker 8: a pay it Forward event where we put together kids
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Speaker 8: that mentioned your health will provide to their oncology patients
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Speaker 8: when they have a new diagnosis and are starting a
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Speaker 8: new specialty therapy. And it was this moment of realizing
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Speaker 8: that you were providing service and a care to a
18:45
Speaker 8: patient who could have just had the worst day or
18:48
Speaker 8: the hardest news of their life. And so if we
18:52
Speaker 8: can be a partner to a patient and a care
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Speaker 8: team and the care providers in that scenario, it is
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Speaker 8: an incredible honor. And so, you know, you talk about
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Speaker 8: the impact that it has on patients. When a hospital
19:03
Speaker 8: or a health system provides specialty pharmacy services in an
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Speaker 8: environment where a patient is already comfortable and confident and
19:10
Speaker 8: familiar receiving care, there is no better person to serve
19:15
Speaker 8: that patient than the health system where they're used to
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Speaker 8: receiving care. So truly a great opportunity from a patient
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Speaker 8: share perspective and from a market share perspective for the
19:25
Speaker 8: hospital where they're able to protect and defend market share
19:28
Speaker 8: that is becoming a lot more saturated, especially in the
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Speaker 8: specialty pharmacy space.
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Speaker 2: If you're listening, you are working in health system, you
19:39
Speaker 2: are working on the hospital systems, you're going to assembly,
19:42
Speaker 2: you're exploring what's out there in specialty. You may be
19:46
Speaker 2: making decisions are we going to take on the responsibility
19:49
Speaker 2: of building out a specialty pharmacy or are we partnering
19:52
Speaker 2: with an organization. Alison and your team are going to
19:55
Speaker 2: be there. You're going to be almost like a mission
19:59
Speaker 2: and poss secret agents floating around the event, you know,
20:03
Speaker 2: scheduling the one on ones and digging into those conversations
20:07
Speaker 2: help come to those decisions. Ascembia is a special time,
20:12
Speaker 2: it's it's a special time. It's the super Bowl of
20:14
Speaker 2: specialty pharmacy. It's bringing all of these minds together and
20:18
Speaker 2: the insights together. But for me, I really like the
20:22
Speaker 2: business aspect of being able to shake a hand of somebody.
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Speaker 2: This age of digital and constantly zooming with each other,
20:30
Speaker 2: but to be able to physically get together with each other.
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Speaker 2: It's such a special time. It's one of my favorite events.
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Speaker 3: Every year.
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Speaker 7: It's a great event. We're excited to be there.
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Speaker 8: And you know, you talk about the networking, I think
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Speaker 8: so often, especially when you think about the pharmacy space,
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Speaker 8: there are so many verticals.
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Speaker 7: There are so many solutions.
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Speaker 8: You know, we stretch from the entrance of AI and
20:50
Speaker 8: how it powers technology. We think about innovative spaces that
20:54
Speaker 8: have been long known but continue to do incredible work
20:57
Speaker 8: in spaces psyche gene and cell therapy, and you think
21:00
Speaker 8: about the health systems who are figuring out how to
21:03
Speaker 8: balance all of that. When you think about the partners,
21:06
Speaker 8: the folks like Clearway Health, it's incumbent upon us to
21:09
Speaker 8: think about ways that we built partnerships with other partners
21:11
Speaker 8: in the space so that we are truly providing the
21:14
Speaker 8: best kind of connected service for hospitals. So a lot
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Speaker 8: of opportunity at a Cymbia. We're really looking forward to
21:21
Speaker 8: being there.
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Speaker 2: Alison, you just hit on all three of our major
21:25
Speaker 2: themes covering the event. I want the listeners to also participate.
21:29
Speaker 2: You want to sign up for a press insight quote,
21:33
Speaker 2: You're more than welcome to.
21:34
Speaker 3: I'll put a show in the show notes.
21:37
Speaker 2: I'll put a link where you can actually get your
21:39
Speaker 2: time scheduled. But you mentioned women's health, you mentioned selling
21:44
Speaker 2: gene therapy, and you mentioned AI in pharmacy, AI's impact
21:49
Speaker 2: on specialty pharmacy. All three of these Clearway Health has
21:54
Speaker 2: connections into that kind of Talk to me about the
21:59
Speaker 2: women's health in your experience, what have you seen in
22:05
Speaker 2: the advancement of you know, things that are happening specifically
22:11
Speaker 2: in the uterus, or people struggling with getting pregnant or
22:17
Speaker 2: going through menopause, or what aspects of women health has
22:20
Speaker 2: really stuck out to you lately in being advanced in
22:23
Speaker 2: us getting more attention around it.
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Speaker 8: Yeah, I will say bravo to all advancements being made
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Speaker 8: in women's health, a space where we have long needed
22:34
Speaker 8: modernization and ways that we're just learning and doing better.
22:38
Speaker 7: And so I'll start by saying that.
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Speaker 8: From a specialty pharmacy lens, if you look at the
22:43
Speaker 8: drug pipeline, I'm incredibly excited to sit in on the
22:46
Speaker 8: sessions coming up here at a SYNBIA in a few
22:48
Speaker 8: weeks to really hear about the new novel therapies that
22:51
Speaker 8: are coming out, especially in the women's space. But for
22:54
Speaker 8: specialty pharmacy, I do not think women's services is often
22:59
Speaker 8: a service line that hits the top. You know, we
23:02
Speaker 8: think oncology, rheumatology, derm, you know the ones that should
23:06
Speaker 8: be at the top, and we have women's health and.
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Speaker 7: Have had a lot of success.
23:11
Speaker 8: When we've thought about specialty drugs in the way of access,
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Speaker 8: it is not always about cost, though it's certainly a
23:18
Speaker 8: key driver.
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Speaker 7: It's also about access.
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Speaker 8: And when you think about access to therapies that are
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Speaker 8: needed for reproductive therapy as an example, we have built
23:28
Speaker 8: programs inside of reproductive clinics where we are helping women
23:31
Speaker 8: and families access in a forward medication that are complex
23:36
Speaker 8: and that are expensive, that often are not covered by
23:40
Speaker 8: you know, payer commercial plans, and so we are helping
23:43
Speaker 8: to enable patients to access that kind of care, especially
23:47
Speaker 8: in the reproductive space. And so I would say, as
23:50
Speaker 8: folks are sitting at a cynthia and thinking about places
23:52
Speaker 8: where specialty pharmacy fits in your organization, don't overlook women's
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Speaker 8: health the obgyn clinics, especially in the reproductive therapy services,
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Speaker 8: and thinking about ways that specialty pharmacy can be an
24:04
Speaker 8: extension of that.
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Speaker 3: That is a special in and of itself.
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Speaker 2: And therein lies the sweet sauce of it that the
24:13
Speaker 2: pharmacist that has the experience, the team that surrounds the
24:18
Speaker 2: pharmacist that has the experience, that understands the prior authorization.
24:22
Speaker 3: Hurdles right from the get go.
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Speaker 2: They're like, oh, this NDC is definitely going to trigger this, this, this,
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Speaker 2: We're prepared for it so that we get the medication
24:30
Speaker 2: started faster, so that we get over the potential hurdles
24:35
Speaker 2: of the way PBMs kind of do things and sometimes
24:39
Speaker 2: muck things up and keeping people on therapy because of
24:42
Speaker 2: where the payment's coming from. Follow up, and then of
24:47
Speaker 2: course all the other factors like getting people to their
24:50
Speaker 2: doctor's appointments, and there's just so much more to it.
24:53
Speaker 2: So that's why I love when we come together and
24:56
Speaker 2: we're able to talk with each other but ask questions
25:00
Speaker 2: of each other. It's not just showing up and throwing up.
25:02
Speaker 2: It's like, Hey, here's what this last session was about.
25:06
Speaker 2: I'm having challenges as a business organization really scaling and
25:11
Speaker 2: getting more coverage in places where, like you said as
25:14
Speaker 2: we started out, pharmacy deserts are eating away at the
25:17
Speaker 2: healthcare available. Sometimes pharmacy is the only healthcare service in
25:22
Speaker 2: twenty miles of a community that doesn't have public health
25:25
Speaker 2: transport or it doesn't have public transportation. So when you
25:29
Speaker 2: think of the challenges we're all meeting up at Ascembia,
25:34
Speaker 2: is there anything that sticks out Allison that you're like,
25:37
Speaker 2: we should really hammer more on this issue because of
25:41
Speaker 2: you seeing it through the data that you guys, the
25:43
Speaker 2: powerful data that you're collecting, and the insights that you understand.
25:47
Speaker 3: What is that What is that theme that we need
25:49
Speaker 3: more attention on.
25:51
Speaker 7: Yeah?
25:52
Speaker 8: Yeah, I think it's a lot of the things that
25:53
Speaker 8: you mentioned that probably connect together into this common theme
25:57
Speaker 8: of helping hospitals and health systems have the enablement to
26:02
Speaker 8: provide the service in their local community, and I think
26:05
Speaker 8: we all play a part in that.
26:07
Speaker 7: You know, you've mentioned pharmacy.
26:08
Speaker 8: Deserts, You've talked about competitive environments for hospitals to function in.
26:13
Speaker 8: One of the things that we think about so often
26:15
Speaker 8: is kind of a combination of all of those things
26:18
Speaker 8: plus some of the social determinants of health concepts that
26:21
Speaker 8: you mentioned. So let's first take pharmacy deserts. If you
26:25
Speaker 8: think about the definition of a pharmacy desert and a
26:27
Speaker 8: suburban area, it is not having a pharmacy within five
26:32
Speaker 8: miles of where you live. In a rural area, it's
26:35
Speaker 8: not having a pharmacy within ten miles of where you live.
26:38
Speaker 8: But then you take that step further and say, even
26:41
Speaker 8: if there's a pharmacy within that mile radius, is their access,
26:45
Speaker 8: is their transportation? Is there the ability to travel? And
26:49
Speaker 8: so you take those compounding challenges and then you look
26:52
Speaker 8: at health systems who are facing increasing pressures regulatory, financial pressures,
26:57
Speaker 8: compliance pressures, and you look at a decisions that are
27:01
Speaker 8: being made oftentimes through retail big box chains and pharmacies
27:05
Speaker 8: who are choosing to close their doors, But a hospital
27:09
Speaker 8: doesn't choose to close their doors when their margins are
27:11
Speaker 8: scarce or thin. And so you have hospitals who were
27:15
Speaker 8: truly the definition of doing more with less, providing care
27:19
Speaker 8: to communities of people who rely on it desperately in
27:23
Speaker 8: a more challenging environment. And so what we think about
27:26
Speaker 8: solving for is how do we help hospitals provide a
27:30
Speaker 8: service line that is going to care for those patients
27:33
Speaker 8: and create financial transformation so that they can continue to
27:37
Speaker 8: offer services to the community who needs it. The other
27:40
Speaker 8: part of that is just the increasing competitive pressure that
27:44
Speaker 8: we're seeing in healthcare through so much vertical consolidation.
27:48
Speaker 7: We for many years have.
27:50
Speaker 8: Seen non traditional entrants into the hospital markets, where maybe
27:55
Speaker 8: you have payers, you have retail chains, you have urgent
27:58
Speaker 8: care chains who are who are coming in and competing
28:02
Speaker 8: for business that hospitals have long been the providers of.
28:07
Speaker 8: And so I think we have to step back and think,
28:10
Speaker 8: how do we equit the hospitals to do the care
28:13
Speaker 8: that they're there to provide without creating a more complex
28:18
Speaker 8: competitive environment where it becomes more difficult for them to
28:21
Speaker 8: do that life changing, life saving work. So, you know,
28:24
Speaker 8: there's a lot of underpinnings of that. You have to
28:26
Speaker 8: have the data, you have to understand the opportunity, you
28:29
Speaker 8: have to understand the risk you know and have.
28:31
Speaker 7: The propensity to do the work that matters.
28:34
Speaker 8: And then I think about the advocates and the folks
28:36
Speaker 8: who are into space who are really helping to support
28:39
Speaker 8: these hospitals and the work that they're doing. So to
28:41
Speaker 8: the folks who are listening who are not on the
28:44
Speaker 8: hospital health system side, I would say, figure out.
28:46
Speaker 7: How to do your part. Don't make it harder. And
28:49
Speaker 7: for the.
28:49
Speaker 8: Hospitals and help systems, I would say, look for the
28:52
Speaker 8: helpers and the experts who can help you do that
28:54
Speaker 8: hard work because we're here.
28:58
Speaker 3: Thank you for saying that.
29:00
Speaker 2: And it doesn't have to be a competitive situation. It
29:04
Speaker 2: can be, Hey, we're doing this together for the betterment
29:07
Speaker 2: of access to care within this community that we know
29:10
Speaker 2: is suffering because your local independent.
29:15
Speaker 3: Community wall well you know.
29:16
Speaker 2: Pharmacy just closed, and then your two chained pharmacies of
29:22
Speaker 2: one of them has closed or another has closed, like
29:24
Speaker 2: this is happening all across the country. It's everybody knows
29:27
Speaker 2: within within pharmacy with the pinches and what it feels
29:30
Speaker 2: like and but the solution is coming together. It's it's
29:35
Speaker 2: working together, it's using each other's strengths. That's why we
29:38
Speaker 2: use podcasting in public relation campaigns because it's like, hey,
29:42
Speaker 2: you might not have read the press release, but you're
29:44
Speaker 2: tuned into twerks today, and now you know that there's
29:48
Speaker 2: another hospital system that's now being empowered by an expert
29:51
Speaker 2: organization who really understands workflow and specialty and all of
29:56
Speaker 2: the intricacies. There's so many like tiny little Nixon crannies
30:00
Speaker 2: that or what you can get stuck on from preventing
30:03
Speaker 2: care to flow. Later on the show, today, John Nosta
30:08
Speaker 2: comes back. He's been my I called him my digital
30:12
Speaker 2: health godfather ten years ago, but he's really evolved to
30:16
Speaker 2: large language models and how to leverage clinical data into
30:21
Speaker 2: an AI machine that really knows how to pull out
30:24
Speaker 2: specific things. One of our the other one of the
30:28
Speaker 2: other three segments of Assembia for Us is going to
30:31
Speaker 2: be covering how does AI impact specialties specifically, So share
30:36
Speaker 2: share with our listeners your experience in leveraging artificial intelligence
30:42
Speaker 2: in the specialty pharmacy space.
30:45
Speaker 8: I think there is a tremendous amount of opportunity to
30:48
Speaker 8: use it in the right and productive ways to power
30:51
Speaker 8: specialty pharmacy.
30:53
Speaker 7: I think some of the.
30:54
Speaker 8: Areas are even things like with benefits investigation or payer
30:59
Speaker 8: assistance programs where we're looking for financial assistance for patients,
31:04
Speaker 8: really using those opportunities for AI as ways to power
31:08
Speaker 8: better workflows so that the liisons and the caregivers are
31:12
Speaker 8: able to spend more time with the patient and have
31:14
Speaker 8: AI work in a supportive role. And I think that's
31:17
Speaker 8: really consistent with the way that Clearway Health approaches our
31:20
Speaker 8: philosophy on technology. We are a service organization that's powered
31:25
Speaker 8: by technology. So first we have the people who are
31:29
Speaker 8: doing the work on the frontlines caring for the patients,
31:32
Speaker 8: supporting the providers and the clinicians and the care teams.
31:36
Speaker 8: And then you have Charter, which is our proprietary software
31:39
Speaker 8: that works as a pharmacy management system in the background,
31:43
Speaker 8: really doing the work that no other technology is doing.
31:46
Speaker 8: It's not a replacement of an EHR, it's not a
31:49
Speaker 8: replacement of a dispensing system, but really in overlay and
31:53
Speaker 8: filling a gap that is otherwise created in the technology
31:57
Speaker 8: components of that care continuum. And I think there are
32:00
Speaker 8: many points of that patient journey where AI has a role,
32:04
Speaker 8: and so I think looking more into those areas like
32:08
Speaker 8: the benefits, the insurance work, the prior authorization work that
32:11
Speaker 8: is an incredible burden, and certainly the financial assistants are
32:15
Speaker 8: places to get started. And then you know, I'm interested
32:18
Speaker 8: to hear more later about the work, especially in the
32:20
Speaker 8: clinical spaces where AI is powering, even things like childs
32:24
Speaker 8: and work that is happening to continue to drive the
32:27
Speaker 8: work in the drug pipeline.
32:30
Speaker 2: Allison so excited that we're going to get to spend
32:33
Speaker 2: some time together in two weeks at the Super Bowl
32:35
Speaker 2: of Specialty Pharmacy as SMBIA twenty twenty six. We have
32:40
Speaker 2: several segments of the show that Clearway Health is going
32:44
Speaker 2: to be helping to draw out some of the dig
32:46
Speaker 2: deep a little bit deeper into some of the issues
32:48
Speaker 2: that we're talking about. I'm excited to see you in person,
32:52
Speaker 2: get some pictures. Wish we had some time to do
32:56
Speaker 2: something fun. It's so funny, Like I'll have relatives of
33:01
Speaker 2: mine who my my brother is an electrician, for example,
33:06
Speaker 2: and and when I'm traveling, he's like, it's so nice
33:09
Speaker 2: that you get to go to all these places, and
33:11
Speaker 2: I'm like, you know sometimes I see the inside of
33:15
Speaker 2: an airport, I see the uber, I see the conference hall,
33:20
Speaker 2: I see my room, possibly a restaurant, and then I
33:24
Speaker 2: see the airport again, like and it's like I never
33:26
Speaker 2: get to really like get out there. Like I know
33:28
Speaker 2: there's a TV riding in Las Vegas. I know that
33:31
Speaker 2: there's like, you know, things I could be doing, and
33:33
Speaker 2: I'm like, I'm not gonna I'm not gonna get to
33:35
Speaker 2: see any of it.
33:37
Speaker 9: But you could.
33:38
Speaker 7: You could lots to choose from. But there's there's lots
33:41
Speaker 7: in Vegas. There will be lots of the Sylvia. I'm
33:43
Speaker 7: really excited to.
33:44
Speaker 9: See you too.
33:46
Speaker 2: I want to thank Clearway Health for being our press
33:50
Speaker 2: support sponsor for the event.
33:52
Speaker 3: We're so excited to be working with you.
33:55
Speaker 2: Get your get your mug, get your metal, clear Way
33:58
Speaker 2: Health Aluminum.
34:00
Speaker 3: Lu. I love that. I love my mug.
34:02
Speaker 2: I left it upstairs before we started recording, Otherwise I'd
34:05
Speaker 2: have been sipping my fresca here talking with you.
34:08
Speaker 7: That is great.
34:09
Speaker 8: Well, I really appreciate your partnership. Thanks for having me,
34:12
Speaker 8: and I will see you very soon.
34:14
Speaker 3: We'll see you soon.
34:15
Speaker 2: Stay tuned for a a great interview with doctor John
34:19
Speaker 2: NaSTA coming up on twerks. Hey, welcome back to this
34:57
Speaker 2: week in Pharmacy. It is a interesting week we are
35:02
Speaker 2: preparing for as NBA. As we've said, I want to
35:05
Speaker 2: just emphasize reach out to me. If you're going to
35:08
Speaker 2: the super Bowl of a Specialty pharmacy twenty seventh I
35:12
Speaker 2: think yeah, April twenty seventh through twenty ninth. Hey, listen,
35:16
Speaker 2: there is a book out that I have ordered. I
35:21
Speaker 2: just put my order in. My book's supposed to be
35:23
Speaker 2: here on Saturday. There'll be some great reading for Sunday.
35:27
Speaker 2: I love reading on Sundays. The Borrow Mind Reclaiming Human
35:31
Speaker 2: Thought in the Age of AI by John Nosta, my
35:36
Speaker 2: special friend, one of the first big names that came
35:41
Speaker 2: to the Pharmacy podcast Network years ago.
35:44
Speaker 3: I want to welcome back, John NaSTA.
35:51
Speaker 9: I am back in right, Okay, what a pleasure to
35:55
Speaker 9: be here. We go back a long long time, Todd.
35:59
Speaker 9: I remember the golden age of podcasting and some of
36:03
Speaker 9: the things that you've been doing and see the evolution
36:06
Speaker 9: of your contribution to pharmacy to medicine. It's been amazing
36:12
Speaker 9: watching you. So thanks, thanks again, and it's great to
36:14
Speaker 9: be back. It's great to have you back. I'll never
36:17
Speaker 9: forget the email that I wasn't sure where it was
36:20
Speaker 9: going to go and if I was going to get
36:21
Speaker 9: a response, and you responded I think the same day,
36:25
Speaker 9: and you're like, yeah, I'll be on your podcast, and
36:27
Speaker 9: I was just blown away and it.
36:28
Speaker 2: Was it's pretty cool. So you've taught me a lot.
36:31
Speaker 2: You introduced me to You've been an incredible branch in
36:37
Speaker 2: the age in the evolution of my career. You've introduced
36:41
Speaker 2: me my dear friend, our dear friend, Gilbash with Finn Partners.
36:45
Speaker 2: We're going to be interviewing him later today on his
36:48
Speaker 2: new book. And things are happening. Meaning I understand. When
36:53
Speaker 2: I came into pharmacy in healthcare two thousand and four,
36:57
Speaker 2: we were entering the age of sequels server. You were
37:00
Speaker 2: able to access data in ways you never did before.
37:03
Speaker 2: People were going nuts. It was wonderful. It's now we're
37:07
Speaker 2: in this I feel like we're in a whole new
37:09
Speaker 2: season and cycle because of what's happening with the implementation
37:13
Speaker 2: and leverage of AI and things that you bring to
37:17
Speaker 2: mind are much more. Instead of the sectors of pharmacy
37:21
Speaker 2: who pay attention, we've got specialty who's building out systems.
37:24
Speaker 2: We're going to be talking about that at ASSEMBIA. We've
37:27
Speaker 2: got health systems that treat things differently because it's EHR driven.
37:32
Speaker 3: We have.
37:32
Speaker 2: So you kind of slow everybody down with this book
37:35
Speaker 2: and you explore what happens when human thought takes place
37:38
Speaker 2: in the presence of systems that generate fluent language, but
37:42
Speaker 2: they don't understand there's no responsibility. That reminds me of
37:46
Speaker 2: my favorite movie line, one of my favorites, that is
37:49
Speaker 2: with great response, with great power comes great responsibility. John,
37:54
Speaker 2: talk to our listeners and open up about where this
37:57
Speaker 2: book takes us.
37:58
Speaker 9: With great power, let's just talk about those first three words.
38:07
Speaker 9: In today's world, we often talk about great power in
38:10
Speaker 9: the context of AI as being the fat powerful domain.
38:16
Speaker 9: The computer is more and more powerful we scale it.
38:19
Speaker 9: It has more parameters, It has a dimensionalization that actually
38:25
Speaker 9: becomes less clear in essence. I have a V six
38:33
Speaker 9: HEMI engine, right, I mean, you probably know what that means,
38:36
Speaker 9: but most people will say hemy and like what hemy?
38:41
Speaker 9: You know, obviously it's a hemispherical piston head or even
38:43
Speaker 9: things like rack and pinion steering. You know cars have
38:46
Speaker 9: rack and pinion steering, but nobody knows what the opinion is, right,
38:50
Speaker 9: it just sounds good. And what we're moving into is
38:53
Speaker 9: this hypertechnology domain where we've got bits and bytes and
38:57
Speaker 9: parameters and aspects of AI that is sort of defining power.
39:03
Speaker 9: But to me, I think that the ultimate power that
39:05
Speaker 9: we need to understand is the power of the human.
39:09
Speaker 9: And the book started off, Actually, it's an interesting story.
39:14
Speaker 9: The book started off a year or so ago and
39:18
Speaker 9: the title was The Cognitive Age. I probably even talked
39:22
Speaker 9: to you a little bit about it, Sean, we talked.
39:25
Speaker 9: We started with this idea of Gutenberg unlocked words with
39:30
Speaker 9: the printing press, and then the AI. I'm sorry, the
39:33
Speaker 9: Internet came along with Google and unlocked facts and that
39:37
Speaker 9: was where we kind of wallowed for many years in
39:39
Speaker 9: pharmacy and medicine that we had access to a lot
39:42
Speaker 9: of information, but the information was not always connected. The
39:46
Speaker 9: word interoperatability came up a lot, the word the digital
39:51
Speaker 9: agent DIG digital transformation. But while Gutenberg unlocked words and
39:57
Speaker 9: the Internet unlocked facts, you know, a kind of cold
40:00
Speaker 9: hearted transational way, what AI did, particularly large language models,
40:04
Speaker 9: is they unlocked thought. And that's a really freaky thing
40:09
Speaker 9: when you think about it, because thought is something that's
40:13
Speaker 9: intrinsically human. So here I am writing this book, cobbling
40:17
Speaker 9: it together based upon a lot of my writing, my
40:20
Speaker 9: writing in psychology today, and I realize that there's something
40:24
Speaker 9: more important going on here. And it certainly touched on
40:29
Speaker 9: these issues of hallucinations, of the synchophatic nature of large
40:34
Speaker 9: language models, where they speak to us in ways that
40:37
Speaker 9: satisfy our own personal needs and are almost corrupting in
40:42
Speaker 9: a certain way. So I stop. I came full stopper said, wait,
40:45
Speaker 9: something is more important there. I don't want to write
40:46
Speaker 9: another book about horay hoay for AI. Everybody's writing those
40:51
Speaker 9: books today, how technology will change life, how technology would
40:54
Speaker 9: change medicine. To me, it came down to something much
40:56
Speaker 9: more important, how will technology change the way I think?
41:01
Speaker 9: Because what AI is doing for me is something very
41:05
Speaker 9: very curious. It's getting to the answer very quickly. It's
41:10
Speaker 9: getting from A to B. Write a discharge summary, Tell
41:13
Speaker 9: me the drug drug interactions of amiodorone with a patient
41:17
Speaker 9: who's on concomin at meds. Right. These are often complicated
41:22
Speaker 9: clinical dynamics, but the information comes at us very very quickly.
41:26
Speaker 9: In essence, we get from point A to point B
41:30
Speaker 9: in an instant. But what lives between point A and
41:33
Speaker 9: point B error failure. Perhaps the most interesting word for
41:41
Speaker 9: me is imagination. So what happens when we get the
41:45
Speaker 9: answer and the answer is served up in a way
41:49
Speaker 9: that sounds like it's the chief of medicine answering the
41:51
Speaker 9: question personal into your query about amiodorone with respect to
41:54
Speaker 9: cordial micro thepolitan and a patotaxicity. There's you know, it
41:59
Speaker 9: already sounds good, right, it sounds coherent, and to me,
42:03
Speaker 9: this is a can of worms. This is a big deal.
42:05
Speaker 9: So that's how the book was born. The book was okay, AI,
42:09
Speaker 9: cool stuff, But something else is going on here. So
42:12
Speaker 9: for me, the book has three parts. One is the promise,
42:16
Speaker 9: and that's what we've been talking about for years now.
42:18
Speaker 9: The promise of AI is undeniable. The clinical application of
42:21
Speaker 9: AI is undeniable. The brilliance of AI from a computational
42:26
Speaker 9: perspective is undeniable. But that's only part of the story.
42:30
Speaker 9: There's the promise, then there's the peril, and those are
42:35
Speaker 9: the issues that come out of AI. When we decide
42:38
Speaker 9: to offload our cognition to a machine, we listen to
42:42
Speaker 9: a machine that sounds like it has tremendous authority. And
42:47
Speaker 9: the third part of the book is the path, So
42:49
Speaker 9: how the heck do we get out of this? How
42:51
Speaker 9: do we build a path? And that's in essences, that's
42:53
Speaker 9: where we started. So in it is a lot of
42:56
Speaker 9: interesting theories. There's a little bit of philosophy, there's a
43:00
Speaker 9: little bit of Dustoyevski, there's a little bit, there's a
43:03
Speaker 9: little bit of John Nosta because because in the book,
43:07
Speaker 9: right in the middle of the book there's a soul. Yeah,
43:11
Speaker 9: And even the cover is flat silhouette of a face.
43:16
Speaker 9: The cover is not computer generated art. I don't want
43:21
Speaker 9: it to be computer generated or in fact, the book
43:23
Speaker 9: is not just sort of this this hyper intellectualization driven
43:29
Speaker 9: by large language models. It really has the bumps and
43:34
Speaker 9: the the errors and the contradictions and the uncertainty of
43:38
Speaker 9: the human condition. That's what the path to A and
43:42
Speaker 9: B is. And in medicine, boy, that's that's really critical.
43:46
Speaker 9: When you you know, when you when a patient comes
43:48
Speaker 9: to you with the pharmacy and they ask you a
43:51
Speaker 9: question about drug extra drug y or something, you look
43:56
Speaker 9: at the scenario, you see how they're standing you, you
44:00
Speaker 9: interpret the way they ask the question. In other words,
44:02
Speaker 9: the path from A to B is a little bit
44:04
Speaker 9: more complient. If anything, it's humanistic. So for me, the
44:08
Speaker 9: book The Borrowed Mind the Subhead kind of says it
44:13
Speaker 9: all reclaiming thought, reclaiming human thought in the age of AI.
44:20
Speaker 9: We have to remember that that that we are the
44:24
Speaker 9: owners of the thought. And along that path, I've gone
44:29
Speaker 9: down very very interesting ways of kind of how do
44:32
Speaker 9: we how do we look at AI? You know AI?
44:35
Speaker 9: A lot of people talk about this transhuman mumbo jumbo
44:38
Speaker 9: that that you know, we're just gonna make AI more
44:40
Speaker 9: like humans or humans more like AI, and we're going
44:43
Speaker 9: to end up with this sort of terminator style thing.
44:48
Speaker 9: Whatever it is, doesn't have to be a monster, could
44:50
Speaker 9: be just a box on a wall in the pharmacy storeroom,
44:54
Speaker 9: you know. And so I've come up with some interesting
44:57
Speaker 9: perspectives on that to try to help people understand how
45:00
Speaker 9: AI works, number one, and how AI works with us,
45:04
Speaker 9: with us humans, So we can dig deep on that
45:06
Speaker 9: a little bit. I know, we're just going to kind
45:08
Speaker 9: of do a cursory overview today, Todd, but yeah, I
45:11
Speaker 9: want you know, once you hit the John lost a
45:14
Speaker 9: play button, he doesn't shut up.
45:15
Speaker 3: So no, we're going to have you back.
45:18
Speaker 2: We're going to dig into I want to split it
45:20
Speaker 2: into three interviews. I want to take the book apart
45:24
Speaker 2: and stick to each of your sections and kind of
45:26
Speaker 2: dig a little bit deeper. And I think with a
45:27
Speaker 2: thirty minute run it's dedicated just to this, I think
45:31
Speaker 2: it'll be different and it'll really allow our listeners to
45:34
Speaker 2: kind of dig in, because I'd like our listeners to
45:36
Speaker 2: go get this book and maybe do this along with
45:39
Speaker 2: us and really take time to that would be Here's
45:43
Speaker 2: so I'm a big you know this, we we've heard
45:46
Speaker 2: it out before. So I'm a big science fiction fan.
45:49
Speaker 2: I lost time travels my favorite genre within science fiction.
45:54
Speaker 2: The Matrix had little little bits of that because of
45:58
Speaker 2: Neo's ability to manipulate the code that he could, you know,
46:02
Speaker 2: be a part of and control from that programmer's perspective. So,
46:06
Speaker 2: all right, I'm a gen x er. You're a gen xer.
46:10
Speaker 2: You know I was born. You're a boomer. I thought
46:13
Speaker 2: you were. That's a compliment because.
46:15
Speaker 9: I'm on the edge, right, So so okay, I can live.
46:18
Speaker 10: In the Yeah.
46:19
Speaker 2: So anyway, so you and I experienced the difference in
46:24
Speaker 2: our lives of what the phone transformed from into and
46:32
Speaker 2: helped us communicate in different ways and better. And I
46:36
Speaker 2: remember when I when I had my first, very long,
46:41
Speaker 2: four year love crush, a very innocent relationship. I was
46:45
Speaker 2: on the phone as much as possible because I lived
46:48
Speaker 2: out in the country and I knew that my my
46:53
Speaker 2: personality was changing based on growing and understanding what love
46:59
Speaker 2: means and all that fun stuff. And then I'd write
47:01
Speaker 2: her poetry and mail her snail mail letters that you get,
47:05
Speaker 2: you know, three days after I mailed them.
47:07
Speaker 3: All right, So fast forward.
47:10
Speaker 2: We've experienced the Internet, we've experienced data processing, We've experienced
47:15
Speaker 2: so many of these things. The point that you made
47:19
Speaker 2: that you said, we're getting to the answers faster. The
47:24
Speaker 2: evil of AI, in my mind is not science fiction.
47:28
Speaker 2: It's not the it's not the make believe ish terrors
47:32
Speaker 2: of AI. AI's destruction in my or partial destruction of
47:38
Speaker 2: where humanity.
47:39
Speaker 3: Has been is exactly what you're saying.
47:42
Speaker 2: Where we don't have to think our ways through to conclusions.
47:48
Speaker 2: And what's going to happen when are eighteen year olds
47:51
Speaker 2: right now today going into college will find a way
47:56
Speaker 2: to not have to exercise their minds the way that
48:00
Speaker 2: we did because we had to do things differently to
48:04
Speaker 2: come to conclusions in the way that we learned. And
48:08
Speaker 2: I think, let's fast forward fifty years. I probably won't
48:11
Speaker 2: be here anymore. You probably won't be here anymore, but
48:14
Speaker 2: maybe we will. It'd be fun. Yeah, actually that could be.
48:17
Speaker 2: I'll only be in my nineties, so all right, So
48:22
Speaker 2: when that happens fifty years from today, the generations who
48:25
Speaker 2: have been born into the cell phone, who have been
48:28
Speaker 2: born into the iPad, who have now been born into AI,
48:32
Speaker 2: I think it's going to be crippling based on some
48:36
Speaker 2: of the stats that we've seen come out about gen X,
48:38
Speaker 2: and they're saying that their outcomes are not as promises
48:43
Speaker 2: what their parents were. So kind of dig into that
48:47
Speaker 2: side of it where your word responsibility stood out to
48:52
Speaker 2: me in the description of this book, and that is
48:56
Speaker 2: exactly what I'm saying. As a human culture, as psych cologists,
49:00
Speaker 2: as people that are teachers that are teaching children, they
49:04
Speaker 2: have our responsibility to teach children the dangers of AI
49:09
Speaker 2: and what it could do to the human mind.
49:12
Speaker 9: A lot of a lot of a lot of interesting
49:13
Speaker 9: words that you use their destruction, danger, you know, And
49:19
Speaker 9: I'm going to try to back into this number one.
49:25
Speaker 9: I can cook your dinner with a knife, or I
49:29
Speaker 9: could stab you with a knife. So again, you know,
49:33
Speaker 9: how do you put that into some contextual dynamic, right,
49:39
Speaker 9: and how do you put it in a context so
49:40
Speaker 9: that that's a question in of itself. The other question
49:43
Speaker 9: is the knife or the screwdriver or the hammer. Those
49:46
Speaker 9: are tools, and I can put down the tool and
49:50
Speaker 9: walk away. And we often refer to AI, you know,
49:54
Speaker 9: maybe back in the day before large language models, but
49:57
Speaker 9: we refer to AI as a tool, and people will
49:59
Speaker 9: say clinicians will say, well, it's it's how you use it.
50:03
Speaker 9: And I would argue that it's a little bit more
50:04
Speaker 9: complicated in today's world because while I can put that
50:08
Speaker 9: hammer down and walk away, can I unthink a thought
50:13
Speaker 9: I shared with a large language model. That's that's what's
50:17
Speaker 9: so interesting to me. Now, now what happens? Okay, I
50:20
Speaker 9: think there's there's really two basic issues here. One is
50:24
Speaker 9: the slippery slope of deferred cognition, for example, misinterpreting fluency
50:33
Speaker 9: as understanding. We all know those people, todd We see
50:36
Speaker 9: them all the time in conventions. I'm not going to
50:38
Speaker 9: mention names, but you know these guys who walk around
50:40
Speaker 9: talk a mile a minute but don't say anything. Yet
50:44
Speaker 9: they get speakers positions at conventions because they are glib.
50:49
Speaker 9: Do they say anything new? Now? They mix up the
50:52
Speaker 9: language and say a lot of mumbo jumbo. Lms are
50:55
Speaker 9: not just crafting just a mish of information. They're they're
51:01
Speaker 9: creating it in a coherent way. That sounds great, That
51:06
Speaker 9: that makes a lot of sense, and that that I
51:10
Speaker 9: think that's one thing that happens. The second thing that
51:12
Speaker 9: happens is that we begin to develop a tolerance of friction. Now,
51:18
Speaker 9: what the heck does that mean? One of the joys
51:22
Speaker 9: of life is thinking. It's been said time and time again.
51:26
Speaker 9: You probably have had the bumper sticker on your car
51:28
Speaker 9: at one point or another. Todd the it's not the destination,
51:36
Speaker 9: but it's the journey.
51:37
Speaker 3: Yep.
51:39
Speaker 9: The destination is almost a byproduct of the journey. Our
51:43
Speaker 9: lives are built upon our stumbles, our falls, our our contradictions.
51:50
Speaker 9: What happens when we misinterpret what happens to me. We
51:53
Speaker 9: don't understand that the friction is good. So that that's
51:58
Speaker 9: another big idea big big that's happening is that you
52:01
Speaker 9: know what I don't want to do I have to
52:03
Speaker 9: really write that discharge summary? Oh brother, you know what,
52:07
Speaker 9: I'll just have chat GPT. Do do I have to
52:09
Speaker 9: really write that email about the rays? I want just
52:12
Speaker 9: have chat GP to it. I'll go the easy path.
52:15
Speaker 9: And the easy path is not only the best path,
52:19
Speaker 9: it's it's a precarious path because what we're doing is
52:21
Speaker 9: not only outsourcing cognition, right, we're outsourcing discernment. Wow. So
52:30
Speaker 9: do I trust the machine to read that EKG and
52:34
Speaker 9: say if someone has an m I or not and
52:36
Speaker 9: discharge them from the emergency room.
52:37
Speaker 3: I don't know. I don't know.
52:38
Speaker 9: So you know, it's it's very very problematic for us,
52:43
Speaker 9: and you know, we develop a sense of overconfidence from this.
52:48
Speaker 9: Now we all know people who maybe they don't respond
52:53
Speaker 9: to their posts on social media in their own voice.
52:56
Speaker 9: They respond with what chat GPT tells them, and they
53:00
Speaker 9: sound like an expert. Right, But you could almost read it,
53:03
Speaker 9: and you know, you know that it has a certain
53:07
Speaker 9: intellectual heft that feels contrived. It feels like bullshit to
53:11
Speaker 9: use the language, and actually that term has been used
53:14
Speaker 9: in some peer reviewed papers as to define the kind
53:18
Speaker 9: of engagement. So all this stuff happens and it happens really,
53:23
Speaker 9: really fast. There's a paper, an article I just published
53:28
Speaker 9: in Psychology today that compares the ten thousand hours we
53:33
Speaker 9: need to establish mastery. Remember Malcolm Gladwell wrote about that
53:37
Speaker 9: there was there was ten thousand hours of sort of
53:38
Speaker 9: cognitive mastery. To learn to play the violin, you have
53:41
Speaker 9: to put in ten thousand hours of practice. Interestingly, on
53:44
Speaker 9: the health side, we needed ten thousand steps right to
53:47
Speaker 9: stay healthy. Funny how how those two numbers came up.
53:51
Speaker 9: But recently, what I found is that you need ten
53:54
Speaker 9: thousand hours to establish some level of mastery, but you
53:58
Speaker 9: need ten minutes to experiences the cognitive decline we see
54:02
Speaker 9: from AI. Well, that's startling. I don't want to drill
54:05
Speaker 9: down too deeply on that, but basically, what they did
54:08
Speaker 9: is they gave people a test and they answered questions,
54:12
Speaker 9: and they had people use AI an LM in the
54:16
Speaker 9: margin of the test to help them. Who did better.
54:21
Speaker 9: The group who used AI did better, They did about
54:24
Speaker 9: an eighty eighty five, and the group without the AI
54:26
Speaker 9: did about a seventy five or so. Then suddenly they
54:31
Speaker 9: turned off the AI to one group and their performance
54:37
Speaker 9: went down in as little as ten minutes. They found
54:40
Speaker 9: they couldn't answer the questions. In fact, they gave up
54:42
Speaker 9: more quickly. Isn't that interesting? That's not even a cognitive area.
54:47
Speaker 9: But that's sort of the idea that, well, I'm losing
54:49
Speaker 9: my consciousness, my confidence. I don't want to do this.
54:53
Speaker 9: So for me, it comes back to what do we do?
54:58
Speaker 9: How do we manage this? We have to recognize what
55:01
Speaker 9: we're doing, because sometimes we don't even recognize the cognitive
55:06
Speaker 9: laziness of AI. You know, it just becomes second nature.
55:09
Speaker 9: And that's not necessarily a bad thing. You know, cognitive
55:12
Speaker 9: offloading may provide us the opportunity to do cognitive onloading. So, Okay,
55:19
Speaker 9: I don't know what one six fructose diphosphate is in
55:21
Speaker 9: the crib cycle. Okay, my pharmacy professor is probably gonna
55:25
Speaker 9: yell at me, and so you should remember that. But
55:28
Speaker 9: in the real world, maybe knowing that esoteric fact that
55:33
Speaker 9: cognitive heavy lifting can be shifted. So again, to me,
55:36
Speaker 9: the promise of AI is that we could engage in
55:39
Speaker 9: things that are that are extraordinary. Our ability to learn
55:43
Speaker 9: and to think and to interact and to iterate with
55:46
Speaker 9: ais profound. But we got to be careful because along
55:49
Speaker 9: the way things happen where our brain kind of slips
55:53
Speaker 9: into what's the word. Maybe it's a more passive kind
56:01
Speaker 9: of perspective, you know, maybe maybe we have cognitive cruise control.
56:06
Speaker 9: And that's problematic to me for one simple reason. This
56:09
Speaker 9: is what really really is interesting. You know, we understand
56:12
Speaker 9: that that obsolescence kind of goes hand in love with innovation.
56:16
Speaker 9: You know, our one Tesla MRI machines in our hospitals
56:19
Speaker 9: now are old and antiquated. Everybody wants a three or
56:22
Speaker 9: a five Tesla to get better imaging. So we throw
56:26
Speaker 9: them away. We get a new on. Our phone doesn't
56:28
Speaker 9: work anymore, we get a new one. Our car, we
56:30
Speaker 9: get a new one. And whatever it is, we get
56:32
Speaker 9: a new one. That's the that's the language. We get
56:34
Speaker 9: a new one. That's what my kids say. Something breaks,
56:38
Speaker 9: we don't try to fix it, we get a new one. Well,
56:41
Speaker 9: for the first time in history, human cognition itself is
56:44
Speaker 9: on the obsolescence chopping block. Human cognition itself is on
56:48
Speaker 9: the obsolescence shopping block. So can we apply that that
56:52
Speaker 9: sentence get a new one. No, it's it's a very
56:55
Speaker 9: curious thing. Now, My view of this is that the
57:01
Speaker 9: challenge to make AI and human cognition compete is a
57:06
Speaker 9: fool's errand maybe we should recognize their difference. And by
57:11
Speaker 9: recognizing their difference, we can see that both have different paths,
57:16
Speaker 9: different utilities. And what I come back to is a
57:18
Speaker 9: very simple idea of vision. We have two eyes because
57:25
Speaker 9: we see in something called parallax, two perspectives. And what
57:30
Speaker 9: that parallax actually gives us is depth perception. So if
57:34
Speaker 9: you close one eye, you lose depth perception. You know,
57:37
Speaker 9: when you see a patient in the emergency room when
57:39
Speaker 9: they have a scratched cornea and they patch the eye
57:43
Speaker 9: and they leave the emergence room, get in their car
57:46
Speaker 9: and drive home, you got to warn them. You got
57:47
Speaker 9: to say, what, be careful, your depth perception is off.
57:51
Speaker 9: And what I think that that AI does, AI is brilliant.
57:55
Speaker 9: AI is different in fact, and maybe we can discuss
57:58
Speaker 9: this a little bit next time. I believe that AI
58:00
Speaker 9: is anti intelligence. I believe that AI is antithetical to
58:04
Speaker 9: human cognition. Is a statistical model that sees a world
58:08
Speaker 9: that is vastly different from ours, and it's made up
58:11
Speaker 9: of a statistical matrix that is extraordinary, much more powerful
58:15
Speaker 9: than ours. And then we've got the human side, that
58:19
Speaker 9: is the lived experience that actually has time, that is
58:24
Speaker 9: the manifestation of all those individual bumps and bruises. It
58:29
Speaker 9: has an arrow of time. But those two act synergistically.
58:33
Speaker 9: When they come together, they give us a sense of
58:34
Speaker 9: almost a parallax cognition. Now I know in the back
58:39
Speaker 9: of your head you're saying, NaSTA should shut up now
58:41
Speaker 9: because he's going way too long on this. So I'm
58:43
Speaker 9: gonna take a slug of coffee and a drink. This
58:45
Speaker 9: is what the book is about. The book. The book
58:48
Speaker 9: pushes us down these ways and saying, what is anti intelligence?
58:51
Speaker 9: What does an apple look like to an LM? What
58:55
Speaker 9: is twelve two hundred and eighty eight dimensions? How the
58:58
Speaker 9: heck can we even understand that?
59:00
Speaker 3: We can't?
59:01
Speaker 9: The answer is we can't. But we see an apple
59:04
Speaker 9: in three dimensions with maybe fifteen or twenty linguistic associations
59:08
Speaker 9: such as apple computer, Apple a day, keeps the doctor away,
59:12
Speaker 9: But an LM sees it completely different. We can think
59:17
Speaker 9: of five dimensions, as Todd you talk about science fiction, right,
59:25
Speaker 9: with a multiple dimensional multiple reality. We think of the
59:28
Speaker 9: taro sec or a five dimension tube. Right, What we
59:30
Speaker 9: can't even imagine what five dimensions is. Right, our heads
59:33
Speaker 9: blow up. And then some physicists comes along and says,
59:36
Speaker 9: you know, we did some work on string theory and
59:38
Speaker 9: that lives in eleven dimensions. And then our head blows
59:41
Speaker 9: up again. Eleven dimensions? What the heck is that? Well,
59:45
Speaker 9: how can we have And now it's not even twelve thousand,
59:48
Speaker 9: it's actually twenty five thousand dimensions in the matrix where
59:52
Speaker 9: these words or tokens exist. We can't force that into
59:57
Speaker 9: the human construct, and we can't take the human construct
1:00:00
Speaker 9: force that into AI. They're different, they're antithetical. That's why
1:00:03
Speaker 9: I call them anti intelligence. But together they provide a
1:00:06
Speaker 9: very very interesting world of view. And you know, those
1:00:09
Speaker 9: are the things that I kind of pick part in
1:00:10
Speaker 9: the book. Sometimes it gets a little philosophical, sometimes it
1:00:13
Speaker 9: gets a little mathematical. We even talk about the square
1:00:17
Speaker 9: root of negative one in the book, and those of
1:00:19
Speaker 9: you everybody studied a little bit of math, right, and
1:00:21
Speaker 9: we get the what is it when when x equals
1:00:25
Speaker 9: x square equals nine, the answer is three? Right, No,
1:00:28
Speaker 9: the answer is plus three and minus three because the
1:00:31
Speaker 9: negative times a negative is a possible. So you go
1:00:33
Speaker 9: down this rabbit hole of imaginary numbers. Well, I've created
1:00:38
Speaker 9: this imaginary axis in the context of cognition. So the
1:00:42
Speaker 9: book is fun, you know, it takes you on a journey.
1:00:46
Speaker 9: It's written in a very kind of conversational way.
1:00:52
Speaker 3: I love it.
1:00:52
Speaker 2: There we go, The Borrowed Mind Reclaiming Human Thought in
1:00:56
Speaker 2: the Age of AI. John, are going to once again
1:01:01
Speaker 2: have you back break out the book into three parts
1:01:05
Speaker 2: and kind of dig into that, and we'll have guests
1:01:07
Speaker 2: that will accompany us for each of the three parts.
1:01:10
Speaker 2: But and if you're listening, the link to to access
1:01:15
Speaker 2: get this book is in the link. Once again, The
1:01:18
Speaker 2: Bar of Mind by John NaSTA. John, I appreciate you
1:01:21
Speaker 2: being on twerks today.
1:01:23
Speaker 9: You know what, just one quick question Todd before we
1:01:25
Speaker 9: go away. Education. Education is the bane of our existence,
1:01:30
Speaker 9: is Pharmacists, we need to be educated. We need to
1:01:32
Speaker 9: update what we know. Patients need to be educated, doctors,
1:01:35
Speaker 9: everybody needs to be educated. AI and large language models
1:01:39
Speaker 9: may be the single most powerful tool to educate ourselves,
1:01:43
Speaker 9: our patients, and our peers by using something that I
1:01:47
Speaker 9: call learner centricity, you know, patient centricity. Every pharm of
1:01:52
Speaker 9: company says everything we do, we do for the patient. Right, Well,
1:01:56
Speaker 9: I would say that's sometimes true, sometimes not. But in
1:01:58
Speaker 9: this instance, learners centricity is the powerful dynamic that I
1:02:02
Speaker 9: think we should jump in next because that can change
1:02:04
Speaker 9: the game. I think that could be actually tied to
1:02:07
Speaker 9: a clinical endpoint of improving efficacy.
1:02:11
Speaker 3: Thank you for that.
1:02:12
Speaker 2: That's a good place setter, and it'll get people to
1:02:15
Speaker 2: come back. We're going to be right back with another interview.
1:02:18
Speaker 2: Gil Bash is coming up next on twerques.
1:02:25
Speaker 6: Feeling lost with the complexities of pharmacy accounting.
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1:02:34
Speaker 11: that impact the pharmacy, books, records, accounting, the profitabilities, so
1:02:38
Speaker 11: or so forth. There's different components of pharmacy that have
1:02:41
Speaker 11: its own nuances from an accounting standpoint, and so it's tricky,
1:02:45
Speaker 11: there's no doubt about it.
1:02:46
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1:02:49
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1:03:10
Speaker 11: who understands the industry and how the accounting and tax
1:03:14
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1:03:17
Speaker 11: your chance to get under the hood check of what's
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Speaker 6: Get the financial check up your pharmacy needs and head
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Speaker 6: over to peychs HYPHENCPA dot com or call two five
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Speaker 6: two four eight two seven six four four.
1:04:03
Speaker 2: The super Bowl of Specialty Pharmacy. I've I've given that name,
1:04:08
Speaker 2: and I've seen a couple other organizations give me that
1:04:12
Speaker 2: reference or say that reference. So there's I guess they're
1:04:15
Speaker 2: stealing my words. I'm headed to the Super Bowl Specialty
1:04:18
Speaker 2: Pharmacy as MBIA twenty twenty six. Chris antipass is in
1:04:22
Speaker 2: the studio or twerks And how are you doing, Chris?
1:04:25
Speaker 12: I'm doing great. Such a pleasure to be here with
1:04:28
Speaker 12: the RX Podfather, the RX Podfather.
1:04:32
Speaker 3: That's right, Yeah, don't even don't even get me started.
1:04:38
Speaker 2: Ted you're back on twerks. This is not your first rodeo.
1:04:41
Speaker 2: Welcome back, it's good to see you.
1:04:43
Speaker 10: Yeah, thank you for having me.
1:04:45
Speaker 2: What's the uh, what's the weather like today on this
1:04:48
Speaker 2: beautiful Friday as we get ready for the weekend.
1:04:51
Speaker 3: What what's the weather up there? Like?
1:04:54
Speaker 10: April showers, a little cool?
1:04:57
Speaker 2: Yeah, absolutely, it's uh, it's either thirty one or eighty
1:05:03
Speaker 2: two northwestern Pennsylvania. It's this spastic middle aged woman going
1:05:09
Speaker 2: through menopause or something like that.
1:05:12
Speaker 13: You don't know what we're gonna get.
1:05:14
Speaker 2: We're just gonna be God, bless God, bless my wife.
1:05:17
Speaker 2: It's like just starting to happen. So we're edging into
1:05:20
Speaker 2: that realm. We got three grandkids. I'm gonna be fifty
1:05:23
Speaker 2: four in the summer. Like, I'm starting to get there,
1:05:26
Speaker 2: and it's not fun. I don't like it.
1:05:28
Speaker 3: You do not like it. Hey, today's episode is brought
1:05:32
Speaker 3: to us.
1:05:32
Speaker 2: This segment is brought to us by Paragon and Paragon
1:05:38
Speaker 2: Pharmacy three sixty Complex Therapies, rare Capabilities Personal Care. I
1:05:44
Speaker 2: have been watching this thing grow for ten years. And
1:05:49
Speaker 2: I know you don't know how much I pay attention
1:05:51
Speaker 2: to you, Chris, but I'm so proud of you. You're
1:05:52
Speaker 2: from Pittsburgh, You're multi What do they call it multipatial.
1:05:57
Speaker 2: I think doctor Aaron Albert said that she wrote a
1:05:59
Speaker 2: book called multi I think it was like it was
1:06:02
Speaker 2: pharmacists that are doing multiple things. They're entrepreneurial and you
1:06:07
Speaker 2: definitely fit that mold.
1:06:08
Speaker 3: But proud of you, buddy, appreciated man.
1:06:11
Speaker 13: It's the feeling is mutual. Trust me. It's just amazing.
1:06:14
Speaker 13: We got all this activity going on in Southwestburg.
1:06:18
Speaker 2: Pittsburgh Bergen Pharmacy. Shout out to Harry Travis. He's going
1:06:22
Speaker 2: to be part of our Assembia coverage, which we're going
1:06:24
Speaker 2: to be talking more about today. But he and I
1:06:28
Speaker 2: have said that we'll fight people in arguing of where
1:06:33
Speaker 2: did specialty pharmacy start and it was in Pittsburgh.
1:06:36
Speaker 13: Pittsburgh for sure.
1:06:37
Speaker 3: Do you agree with that? Ted?
1:06:38
Speaker 2: What what side of the fence are you gonna? Are
1:06:40
Speaker 2: you gonna you have to join one of the sides?
1:06:42
Speaker 2: Is it Orlando or was it Pittsburgh.
1:06:46
Speaker 14: I'm pretty sure it was Pittsburgh and then it migrated south.
1:06:49
Speaker 3: That's right.
1:06:50
Speaker 2: I guess the the argument that the other side is Orlando.
1:06:55
Speaker 2: And it makes sense because it's like the one pharmacy
1:06:58
Speaker 2: hooked up with a FEDE runway that they were actually
1:07:02
Speaker 2: pretty close to This is part of the story. I
1:07:04
Speaker 2: don't remember the name of that pharmacy, but everybody.
1:07:07
Speaker 12: Like pretty sure script it was Donnie Howard and Don
1:07:11
Speaker 12: Mef that they founded Cure Script and they just liked
1:07:15
Speaker 12: the golf that they wanted to go somewhere where they
1:07:19
Speaker 12: can golf year round, and they went to Orlando. I
1:07:22
Speaker 12: think I've heard the story from the Horse's mount that's
1:07:26
Speaker 12: that's actually what happened.
1:07:27
Speaker 3: And even though that's a nice story and I like that.
1:07:29
Speaker 2: And by the way, just as back back reference the Mefs,
1:07:34
Speaker 2: their amazing family. Mef Senior and I worked together God
1:07:40
Speaker 2: rest his soul at well met Rx and the pharmacogenomics
1:07:46
Speaker 2: project that he ended up selling to UPMC enterprises. That family,
1:07:50
Speaker 2: the Mef family, nobody knows because they're not they're not
1:07:55
Speaker 2: they're not like it. They don't want to be out
1:07:56
Speaker 2: there like they just want to do their work and
1:07:58
Speaker 2: build their business. But they have had impact on They've
1:08:02
Speaker 2: had an impact on millions of people.
1:08:04
Speaker 3: And in Don.
1:08:06
Speaker 2: Mef Senior, he taught me so much about just business
1:08:11
Speaker 2: and healthcare business more specifically, and he said, if you're
1:08:14
Speaker 2: in healthcare business, you have a higher just because he's
1:08:20
Speaker 2: very Catholic, and he's like, when you're a priest and
1:08:23
Speaker 2: you're overseeing people and you're protecting people and you're a shepherd,
1:08:26
Speaker 2: you have a higher calling. Well, if you're in healthcare,
1:08:30
Speaker 2: if you're a nurse, if you're a publicist, if you're
1:08:33
Speaker 2: in research and clinical, you are now held to a
1:08:37
Speaker 2: higher standard because you're impacting people's freaking lives.
1:08:40
Speaker 3: Yeah, and I love that about him.
1:08:42
Speaker 13: Yeah, that's what we say.
1:08:43
Speaker 12: We talk to our team members about the responsibility that
1:08:46
Speaker 12: you have and it's something that you have to accept
1:08:50
Speaker 12: and embrace. You know, everybody out there that has a job,
1:08:55
Speaker 12: a very important part of it is you have to
1:08:57
Speaker 12: earn a living and you got to take care of
1:08:59
Speaker 12: your face family. But when you're in healthcare, it's a responsibility.
1:09:05
Speaker 12: And if we can't meet those basic or elements of
1:09:08
Speaker 12: the responsibility, then be in healthcare you got to get out.
1:09:12
Speaker 3: That's very true.
1:09:13
Speaker 2: We see that in our own pharmacy space, and there's
1:09:16
Speaker 2: always been good and bad. And we didn't even we
1:09:19
Speaker 2: didn't even introduce Ted Mills.
1:09:21
Speaker 3: I'm so sorry, I cannot believe this.
1:09:23
Speaker 2: We're getting way too excited here on twitters, Ted share
1:09:27
Speaker 2: with our listeners who might not be watching us on
1:09:29
Speaker 2: YouTube or LinkedIn, share if they're just listening a little
1:09:34
Speaker 2: bit about about yourself, where you're at, and give us
1:09:37
Speaker 2: an overview of Paragon Pharmacy three sixty.
1:09:41
Speaker 3: Yeah.
1:09:41
Speaker 9: Thanks.
1:09:42
Speaker 14: So my name is Ted Mills'm the CEO of Paragon Health,
1:09:45
Speaker 14: which is the.
1:09:46
Speaker 10: Parent of Paragon Pharmacy three sixty.
1:09:49
Speaker 14: I'm actually based here in Michigan, but our primary pharmacy
1:09:53
Speaker 14: location is in Pittsburgh, that's where Chris and I met
1:09:57
Speaker 14: a few years ago, a secondary location in southern California.
1:10:02
Speaker 10: We're fifty state licensed pharmacy.
1:10:04
Speaker 14: We have capabilities to do the most complex programs all
1:10:07
Speaker 14: the way down to specialty LA programs. We serve as
1:10:10
Speaker 14: PBMs manufacturers three forty b clinics, So there really is
1:10:14
Speaker 14: anything that we haven't done or can't do. Really proud
1:10:16
Speaker 14: of that, you know. Being a smaller especially pharmacy, we
1:10:20
Speaker 14: really have leaned heavily into which was my background, into
1:10:24
Speaker 14: technology and really focusing on the patient experience and by
1:10:29
Speaker 14: putting the patient first and trying to improve the support
1:10:32
Speaker 14: that we can provide them using technology. We built out
1:10:35
Speaker 14: a team and a platform that really enabled us to
1:10:38
Speaker 14: impact pharmacy operations as well, and I think we're going
1:10:41
Speaker 14: to talk a little bit about that over the course
1:10:43
Speaker 14: of today in the coming days as well. So we're
1:10:48
Speaker 14: really proud of the fact that our time to fill
1:10:49
Speaker 14: is very low. You know, we can elimitate gaps and
1:10:51
Speaker 14: care I think real efficiently. I'd put our pharmacy performance
1:10:55
Speaker 14: up against anybody in that regard from an operations perspective,
1:10:59
Speaker 14: and I think the implementation of the technology that we've
1:11:02
Speaker 14: demonstrated in the type of data that we can produce,
1:11:05
Speaker 14: the persistency that we can impact is I would say
1:11:09
Speaker 14: top notch if I had to put ourselves up against
1:11:11
Speaker 14: anybody in the peer groups. So my background, just by
1:11:14
Speaker 14: the way, is not I don't have the depth of
1:11:17
Speaker 14: experience and knowledge that Chris does. Chris is he's my
1:11:22
Speaker 14: go to guy, you know, he's he's the pilot of
1:11:24
Speaker 14: the plane.
1:11:24
Speaker 10: I'm a little bit of the navigator. I think.
1:11:28
Speaker 14: My background is really kind of a from a personal
1:11:31
Speaker 14: experience perspective, I had several, over a very condensed periods,
1:11:34
Speaker 14: several family members in different use cases and diseases that
1:11:39
Speaker 14: I saw interact with the healthcare system and their primary
1:11:43
Speaker 14: care or their specialty care, whether it's cancer and ecology
1:11:46
Speaker 14: and the medications, and it just left me to kind
1:11:51
Speaker 14: of bark in this mission. Unfortunately, I was fortunate enough
1:11:54
Speaker 14: to meet with Chris. You mentioned that he's very entrepreneurial,
1:11:57
Speaker 14: and it really wouldn't have worked with anybody else. Somebody's
1:11:59
Speaker 14: capable of thinking outside the box and as subject subject
1:12:03
Speaker 14: matter expertise, willing to take risks and really think differently
1:12:08
Speaker 14: about how we approach at.
1:12:10
Speaker 10: Scale like patient care. And so we'll talk a little
1:12:13
Speaker 10: bit about that.
1:12:14
Speaker 14: But it was truly from my experiences that I wanted
1:12:19
Speaker 14: to get into the space to help support people and
1:12:21
Speaker 14: get them to a better place. And then I learned
1:12:23
Speaker 14: through the school hard knocks specialty industry and how challenging
1:12:26
Speaker 14: it is, and it only reiterated my belief that there's
1:12:31
Speaker 14: a lot of improvement to be had and I like
1:12:33
Speaker 14: to think that we're at the tip of the sphere
1:12:36
Speaker 14: in terms of implementing that technology and really excited to share,
1:12:40
Speaker 14: you know, with your listeners and with attendees at ASSEMBIA,
1:12:43
Speaker 14: you know, how we can maybe help them out.
1:12:46
Speaker 3: He said.
1:12:47
Speaker 2: The word the word of today is a SMBIA. So
1:12:51
Speaker 2: freaking excited, shout out to Chris Ben's and the Sembia crew.
1:12:55
Speaker 2: They they have been hard at work at putting together
1:13:00
Speaker 2: a conference that is super hyper focused on the business
1:13:04
Speaker 2: of specialty pharmacy. And it just exudes exactly exactly that.
1:13:10
Speaker 2: And the food and the atmosphere and the whole vibe
1:13:15
Speaker 2: I love. I think that's one of my top three
1:13:17
Speaker 2: favorite conferences.
1:13:19
Speaker 12: It's a top shelf experience. It kind of sets the
1:13:22
Speaker 12: standard for what really what a conference should be. The quality.
1:13:26
Speaker 12: I mean, They've got the the top most knowledgeable experts
1:13:31
Speaker 12: across so many different areas of the industry that come
1:13:37
Speaker 12: there and share information, share knowledge, got the top organizations
1:13:42
Speaker 12: out there to learn from and to buy from and
1:13:44
Speaker 12: to do business with. And the manufacturers all have their
1:13:48
Speaker 12: key folks there. It really is the industry of the
1:13:52
Speaker 12: year for this for a special pharmacy space.
1:13:55
Speaker 3: Sure, without a doubt.
1:13:57
Speaker 2: One part of it that I am always most excited about.
1:14:01
Speaker 2: I don't get enough time because I'm always on the
1:14:03
Speaker 2: showroom floor preparing for interviews, but I'm going to try
1:14:06
Speaker 2: to make a couple of sessions on artificial intelligence impact
1:14:10
Speaker 2: on specific things. And there are five presentations over the
1:14:15
Speaker 2: ENTIRESEMBIA day that are all focused on something to do
1:14:18
Speaker 2: with artificial intelligence, and I think they split it. I
1:14:21
Speaker 2: can't remember the names of them right off the.
1:14:24
Speaker 3: Top of my head right now.
1:14:25
Speaker 2: However, one of our focuses of our three part series
1:14:29
Speaker 2: is going to be how does AI impact specially pharmacy specifically, Like, so,
1:14:36
Speaker 2: what aspects just to set the stage, what aspects of
1:14:40
Speaker 2: AI have you seen impact especially workflow or something in
1:14:46
Speaker 2: that space.
1:14:47
Speaker 13: So we're at paragon. We're using.
1:14:51
Speaker 12: We're using these latest advancements in technology to help in
1:14:55
Speaker 12: a few ways.
1:14:56
Speaker 13: It's got to be used.
1:14:58
Speaker 12: One of the major advantages is digesting and making sense
1:15:03
Speaker 12: of large data sets and making recommendations on what types
1:15:10
Speaker 12: of interventions are necessary on.
1:15:12
Speaker 13: Those data sets.
1:15:13
Speaker 12: So whether it's ingesting medical data from the EMR, combining
1:15:19
Speaker 12: that with data that we get from patients and from
1:15:21
Speaker 12: our pharmacy management system, and then identifying opportunities to help
1:15:25
Speaker 12: our patients. That's one of the areas that we're using
1:15:28
Speaker 12: it because.
1:15:31
Speaker 13: There's so much.
1:15:33
Speaker 12: More that the data has buried within it than we
1:15:37
Speaker 12: can assess just by looking at it ourselves.
1:15:40
Speaker 13: When you use AI to.
1:15:43
Speaker 12: Interpret really large data sets at a patient level, you'd
1:15:48
Speaker 12: be really blown away to see the insights that are
1:15:52
Speaker 12: revealed and the opportunities that are really revealed for us
1:15:55
Speaker 12: to do something about. Because we're here to take care
1:15:58
Speaker 12: of our patients, we're here to all so support the
1:16:01
Speaker 12: interests of all the parties that are focused on that
1:16:04
Speaker 12: patient care. Because you have the payers, you also have
1:16:07
Speaker 12: the manufacturers, you have the providers, and you have us.
1:16:09
Speaker 12: We're all kind of centered around this patient. Everyone wants
1:16:12
Speaker 12: the best for that patient, but also they all have
1:16:15
Speaker 12: their own objectives with their business models that surround that patient.
1:16:20
Speaker 12: And so we're really excited to talk about what we're doing.
1:16:24
Speaker 12: But that's kind of a high level example of how
1:16:28
Speaker 12: you can really use AI to better a patient experience
1:16:32
Speaker 12: but also deliver meaningful impact for the business of pharmacy.
1:16:37
Speaker 2: And I don't want to put you in a specific
1:16:42
Speaker 2: corner of a specific type of personality, but I would
1:16:46
Speaker 2: lean more to some of your ideas around the CFO
1:16:50
Speaker 2: position or the you know, the.
1:16:53
Speaker 3: The money side per se.
1:16:55
Speaker 2: But the reason why I'm mentioning that is is how
1:16:58
Speaker 2: is AI now impacting running a business in comparison to
1:17:05
Speaker 2: maybe drilling down into the clinical or the treatment. What
1:17:09
Speaker 2: part of AI in specially pharmacy are you most excited about.
1:17:15
Speaker 14: Well, I think AI is going to go over a
1:17:17
Speaker 14: course of time. There's going to be early adoption, adoption,
1:17:20
Speaker 14: and I think it's going to go in phases. And
1:17:22
Speaker 14: I think what you're seeing right now is in the
1:17:25
Speaker 14: specialty space, you get a lot of legacy pharmacies, large
1:17:28
Speaker 14: pharmacies that are on legacy systems, and it's a labor
1:17:32
Speaker 14: intensive business. You know, when you talk about patient care coordination,
1:17:35
Speaker 14: insurance verification, prior authorization. In this particular industry, there's a
1:17:40
Speaker 14: lot of human touch. And I think what you're going
1:17:43
Speaker 14: to see and we are seeing is companies adopting point
1:17:47
Speaker 14: solutions they put on top of their legacy pharmacy management
1:17:50
Speaker 14: systems to help with.
1:17:53
Speaker 10: All of those things.
1:17:54
Speaker 14: So virtual agents to help contact patients, do the prior authorization,
1:18:00
Speaker 14: do the insurance verification. I think that most companies, if
1:18:04
Speaker 14: they're not doing right now, will be this year, I
1:18:06
Speaker 14: think really examining how to implement that. So from a
1:18:09
Speaker 14: finance perspective, this year I think is going to be
1:18:11
Speaker 14: the next twelve months. I would characterize it most likely
1:18:13
Speaker 14: as implementation, experimentation and cost savings, you know, trying to
1:18:20
Speaker 14: drive some more dollars to the bottom line. The industry though,
1:18:24
Speaker 14: was primarily driven by the gross margin line, and so
1:18:29
Speaker 14: the impact will be relatively quick. It'll be beneficial, but
1:18:31
Speaker 14: I think for most, at least the pharmacies that we
1:18:35
Speaker 14: speak to and our pharmacy, I think the idea that
1:18:38
Speaker 14: you can grow a business without having to add more
1:18:40
Speaker 14: and more people to support these complex programs is really
1:18:43
Speaker 14: going to be the benefit of these agents. The really
1:18:46
Speaker 14: exciting part, though, is is just alluded to, which is
1:18:50
Speaker 14: what we're doing at Paragon is our technology platform sits
1:18:54
Speaker 14: on top of a pharmacy management system. We've aggregated the
1:18:59
Speaker 14: most advanced points solutions and develop our own intellectual property
1:19:02
Speaker 14: that we can incorporate that technology into clinical care, so
1:19:06
Speaker 14: we can automate development of clinical care plans, we can
1:19:09
Speaker 14: automate tracking medication therapy.
1:19:12
Speaker 10: We can really enable these.
1:19:13
Speaker 14: Highly talented pharmacists to take on a bigger role and
1:19:16
Speaker 14: I have to do the paper pushing and script filling,
1:19:19
Speaker 14: you know, that takes a lot of their time.
1:19:21
Speaker 10: That's where I think we're most excited about.
1:19:24
Speaker 14: And I think, you know, we're going to talk a
1:19:25
Speaker 14: little bit about other aspects of just the level of
1:19:30
Speaker 14: information that we can pull together on a core basis.
1:19:33
Speaker 14: I think manufacturers today look for data from their pharmacies
1:19:38
Speaker 14: and I think we're just scratching the surface.
1:19:40
Speaker 10: The type of data they're looking for.
1:19:41
Speaker 14: Now is like status, like what's the status of my
1:19:43
Speaker 14: drug and these patients, And I think they're going to
1:19:46
Speaker 14: be I think we're going to be as an industry
1:19:47
Speaker 14: blown away over the course the next twelve and eighteen months.
1:19:52
Speaker 10: Related to.
1:19:55
Speaker 14: The level of real world evidence that we can generate
1:19:58
Speaker 14: on a core boarded basis, so we can get super
1:20:01
Speaker 14: specific on a patient cohort and overlay that information real
1:20:06
Speaker 14: world evidence relative to their medication efficacy on top of
1:20:09
Speaker 14: EHR data that were scraping and pulling from across the country.
1:20:13
Speaker 14: And it's going to produce really actionable and amazing insights
1:20:18
Speaker 14: not only from the manufacturer, but also from a clinical
1:20:21
Speaker 14: support perspective. And I think that's where we're going to
1:20:23
Speaker 14: see the most exciting advances, at least in our application.
1:20:28
Speaker 3: I have an imagination based on the patient.
1:20:34
Speaker 2: Amber Pharmacy was my first experience where I got to
1:20:37
Speaker 2: go to their new location like a guesstino and he
1:20:40
Speaker 2: had has come in because we were trying to evaluate
1:20:42
Speaker 2: some workflow and trying to sell the pharmacy management system,
1:20:47
Speaker 2: and we signed a BA and we were able to
1:20:49
Speaker 2: walk around and so I got some time with some
1:20:52
Speaker 2: of the texts, and the texts were asking I didn't know.
1:20:56
Speaker 2: I didn't get to see who the patient was, but
1:20:57
Speaker 2: I could hear them throughout the call center asking specific
1:21:00
Speaker 2: questions to the patient on the phone, and it was
1:21:04
Speaker 2: it was sweet. They were being It was almost like
1:21:07
Speaker 2: they treated them like their friends and they knew who
1:21:09
Speaker 2: they were talking to. So but I could hear them
1:21:12
Speaker 2: weaving in very specific things. So they would be like, hey, Julie,
1:21:17
Speaker 2: it's you know, how are you? Hey, how's your dog doing?
1:21:21
Speaker 2: Because they had notes on the screen. It's like, hey
1:21:23
Speaker 2: have a dog, and they're like, oh.
1:21:25
Speaker 3: You know, my dog, it's getting better, blah blah blah.
1:21:28
Speaker 2: And then she'd be like, hey, so how are you
1:21:30
Speaker 2: feeling today? Like on a scale from one to ten,
1:21:33
Speaker 2: where's your pain?
1:21:34
Speaker 4: Oh? I guess it's a sex Well all right, So
1:21:38
Speaker 4: this is this is happening fifteen years ago. If I
1:21:42
Speaker 4: had all that data of any patient that was on
1:21:46
Speaker 4: the XYZ and DC and after ninety days, everybody's pain
1:21:52
Speaker 4: ratio was coming in on an average, it was coming
1:21:56
Speaker 4: in at a five or a six. Like if I
1:21:58
Speaker 4: had put AI on that I could call up as
1:22:01
Speaker 4: a pharmacy tech just to check up on my patient
1:22:03
Speaker 4: and I could be something like, hey, Chris.
1:22:06
Speaker 3: How you doing. Oh okay, you know a little bit
1:22:09
Speaker 3: of a pain?
1:22:10
Speaker 2: Would you say your pain's like right abound around or
1:22:12
Speaker 2: like a round around five six?
1:22:14
Speaker 9: You know?
1:22:15
Speaker 3: Yeah, yeah, I guess you know something like you're bringing
1:22:17
Speaker 3: out of the now.
1:22:18
Speaker 2: I'm able to like be more personalized and more precision,
1:22:22
Speaker 2: and we're really squeezing the humanity out of the data.
1:22:26
Speaker 2: Whereas I know there's financial sides of this, but if
1:22:30
Speaker 2: I'm designing something based on AI to take care of patients,
1:22:32
Speaker 2: if I had the control of the money, don't give
1:22:35
Speaker 2: me the money.
1:22:36
Speaker 3: You will lose the money.
1:22:37
Speaker 2: But if you did, I would like squeeze the humanity
1:22:41
Speaker 2: out of it, where I could be like, this data
1:22:42
Speaker 2: is telling me that millions of people that participated in
1:22:46
Speaker 2: the survey said this, this, this, and this about this
1:22:49
Speaker 2: specific medication. Like now, now you're calming people, because when
1:22:53
Speaker 2: I'm on the phone with you, I feel like you're empathizing.
1:22:56
Speaker 3: I feel like you get it.
1:22:57
Speaker 12: Well, it's all about a relationship, and as Ted kind
1:23:01
Speaker 12: of alluded to our industry, it's hard to operate a pharmacy.
1:23:06
Speaker 12: There's a lot of manual stuff that we're doing, and
1:23:10
Speaker 12: the manual stuff takes away from our ability to actually
1:23:15
Speaker 12: do the stuff we want to do. There are things
1:23:17
Speaker 12: we have to do in order to generate the revenue
1:23:21
Speaker 12: out the door by shipping these drugs. But we view
1:23:27
Speaker 12: AI and how we're incorporating it into our operations.
1:23:31
Speaker 13: As removing the noise.
1:23:35
Speaker 12: And just presenting our team with the things that need
1:23:38
Speaker 12: their attention, taking away the manual tasks that just take
1:23:43
Speaker 12: up time and money. So the experience you're describing is
1:23:47
Speaker 12: very achievable when you don't have the burden of calling
1:23:53
Speaker 12: a thousand patients today and just trying to churn out product.
1:24:00
Speaker 12: It's going to be better received from the patient as well,
1:24:02
Speaker 12: because we're not suggesting that you replace human beings with
1:24:07
Speaker 12: bots that talk to patients. You can still have humans
1:24:10
Speaker 12: interact with your patients, but the question is what are
1:24:13
Speaker 12: they talking about? Because if you can use the technology
1:24:16
Speaker 12: to extract the stuff and maximize efficiencies on these repetitive
1:24:22
Speaker 12: manual tasks, then you can save the good stuff for
1:24:26
Speaker 12: the actual human interaction. That's kind of our vision for it.
1:24:29
Speaker 12: It very much aligns with what you're saying, because for
1:24:31
Speaker 12: years pharmacies have been doing all of this work manually
1:24:35
Speaker 12: over the phone, and it's really difficult to do it
1:24:39
Speaker 12: doul efficiently, do it effectively and handle the business side
1:24:43
Speaker 12: of pharmacy that we have to focus on in order
1:24:48
Speaker 12: to survive.
1:24:50
Speaker 10: That.
1:24:50
Speaker 2: Are you a science fiction movie guide? You like science
1:24:54
Speaker 2: fiction movies?
1:24:55
Speaker 13: I do so.
1:24:57
Speaker 2: I loved Edge of Tomorrow with Tom Cruise where they
1:25:00
Speaker 2: had the ecdoskeleton robots, So I think of AI like that, Like,
1:25:06
Speaker 2: I don't think AI is going to take anything over really.
1:25:09
Speaker 3: I mean, maybe it will and who knows.
1:25:11
Speaker 2: But in my my realistic view, it's it's putting on
1:25:15
Speaker 2: this robot suit on top of the pharmacist and making
1:25:19
Speaker 2: you more powerful because you're able to not only access
1:25:23
Speaker 2: data faster, but you're you're better organizing data, you're better
1:25:28
Speaker 2: seeing patterns quickly, and then you're giving that back to
1:25:32
Speaker 2: the pharmacists who's passionate about that specific medication treatment. Anyway,
1:25:37
Speaker 2: It's like, I, I think our fine.
1:25:40
Speaker 3: I already know.
1:25:41
Speaker 2: I've talked to so many pharmacists that are telling me
1:25:43
Speaker 2: this but when they're nerding out with AI behind them
1:25:47
Speaker 2: to really really dial in, it's like, that's cool, Like
1:25:50
Speaker 2: I see I see it as an enhancement.
1:25:53
Speaker 3: I don't see it.
1:25:53
Speaker 13: As totally agree, totally agree.
1:25:57
Speaker 3: I want them to make another Edge of Tomorrow movie,
1:25:59
Speaker 3: by the way.
1:25:59
Speaker 13: That's a good movie, you know.
1:26:00
Speaker 3: I like that movie.
1:26:01
Speaker 9: You know.
1:26:02
Speaker 14: I think it's going to enable the pharmacists to actually
1:26:04
Speaker 14: take on I don't want to say more meaningful, because
1:26:08
Speaker 14: that's I don't think that's right, but in a more
1:26:10
Speaker 14: efficient role within healthcare as a whole, because we're going
1:26:15
Speaker 14: to be able to get access to information that providers
1:26:17
Speaker 14: actually have on a real time basis, and we're going
1:26:20
Speaker 14: to be able to identify trends, real world trends based
1:26:25
Speaker 14: on real world evidence quickly, and then we can share
1:26:28
Speaker 14: that with folks real efficiently that are the primary care source.
1:26:32
Speaker 14: And I think that's an exciting part of it too.
1:26:34
Speaker 14: Like our platform enables us to communicate with doctors right
1:26:36
Speaker 14: now with their HR so we can send real world
1:26:39
Speaker 14: evidence about how a drugs performing to a doctor so
1:26:44
Speaker 14: they're they're prepared, you know, prior to a visit. So
1:26:46
Speaker 14: that that's only going to get better and the data
1:26:49
Speaker 14: is only going to get richer from from patients as
1:26:53
Speaker 14: you know, as biometrics digital wearables only, they're only going
1:26:56
Speaker 14: to improve over time. So the ore rings are an
1:26:58
Speaker 14: amazing example, and the option of the R rings and
1:27:01
Speaker 14: the younger generation is pretty significant and that information is
1:27:04
Speaker 14: going to start being incorporated into these data sets as well.
1:27:07
Speaker 14: So there's exciting times ahead. And I think not all
1:27:10
Speaker 14: patients are the same. I think with you know, two
1:27:13
Speaker 14: years ago, all patients we know aren't the same. But
1:27:16
Speaker 14: from a data perspective, they're kind of the same. But
1:27:19
Speaker 14: we're able to drill down and identify a newly diagnosed
1:27:23
Speaker 14: patient that's twenty five year old is going to be
1:27:27
Speaker 14: responding potentially differently to a new therapy versus maybe a
1:27:31
Speaker 14: fifty year old that's been battling this particular condition for
1:27:34
Speaker 14: fifteen years and tried four or five different therapies. In
1:27:37
Speaker 14: pharmacy should have different strategies about handling those patients differently,
1:27:41
Speaker 14: because a critical time on these new medications, if you're
1:27:44
Speaker 14: you know, onboarding a patient for the first time, is
1:27:46
Speaker 14: at first thirty to ninety days. That's when you lose
1:27:49
Speaker 14: patients or you gain patients and that's where we can
1:27:51
Speaker 14: really have a significant impact. But that's all enabled by technology.
1:27:54
Speaker 14: Otherwise it's just, you know, it's not realistic. You don't
1:27:57
Speaker 14: have enough hours in a day to be able to
1:27:58
Speaker 14: you don't have the availability to data to empower the
1:28:01
Speaker 14: clinical pharmacists to be able to, you know, help support
1:28:05
Speaker 14: these people.
1:28:06
Speaker 10: But today you can.
1:28:08
Speaker 14: And it's and I think that's only going to get
1:28:10
Speaker 14: better and better and better, and it's going to be
1:28:12
Speaker 14: amazing for the patient. And I you know, we talk
1:28:15
Speaker 14: about AI too. I almost think I don't think it's
1:28:17
Speaker 14: the right term.
1:28:18
Speaker 10: Almost.
1:28:18
Speaker 14: I think it's like real intelligence. We're actually getting real information.
1:28:22
Speaker 14: The AI is helping us overlay intelligence from other systems.
1:28:26
Speaker 10: Really quick and quickly and rapidly.
1:28:28
Speaker 14: But we're able to generate real intelligence really quickly, complement
1:28:32
Speaker 14: that with artificial intelligence to do real clinical work that
1:28:36
Speaker 14: hasn't been done at a level before.
1:28:40
Speaker 2: Yeah, I see big opportunities coming. I also see the
1:28:45
Speaker 2: board of specialties starting to to grow outside where they
1:28:50
Speaker 2: are now very specific disease date dig in and especially
1:28:58
Speaker 2: processes and understanding and relevance. And that's even in podcasting.
1:29:04
Speaker 2: That's what I want to bring. I want to bring
1:29:05
Speaker 2: to the market where you're really dialing into very very
1:29:08
Speaker 2: specific things happening, so that a pharmacist could really like
1:29:11
Speaker 2: brush up on something that you've that you've been studying,
1:29:15
Speaker 2: something that is getting a lot more attention, and we're
1:29:18
Speaker 2: going to be focused on it is women's health specifically,
1:29:22
Speaker 2: So give us some background in your experience, Chris as
1:29:27
Speaker 2: a pharmacist.
1:29:28
Speaker 3: But then with with Paragon.
1:29:31
Speaker 2: Three sixty, not that you're singling out women, but but
1:29:35
Speaker 2: there is this there's specific things happening to women that
1:29:38
Speaker 2: aren't happening to men, and it's developing not only opportunity,
1:29:43
Speaker 2: but the advantage that our patients have.
1:29:47
Speaker 3: Women patients have.
1:29:49
Speaker 2: Now sixty two sixty four percent of all of our
1:29:53
Speaker 2: pharmacists are women.
1:29:55
Speaker 3: So now you have women who.
1:29:58
Speaker 2: Understand what's going on in your uterus or your periods
1:30:02
Speaker 2: or periods or getting pregnant.
1:30:04
Speaker 3: Like I love that.
1:30:06
Speaker 2: I love that we have an opportunity to become just
1:30:09
Speaker 2: a little bit more empathetic from an understanding perspective. But
1:30:13
Speaker 2: then I have heard other stories that female gynecologists are
1:30:17
Speaker 2: like harder, like they're not as gentle, So.
1:30:21
Speaker 3: I don't know.
1:30:22
Speaker 12: Yeah, I think that women's health is getting a lot
1:30:24
Speaker 12: of attention lately. I've literally just had a conversation yesterday.
1:30:28
Speaker 12: I was at an advisory board meeting and we were
1:30:31
Speaker 12: talking about women's health and the you know, the progression
1:30:37
Speaker 12: and the challenges that hormone balances or imbalances have on
1:30:43
Speaker 12: the total picture, including mental health. We were really zeroing
1:30:46
Speaker 12: in on mental health and women's health related to that.
1:30:52
Speaker 12: There's a real opportunity, but it comes down to Ted's
1:30:56
Speaker 12: point about having a strategy customer to a patient. This
1:31:01
Speaker 12: is really where we've been relegated to cookie cutter approaches,
1:31:07
Speaker 12: like we're gonna this is what we do for this
1:31:09
Speaker 12: and it's going to be good for a lot, but
1:31:12
Speaker 12: we know that it can't be good or great for
1:31:15
Speaker 12: any one person because we can't make it that specific.
1:31:19
Speaker 12: It's just impossible for us to do it. So I
1:31:20
Speaker 12: think technology leading to the ability to customize something for
1:31:25
Speaker 12: an individual patient is going to be really key in
1:31:29
Speaker 12: my conversation with payers, They're very open and interested in
1:31:32
Speaker 12: exploring ways to support women specifically. You know, when we
1:31:38
Speaker 12: were talking again about hormones, it's like, how many women
1:31:42
Speaker 12: are actually getting their hormones tested. You can do a
1:31:45
Speaker 12: saliva test and have a litany of your estrogen's progesterone levels, testosterone.
1:31:52
Speaker 12: Talking about testosterone and women and how they're not getting
1:31:54
Speaker 12: adequate Women need to have levels of testosterone. It's not
1:31:57
Speaker 12: like testosterone as the man, you know, the male hormone,
1:32:01
Speaker 12: and it's not for women and vice versa with estrogen.
1:32:04
Speaker 12: Same deal on the men's side. We need some level
1:32:06
Speaker 12: of estrogens in our body. But you know, we're looking
1:32:10
Speaker 12: at how do we bring an individualized approach for each patient,
1:32:15
Speaker 12: understanding where they are in their care journey, supporting them
1:32:19
Speaker 12: and not putting them into a box. Well, this is
1:32:23
Speaker 12: just how we take care of the you know, patients
1:32:25
Speaker 12: with this diagnosis, and that's the best that we can do.
1:32:29
Speaker 3: He said, box.
1:32:30
Speaker 2: And there is now a new device out And if
1:32:33
Speaker 2: you guys heard about this, I think this was out
1:32:35
Speaker 2: on Pharmacy Times a couple of weeks ago that is
1:32:39
Speaker 2: being inserted into under people's skin that will have a
1:32:43
Speaker 2: multitude of different substances in it that will inject on
1:32:47
Speaker 2: demand based on the technology of reading. And I'm like,
1:32:51
Speaker 2: that's like the future pharmacy is going to be like
1:32:54
Speaker 2: partially embedded into you.
1:32:56
Speaker 13: Well, we got three D printing of drugs.
1:32:58
Speaker 3: Yeah, it's.
1:33:01
Speaker 12: The future is exciting and scary at the same time.
1:33:04
Speaker 12: It's a combination of both of them. And I think
1:33:06
Speaker 12: that this is part of our responsibility is to drive it.
1:33:09
Speaker 12: What do we want it to look like? Because we
1:33:11
Speaker 12: can come up with a bunch of ideas, but what
1:33:13
Speaker 12: is in the best interest of those patients?
1:33:17
Speaker 13: And I don't you know, it's I don't want to
1:33:20
Speaker 13: sound Pollyanna.
1:33:21
Speaker 12: I mean, because we do talk a lot about patients,
1:33:23
Speaker 12: but then when we look at the industry, the industry
1:33:25
Speaker 12: really does center around money in a lot of ways,
1:33:28
Speaker 12: unfortunately to at the expense of patients and patient care.
1:33:32
Speaker 12: So those of us that really do want to run
1:33:35
Speaker 12: successful businesses as a side effect of taking care.
1:33:38
Speaker 13: Of patients, we got to make sure that our voice
1:33:41
Speaker 13: is heard. We got to be out there.
1:33:42
Speaker 12: We got to be the ones driving the industry so
1:33:45
Speaker 12: that we don't just talk about patients but then act
1:33:51
Speaker 12: differently or purely financial interest.
1:33:55
Speaker 3: Right, absolutely, all right.
1:33:59
Speaker 2: Mister Joe DiPietro Is has been on twerk so many times.
1:34:03
Speaker 2: I really appreciate him. He adds up McKesson.
1:34:07
Speaker 13: I think it's.
1:34:10
Speaker 3: Yes, I've said his name wrong before. I'm so sorry, Joe.
1:34:15
Speaker 2: I just to get it too excited. So they're going
1:34:19
Speaker 2: to be on the show at McKesson. He's focused on
1:34:21
Speaker 2: the advancement of cell and gene and I'm going to
1:34:24
Speaker 2: be asking about how he thinks AI is going.
1:34:26
Speaker 3: To impact that part of it.
1:34:27
Speaker 2: But you guys are also going to be participating in
1:34:31
Speaker 2: kind of that subject. And that is a segment of
1:34:34
Speaker 2: pharmacy that is so kind of confusing in some some
1:34:40
Speaker 2: ways because is it an ever changing component, is it
1:34:44
Speaker 2: an ever changing compound? Is it an ever changing is it?
1:34:48
Speaker 2: Is it also customizable? Like, give us some overviews in
1:34:52
Speaker 2: what you've seen happening in selling gene two.
1:34:54
Speaker 3: What you think of that?
1:34:56
Speaker 12: Yeah, I mean selling gene it's obviously the cutting edge.
1:35:00
Speaker 12: A lot of pharmacies want to be in that space.
1:35:03
Speaker 13: We have some experience in the gene therapy space. You've got.
1:35:08
Speaker 12: It just takes specialty pharmacy to another level of infrastructure
1:35:13
Speaker 12: that's necessary, of expertise, that's necessary infrastructure in the case
1:35:19
Speaker 12: of these are living organisms. The drugs themselves, they're viral vectors.
1:35:26
Speaker 12: You've got to store them ultra frozen, so you've got
1:35:29
Speaker 12: to have an infrastructure to support distribution of ultra cold
1:35:33
Speaker 12: chain products, and these products are typically infused, so you
1:35:37
Speaker 12: have this dynamic of is it the specialist that's buying
1:35:42
Speaker 12: and billing the product, it's under the medical benefit and
1:35:46
Speaker 12: just the whole care coordination process, and then of course
1:35:49
Speaker 12: the safety factors. Sadly we've seen with some gene therapies
1:35:52
Speaker 12: they have led to some patient deaths, you know, and
1:35:57
Speaker 12: so I certainly am far from an expert on the topic,
1:36:01
Speaker 12: but I do think that this is it's kind of
1:36:05
Speaker 12: you got to tread lightly going into the space because
1:36:09
Speaker 12: we talked about earlier the responsibility that we have to
1:36:12
Speaker 12: make sure that we take care of our patients and
1:36:14
Speaker 12: we step up to the plate. These are massive amounts
1:36:18
Speaker 12: of money that are being spent on these products, So
1:36:21
Speaker 12: I mean, we're really looking at it to see too,
1:36:23
Speaker 12: how can we integrate technology to help support the process
1:36:25
Speaker 12: and help support patients because typically in a lot of
1:36:29
Speaker 12: these conditions, we're dealing with children, at least in some
1:36:32
Speaker 12: of these gene therapies, we're dealing with pediatric diseases, genetic
1:36:37
Speaker 12: diseases or disorders, and you got the parent dynamic. People
1:36:43
Speaker 12: are scared, they're concerned, So how are we communicating with
1:36:47
Speaker 12: the family how are we keeping them informed? They're kind
1:36:49
Speaker 12: of hoping and praying that this therapy will save their child,
1:36:53
Speaker 12: and so we're, like I said, we're by no means experts,
1:36:58
Speaker 12: but we do have some experience, and we have a
1:37:00
Speaker 12: perspective on it, and we have some capabilities on it
1:37:02
Speaker 12: within Paragon that can support helping patients get access to
1:37:07
Speaker 12: these totally mind blowing and life altering treatments.
1:37:14
Speaker 2: Ed what in the space of selling gene has complicated maybe,
1:37:23
Speaker 2: like you're forward thinking of business model, is there anything
1:37:27
Speaker 2: that you have to dial into that is more prohibitive
1:37:30
Speaker 2: to being successful in that space in comparison to other medications.
1:37:36
Speaker 14: Well, it's a completely different experience. You know, it's a
1:37:40
Speaker 14: very labor intensive dispense. I would say, you know, you
1:37:46
Speaker 14: get a patient on therapy, it's there's a lot of
1:37:48
Speaker 14: people involved, so coordinating that activity is just labor intensive.
1:37:51
Speaker 14: I don't think when we talk about operational efficiency in
1:37:55
Speaker 14: those types of applications for AI, I don't think it's
1:37:57
Speaker 14: necessarily relevant for that type of because it.
1:38:01
Speaker 10: Needs to be a very It's a different experience.
1:38:06
Speaker 14: Relative to impacting from a manufacturer's perspective, though, you know,
1:38:11
Speaker 14: manufacturers are required to monitor these patients for fifteen years.
1:38:15
Speaker 14: So you you just you you, I'll say, dispense, but
1:38:19
Speaker 14: infuse a product into a seven year old person or
1:38:22
Speaker 14: eight year old or whatever it might be.
1:38:25
Speaker 10: You're required to get real world dad and real.
1:38:27
Speaker 14: World evidence on that person over time. And so pharmacies
1:38:31
Speaker 14: are typically very transactional. You know, I shift you a product,
1:38:34
Speaker 14: you maybe stand therapy for a while, you leave, and
1:38:37
Speaker 14: then you know, we get rid of your dad after
1:38:39
Speaker 14: a certain amount of time because you've moved on in life.
1:38:41
Speaker 14: And I think going forward, the technology is going to
1:38:45
Speaker 14: enable us to really monitor that patient with real data
1:38:48
Speaker 14: coming out of EHR and medical records over time, and
1:38:51
Speaker 14: we can create a different type of relationship with that
1:38:53
Speaker 14: person person in a really efficient manner that enables a
1:38:58
Speaker 14: pharmacy to provide value to manufacturer and follow through on
1:39:01
Speaker 14: helping them develop and implement and analyze and distribute that
1:39:06
Speaker 14: information over the lifetime of that drug. I don't think
1:39:09
Speaker 14: there's a lot of pharmacies that can do that today
1:39:11
Speaker 14: that's not super manually intensive to get a price that
1:39:13
Speaker 14: into the dispense. You know, I think we've we've we've
1:39:17
Speaker 14: built i'll say a better mouse trap to be able
1:39:19
Speaker 14: to do that over time.
1:39:20
Speaker 10: That's pretty impactful.
1:39:21
Speaker 14: And so I see the application from you know, our
1:39:26
Speaker 14: technology more in that part of it. From a pharmacy perspective,
1:39:29
Speaker 14: the drug development side I can't speak to. I'm sure
1:39:31
Speaker 14: it's crazy acceleration on the drug development side because of
1:39:35
Speaker 14: the use of these models. But from a pharmacy perspective,
1:39:38
Speaker 14: that's where I think the biggest impact can be that
1:39:40
Speaker 14: we're leveraging right now.
1:39:44
Speaker 12: I would just add to that that you also have
1:39:47
Speaker 12: to be mindful of the finance side of selling gen therapy.
1:39:53
Speaker 12: So that's a that's a category. We won't go into
1:39:55
Speaker 12: detail on it, but uh yeah.
1:39:57
Speaker 10: Don't get me started working out working.
1:40:01
Speaker 12: It's just an interesting dynamic, very interesting how you got
1:40:05
Speaker 12: to navigate. There's still an acquisition of product that's very expensive,
1:40:08
Speaker 12: there's still a payer, there's still a.
1:40:10
Speaker 13: Time to be paid, and so.
1:40:14
Speaker 12: It requires a different approach to the finance side of
1:40:22
Speaker 12: how you handle sellergy. So establishing that infrastructure, which we
1:40:26
Speaker 12: we've gone through and we have established it's it's a
1:40:29
Speaker 12: very important consideration.
1:40:32
Speaker 2: That's something I wouldn't have I wouldn't have thought of,
1:40:35
Speaker 2: but yeah, only cow That's that's why when I hear
1:40:39
Speaker 2: comments and I understand the passion behind the comment. We'll
1:40:43
Speaker 2: hear people in the community pharmacy space and PBM reform
1:40:47
Speaker 2: and in the advocacy and even some of the the
1:40:50
Speaker 2: legislators who are who are agreeing with the sentiment there's
1:40:55
Speaker 2: nothing specialty about specialty. And I'm like, guys, oh, listen,
1:41:00
Speaker 2: don't get me started. I'm mister PBM reform, Like I'm
1:41:03
Speaker 2: ready to you know, fight. But I'm also very realistic
1:41:06
Speaker 2: where I'm like, I'm not even a pharmacist.
1:41:09
Speaker 3: I'm not a technician. I'm a publicist.
1:41:12
Speaker 2: I'm a documenter of podcasting, and I've learned how complex,
1:41:17
Speaker 2: especially pharmacy is depending on what medication it is. Does
1:41:21
Speaker 2: it have remens reporting involved?
1:41:23
Speaker 3: Is there?
1:41:24
Speaker 2: Is it a cancer medication? Is it well, I mean
1:41:27
Speaker 2: it's delivery.
1:41:29
Speaker 3: Temperature control, follow up data.
1:41:31
Speaker 2: I mean Ted just said fifteen years of data, Like,
1:41:35
Speaker 2: come on, we didn't just this isn't just a you know.
1:41:39
Speaker 13: Yeah, I think that it's the that is the immediate.
1:41:42
Speaker 13: And I've had those conversations.
1:41:44
Speaker 12: I mean, I've got community pharmacy blood that runs through
1:41:46
Speaker 12: my chains, right yeah.
1:41:50
Speaker 13: And I think there are some therapies where it could
1:41:52
Speaker 13: be argued.
1:41:53
Speaker 12: That it's it's kind of a quote unquote glorified mail order.
1:41:57
Speaker 13: But I agree with you.
1:41:58
Speaker 12: I think there are If we're to do specialty the
1:42:01
Speaker 12: right way, then it really is different.
1:42:03
Speaker 13: It really is a different experience.
1:42:04
Speaker 12: And I would say even in the community pharmacy, you
1:42:06
Speaker 12: can argue that what makes what makes a community pharmacy special?
1:42:11
Speaker 12: And I've had these conversations with my colleagues. It's like,
1:42:13
Speaker 12: we can really, to an extent, you could replace standard
1:42:16
Speaker 12: community dispensing with robots.
1:42:18
Speaker 13: They can check a prescription. They can we now see.
1:42:21
Speaker 12: That AI can do order entry, they can enter the prescription,
1:42:25
Speaker 12: they can evaluate whether it's an appropriate dose. They can
1:42:27
Speaker 12: look at the patient's history and say whether this drug
1:42:30
Speaker 12: makes sense. They can look at drug interactions. They can
1:42:33
Speaker 12: actually physically look at the product and confirm, oh, this
1:42:36
Speaker 12: is supposed to be like centerpril. This is what's in it.
1:42:39
Speaker 12: It's like centerpril. They could effectively. Robots can do that
1:42:45
Speaker 12: better than human being could do it, arguably. So the
1:42:48
Speaker 12: real question is what should we be doing to take
1:42:51
Speaker 12: best care of that patient? And if in specialty we
1:42:54
Speaker 12: do that, then it really is special. And just like
1:42:57
Speaker 12: in the community pharmacy, there's an opportunity to do so
1:42:59
Speaker 12: much more than we're doing today, and you see that
1:43:03
Speaker 12: it is being done differently in different pharmacy settings. There
1:43:07
Speaker 12: are pharmacies that where the pharmacists, unfortunately are relegated to robots,
1:43:11
Speaker 12: and you have other pharmacies where they're delivering meaningful patient care.
1:43:15
Speaker 12: And sometimes that patient care doesn't have anything to do
1:43:18
Speaker 12: with the drug. It does have to do with their dog.
1:43:21
Speaker 12: It has to do with the support, the emotional support
1:43:25
Speaker 12: that we provide our patients to help them get through
1:43:28
Speaker 12: their care journey, which can be daunting and challenging for them.
1:43:32
Speaker 12: So I don't want to cut short the value of
1:43:34
Speaker 12: the human interaction. And I think the pharmacies that embrace
1:43:38
Speaker 12: that responsibility, they really are doing something meaningful, whether it's
1:43:42
Speaker 12: specialty or not. I think that's the opportunity and the
1:43:46
Speaker 12: responsibility that we have.
1:43:47
Speaker 3: Yep, yep, absolutely excited. This means I'm going to see
1:43:53
Speaker 3: you guys.
1:43:53
Speaker 2: And not next week, in the weekend. After that, it's
1:43:58
Speaker 2: like two weeks I'll see you. It's crazy ed you're
1:44:01
Speaker 2: excited about Vegas. I can't stand Vegas. I always say
1:44:04
Speaker 2: this and saying it forever Put me in Florida, put
1:44:09
Speaker 2: me in Arizona. Los Los Angeles would be nice. Colorado
1:44:14
Speaker 2: for goodness sake. I love when they have conferences. But Vegas.
1:44:17
Speaker 2: I mean, once you're in Vegas and I get to
1:44:19
Speaker 2: be around the people that I love, hanging out with
1:44:21
Speaker 2: pharmacystem business people, it's wonderful. But to get there and
1:44:25
Speaker 2: to be in the midst of we should.
1:44:28
Speaker 13: Have good weather though, Yeah, it should be decent.
1:44:30
Speaker 12: We're not gonna We're gonna be if we can spend
1:44:33
Speaker 12: some time outside, I mean you're gonna be.
1:44:35
Speaker 3: Yeah.
1:44:35
Speaker 2: I would like to go outside. I want to go
1:44:36
Speaker 2: on a rooftop bar somewhere. Let's make that happen. Let's
1:44:40
Speaker 2: go get lost.
1:44:41
Speaker 3: It's Ted knows all the good people in pharma that could.
1:44:44
Speaker 13: Like, yeah you Ted, you got to make that happen.
1:44:47
Speaker 10: Yeah, we'll make it him. I love Vegas. I think
1:44:49
Speaker 10: it's great. I think this rounding year is beautiful too.
1:44:52
Speaker 14: If you want to get out in or golf or
1:44:53
Speaker 14: go hiking, it's twenty minutes away, thirty minutes away.
1:44:56
Speaker 10: It's great.
1:44:57
Speaker 3: We're gonna do something different, do something crazy. Let's get
1:45:02
Speaker 3: out there.
1:45:02
Speaker 2: Hey Amba twenty twenty six, COMCS Booth.
1:45:07
Speaker 3: One eight zero five.
1:45:09
Speaker 2: It's the Press podcast Press Booth. If you haven't signed
1:45:13
Speaker 2: up for participation in the three part series, if you
1:45:17
Speaker 2: want to talk about women's health, AI and specialty pharmacy,
1:45:20
Speaker 2: selling gene therapy, it's Joe de Pinto, not Joe DiPietro.
1:45:26
Speaker 13: I thought it was no.
1:45:28
Speaker 2: I'm sorry, buddy, but he always shows up. He's always
1:45:31
Speaker 2: on the show. He's always at this MBA. So shout
1:45:34
Speaker 2: out to Joe. But maybe we can get Joe to
1:45:37
Speaker 2: pay for our drinks. Hey, Joe, come on for you,
1:45:39
Speaker 2: coming for you, Joe. Thanks, Hey, welcome back to this
1:45:47
Speaker 2: Week in Pharmacy. Someone that I've connected with on LinkedIn.
1:45:51
Speaker 2: I love LinkedIn as a professional networking tool. It's it's
1:45:54
Speaker 2: brought so many people to the network. It's brought intelligence
1:45:58
Speaker 2: to the network, It's brought new ho to the network
1:46:00
Speaker 2: and our clients. Doctor Andy Krutt, it's great to have
1:46:05
Speaker 2: you on twerks.
1:46:06
Speaker 3: Welcome to the show.
1:46:08
Speaker 15: Thanks so much. I'm happy to be here all right.
1:46:11
Speaker 9: Andy.
1:46:11
Speaker 2: So, one of the aspects of medicine and therapy, especially
1:46:17
Speaker 2: when it comes to mental health, is how our pharmacists
1:46:21
Speaker 2: are starting to learn a lot more about the end
1:46:25
Speaker 2: of cannabinoid system, of how to leverage psychedelics possibly in
1:46:31
Speaker 2: treatment or how that could give them another tool, especially
1:46:36
Speaker 2: for conditions like PTSD with our veterans. So you have
1:46:41
Speaker 2: a survey, you're going to be collecting information to really
1:46:44
Speaker 2: do exactly what we're talking about, which is learn more
1:46:47
Speaker 2: about the science and get information from the providers that
1:46:50
Speaker 2: are out there that are in the trenches. So give
1:46:53
Speaker 2: our listeners a short overview of this survey and how
1:46:58
Speaker 2: they can get involved.
1:47:00
Speaker 15: So the survey, the Psychedelic Pharmacist Association is working with
1:47:05
Speaker 15: doctor Dan Krueger of the University of Michigan, and this
1:47:09
Speaker 15: is one part of a study that we're doing on
1:47:12
Speaker 15: the current state of psychedelic education and pharmacy schools. So
1:47:18
Speaker 15: we're kind of trying to scientifically evaluate our assumption that
1:47:22
Speaker 15: curriculum is not including psychedelics even though they've kind of
1:47:27
Speaker 15: been in pipelines for quite some years, and we're just
1:47:33
Speaker 15: trying to pull practicing pharmacists to see where they are.
1:47:36
Speaker 15: We have other parts of the study where we've asked
1:47:39
Speaker 15: schools of pharmacy to check their curriculum and then we're
1:47:41
Speaker 15: also checking their website. So really hope for folks to
1:47:46
Speaker 15: participate with that.
1:47:48
Speaker 3: So we're going to have a link to the to
1:47:52
Speaker 3: the survey in the show notes.
1:47:54
Speaker 2: So listeners, if you're driving, if you're if you're jogging,
1:47:58
Speaker 2: don't worry about it. Get somewhere safe, get access. I'm
1:48:01
Speaker 2: also going to post this on Instagram, Twitter, Facebook, and
1:48:06
Speaker 2: our LinkedIn so that people know that it's out there,
1:48:08
Speaker 2: that it's it's something that they should be involved in.
1:48:11
Speaker 3: We want their feedback.
1:48:12
Speaker 2: I don't I don't necessarily want the consumers feedback.
1:48:15
Speaker 3: They don't understand, they don't you know.
1:48:17
Speaker 2: And I don't even want people that aren't tied back
1:48:20
Speaker 2: to pharmacology like I'd much rather have. I think, if
1:48:23
Speaker 2: I think of all of our providers, unless you're a
1:48:26
Speaker 2: physician that hasn't been nothing, you know, really been digging
1:48:29
Speaker 2: into psychedelics specifically, I want the pharmacists to chime in
1:48:33
Speaker 2: because of interactions and metabolization and allergicness or whatever else
1:48:41
Speaker 2: might come into this, but share with our listeners some
1:48:44
Speaker 2: of the work.
1:48:45
Speaker 3: That you've been doing.
1:48:45
Speaker 2: And also, you know, the tie back to the Psychedelic
1:48:49
Speaker 2: Pharmacist Association too.
1:48:52
Speaker 15: Sure, So my primary work is in the cannabis space,
1:48:55
Speaker 15: I'm a practicing pharmacy and the pharmacist and the PA
1:48:58
Speaker 15: Medical Cannabis program and psychedelics have a lot of crossover,
1:49:02
Speaker 15: and that they all went in to schedule want at
1:49:04
Speaker 15: about the same time we said that there was no
1:49:07
Speaker 15: medicinal value to any of these substances and control them
1:49:12
Speaker 15: that way. Well, it turns out that we're finding quite
1:49:14
Speaker 15: a lot of potential when it comes to several of
1:49:18
Speaker 15: these substances, and we need to, you know, really look
1:49:22
Speaker 15: at that as patients and people throughout are suffering from
1:49:27
Speaker 15: mental health care conditions. You know, it's quite a high prevalence,
1:49:31
Speaker 15: and a lot of folks are running into being refractory
1:49:36
Speaker 15: to care whatever we want to call that. They're having
1:49:40
Speaker 15: trouble with the current standard of care. It's not helping them,
1:49:43
Speaker 15: and there does seem to be some utility in some
1:49:46
Speaker 15: of these modalities.
1:49:47
Speaker 3: For that.
1:49:48
Speaker 15: There is you know, stage three clinical trials for psilocybin
1:49:53
Speaker 15: twenty five milligrams coming out for treatment resistant depression. The
1:49:58
Speaker 15: same company that's actually two companies, The same company has
1:50:02
Speaker 15: it also in trial for PTSD and anarexia ni versa.
1:50:08
Speaker 15: We're looking at a few different psychedelics when it comes
1:50:11
Speaker 15: to seeing how they sort of amp up this neuroplasticity,
1:50:15
Speaker 15: and although that that mechanism isn't fully elucidated, it is
1:50:18
Speaker 15: very interesting to look at and it really doesn't go
1:50:22
Speaker 15: off of that that mindset that we came through pharmacy
1:50:26
Speaker 15: school with that mental health is related to a neurotransmitter imbalance.
1:50:31
Speaker 15: It is the way we go through the world that
1:50:34
Speaker 15: creates that neurochemistry, and if we're not working on the
1:50:38
Speaker 15: mindsets that got us into that neurochemistry, then we can't
1:50:42
Speaker 15: really move it forward. And there does seem to be
1:50:45
Speaker 15: some capacity for cannabis to help in the mental health space,
1:50:49
Speaker 15: although you really have to be careful when developing that
1:50:52
Speaker 15: right relationship. A lot of folks are finding we're seeing
1:50:55
Speaker 15: an increased prevalence of cannabis use disorder as it becomes
1:50:58
Speaker 15: we're widely used. Psychedelics don't seem to have quite the
1:51:02
Speaker 15: same when it comes to a use disorder potential. They
1:51:07
Speaker 15: actually seem to help with a lot of the folks
1:51:10
Speaker 15: that are trying one of the big studies with psilocybin
1:51:13
Speaker 15: for smoking cessation or things like that. I think I
1:51:18
Speaker 15: answered your question.
1:51:18
Speaker 2: Yeah, yeah, I want from your perspective and experience. When
1:51:25
Speaker 2: I hear pharmacists talking about psilocybin THHC ended kinnabinoid system,
1:51:32
Speaker 2: I always think of administration. I think there's the smoking,
1:51:39
Speaker 2: administration vapor, there's.
1:51:42
Speaker 3: The edibles, there's the topicals.
1:51:46
Speaker 2: Of course they're using THHC and topical where you're you're
1:51:50
Speaker 2: drilling down into the pain right in the exact spot
1:51:53
Speaker 2: where you're kind of like messing with the nerves.
1:51:55
Speaker 9: And I love it.
1:51:57
Speaker 2: I just freaking love the because it's not only the
1:52:01
Speaker 2: application and the disease state and the condition, but it's
1:52:04
Speaker 2: also at administration the way the way that a cannabis product,
1:52:11
Speaker 2: so you start digesting it, you're metabolizing it. It's a
1:52:14
Speaker 2: different I've even tried an edible, and it's a different
1:52:17
Speaker 2: type of experience than in you know, smoking something that
1:52:23
Speaker 2: was like going right to my head. And and so
1:52:26
Speaker 2: all of that knowledge comes back to the pharmacists where
1:52:29
Speaker 2: they're like, so my question is do you see psilocybin
1:52:33
Speaker 2: and THHD moving into the compounding space so that we
1:52:37
Speaker 2: could customize therapy as we move through condition, especially if
1:52:42
Speaker 2: it was like mental health for example, and you're like,
1:52:45
Speaker 2: maybe they need a slight variation or a slight bit more,
1:52:49
Speaker 2: a slight slight bit less. But do you see a
1:52:53
Speaker 2: freedom of the provider to really kind of dial into
1:52:56
Speaker 2: the speccivity of the patient.
1:53:00
Speaker 15: The answer is, I'm not sure. With the way that
1:53:03
Speaker 15: the programs are currently rolling out, a lot of what
1:53:06
Speaker 15: we would see a compounding pharmacists do is done by
1:53:12
Speaker 15: grower processors. But I also do know that there's cannabis
1:53:18
Speaker 15: practitioners that very much try to dial in each phytocannabinoid
1:53:23
Speaker 15: to their patient. And then if we could ease that
1:53:26
Speaker 15: in some way ease the burden of trying to remember
1:53:29
Speaker 15: all of these things to take and compounding it into
1:53:32
Speaker 15: a single form, I think that that could be useful.
1:53:35
Speaker 15: So there's definitely possibilities there. And the other thing to
1:53:39
Speaker 15: remember is that just because these things kind of exist
1:53:44
Speaker 15: in one space doesn't mean they're existing across the board.
1:53:46
Speaker 15: We have like forty different cannabis markets. It's very different
1:53:50
Speaker 15: for patients as they try to go in each state,
1:53:52
Speaker 15: and the lack of federal clarity on any of these
1:53:56
Speaker 15: is just harming patients try to navigate the space because
1:53:59
Speaker 15: they don't even have the assistance of health care. Health
1:54:02
Speaker 15: Care is afraid to come out and say, okay, well,
1:54:04
Speaker 15: we're not just neutral. We even see the utility in
1:54:07
Speaker 15: this because you know that they're afraid of what the
1:54:10
Speaker 15: federal government come back and say. And it's just it's
1:54:13
Speaker 15: difficult because we don't have you know, there isn't a
1:54:17
Speaker 15: big money payday to help people engage with some of
1:54:21
Speaker 15: these substances that could be a lot more common. You know,
1:54:25
Speaker 15: just because a drug company is coming with a product
1:54:30
Speaker 15: that is going to be on the market doesn't mean
1:54:32
Speaker 15: that people still can't go by psilocybin mushrooms from someone
1:54:37
Speaker 15: and trying to help people navigate those spaces. I think
1:54:40
Speaker 15: a place where pharmacists could could really be of assistance.
1:54:43
Speaker 3: That's what we do.
1:54:44
Speaker 2: Yeah, self medication angle, I don't think it's a good
1:54:49
Speaker 2: long term, you know solution. I think having a pharmacist
1:54:54
Speaker 2: to really become consultative and dialing in and making the
1:54:59
Speaker 2: recommendtions based on the research and the you know, the
1:55:02
Speaker 2: experience that they have, especially like you Andy, have really
1:55:06
Speaker 2: dialed deep into endocannabinoid system and be starting to be
1:55:10
Speaker 2: specific for condition and in weight and you know, sex
1:55:15
Speaker 2: and in like stage of life, and like it's there's
1:55:18
Speaker 2: a whole this is a whole science in and of itself.
1:55:21
Speaker 2: I could I could see Board of Specialty start building
1:55:25
Speaker 2: certification for whatever they're going to, whatever category that they're
1:55:30
Speaker 2: going to put, you know, psilocybin and in cannabis, if
1:55:33
Speaker 2: they belong together.
1:55:35
Speaker 3: That's actually a follow up question for you.
1:55:36
Speaker 2: Do you think that if you're learning and you're you're
1:55:39
Speaker 2: becoming a consultative pharmacist, is that a certification or or
1:55:44
Speaker 2: is that an education that could go together that that
1:55:47
Speaker 2: would be in the same category.
1:55:49
Speaker 15: There currently isn't any board certification. I will tell you
1:55:53
Speaker 15: that the nursings organizations have created a specialization in cannabis,
1:55:59
Speaker 15: but it really has and come to the pharmacy realm.
1:56:02
Speaker 15: Yet we haven't seen anything on kind of these modalities
1:56:07
Speaker 15: that are coming through state you know, they're not coming
1:56:10
Speaker 15: through the normal healthcare pipeline. They're coming through state organizations.
1:56:15
Speaker 15: You know, politicians seeing their constituents saying we need this
1:56:19
Speaker 15: and we need to figure out a way for it.
1:56:20
Speaker 15: So that's why we have three states now with the
1:56:22
Speaker 15: legal route to psilocybin. So you know, it really would
1:56:26
Speaker 15: be great for pharmacists to start understanding that as we
1:56:28
Speaker 15: see more and more states kind of jump onto that.
1:56:32
Speaker 15: As for education, they did a big DELFI study on
1:56:35
Speaker 15: what it would look like to put the endocannabinoid system
1:56:39
Speaker 15: and cannabis pharmacology into healthcare curriculum for physicians. They wanted
1:56:44
Speaker 15: forty hours. And the big question becomes where do you
1:56:46
Speaker 15: put it? What do you lose to do that? And
1:56:51
Speaker 15: I mean it's an important discussion, but I also understand
1:56:54
Speaker 15: that it's where do you put it in? But we
1:56:58
Speaker 15: don't have the endocannabinoid system really in pharmacy curriculum. I
1:57:01
Speaker 15: think it's getting better. I ask pharmacy students all the time,
1:57:04
Speaker 15: what do you know about the endocannabinoid system? Let's talk
1:57:06
Speaker 15: about it, And I'm starting to get better answers like
1:57:09
Speaker 15: at least we'll talk about CB one and CB two,
1:57:12
Speaker 15: but you know, really getting into the nuance of what
1:57:15
Speaker 15: it does to regulate people's homeostasis is still very much
1:57:19
Speaker 15: a specialized nuance.
1:57:21
Speaker 3: Yeah. Well, it's fascinating. We can't wait to dig in more.
1:57:25
Speaker 2: I want to invite you back Andy on a follow
1:57:27
Speaker 2: up discussion. I also want to give the listeners a
1:57:31
Speaker 2: heads up. Go to the Psychedelicpharmacist dot org website. Once again,
1:57:37
Speaker 2: that's Psychedelic Pharmacist dot org and then reach out to Andy.
1:57:42
Speaker 2: Last name is k r U t Andy Krut, doctor
1:57:47
Speaker 2: Andy Krutt. Just look him up on LinkedIn, reach out
1:57:51
Speaker 2: to him, ask questions, but Andy, promise you're going to
1:57:53
Speaker 2: come back to twerks.
1:57:55
Speaker 3: Absolutely.
1:57:56
Speaker 15: It's been great to be here.
1:57:57
Speaker 3: Thank you, all right, we'll talk to you sin.
1:58:00
Speaker 15: Thanks, good bye,