Latest / Becker’s Healthcare Podcast / How AI and Data Are Reshaping Pharmacy Operations

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How AI and Data Are Reshaping Pharmacy Operations · Becker’s Healthcare Podcast

• 0:00
  - Hello, everyone. This is Erica Spicer Mason with
• 0:02
  - Becker's Healthcare. Thank you so much for tuning
• 0:05
  - in to the Becker's Healthcare podcast series.
• 0:08
  - So today, we're going to talk about how
• 0:10
  - AI and data are reshaping medication management and
• 0:13
  - the pharmacy workforce.
• 0:15
  - And joining me for this conversation is doctor
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  - Susan Wright, the vice president of pharmacy services
• 0:20
  - at Wellstar Health System.
• 0:22
  - Doctor Wright, great to have you with us
• 0:23
  - on the podcast. Thanks so much for being
• 0:25
  - here. Thank you, Erica. Thanks for including me.
• 0:28
  - Of course. And before we get into the
• 0:31
  - conversation,
• 0:32
  - would you mind saying just a little bit
• 0:33
  - about yourself and your work in pharmacy to
• 0:35
  - give our listeners some perspective on where you're
• 0:37
  - coming from?
• 0:38
  - Absolutely.
• 0:40
  - Once again, I'm Susan Wright, vice president of
• 0:42
  - pharmacy services for Wellstar Health System.
• 0:44
  - I have been with Wellstar almost twenty five
• 0:46
  - years. I started as a volunteer to see
• 0:49
  - if I wanted to go to pharmacy school.
• 0:51
  - So it's been just
• 0:53
  - a a great opportunity for me to learn
• 0:55
  - and grow here within the same organization.
• 0:58
  - Have been very active in,
• 1:00
  - our state at,
• 1:02
  - the... For Georgia Society of Health System Pharmacists,
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  - serving on that committee, extensively.
• 1:08
  - And also, being involved in ASHP
• 1:11
  - and the work that that very important organization
• 1:13
  - does for health systems as well.
• 1:15
  - Wonderful.
• 1:16
  - Doctor Wright, great to learn that about your
• 1:18
  - background and and your tenure
• 1:20
  - at Wellstar. I'm sure you've seen medication management
• 1:24
  - evolve in so many ways since those early
• 1:26
  - days at the health system.
• 1:27
  - So that... That's really where I'd like to
• 1:29
  - start our conversation.
• 1:31
  - I know medication management has always been a
• 1:33
  - complex process, but I think the pressures that
• 1:36
  - leaders are feeling lately,
• 1:38
  - those pressures are especially heightened. So from where
• 1:41
  - you sit, what have been the biggest changes
• 1:43
  - in just the last few years in medication
• 1:45
  - management, and how are they reshaping how health
• 1:48
  - systems approach it?
• 1:49
  - Yeah. So that's a great question, and
• 1:52
  - I think there's a number of factors that
• 1:54
  - we have seen a tremendous amount of change,
• 1:56
  - in recent times.
• 1:58
  - You know, first and foremost is limited staff.
• 2:02
  - You know, we are having such an issue
• 2:04
  - recruiting,
• 2:05
  - training, retaining pharmacy technicians.
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  - There's also been a decrease in the number
• 2:10
  - of pharmacists that are graduating from our pharmacy
• 2:13
  - schools.
• 2:14
  - So, you know, we have this aging population
• 2:16
  - and a decrease in pharmacy services to sub...
• 2:19
  - To support that.
• 2:21
  - So, you know, this this has a downstream
• 2:23
  - effect. It ultimately
• 2:25
  - impacts the type of care that we can
• 2:26
  - provide. It limits the pharmacist's ability to work
• 2:29
  - at the top of their license,
• 2:31
  - when they get pulled back into dispensing type
• 2:33
  - activities.
• 2:34
  - So we need to find not only ways
• 2:38
  - to
• 2:39
  - increase the workforce, but also ways the technology
• 2:42
  - can help, solve for those problems.
• 2:44
  - In addition, we have this very fragile supply
• 2:48
  - on the medication pipeline.
• 2:50
  - Direct shortages have pretty much become a permanent
• 2:53
  - part of our operational procedures,
• 2:56
  - in the health systems.
• 2:58
  - There's so many sole source products that
• 3:01
  - are creating
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  - these overwhelming challenges on a day to day
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  - basis.
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  - We have to work through many therapeutic substitutions,
• 3:09
  - lots of changes in the electronic health records,
• 3:12
  - pump changes. You know, it creates such
• 3:16
  - a disarray of of problems,
• 3:19
  - that that we see and spend a lot
• 3:22
  - of time working through them and and trying
• 3:24
  - to solve for them.
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  - And then last but not least,
• 3:27
  - we are really seeing tighter margins in pharmacy.
• 3:31
  - When I first started in pharmacy,
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  - we... It was... Pharmacy was seen as mostly
• 3:36
  - a cost center,
• 3:38
  - and the the focus was on reducing medication
• 3:40
  - costs, reducing medication costs. And then things began
• 3:43
  - to change, and we saw the rise in
• 3:45
  - infusion and specialty pharmacy,
• 3:47
  - and it started to flip toward more of
• 3:49
  - a revenue center.
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  - Well, now we are seeing headwinds,
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  - on reimbursements
• 3:54
  - on the three forty b model that are
• 3:56
  - going to significantly
• 3:58
  - impact,
• 3:59
  - future of of pharmacy and its role in
• 4:01
  - the health system. So we need to find
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  - some solutions,
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  - to not only continue to promote,
• 4:07
  - those specialty and infusion type services, but also
• 4:10
  - to realistically
• 4:12
  - reduce
• 4:13
  - the operational costs associated with medications in the
• 4:16
  - hospital.
• 4:18
  - Yeah. Doctor Wright, I appreciate the overview, and
• 4:20
  - I'm struck by
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  - how
• 4:23
  - those three forces that you just mentioned, limited
• 4:25
  - staff, a fragile supply chain, tighter margins.
• 4:28
  - I mean, those are very significant issues coming
• 4:31
  - at pharmacy teams from all directions. So I
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  - imagine this is a lot to work through
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  - at the health system level.
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  - I do wanna talk a little bit more
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  - about the limited staff piece. I know that
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  - that was one of the first issues that
• 4:44
  - you raised in medication management.
• 4:47
  - And through our own reporting at Becker's and
• 4:49
  - some industry insights, we've... We know that pharmacy
• 4:52
  - technician shortages
• 4:53
  - do continue to strain hospitals nationwide,
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  - and pharmacy graduation rates have have also declined
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  - at the same time by about nearly percent...
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  - Nearly 10 in just a few... In in
• 5:04
  - recent years. So how do you see technology,
• 5:07
  - especially AI enabled tools, changing the equation for
• 5:10
  - your workforce, and and what long term gains
• 5:12
  - do you see them driving?
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  - Yeah. I think it's an opportunity
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  - for us,
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  - to not necessarily reduce the workforce,
• 5:21
  - but to expand what they do and give
• 5:23
  - time back so that way they can do
• 5:25
  - activities
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  - that are closer to the patient and more
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  - meaningful
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  - in helping across that continuum
• 5:31
  - of medication care. You know, once a a
• 5:34
  - patient leaves the hospital,
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  - there's this huge gap between
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  - the acute setting and what happens once they
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  - get into their home. And I think that
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  - programs like meds to beds, putting the prescriptions
• 5:46
  - in patients hands,
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  - giving more medication access to the patients, finding
• 5:50
  - out, working with them with what their insurance
• 5:53
  - will cover,
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  - ensuring adherence down the road. I think all
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  - of those are activities
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  - that if we can
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  - take off some of the routine
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  - burden of some of the operational things that
• 6:06
  - pharmacy technicians do, where technology or AI has
• 6:09
  - shown to be effective.
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  - I I think we'll end up
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  - providing better patient care
• 6:15
  - in a more meaningful way with the staff
• 6:18
  - that we do have.
• 6:20
  - Yeah. Doctor Wright, thank you. And I'm curious.
• 6:24
  - Have you seen an example like that play
• 6:26
  - out at Wellstar, you know, an instance where
• 6:29
  - you were able to take some of that
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  - routine operational burden off of your pharmacy teams
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  - and
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  - by the product of that, they were able
• 6:37
  - to provide more maybe personalized patient care or
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  - just get more... Even even get more satisfaction
• 6:42
  - from their roles. Would love any examples where
• 6:44
  - you've seen that. Sure. Well, one of the
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  - things we're doing at Wellstar is,
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  - we are in the process. Some of our
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  - facilities have what they call medication carousels
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  - which,
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  - helps with storage,
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  - barcode scanning, making sure that we are getting
• 6:58
  - the right medications up to the nursing units,
• 7:01
  - at the right time.
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  - We're implementing a platform called BD Logistics
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  - with those carousels across the system
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  - and what that allows us to do is
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  - have one source of truth
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  - on what medications
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  - we have in the pharmacy. You know, obviously,
• 7:17
  - each hospital pharmacy,
• 7:18
  - it has its own purchaser.
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  - It has its own medication inventory.
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  - These types of AI tools allow us not
• 7:26
  - only to have visibility into what is in
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  - each hospital,
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  - but it also allows us to make better
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  - decisions
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  - around moving that inventory
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  - around. So,
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  - one example is we just approved a high
• 7:39
  - dollar medication through our p and t committee,
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  - And instead of stocking it at... On the
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  - shelves of every pharmacy,
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  - we made the decision to stock it at
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  - the highest acuity hospitals where it would most
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  - likely be used knowing that we would have
• 7:53
  - that visibility if we needed to move the
• 7:57
  - medication,
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  - across the system. And we're also can do
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  - that on a facility level between our automated
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  - dispensing cabinets and and the pharmacy inventory as
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  - well. So, you know, the the AI in
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  - that role has really helped us,
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  - maximize our space, better utilize
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  - our barcode scanning technology,
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  - and also reduce inventory overall.
• 8:19
  - Yeah. Great to hear some of those outcomes,
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  - doctor Wright. And and what you just described,
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  - I think, is very reflective of a broader
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  - trend that we're seeing across health systems.
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  - We're seeing many leaders say that they're prioritizing
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  - working toward that better visibility that you just
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  - described
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  - into inventory,
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  - you know, across their enterprise
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  - and also to enable more proactive
• 8:42
  - data driven pharmacy operations.
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  - So I'd love to know a little bit
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  - more about how it will start those goals
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  - connect. You know, what has to be in
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  - place, whether that's across technology, governance, culture, to
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  - really move from reacting to problems in pharmacy
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  - toward anticipating them?
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  - Sure. And I think it's important to use
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  - all three of those,
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  - the technology, the governance, and the culture in
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  - your practice. You know, so one thing that
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  - we've had for a long time,
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  - is a standing shortage call. We get our
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  - inventory specialist together twice a week. We discuss
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  - any shortages, anything they're having a hard time
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  - seeing
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  - or obtaining. We share that across the facilities
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  - and, make decisions as far as, hey. Can
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  - you help me out here and send, you
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  - know, drug x that I'm having a hard
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  - time getting?
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  - Which is fine, and it's been a useful
• 9:33
  - tool up to this point.
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  - But now, once again, we have this technology
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  - that can assist with some of that and
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  - help us make better decisions,
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  - help us make more expedited decisions
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  - around, you know, do we need to take
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  - this to a p and t for a
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  - therapeutic substitution?
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  - Do we have better data
• 9:52
  - from the industry itself on what may be
• 9:55
  - going on shortage? And AI can also help
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  - with some of those decisions as well to
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  - help us make better
• 10:02
  - utilization and governance around these medications.
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  - We can also use it to predict
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  - demand
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  - for our infusion patients or our specialty pharmacy
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  - patients.
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  - So that way we know that if we
• 10:14
  - have these patients coming in for this specific
• 10:17
  - infusion,
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  - we know exactly how much inventory we need
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  - to keep and anticipate any barriers that we
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  - might have between now and when that patient
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  - is is coming for their treatment.
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  - Yeah. Absolutely.
• 10:29
  - And doctor Wright, I know storage design itself
• 10:33
  - is increasingly seen as a safety factor at
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  - many health systems rather than just an operational
• 10:38
  - one. So I'd love to know how wellSTAR
• 10:40
  - is thinking about storage design and, you know,
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  - what is your approach
• 10:45
  - between storage design and reducing selection errors at
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  - the point of care?
• 10:49
  - Yes. And that's a very timely topic, and
• 10:52
  - something that I think is very front of
• 10:53
  - mind right now. So we are trying to
• 10:55
  - deploy technology
• 10:57
  - that makes it easy to do the right
• 10:59
  - thing.
• 11:00
  - So whether that is barcode scanning,
• 11:04
  - nurse guided removal,
• 11:06
  - interoperability,
• 11:07
  - hard stops around high risk medications,
• 11:11
  - lack of,
• 11:13
  - being able to override
• 11:15
  - certain areas, and also standardization
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  - across, the
• 11:20
  - the system from cabinet to cabinet.
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  - I I think that all of those things
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  - help
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  - maximize
• 11:28
  - the end user's ability to do the right
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  - thing at the right time.
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  - It's all too easy. You know, everybody has
• 11:34
  - a lot of things going on, a lot
• 11:36
  - of challenges
• 11:37
  - that they're working with at the point of
• 11:39
  - care, and the the things and the technology
• 11:42
  - that you can deploy
• 11:44
  - to make the the person do the right
• 11:46
  - thing at that moment,
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  - that, you know, that's just a win for
• 11:49
  - everyone. And then once again, taking it back
• 11:52
  - and going back to that governance as well,
• 11:54
  - making sure that you're still having oversight
• 11:57
  - to those decisions
• 11:58
  - and making sure that
• 12:01
  - you are using them in the most effective
• 12:03
  - manner.
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  - Yeah. And doctor Wright, I appreciate how you
• 12:07
  - boiled that down to that that simple aim
• 12:09
  - that
• 12:10
  - you have of trying to deploy tech that's
• 12:12
  - making it easy to do the right thing.
• 12:14
  - Such a simple but powerful way of stating
• 12:16
  - that.
• 12:17
  - So I wanna make sure we touch on
• 12:19
  - one more trend here before I let you
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  - go.
• 12:22
  - I know that there's growing interest in following
• 12:24
  - the patient's medication journey beyond just the four
• 12:27
  - walls of the hospital.
• 12:28
  - You know, leaders and and health systems are
• 12:30
  - interested in seeing the patient's journey from the
• 12:33
  - physician's office through inpatient discharge and back home.
• 12:37
  - What role do you see connected data and
• 12:39
  - analytics platform is playing in making that possible?
• 12:43
  - Yeah. Well, we know that when you have
• 12:44
  - that type of care across the the continuum,
• 12:48
  - that patients do better, that we don't see
• 12:50
  - them in the acute care environment as as
• 12:53
  - often. They're they're not coming back on readmissions,
• 12:57
  - and
• 12:58
  - generally maintain,
• 13:00
  - healthier
• 13:01
  - status and lifestyles.
• 13:03
  - So
• 13:04
  - my goal would be from a medication perspective
• 13:07
  - is to know, number one, what was prescribed,
• 13:11
  - number two,
• 13:12
  - what they obtained.
• 13:14
  - Number three, what they are actually taking.
• 13:17
  - And last but certainly not least, what is
• 13:20
  - working for them.
• 13:21
  - And what I would like is for one
• 13:24
  - platform
• 13:25
  - that integrates with our EHR
• 13:27
  - to do this.
• 13:28
  - Because I think when we have this fragmented
• 13:31
  - approach,
• 13:32
  - we lose bits and pieces along the way,
• 13:34
  - and it's also more of a burden on
• 13:36
  - our IT teams to maintain multiple platforms.
• 13:40
  - So I I think
• 13:42
  - what my desire would be is to have
• 13:45
  - some type of oversight
• 13:47
  - that would work in conjunction with our EHR
• 13:49
  - to have that visibility into what's happening with
• 13:52
  - the patient, not when they're in our care,
• 13:54
  - but also when they are at home, which
• 13:56
  - is becoming a more and more
• 13:58
  - important
• 13:59
  - piece of the equation.
• 14:01
  - So once again, I think bring the EHR
• 14:04
  - and outpatient prescription records together, reduce fragmentation,
• 14:09
  - use smart technology in the home when we
• 14:11
  - can, whether that is,
• 14:14
  - smart prescription
• 14:15
  - vials and and caps,
• 14:17
  - or
• 14:18
  - blood pressure monitors,
• 14:19
  - scales,
• 14:20
  - checking your blood sugar, things like that. So
• 14:23
  - that way we can have a better understanding
• 14:25
  - of of what is actually working in the
• 14:27
  - patient's home as well. And then once again,
• 14:30
  - that AI to bring in what is the
• 14:33
  - patient's prescription challenges, you know, is it being
• 14:36
  - covered? Is there a way to make adherence
• 14:38
  - easier for them by having it delivered to
• 14:40
  - their door?
• 14:41
  - All those factors,
• 14:43
  - just trying to make it as simple for
• 14:45
  - the patient and as effective as possible and
• 14:47
  - for us to have visibility
• 14:49
  - into what that looks like for them.
• 14:51
  - And doctor Wright, I I so appreciate all
• 14:53
  - of those thoughts and everything that you just
• 14:55
  - highlighted, all of those steps that have to
• 14:57
  - go right for the patient to even obtain
• 14:59
  - the medication,
• 15:01
  - continue taking it, assess whether it's working for
• 15:03
  - them. You know, there's so much that goes
• 15:05
  - into that, and so I can completely understand
• 15:07
  - how that goal of having one platform that
• 15:10
  - can integrate all of that, so that health
• 15:12
  - systems and pharmacy teams can better track a
• 15:14
  - patient's journey.
• 15:15
  - I can completely see the case for that.
• 15:17
  - So I just wanna thank you again for
• 15:19
  - for your time and your insights with Becker's
• 15:21
  - today. Thank you.
• 15:22
  - Thanks, Erica.
• 15:24
  - And, of course, we'd also like to thank
• 15:25
  - our podcast sponsor, BD.
• 15:28
  - Listeners, be sure to tune in to more
• 15:30
  - podcasts from Becker's Healthcare by visiting our podcast
• 15:33
  - page at beckershospitalreview.com.