Latest / Becker’s Healthcare Podcast / Nilesh Desai, MBA, BS, RPh, CPEL, CPPS, Chief Pharmacy Officer at Baptist Health System

Transcript

Nilesh Desai, MBA, BS, RPh, CPEL, CPPS, Chief Pharmacy Officer at Baptist Health System · Becker’s Healthcare Podcast

• 0:00
  Welcome to the Becker's pharmacy leadership podcast. I'm
• 0:03
  Ella Jeffries, pharmacy reporter with Becker's Healthcare. Today,
• 0:06
  I'm joined by Nilesh Desai, chief pharmacy officer
• 0:09
  at Baptist Health System. In this episode, we'll
• 0:11
  be discussing the headwinds pharmacy leaders are navigating
• 0:14
  today along with the opportunities emerging for pharmacy
• 0:17
  teams as health care to continues to evolve.
• 0:19
  Nilesh, thank you so much for joining me
• 0:21
  today. To start us off, can you share
• 0:23
  a bit about your role as chief pharmacy
• 0:25
  officer and what's top of mind for you
• 0:26
  as you lead pharmacy across your system today?
• 0:29
  Thank you, Ella, for having me.
• 0:32
  So, Nilesh Shasai. I'm the chief pharmacy officer
• 0:34
  at Baptist Health. I've been here almost six
• 0:37
  years now,
• 0:38
  and,
• 0:40
  I oversee all of pharmacy services across our
• 0:43
  health system. We are,
• 0:45
  eight hospital system.
• 0:47
  We have 12 retail pharmacies. We have a
• 0:49
  big central pharmacy that we just went live
• 0:51
  last year. And,
• 0:53
  we're in the middle of,
• 0:55
  completing our implementation
• 0:57
  across our system.
• 0:59
  And,
• 1:01
  you know, as as,
• 1:03
  we have done a lot of work, in
• 1:05
  the pharmacy space, we really brought pharmacy
• 1:09
  to the forefront at Baptist with all our
• 1:11
  initiatives,
• 1:13
  and, you know, as recent as opening the
• 1:15
  100,000 square feet central pharmacy.
• 1:18
  But there are obviously a lot more headwinds,
• 1:20
  You
• 1:21
  know, three forty
• 1:23
  space with all the changes, the Inflation
• 1:25
  Reduction Act,
• 1:27
  all the initiatives that are kicking off, oneone
• 1:29
  hundred and twenty six with the 10 drugs
• 1:31
  or nine drugs now. And then,
• 1:34
  ongoing
• 1:34
  changes with 340B
• 1:36
  Medicaid,
• 1:37
  you know, reduction in Medicaid patients that is
• 1:39
  resulting in some
• 1:41
  issues on the dish percentage.
• 1:44
  And then really,
• 1:45
  medication access continues to be the biggest challenge
• 1:49
  as as a lot of these,
• 1:51
  pharmacies,
• 1:53
  are closing and or gonna close depending on
• 1:56
  how,
• 1:58
  the financial viability turns out.
• 2:01
  You know, end of the day, we still
• 2:02
  have to figure out a way how to
• 2:04
  provide patients with access to medications.
• 2:08
  You know, a lot of our retail pharmacies
• 2:10
  are not open, twenty four seven, except, you
• 2:13
  know, we may have some weekend coverage here
• 2:15
  and there at couple other sites.
• 2:17
  So we're looking at other options where, you
• 2:20
  know, we can deploy kiosks or some type
• 2:22
  of technology
• 2:24
  where you can you can have at least
• 2:26
  the top medications that folks when they come
• 2:28
  to the ED and they need some medications,
• 2:30
  we can have those medications be available for
• 2:33
  them.
• 2:34
  So those are the kind of things that
• 2:35
  we're looking at right now.
• 2:37
  Again, sustaining,
• 2:38
  the growth,
• 2:39
  sustaining,
• 2:41
  and maintaining or increasing growth.
• 2:43
  But it it's just that,
• 2:45
  I wanna make sure that,
• 2:48
  you know, pharmacy continues to contribute to the
• 2:52
  health of our,
• 2:54
  our patients and then really to the bottom
• 2:56
  line to our, from a health system perspective.
• 2:59
  Great. Thank you for sharing. That was really
• 3:01
  helpful context.
• 3:03
  You mentioned, you know, three four two b
• 3:04
  and those pressures. What is your health system
• 3:07
  doing or what are you doing with your
• 3:08
  team to prepare for those?
• 3:10
  Yeah. A lot of, preparation
• 3:12
  in order to get our,
• 3:14
  data sharing and everything that we need to
• 3:17
  do,
• 3:18
  and
• 3:19
  in in leveraging technology again where we can.
• 3:23
  You know, one thing we don't wanna do
• 3:25
  is keep adding FTEs,
• 3:27
  because as you all know,
• 3:29
  there's a shortage of staffing as it is.
• 3:31
  You know, we've been dealing with pharmacy technician
• 3:33
  shortage for the last fifteen years, and that
• 3:36
  hasn't improved significantly. So that continues to be
• 3:39
  a challenge. We're also dangerously entering pharmacist shortages.
• 3:43
  So, you know, we wanna make sure that
• 3:45
  judiciously
• 3:47
  use our staff.
• 3:48
  So the goal is, if we can leverage
• 3:50
  technology
• 3:52
  to to,
• 3:53
  you know, continue to do what we need
• 3:54
  to do,
• 3:56
  because these these requirements that that are out
• 3:58
  there now,
• 4:00
  you know, hope
• 4:01
  I I know a lot of vendor,
• 4:03
  community that's out there. They're trying to work
• 4:05
  on a solution here,
• 4:07
  to to help us out. So we're exploring
• 4:09
  the right partnership,
• 4:11
  so that
• 4:12
  we can do things, you know, the right
• 4:14
  way.
• 4:15
  Mhmm. For sure. Thank you for sharing that.
• 4:18
  But, you know, given all that, it does
• 4:19
  sound like there's a lot competing for attention.
• 4:20
  How are you prioritizing where pharmacy focuses its
• 4:20
  time, resources, and leadership energy?
• 4:26
  You
• 4:27
  know, as a team,
• 4:30
  we now have,
• 4:33
  a lot of projects,
• 4:34
  what we have prioritized.
• 4:36
  And then really,
• 4:38
  as we continue,
• 4:39
  to evaluate these projects
• 4:41
  periodically to say, you know, what is important.
• 4:44
  Obviously,
• 4:45
  anything that is, patient safety
• 4:48
  or
• 4:49
  or or regulatory,
• 4:50
  I mean, those always are up there. But
• 4:52
  even, you know, financial,
• 4:54
  projects that that affects the bottom line. So
• 4:57
  anything that we can be efficient, anything that
• 4:59
  we can grow our services,
• 5:01
  these three kinda
• 5:03
  always,
• 5:04
  rise to the top, but not forgetting everything
• 5:06
  else that we need to do,
• 5:08
  you know, from, from an employee engagement perspective.
• 5:11
  And, you know, if you do those things
• 5:14
  first, financials always, financials always follow. But you
• 5:18
  also have to make sure you're prioritizing or
• 5:20
  reprioritizing
• 5:21
  or adding new projects timely. So this way,
• 5:24
  you're not stuck in a in a document,
• 5:27
  or a project list all the time.
• 5:30
  For sure. And as you look into 2026,
• 5:32
  are there any new projects or new things
• 5:34
  that your team is prioritizing that you're really
• 5:36
  looking forward to?
• 5:38
  I mean, there are, many projects that we're
• 5:40
  looking at,
• 5:41
  our pump, IV pump in our operability with
• 5:44
  our EMR.
• 5:45
  We're thinking about, many other improvements to our
• 5:49
  financial assistance with our patients. So we're looking
• 5:52
  at applications. We're looking at,
• 5:55
  many other other initiatives from an inventory management
• 5:58
  perspective to streamline those things so that we're
• 6:00
  not,
• 6:02
  spending a lot of time reconciling,
• 6:05
  invoices and payments and all that stuff,
• 6:08
  that that that really takes hours and hours,
• 6:11
  and and a lot of resources on the
• 6:13
  back end.
• 6:14
  So,
• 6:15
  you know and then,
• 6:17
  you know, like I said, the big thing
• 6:19
  is the three forty b changes.
• 6:21
  The all of that is is is a
• 6:23
  big big to do because
• 6:25
  and we know it's not gonna stop here.
• 6:26
  I know there's another 15 drugs coming up
• 6:28
  in
• 6:29
  on 01/01/1927
• 6:30
  and then continued,
• 6:32
  every year, but more drugs coming on board.
• 6:34
  So we need to have systems in place.
• 6:36
  We're looking at,
• 6:38
  you know, how how other systems can come
• 6:40
  into play, more integration, more interoperability
• 6:43
  so that we're not,
• 6:46
  chasing. And then the other piece is day
• 6:48
  data
• 6:49
  is is the key where we're normalizing a
• 6:51
  lot of our data, building a lot of
• 6:53
  dashboards out, and getting prepared for the AI,
• 6:57
  in, you know,
• 6:58
  I call it the AI invasion, but it's
• 7:00
  more how do how do we leverage AI?
• 7:02
  How do we u utilize AI
• 7:05
  so that we can become continually become more
• 7:07
  efficient?
• 7:09
  Mhmm.
• 7:09
  For sure. Thank you for sharing. And now
• 7:12
  stepping back a bit to a more broader
• 7:14
  picture, where do you see the biggest opportunities
• 7:16
  for pharmacy to lead, innovate, or expand its
• 7:19
  impact within health systems?
• 7:21
  I mean, pharmacy definitely now you know, if
• 7:24
  you compare ten, fifteen years ago to what
• 7:26
  it is today, it's it's literally apples and
• 7:28
  oranges.
• 7:29
  Pharmacy now is at the forefront,
• 7:32
  you know, whether you talk clinically, whether you
• 7:34
  talk quality, whether you talk safety.
• 7:36
  And, you know, you know, now,
• 7:40
  revenue generation and,
• 7:42
  all the medication access initiatives that we're working
• 7:45
  on value based care,
• 7:46
  you know, now with addition of CAR T
• 7:49
  cell therapy and or cell and gene therapy,
• 7:52
  pharmacy is now
• 7:54
  really at the forefront,
• 7:55
  leading a lot of those efforts to make
• 7:58
  sure that the health systems
• 8:00
  are now up there,
• 8:02
  trying to provide those, you know, streams of,
• 8:05
  care, I call it.
• 8:07
  And and then really you wanna make sure
• 8:09
  you're viable financially. So
• 8:11
  negotiating with pharma, negotiating with payers, negotiating with,
• 8:15
  you know, within our providers,
• 8:17
  you know, hiring the right provider network, creating
• 8:19
  the specialty,
• 8:21
  and assisting in
• 8:24
  those spectrums with our health system so that
• 8:26
  we continue to become that center of excellence
• 8:29
  in many facets
• 8:34
  opportunities to grow and, you know, again, improve
• 8:36
  our health systems
• 8:37
  and and access to our patients.
• 8:40
  Mhmm. And where would you say pharmacy's influence
• 8:43
  is growing the fastest right now?
• 8:45
  I think it's, the more if if you
• 8:47
  look at
• 8:48
  specialty pharmacy continues to grow, community pharmacies,
• 8:51
  with Meds2Beds and all the other initiatives that
• 8:54
  are out there. Obviously,
• 8:56
  from an inpatient perspective, everything that we're doing,
• 8:59
  I think that continues to evolve.
• 9:02
  But a lot of clinical care antimicrobial stewardship
• 9:04
  is another big area. You know, in the
• 9:06
  in the initial years antimicrobial stewardship was more
• 9:09
  inpatient driven, but now we're seeing a lot
• 9:12
  more value on the outpatient side with,
• 9:14
  many,
• 9:16
  OPAD and COPAD
• 9:17
  and and all these additional stuff that goes
• 9:20
  on. Obviously, that requires resources, but that's a
• 9:22
  big quality impact on our patients.
• 9:24
  And and and, you know, making sure we're
• 9:27
  taking the right antibiotics.
• 9:29
  So these things are really a big area.
• 9:31
  And I think the other big area of
• 9:33
  focus is home infusion.
• 9:36
  This is a big, big opportunity for health
• 9:37
  systems to look at,
• 9:39
  where home infusion can can play a big
• 9:42
  role in providing out closing their rec you
• 9:45
  know, their last step of the care. So
• 9:47
  that that's another big area where we're we're
• 9:50
  focusing on as well. Mhmm. Thank you for
• 9:52
  sharing. And for pharmacy to fully capitalize on
• 9:55
  those opportunities you just discussed, what does pharmacy
• 9:58
  need to demonstrate today to be seen as
• 10:00
  a growth driver, not just a cost center
• 10:02
  within health systems?
• 10:04
  Yeah. I mean, you know, we have already
• 10:06
  demonstrated over the last few years of what
• 10:08
  pharmacy can bring to the table.
• 10:11
  Not only,
• 10:12
  revenue and all that, but also services,
• 10:15
  our patient satisfaction,
• 10:17
  you know, our retention rate with our patients,
• 10:20
  our provider satisfaction, you know, how we're reducing
• 10:23
  the administrative burden for our providers so that
• 10:26
  they can focus on seeing more patients.
• 10:29
  So a lot of that, really, and then,
• 10:31
  you know,
• 10:32
  even growing new business,
• 10:34
  plans,
• 10:35
  writing those business plans that are more effective
• 10:38
  and and and seeing that, you know, we're
• 10:40
  not only cost efficient, but also growing
• 10:43
  services in areas that we have not ventured
• 10:45
  into.
• 10:46
  I think a lot of that focus for
• 10:48
  pharmacy is gonna be in those areas.
• 10:50
  Mhmm.
• 10:51
  And how would you say that conversation has
• 10:53
  changed over time?
• 10:55
  Definitely.
• 10:56
  You know,
• 10:57
  if if I had to think, you know,
• 11:00
  again, many years ago,
• 11:02
  bringing pharmacy initiatives
• 11:03
  when we were
• 11:05
  specifically a call center
• 11:07
  to what it is today is night and
• 11:09
  day difference. How things have evolved, discussions are
• 11:11
  involved,
• 11:13
  and and and on how,
• 11:15
  we approach,
• 11:16
  subject. I think chief pharmacy officers now have
• 11:19
  a larger role to play on how to
• 11:21
  grow services,
• 11:23
  how to build that infrastructure, how to build,
• 11:26
  you know, all the things that that are
• 11:28
  necessary from a medication management perspective.
• 11:31
  I mean, these things have really changed the
• 11:33
  way of how we operate,
• 11:35
  and look at pharmacy,
• 11:37
  and and and and also,
• 11:40
  to show,
• 11:41
  the leadership
• 11:43
  that what pharmacy can bring to the table,
• 11:45
  you know, being at that
• 11:48
  seat,
• 11:48
  trying to gain trust,
• 11:51
  and and show
• 11:52
  demonstrate,
• 11:53
  and demonstrate the results, that come out of
• 11:56
  it.
• 11:57
  That really shows, you know, where pharmacy can
• 12:00
  make inroads and really deliver on the results.
• 12:02
  So this,
• 12:03
  overall, you know, I call it the three
• 12:05
  sixty
• 12:06
  or the quadruple aim.
• 12:08
  You know, we've delivered on every front, whether
• 12:11
  it's patient satisfaction, provider satisfaction, financial,
• 12:14
  bottom line, etcetera.
• 12:16
  This this this has shown where,
• 12:19
  you know, where pharmacy can make an impact,
• 12:21
  and this continues to evolve as as we
• 12:24
  continue to grow our services.
• 12:26
  Definitely.
• 12:27
  And as you look ahead, what's one change
• 12:29
  or shift do you think would make the
• 12:30
  biggest difference for pharmacy over the next few
• 12:33
  years?
• 12:34
  I think I think, pharmacy getting involved in
• 12:36
  many of the other service areas.
• 12:38
  I I think, you know, by showing what
• 12:41
  we can do,
• 12:42
  you know, improving our systems, aligning,
• 12:45
  and, you know, not and not getting stuck
• 12:46
  in the stereotyping of systems or, you know,
• 12:50
  going outside of the industry to see what
• 12:52
  is out there. And I think, taking a
• 12:54
  big leap forward on that those fronts, I
• 12:57
  think it's gonna help. And then with AI
• 12:59
  coming in, I think that's gonna be a
• 13:01
  great, you know, initiative, I would say.
• 13:05
  We have to be, careful,
• 13:07
  you know, while we wanna leverage AI to
• 13:09
  really improve our
• 13:11
  operations, become more efficient, all of that. But
• 13:14
  we also wanna do it right,
• 13:17
  that,
• 13:17
  that that information
• 13:21
  kinda, you know,
• 13:23
  is is more safer
• 13:24
  and it provides more, you know, appropriate timing
• 13:27
  for our staff.
• 13:29
  You know, this is an opportunity where you
• 13:31
  can reallocate staff to do other things.
• 13:34
  And as I spoke about staffing shortages,
• 13:37
  and drug shortages and pharmacy deserts,
• 13:40
  these are gonna continue to be a challenge.
• 13:42
  So for leaders,
• 13:44
  it's how you assess, how you make an
• 13:46
  impact,
• 13:47
  leveraging technology, leveraging AI, All these things are
• 13:50
  gonna be a big, big, challenge for us.
• 13:53
  But it's a way of, mitigating,
• 13:56
  these these, challenges as well.
• 13:59
  Mhmm. And in terms of AI, what are
• 14:02
  some air areas of AI governance that Baptist
• 14:04
  Health is looking into for 2026?
• 14:09
  Definitely,
• 14:11
  we we at Baptist, what we've done is
• 14:13
  we have, proactively created our AI
• 14:16
  infrastructure. We have a com we have committees.
• 14:18
  We have pharmacy is a big part of
• 14:20
  it. And and really what we have done
• 14:22
  is, you know, anytime we wanna bring an
• 14:25
  application that provides some type of AI functionality,
• 14:28
  then we really go through the process of
• 14:30
  vetting them out to see what what that
• 14:32
  what that advantage
• 14:33
  of bringing an AI
• 14:35
  application in it and then really look at
• 14:37
  what's the ROI. You know, what what are
• 14:39
  we trying to achieve,
• 14:41
  by bringing this AI application in? And then
• 14:43
  really, if we can start measuring outcomes, that's
• 14:46
  even a better benefit. So that's another focus
• 14:49
  point on, you know, what are the data
• 14:51
  metrics that we can collect and then really
• 14:53
  show what the value of it is. Because
• 14:55
  I think, you used to wanna bring an
• 14:57
  application in without, some type of ROI in
• 15:00
  place.
• 15:01
  So, whether it's improving quality of care, whether
• 15:04
  it's improving our employee satisfaction, or or even,
• 15:07
  you know, end of the day, some financial
• 15:09
  gains. I think
• 15:11
  there needs to be some outcomes,
• 15:13
  that we need to measure so we can
• 15:15
  drive and bring in more AI applications
• 15:17
  in all the different facets of what we
• 15:19
  practice pharmacy in.
• 15:21
  Definitely.
• 15:22
  Well, Milesh, this has been such an insightful
• 15:24
  conversation. Thank you for sharing your perspective and
• 15:26
  experience with us. That's all for today's episode
• 15:29
  of the Becker's pharmacy leadership podcast. A big
• 15:31
  thank you again to Nilesh for sharing his
• 15:33
  insights on the headwinds pharmacy leaders are currently
• 15:35
  navigating. Thanks for listening, and we'll see you
• 15:38
  next time. Thank you.