Latest / Becker’s Healthcare Podcast / Thomas Carey, PharmD, Senior Director, Pharmacy Services, UW Northern Illinois

Transcript

Thomas Carey, PharmD, Senior Director, Pharmacy Services, UW Northern Illinois · Becker’s Healthcare Podcast

0:00
This is Laura Dierdahl with the Becker's Healthcare
0:02
Podcast. I'm thrilled today to be joined by
0:04
doctor Thomas Carey, senior director of pharmacy services
0:07
at UW Northern Illinois. Doctor Carey, it's a
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pleasure talking on the podcast today. Thank you
0:12
very much. I'm, excited to be here.
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Absolutely. And, you know, this will be a
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great and very timely discussion because I know
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there's so much change happening within the pharmacy
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space and, you know, really, it's it's becoming
0:22
a transformational
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department
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for the hospitals and health systems. So I'm
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looking forward to learning more about what you're
0:28
doing at UW Northern Illinois. But before we
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begin, can you introduce yourself and just tell
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us a little bit more about the organization?
0:34
Sure. Thank you. Again,
0:36
my name is Tom Carey, Thomas Carey. I'm
0:39
the senior director of pharmacy for University of
0:42
Wisconsin in Northern Illinois.
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Within our health system that spans across,
0:47
both, Wisconsin
0:49
and Northern Illinois,
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I oversee all of our clinical and operational
0:53
activities
0:54
in both our ambulatory
0:56
and acute care settings.
0:58
UWNI is the tertiary care hub for
1:01
University of Wisconsin in the Northern Illinois region.
1:04
And as the primary disproportionate
1:07
share
1:08
hospital in Northern Illinois,
1:09
we have one of the largest emergency departments
1:11
in state seeing just shy of about 80,000
1:15
emergency department encounters per year, the largest labor
1:19
and delivery unit, mental health unit, and oncology
1:22
center, in the region.
1:24
Our senior leadership team, really has recognized the
1:27
value of pharmacy and and supporting our
1:30
approximately a 150
1:31
team members across each of our health care
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entities,
1:34
located across, the Northern Illinois region.
1:38
Well, it's amazing to hear. You know, really
1:40
impressive to think about all the different services
1:42
you're covering and truly the the populations of
1:45
communities you serve. Now when you think about
1:47
the last year, what was the most important
1:50
initiative that you led? What did you do,
1:51
and what were the result?
1:54
Yeah. As as I mentioned,
1:56
as we are, we are the largest,
1:59
provider for
2:00
economically
2:01
challenged patients,
2:03
within the region.
2:04
And as such, we implemented,
2:07
a really concerted effort to
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expand and support
2:12
and really optimize
2:14
our discharge medication
2:15
delivery initiative,
2:17
otherwise known as a Med to VED program.
2:20
The Med to Bed program had been in
2:21
place for for really decades.
2:25
But we wanted to really take it to
2:26
a new level, not only to make sure
2:28
that we're optimizing
2:30
the patients that we can reach out to,
2:32
but do so in a way that we
2:34
can be most efficient for the resources,
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I e, our staffing,
2:40
that we had available.
2:41
So we created,
2:43
a multidisciplinary
2:44
team, which included, obviously, our our outpatient pharmacy
2:48
staff, our acute care clinical pharmacist,
2:52
our medication history techs,
2:54
our nursing staff,
2:55
case managers, our hospitalists,
2:58
and I'm sure countless others over the course
3:00
of the year to assure that,
3:03
patients who were prescribed
3:04
either
3:05
high cost medications,
3:07
but also patients who we identified
3:10
as high risk for readmission
3:12
were able to provide medication
3:14
at the time of discharge,
3:17
and do so in a thoughtful manner.
3:19
We sometimes hear about trying to make sure
3:21
that we get,
3:23
as many patients,
3:25
to receive prescriptions at the time of discharge
3:28
as we can, but we sometimes are limited,
3:31
in being able to be able to do
3:32
that with the resources we have. So attempting
3:34
to find a balance was one of one
3:37
of our goals in addition to make sure
3:39
that we can provide as many prescriptions as
3:41
we as we could.
3:43
Obviously,
3:44
the theory behind Med to Bed program is
3:47
attempting to eliminate the barrier of access to
3:50
medication,
3:52
and in doing so, we'd be able to
3:54
reduce this as a potential cause for readmission.
3:58
The effort paid off. Over the past year,
4:00
we've been able to quantify
4:02
the nearly 30%
4:04
reduction
4:05
in our thirty day readmission rate 30% reduction
4:08
in our thirty day readmission rate over the
4:10
year
4:11
for patients who had their prescriptions filled in
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our outpatient pharmacy
4:15
versus external retail pharmacies.
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So it's been a tremendous success. Not only
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are we making sure that we are
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supporting our med to bed program,
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making sure that patients, particularly those who have
4:29
challenges getting medications
4:30
because of access, can get those prescriptions filled,
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but do so in a thoughtful manner from
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the perspective of utilizing
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the limited resources we have,
4:40
to be able to be able to support
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that. And, obviously,
4:42
ultimately, being able to show that we can
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actually reduce or we can actually demonstrate that
4:47
we can reduce that thirty day readmission rate.
4:50
That's amazing to hear. And, you know, really,
4:52
really strong results when you look at the
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thirty day readmission rate is something that's so
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critical right now, especially in thinking about how
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much,
4:59
capacity
5:00
hospitals and health systems are are trying to,
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you know, really manage that more thoughtfully and
5:06
then cost as well as, of course, better
5:08
outcomes for patients.
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So I think that makes a lot of
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sense. You know, when you look at a
5:13
a med to bed program like the one
5:14
you have, what does it take to set
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up? What type of resources do you need
5:18
in leadership is necessary in order to make
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this happen?
5:22
Yeah. It's a good question. Obviously, first and
5:25
foremost,
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having a, a hospital owned or an entity
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owned outpatient pharmacy, I feel, is critical.
5:32
Certainly, contracting with,
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external vendors,
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can make the process certainly turnkey.
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We feel strongly that having our own outpatient
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pharmacy
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with our own staff where we have,
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the informatics systems where they use,
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whichever electronic health record that you use
5:51
that is integrated between the outpatient pharmacy
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and your inpatient pharmacy,
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provides a tremendous amount of efficiency, particularly,
6:03
in eliminating some of the red tape and
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the logistical challenges that can occur
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with outpatient pharmacies.
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So we believe that's key. We also have
6:12
leveraged,
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learners, whether it's our residents,
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interns, or students.
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We are fortunate to be close to University
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of Illinois Chicago,
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Rockford Campus, and this is a tremendous opportunity
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for,
6:28
our student learners to be able to,
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not only learn the the business of pharmacy
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from the outpatient perspective, but be able to
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provide
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education for patients in a unique setting. So
6:41
not at the back of the store, but
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more so at the bedside,
6:45
and to be able to appreciate the challenges
6:47
patients have with being able to afford medication
6:50
and then to see what we do to
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make sure that,
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the ability to pay is not an issue
6:56
to make sure patients get medication. So
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leveraging, having that ownership,
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having that vested team that is in your
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outpatient pharmacy but is well integrated
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into the inpatient
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patient flow and that transition,
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to me, I think is key and can
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really optimize that particular workflow.
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I love that. I I think that makes
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a lot of sense and is really helpful
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to understand what's been critical for you in
7:20
order to make the program work. Now looking
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ahead, what are some of the big priorities
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and headwinds you're focused on for 2026?
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Well, as I mentioned, as as we are
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a disproportionate share of hospitals like everybody else,
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we are following the three four e b
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world
7:37
and regulations
7:38
on a regular basis
7:40
on on a regular basis, on a daily
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basis, it seems like these days.
7:45
Our
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incredible team is is well led. It is
7:49
exceptionally prepared.
7:50
And most importantly,
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we are phenomenally
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agile
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to respond to all the different changes that
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we're being faced with with pharmaceutical industry and
8:01
regular bodies. And this week is no, exception
8:04
to that where we've had to make multiple
8:07
pivots with regards to,
8:09
the rebate,
8:11
initiative. And so all that has to be
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done,
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quickly,
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and you you need a team that's that's
8:18
that's very agile to be able to make
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sure that you can be proactive
8:23
in the decisions we're making related to three
8:25
forty b.
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Obviously, the three forty b program
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allows organizations like ours to stretch our limited
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resources
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to provide these services, like I mentioned before,
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with our med to vet program
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to patients who are most vulnerable.
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And that being said,
8:43
with the with the volatility and the challenges
8:46
that we are faced with with the three
8:47
forty b program,
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organizations like ours and staff like ours
8:52
who have our frontline workers who are doing
8:56
things every single day to make sure that
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we can,
8:59
provide that direct financial impact to patients, whether
9:03
it's subsidizing
9:04
medications,
9:05
whether it's providing blood pressure cuffs, whether it's
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providing
9:10
needle and sharps containers.
9:12
This is a tremendously
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challenging time for those,
9:16
individuals,
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and then subsequently stressful because we don't really
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know what the impact
9:22
may be of the three forty p program
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from from a day to day basis. So
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as leaders,
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this is a huge challenge, but it is
9:30
so important, so necessary
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to that while we are planning for the
9:35
worst, that we are continuing to not only
9:38
provide the current level of care that we're
9:40
able to provide, but continue to expand that,
9:44
and utilize those resources to make sure that
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we are supporting those who are in the
9:48
greatest need, especially as we go from one
9:52
calendar year to the next. And we recognize
9:54
that,
9:55
the out of pocket
9:56
challenges patients have,
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are the most significant this time of year.
10:01
Absolutely. I think that's such a critical reminder,
10:03
especially thinking about how, you know, you can
10:06
really make an impact on the way patients
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receive care and their whole journey of care
10:11
with some of these things. And I I
10:13
appreciate that you bring up the three forty
10:15
b program as well. I know that's something
10:17
we're continuing to watch very closely at Becker's,
10:19
and so many leaders across the country are
10:21
trying to plan around and understand what's gonna
10:23
happen next. And so when you look at
10:25
the teams that you're working with,
10:27
how do you stay agile, especially amid so
10:30
much uncertainty not knowing exactly where some of
10:33
these funding are is gonna come from or
10:35
or where these programs might go?
10:38
I'm biased,
10:39
but I think that we've got a tremendous
10:41
structure within our organization.
10:43
For University of Wisconsin,
10:46
we have, a tremendous team,
10:49
that represents all of our different areas with
10:51
regards to three forty b. And we meet,
10:54
every Friday to discuss,
10:57
not only,
10:58
our compliance,
11:00
the value that we're providing,
11:03
local,
11:04
state, and national regulatory challenges,
11:08
but also program expansion. So,
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it's really easy to become a little jaded
11:13
particularly in these days with three forty d
11:15
to spend all of your effort
11:18
on,
11:19
making sure we're well prepared,
11:21
for these particular challenges, whether it's a rebate
11:24
program or,
11:26
ADM
11:27
or other,
11:29
regulatory issues.
11:30
However
11:32
and as important as it is to continue
11:34
to focus on those, you still have to
11:36
focus on continuing to expand. Patients are still
11:40
here every single day, So we can't keep
11:42
our, we can't lose track of,
11:45
the most important thing, which is continuing to
11:47
expand, but also keeping one eye on on
11:50
the regular challenges. So to me,
11:53
creating that team that has that focus of
11:56
of looking at each one of those particular
11:58
aspects and
12:00
representing not only our our our dish locations,
12:04
our clean sites, our mixed use,
12:08
our physical inventory locations,
12:11
having internal and external regulatory bodies, and having
12:14
that multidisciplinary
12:15
team that
12:16
comes together on on a weekly basis and
12:19
is very,
12:20
engaged. And I guess equally important is making
12:23
sure senior leadership is well,
12:27
informed and up to date on all those
12:29
particular issues as well is obviously critical as
12:32
well.
12:33
That makes a lot of sense. Thank you
12:34
so much for going a bit deeper there.
12:36
Now what do you think the hardest thing
12:38
you'll have to do in the coming year
12:39
will be?
12:41
I think from the hardest thing that I'm
12:44
looking at, you know, in the next year
12:46
and and maybe one of the hardest things
12:48
as as a, you know, senior leader,
12:51
I guess I would
12:53
also probably cheat and say it's probably, for
12:55
me, the most fun thing, which is to
12:57
predict the future.
12:59
As a leader, it's
13:01
critical that we are
13:04
creating that road map and the vision for
13:06
our team,
13:07
identifying and being able to
13:10
illustrate for our leaders and the team that
13:13
works, that we work with what the profession
13:16
looks like in three to five years
13:19
in providing that vision.
13:22
Being confident in that, knowing what the future
13:25
is going to look like, and really probably
13:27
a better way of saying is that
13:30
getting an educated guess and being right
13:33
about what the profession looks like over the
13:35
next three to five years,
13:37
builds trust in our leaders and, subsequently, their
13:41
teams.
13:42
Without this, you know, our leaders are
13:45
continuing continuing to, you know, put their thumbs
13:48
in the dam and just really trying to
13:50
get through day to day. We are all
13:52
faced with sometimes you
13:54
walk into work and then you leave work
13:56
that same day and,
13:58
you spend the entire time,
14:01
just getting through that particular day with that
14:03
and and missing out on on the vision
14:06
and and working towards the future. So I
14:08
think it's important that
14:11
we always keep our eyes on where we're
14:13
going in the future
14:15
and aligning our teams to make sure that,
14:18
there's a good sense of direction on on
14:21
what that vision is and where we're going.
14:23
And why that's important is that I think
14:25
that helps
14:27
prevent complacency,
14:29
but it also, importantly, it fosters innovation for
14:32
our leaders so that,
14:34
as our senior leaders are identifying this is
14:36
where we need to get to, it is
14:38
critically important that our leaders and our team
14:40
members are identifying
14:42
innovation to see how we actually are getting
14:45
there. So to me, I think that's the
14:47
hardest challenge because, obviously,
14:49
you have one chance on getting it right.
14:52
We wanna make sure you're leading your team
14:53
in the right direction while still being able
14:55
to get through your day to day activities.
14:58
That makes a lot of sense, and I
15:00
love that kind of focus on the opportunities
15:02
there, the places where innovation can happen, and
15:06
really thinking about all the different possibilities in
15:08
the future and continuously planning and and just,
15:11
you know, getting right after it. So,
15:13
that's really helpful to know. And speaking of
15:16
the future, where do you see some of
15:17
the best opportunities for organizational
15:19
growth?
15:20
Yeah. I,
15:21
to me, I think in in in being
15:24
in the profession for, more than a couple
15:26
years,
15:27
I I think a
15:30
a concentrated,
15:32
strategic,
15:34
energized
15:35
effort and working as a system,
15:38
to create that
15:40
autonomous pharmacy, that pharmacy where we are eliminating,
15:44
steps,
15:46
and,
15:47
some of our handoffs.
15:49
Embracing technology
15:50
and kind of that marriage of technology and
15:53
automation,
15:54
I think, is going to be
15:56
critical and it's
15:58
necessary,
15:59
to be able to support our most important
16:01
commodity,
16:02
which is our staff,
16:04
while at that same time creating that
16:06
overall infrastructure to provide,
16:09
the most safe and the most efficient operation,
16:13
ultimately,
16:14
for our patients.
16:16
And, obviously, this is easier said than done.
16:18
It entails finding
16:20
people who are much smarter than you,
16:22
providing that,
16:24
support and that knowledge to explore where we
16:29
need to get to. And as a senior
16:31
leader, it's then our job to make sure
16:33
that we get there.
16:35
But, again,
16:36
creating that vision and
16:38
then the other challenging piece to that, which
16:41
is quantifying that incredible financial impact,
16:45
which is going to be necessary to be
16:47
able to provide that automation and technology infrastructure,
16:52
unfortunately, provides very little margin for error. But,
16:56
I think, ultimately,
16:57
it establishes
16:59
us to not only,
17:00
create that infrastructure to be able to support,
17:03
our staff, provides the structure to make sure
17:06
that we are providing the safest,
17:08
environment possible for our patients,
17:10
and also making sure that we then can
17:13
be recognized nationally,
17:15
as a destination
17:17
for,
17:18
top staff across the country.
17:21
I love that. Doctor Carey, thank you so
17:22
much for joining us on the podcast today.
17:24
This has been a really amazing conversation,
17:27
very informative, and and I I look forward
17:29
to connecting with you again soon. It would
17:31
be my pleasure. Thank you very much.