Latest / Becker’s Healthcare Podcast / Integrating Pharmacy Services and Preparing for Change at Michigan Medicine with Karen McConnell, PharmD

Transcript

Integrating Pharmacy Services and Preparing for Change at Michigan Medicine with Karen McConnell, PharmD · Becker’s Healthcare Podcast

• 0:02
  The most important health care decisions don't happen
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  in isolation.
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  They happen when leaders come together.
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  Becker's sixteenth annual meeting brings together more than
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  upper right.
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  Hi. My name is Paige Twenter. I'm an
• 0:47
  assistant editor here at Becker's. Welcome to the
• 0:49
  Becker's Healthcare Podcast. I'm joined here today by
• 0:52
  doctor Karen McConnell.
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  Doctor McConnell is the chief pharmacy officer at
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  Michigan Medicine.
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  And without further ado, I'd love her to
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  briefly introduce herself and tell us about about
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  her career and organization.
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  Sure. Thank you so much, Paige. It's nice
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  to be invited to participate on this podcast.
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  Like you said, my name is Karen McConnell.
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  I'm the chief pharmacy officer at University of
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  Michigan Health, and Michigan
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  Medicine. I'm also the associate dean at the
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  University of Michigan College of Pharmacy.
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  So a little bit about my career, I
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  started out as a clinician. I was a
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  clinical pharmacy specialist in cardiology
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  at Kaiser Permanente for about fifteen years,
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  before I became a clinical director at Cardinal
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  Health for a few years, and then I
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  started as assistant director of clinical pharmacy services
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  at Catholic Health Initiatives, which is a health
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  system,
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  a Catholic health system of about a 100
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  hospitals at the time.
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  We then merged with Dignity Health and became
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  CommonSpirit Health,
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  which is, which at the time was about
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  a 142 hospitals in 24 states.
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  And I became the first chief pharmacy officer
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  there, which was a role that I held
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  for about four years.
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  And I've been here at Michigan Medicine for
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  about a year.
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  A little bit about Michigan Medicine,
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  so we are an, an academic
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  health system.
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  We have, 11 hospitals,
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  and we have about 3,000,000 clinic visits every
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  year,
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  and nearly 2,000 active clinical trials.
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  Our academic medical center was just recently ranked
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  number 12 in The US, and our college
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  of pharmacy is ranked second,
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  in The United States.
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  So I'm really,
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  proud of the clinical care that we provide
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  here as well as the high level of
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  education.
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  Well, how has the past year been in
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  the new role?
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  It's been great.
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  The people here at Michigan Medicine are awesome.
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  They always strive for,
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  high integrity,
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  high quality care for our patients.
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  There's a lot of curiosity here and innovation
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  to do what's best,
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  for,
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  everyone involved, and that's a really exciting place
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  to be.
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  I have really enjoyed being here because they're
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  currently on a a journey of integration,
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  which,
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  through my previous role, I have, quite a
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  bit experience doing.
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  So we have three campuses here.
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  We have
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  our, University of Michigan Health,
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  campus at West, which is in Grand Rapids.
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  We have our Sparrow campus, which is in
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  Lansing.
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  And then, of course, our academic medical center,
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  and the clinics here in Ann Arbor.
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  And so bringing everyone together,
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  has been an exciting journey.
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  For example, we just, kicked off our very
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  first system, pharmacy and therapeutics, our P and
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  T committee so that we can form one
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  formulary and one direct library across the system,
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  and that's been really rewarding work.
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  Would you say the integration work between the
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  three campuses,
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  the PNT committee, or
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  mysterious third thing would be the most important,
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  initiative you led in the last year. I'm
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  kinda interested to hear, like, number one thing
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  you're most excited about over the past twelve
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  months of Michigan Medicine.
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  You know, I'm excited about a lot of
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  things. I would say it's super hard to
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  pick one.
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  You know, pharmacy encompasses both clinical and operation
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  work. So I'd say that might be our
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  most exciting clinical work that we're doing right
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  now, really bringing together,
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  you know, all of our clinicians,
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  physicians,
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  nurses, and pharmacists to work within System P
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  and T.
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  Operationally,
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  we're really excited to continue to grow our
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  specialty pharmacy,
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  our home infusion pharmacy,
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  our community pharmacies, and home infusion. So,
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  we are,
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  you know, out on the forefront here in
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  pharmacy making, impacts,
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  and really having that quality integrated care for
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  our patients,
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  has really, helped us grow our business here.
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  Can you kind of take me through the
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  P and T
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  committee of, like, how that was all organized?
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  Sure. So we,
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  have,
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  subgroups,
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  subcommittees that, go up to P and T,
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  and each of those subcommittees are comprised of
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  various subject matter expertise.
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  So for example, we'd have an infectious disease,
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  subcommittee. We have cardiology subcommittee,
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  oncology subcommittee.
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  I think overall, we have about 16,
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  different subcommittees.
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  And the composition of those subcommittees are really
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  frontline clinicians, both physicians and pharmacists
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  that are treating patients that are specialized in
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  that area, that know the primary literature and
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  the guidelines really well. And those are the
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  folks that are making the recommendations for our
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  assistant PNT committee.
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  And those are clinicians that are from,
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  our different campuses across the state.
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  And so once they make those recommendations,
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  they they then go up to our system
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  clinical pharmacy team or script committee, where we
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  have, consensus building to make sure that everybody's
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  on the same page, and then it goes
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  up to the system P and T committee
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  for voting.
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  And that is,
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  a great,
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  way to do it because we really,
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  make sure that we are hearing our frontline
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  clinicians, and we're making the best clinical decisions
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  for our patients.
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  And I know they're even more vital just
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  with the huge pipeline of very expensive medications,
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  including gene and cell therapies, which could cost,
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  or usually cost up to millions or multimillions.
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  So it's not only important for the kind
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  of clinical alignment with the frontline, but also
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  financial,
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  acumen.
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  Right?
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  Oh, absolutely. Yes. Yeah, as a pharmacy leader,
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  you definitely have to have a a strong
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  financial acumen. I,
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  got my MBA, several years ago,
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  just to make sure that I was, fully
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  up to speed on all of the important
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  things that we need to know about finances.
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  But cell and gene therapy is an is
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  an excellent example.
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  You know, that's, really important to to stay
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  on the cutting edge and to be, you
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  know, a center of excellence to make sure
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  that you're able to provide all the care
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  that patients might need,
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  in a large academic medical center as well
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  as, provide a venue for our,
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  you know, world renowned subspecialists
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  that they can provide, the care that they
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  would like to for our patients.
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  I know I asked you earlier a very
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  hard question of your most important initiative that
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  you led to. Well, our the next question's
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  a bit,
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  wider scope. Don't wanna narrow you in. Looking
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  ahead, what would you say are the biggest
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  priorities and headwinds you're focused on this year?
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  So I think one of the hardest, headwinds
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  in health care right now is how quickly
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  it's evolving and changing.
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  It feels like every day there's new things
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  that we need to take into account,
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  we need to,
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  understand
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  and potentially change the way we're doing things.
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  And then in pharmacy is in the center
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  of so many of those different things. So
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  one of our big priorities,
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  is just being able to pivot and being
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  well prepared for whatever might come down the
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  the the pike,
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  both operationally
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  and,
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  employing all of our advocacy routes so that
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  we are advocating for what we believe is
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  best for not only pharmacy but, for health
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  care and certainly for our patients.
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  What would,
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  a really good pivot look like or has
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  looked like?
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  So, you know, for example, every year, we
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  put together our strategic priorities, and we have
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  work plans and task lists, and people are
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  responsible for each of those things so that
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  we can stay on track.
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  And let's say a new law is passed,
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  and and it requires us to do something
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  different,
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  and to plan for doing that something different
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  into the future. Well, anytime that we're doing
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  something that requires a change, it takes a
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  lot of planning and it takes a lot
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  of prep. So pivoting looks like
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  what's our current strategic priorities, what's this new
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  thing that we need to take into account,
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  And then how do we work that into
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  our current plan? So does it replace something
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  that we're already working on? Does it just
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  bump something down? Can we actually move that
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  to later in the year and work on
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  it later?
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  So really understanding where what the priority is
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  for the new thing that we're pivoting for,
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  and then and then, when in the future,
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  would we need to address it.
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  Is there anything specific
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  either,
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  in Michigan or on the federal level that
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  you're preparing your best, to be able to
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  pivot to if there's, you know I'm I'm
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  thinking of a few federal
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  drug pricing changes, but I don't know.
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  You're concentrated on just Michigan right now.
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  No. I mean, you know, we get to
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  do both. Right? We get to pivot for
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  federal changes, and we get to pivot for
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  state changes. So, you know, IRA is a
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  is is is a good example of the
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  way that that things have changed,
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  and how we, you know, at the maximum
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  fair price, and how we can accommodate that,
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  and how we need to, you know,
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  take the different pricing into account,
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  to make sure that we're being fully compliant,
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  which is absolutely,
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  you know, number one priority,
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  as well as, you know, making sense
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  of of how things flow on the business
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  end as well.
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  Yeah. And I believe it's twenty twenty eight
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  is when the IRA or maximum fair price
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  cycle will include Medicare Part b drugs or
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  hospital
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  administered
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  drugs, if I'm correct. I'm, like,
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  8% sure correct. Yeah.
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  Yeah. Which I'm sure will have even more
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  direct impact on your strategic plan than you'll
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  have to pivot to. So Right. That's exactly
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  right. So, you know, even if we figure
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  out how to, incorporate part d drugs,
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  right, part b is a totally different way
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  of, billing medications. And so then we'd have
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  to take a deep dive and make sure
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  that we are doing that fully compliantly
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  and in the best business way possible.
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  What would you say is the hardest thing
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  you'll have to do this year, whether it's
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  related to I feel like we're using the
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  word pivoting a lot. Whether it's related to
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  pivoting or not.
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  Yeah. It's funny. You know, when I was
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  I was preparing the for the questions in
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  advance,
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  when I
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  filled out this question, it said, what is
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  the hardest thing you'll have to do this
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  year? I literally wrote the word pivot.
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  So it's so funny that that came up
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  earlier in our conversation.
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  You know, and I I would say the
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  other thing that's really,
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  challenging
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  is the sheer number of things that we
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  have on our plates.
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  And I'm sure probably every pharmacy leader that
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  would, potentially listen to this would agree.
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  We have a lot of things coming at
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  us at all times.
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  And, you know, it's really incumbent upon us
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  to make sure that we are communicating well,
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  we're we're resourced appropriately,
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  and that we are,
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  addressing things the best way we possibly can
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  to set up our our organization,
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  the best possible way.
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  And
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  really, the way we do that and the
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  way I've done it is to surround my
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  myself with wonderful teams.
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  And I'm so lucky here at Michigan to
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  have very high quality leaders,
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  to help me, you know, navigate,
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  these these troubled waters at times,
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  to make sure that we have really great
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  outcomes for our patients and our health system.
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  And I'm really excited. I'm getting to recruit
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  some additional leaders here at Michigan Medicine,
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  because we are, growing so fast,
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  that the additional leaders, within my org structure
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  will really help us get to where we
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  need to be, in the next phase of
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  health care.
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  In what areas are you recruiting new pharmacy
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  leaders?
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  So,
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  I have an associate, chief pharmacy officer,
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  open for in our ambulatory space. I have
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  one, in our business operations, and I have
• 12:22
  one, in our clinical and quality space.
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  So we're, really excited to have those additional
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  leaders in place so that we can,
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  utilize,
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  you know, different points of view, to continue
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  to diversify and be really strong in pharmacy.
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  All those years ago when you were working
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  at Kaiser in the kind of cardiology pharmacy
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  area, did you think this is what you
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  would be doing today?
• 12:48
  That's a really interesting question.
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  You know, I loved being a clinician. It
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  was very, very rewarding for me,
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  because, you know, when you treat a patient
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  and you help them right then, you get
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  that instant gratification,
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  that you're helping somebody that day.
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  When you become a leader, it's more of
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  a long term play,
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  and it's not that instant gratification anymore, and
• 13:10
  you have to really understand,
• 13:12
  you know, yourself as a person and,
• 13:14
  how you can be most successful as a
• 13:16
  leader. So I would say initially, probably no.
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  I wouldn't think that I would be the
• 13:21
  chief pharmacy officer at University of Michigan Health,
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  but I did always want to be a
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  leader,
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  because I felt like I could,
• 13:28
  bring that,
• 13:30
  and be and and bring and be beneficial
• 13:32
  to others,
• 13:33
  as a leader.
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  So I'm really happy that I was able
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  to to get here.
• 13:38
  Well, I've I've one more question for you
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  before I let you go. Where do you
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  see
• 13:43
  the biggest opportunity for organizational
• 13:46
  growth this year?
• 13:48
  So, you know, our specialty pharmacies are continuing
• 13:50
  to service more patients because the value of
• 13:53
  continuity
• 13:54
  that we have with our providers.
• 13:56
  Our pharmacists have access,
• 13:58
  to our patients' medical records, which allow our
• 14:00
  process to be streamlined and well coordinated.
• 14:03
  The same can be said for our home
• 14:05
  infusion and our infusion business lines.
• 14:08
  The connectedness that is possible from services that
• 14:10
  are provided from within our health system
• 14:12
  can improve how well our patients are cared
• 14:14
  for. We're also growing our ambulatory care clinical
• 14:18
  pharmacy footprint in areas such as transplant
• 14:21
  because having those transitions of care are really
• 14:23
  important,
• 14:24
  to make sure patients are not only well
• 14:26
  cared for within the hospital, but also on
• 14:28
  the clinic side as well. And so we
• 14:30
  have really strong ambulatory,
• 14:32
  pharmacy clinical services as well.
• 14:35
  I'm also super excited about our education and
• 14:37
  training. We have 33 residents here at Michigan.
• 14:40
  And in fact, we are the very first
• 14:42
  residency in the country. And next year, we're
• 14:45
  gonna be celebrating our 100 year anniversary here
• 14:47
  at Michigan.
• 14:49
  And so that is really,
• 14:51
  a notable,
• 14:53
  place to be,
• 14:54
  for our residency program.
• 14:56
  And not only that, our college of pharmacy
• 14:58
  is also a 150 years old. And so
• 15:00
  we have a lot of landmarks coming up,
• 15:03
  really soon.
• 15:04
  So not only are we,
• 15:06
  you know, helping lead,
• 15:08
  pharmacy within clinical and operations, but also education
• 15:12
  and training too.
• 15:13
  So and and I would be remiss if
• 15:15
  I also didn't mention our research pharmacy,
• 15:18
  which is one of the biggest in the
• 15:20
  country, over 600 studies.
• 15:22
  So I'm,
• 15:23
  very proud of of what we're doing here
• 15:25
  at Michigan.
• 15:26
  Well, thank you so much for joining us
• 15:28
  on the podcast. And, Portia, that's all the
• 15:30
  time we have today, so I'll let you
• 15:32
  go. But I I really appreciate you sharing
• 15:34
  your time and expertise with us. Well, thank
• 15:36
  you so much for the invitation, and I'll
• 15:37
  just end by saying go blue. Thank you
• 15:39
  so much. Take care.