Looking back at the healthcare headlines so far this year, it's not surprising that the importance of pharmacy is growing in the wake of these industry-wide shifts. Hospital leaders continue to wrestle with skyrocketing drug costs; they are testing new approaches to reduce readmission rates; and they're focused on optimizing resources so they can drive new clinical programs and deliver even better high-quality care.
As value-based care continues to take hold, the clinical pharmacist and the pharmacy team are becoming central to this complex equation and how to "do more with less."
October marked National Pharmacists' Month, which makes it an ideal time to examine the unique opportunity pharmacy presents for today's healthcare ecosystem. Particularly in hospitals and hospital networks, the pharmacist is becoming a more strategic clinical provider, positively influencing patient outcomes and the hospital's bottom line on a daily basis. These providers are achieving this by addressing medication spending, engaging in readmission reduction efforts, driving clinical initiatives, avoiding medication errors, and optimizing their workflow across the hospital or system.
When looking for ways to continue to meet the ongoing challenge of lowering costs while improving patient outcomes, CEOs, CFOs, COOs, and even CNOs should turn to the Pharmacy for the following reasons:
1. Inpatient drug spend increased by 23% annually from 2013 to 2015, and is projected at 10-12% growth in 2016, according to recent reports. Pharmacists are essential to making formulary decisions that balance efficacy and cost. When a drug cost skyrockets, they can identify the trend and propose alternatives. They can also skillfully manage drug shortages and set up generic substitution rules, while also addressing potential overuse of medications, which helps to manage the hospital's third largest line item after labor and supplies.
2. Medication errors cause at least one death every day and injure approximately 1.3 million people annually in the United States, according to the FDA. Pharmacy workflow is critical for preventing potential errors that could result in an adverse drug event, as well as for delivering more meaningful interventions to correct for allergies, dose, frequency etc. When supported by advanced medication management technologies, these interventions have shown higher acceptance rates by physicians, and more timely verifications leading to higher Nursing satisfaction and better patient care. Preventing, identifying and resolving medication-related issues can also lead to significant documented cost savings.
3. Clinical pharmacy programs such as antibiotic stewardship, medication reconciliation, pharmacy ED management, and opioid reduction have proven critical for the balance of cost and care. So, why do so many hospitals fail to set up these programs? It's primarily due to a lack of resources. By optimizing pharmacy staff through more efficient workflow, or by using remote services as a cost-effective solution for managing more routine aspects of medication order review and verification, on-site pharmacists can spend more time focused on these high-value initiatives.
4. Transitions of care are when patients are most susceptible to incorrectly taking medications, or not taking them at all, and being readmitted to the hospital, which can carry a hefty financial penalty. In fact, numerous studies have shown that 40% or more of patients have a medication discrepancy on discharge or don't fill their script. In-house or remote pharmacy staff can participate in discharge planning and follow-up care during these critical periods. As recently as this month, studies continue to support the role of the pharmacist to ensure continuity of care, both at the point of discharge and coordinating with the appropriate post-acute care setting.
5. Operationally, pharmacy is primed for transition to an integrated service model, similar to that of a central business office (CBO) or teleradiology model. Pharmacy naturally experiences peaks and valleys throughout the three shifts of each day. When viewed across an IDN, the exponential gaps in demand or duplication of capacity reveals inefficiencies that translate into excess cost and tie up valuable resources that could be addressing crucial patient-centered programs. By using advanced telehealth technology platforms, small and large organizations alike can smooth out demand using software to intelligently assign medication orders to optimize available staff across the system.
CEOs and CFOs have spent ample time and money investing in EMRs and other hospital technology and driving initiatives that steer the organization toward population health. By reorganizing the pharmacy's role to support and optimize these hospital workflows, significant impact can be made on the long-term financial strategy of the organization as well as on the health of the community. In fact, with cloud-based technology, these optimized internal networks can also be offered to nearby hospitals, creating new revenue streams and effectively extending patient care to communities that need it. With a clear ROI and proven impact on value-based care, the time has come for hospital leaders to rethink pharmacy as a strategic tool for creating their future vision and turn potential into reality.
Brian Roberts is the CEO and co-founder of PipelineRx, a medication management services and technology company, based in San Francisco, California. Brian has spent most of his career focused on healthcare services and telemedicine, including leadership roles at Canopy Healthcare, CHG Healthcare Services, as well as venture capital firms Acacia Venture Partners and Summit Partners.
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