Hillary Blackburn, PharmD, is the director of pharmaceutical services for Dispensary of Hope, where she consults with pharmacists to improve access to affordable medications and works to develop and implement programs to address the gaps in pharmaceutical care across the nation.
Becker's Hospital Review recently asked her to discuss the skills pharmacy leaders need in today's healthcare climate, how to control pharmacy spend and what needs to change in the healthcare industry.
Here's what she had to say.
Editor's Note: Responses were edited for length and clarity.
Question: What skills are essential for pharmacy leaders in today's healthcare climate?
Dr. Hillary Blackburn: Pharmacy leaders are joining more executive teams, which demonstrates the impact that pharmacy plays in advancing health system goals — such as improving medication adherence and reducing readmissions. With the pharmacy role being elevated, pharmacy leaders should possess the ability to build relationships, lead transformational change and manage the supply chain.
Being able to build relationships with physicians and nurses across departments is imperative to ensure that the medical and pharmacy staffs are aligned. Being able to identify physician or nurse champions and early adopters will help to accomplish pharmacy goals. These champions can promote initiatives at the local level. Ultimately, this is accomplished through building trust and being a team player. Advocating for the profession and for your department within a health system makes sure that pharmacy has a seat at the table.
Change is happening at a rapid pace within the healthcare industry. In fact, healthcare knowledge is doubling at a rate of nearly every 12 months, up from every 10 years several decades ago. Effective leaders must stay up-to-date with the changes and have a compelling vision for moving forward. Leading change within an organization takes time and an understanding of the process. Leaders must be able to explain the "why" to help others get on board. Sharing early and key wins can keep the new initiative moving in the right direction.
Understanding the pharmaceutical supply chain is essential to navigate the increasing number of drug shortages and drug-pricing changes; thus, pharmacy leaders should understand the dynamics of the market to prepare for these changes. Health systems are often looking at the pharmacy department, drug utilization and spend as a major cost containment category. The pharmacy supply chain should be efficient and productive.
Having the passion to succeed in all the above areas makes for a dynamic, influential leader.
Q: When it comes to managing drug spend, what advice would you offer other pharmacy leaders?
HB: Estimates suggest that $100 billion to $300 billion of annual avoidable healthcare costs are attributed to medication nonadherence in the U.S., accounting for 3 percent to 10 percent of overall healthcare spending. In turn, pharmacies make up to 20 percent of the average hospital's budget. There is a big opportunity for the pharmacy department to bring value to manage that budget and ultimately control overall healthcare spending.
The integration of pharmacy analytics allows the monitoring and assessment of drug spend trends. Pharmacy leaders can monitor trends through benchmarking themselves to other organizations and by identifying the top spends that could indicate a deeper analysis is needed. A drug cost analysis should include the data source, purchase data and volume adjustment — all of which are trends that should be tracked continuously. There are many analytic tools available to analyze purchases to inform the strategy for drug purchasing. These tools can also identify and predict drug prices, which can trigger a review and possible change in the formulary.
As health systems endeavor to find a "true north" in population health, the consistent focus for all organizations centers on the triple aim in healthcare: to enhance the care experience for patients and their families; to improve the overall health of a population; and to reduce per capita costs to manage the health of that population.
The pharmacy department can play a critical role in reducing the overall health system budget by helping patients get access and adhere to their medications. Comprehensive medication access programs that include patient assistance programs, 340B [if eligible] and Dispensary of Hope, can help to address the three goals of population health management leaders: reducing unnecessary utilization, trading high cost services for low cost services and enhancing patient engagement and care coordination. Providing access to medications, even free of charge to patients most in need, leads to decreased emergency department visits, inpatient visits and length of stay.
Q: What needs to change in the healthcare industry?
HB: Healthcare is still unaffordable. There are still more than 30 million Americans lacking access to health insurance, which leads to chronic diseases being terminal. Yet, access to health insurance does not necessarily mean that healthcare is affordable. There is a difference between access to healthcare vs. access to health insurance; however, these terms are used interchangeably. Access to health insurance does not necessarily mean access to healthcare. How do we continue to improve healthcare by making it affordable and by providing appropriate incentives for providers AND for patients to become active participants in their own care?