Amid shrinking reimbursements and rising care costs, hospital and health system leaders find themselves in a financial bind. The pressure is on executives to cut costs in order to maintain their organization's fiscal health.
However, cost cutting options can seem limited and not without pitfalls. Reductions in staff can lead to an overworked and burned out staff. Reductions in the number of services can result in lower patient volumes.
However, hospitals and health systems are not limited to these options. Remotely supplementing pharmacy departments allows hospitals to leverage additional resources while cutting costs and serving additional patients.
Cardinal Health is among the leaders in remote pharmacy services. With extensive expertise, Cardinal Health has helped hospitals and health systems align pharmacy services while controlling costs.
In a webinar hosted by Becker's Hospital Review and sponsored by Cardinal Health, Bala S. Chandrasekhar, MD, CMO at Arcadia-based Methodist Hospital of Southern California, and John Coggins, director of pharmacy at Mary Washington Hospital in Fredericksburg, Va., shared how their hospitals have benefited from remote pharmacy models. Kelly Morrison, director of remote and retail pharmacy services at Cardinal Health, also explained the demands of the market and discussed misconceptions about remote pharmacy models.
Trends in the marketplace and remote pharmacy myths
"As we think about trends in the marketplace today, hospitals and retail pharmacies have the same pressure: do more with less," Ms. Morrison said. "There is a need for pharmacy-led clinical programs to drive hospital cost savings initiatives, reduce readmissions and increase patient satisfaction."
On top of these market trends, technology conversions are driving a negative impact to operating income. Personnel and project budgets are also flat despite growing hospital administration expectations.
The move toward supplementing with remote pharmacy models can generate some pushback, as myths loom with the perception of increased cost and limited scope. For example, leadership may have the notion outsourcing costs more than hiring additional full-time employees. Or that remote pharmacy services can only be leveraged through long-term agreements.
Dr. Chandrasekhar and Mr. Coggins are two leaders who debunked these myths at their hospitals and leveraged remote pharmacy models to execute several strategic initiatives.
Remote pharmacy models for expanding pharmacy services
At Methodist Hospital of Southern California, Dr. Chandrasekhar was challenged with several pharmacy pain points. Operations and drug costs continued to rise, and the hospital had flat HCAHPS scores for discharge counseling and patient understanding of medication. Many of the challenges were a result of limited pharmacy involvement in patient centered care.
"We realized that our clinical pharmacists were all stationed in the main pharmacy," said Dr. Chandrasekhar. "Therefore, pharmacists had limited interaction with other healthcare professionals and patients." Developing pharmacists to work directly on patient care teams was also a great challenge.
As a result, Methodist Hospital of Southern California outsourced 40 percent of its total monthly order volume to a remote pharmacy team that enabled the onsite clinical pharmacists to operate at the top of their license and transition to work directly on patient care units.
Leveraging an outsourcing partner allowed the hospital to implement a successful clinical program that increased clinical interventions as pharmacists began to engage more with physicians, nurses and patients. Also, patient experience and HCAHPS scores improved significantly.
Remote pharmacy models for technology implementations
At Mary Washington Hospital, Mr. Coggins faced staffing issues due to turnover and difficulty recruiting. Retaining two pharmacists on night shift proved challenging to maintain while simultaneously facing recruiting difficulties for the remaining shifts. Because of the staffing burdens, Mary Washington Hospital was also challenged to free up pharmacists to participate in training and maintain pharmacy service levels during their EMR conversion.
"Around two years ago, we got the news we were going to embark on a conversion of our EMR," Mr. Coggins said. "With that, Epic came in and determined the amount of dedicated pharmacist hours we needed for the conversion. Being staffed fairly thin, it was difficult to determine where we were going to get those hours."
Mary Washington Hospital turned to remote pharmacy services in preparation for its go-live date. By using remote services, verification decreased from 70 minutes to 15 minutes on average and staff satisfaction increased. The hospital was also able to maintain productivity by scaling up or down depending on current needs. On top of operational success, the hospital saw financial benefits. Mr. Coggins and his team reduced the amount of overtime dollars paid and to-date has saved $26,000 through the use of remote pharmacy services.
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