Becker’s asked pharmacy executives from hospitals and health systems, along with academic medical centers and universities across the U.S. to share how their system will continue to evolve for future success.
The 16 executives featured in this article have all spoken at Becker’s Healthcare 3rd Annual Fall Chief Pharmacy Officer Summit, set for Nov. 4-6 at the Swissotel Chicago.
As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: How will your organizational structure evolve for sustained success through 2030?
John A. Armitstead. Vice President of Pharmacy Services at Lee Health (Fort Myers, Fla.): As pharmacists and pharmacy technicians continue to expand their depth, breadth, and scope of services, we will continue to see evolution of factions of the pharmacy workforce reporting organizationally to non-pharmacist organizational structures (primary care offices, graduate medical education, data analytics, specialty product lines, etc.). Their comprehensive care management roles, specificity of training and application as well as the need for team-based care, will warrant new integrated health care organizational reporting structures to drive value.
Ron Hartman, PharmD. System Director of Pharmacy at Tanner Health (Carrollton, Ga.): At Tanner Health we have had a significant amount of change in the Pharmacy Division in the past two years. We added specialized Pharmacy Coordinators in Business Operations, Clinical Operations, Quality, and Informatics. We have expanded our oversight and influence to all drug order and supply areas throughout the system—including in system physician clinics—with the addition of a leadership position overseeing all Buyer functions. We added a Specialty Pharmacy to support patients in that environment, and we are exploring expanding our retail and home infusion operations, to fully meet our patient needs, anywhere within the Tanner Health footprint. Our structure will continue to evolve through 2030 and beyond, as we look to add a Pharmacy Residency Program, explore central fill models, and broaden our quality impact with the potential addition of a System Medication Safety Officer. This is an exciting time to be part of pharmacy at Tanner Health, as we continue to grow, driving quality, efficiency, service, and financial endpoints for the health system!
J. Cody Sandusky, PharmD. System Director of Pharmacy Services at Southern Illinois Healthcare (Carbondale): By 2030, I expect pharmacy organizations to become increasingly integrated across the continuum of care, connecting inpatient, ambulatory, retail and specialty, and population health services. At Southern Illinois Healthcare, our focus is on creating a seamless medication management experience for patients across Southern Illinois while expanding pharmacists’ roles in chronic disease management, transitions of care, and other clinical services. Technology, automation, and data analytics will help us improve efficiency and allow pharmacists and technicians to practice at the top of their licenses. Success will ultimately depend on our ability to develop the next generation of pharmacy leaders, embrace innovation, and remain focused on improving access, quality, and outcomes for the communities we serve.
Nilesh Desai. Chief Pharmacy Officer of University of Miami Health System (Fla.): For a health system pharmacy enterprise, an organizational structure designed for sustained success through 2030 should evolve from a traditional model to a more integrated, matrixed, and strategy driven model that balances clinical excellence, growth, financial stewardship, innovation, and workforce development. As a strategic enterprise asset all focus must focus on:
- Improving patient outcomes
- Health system growth
- Data governance
- Leverage AI and automation
- Support research and innovation
- Advances population health
- Develop future pharmacy leaders
Kelley Curtis, PharmD. Chief Pharmacy Officer and Vice President of Pharmacy and Lab COE at St. Luke’s Health System-Idaho (Boise): At St. Luke’s, I don’t believe sustained success through 2030 will come from adding more layers to the organization. We are continuing to move from site-based structures toward an enterprise model where work that can be centralized, such as purchasing, distribution, order verification and other shared services, is managed at scale, while our pharmacists are increasingly embedded closer to patients and care teams. That shift allows us to take work away from highly trained clinicians that do not require their expertise and create more capacity for pharmacists to practice at the top of their scope.
At the same time, our organization, like most others, has become much broader than the traditional hospital pharmacy model, with specialty pharmacy, infusion, home infusion, community pharmacy, 340B, medication access and other ambulatory services requiring leaders who can think across the entire continuum of care. We are also strengthening enterprise governance so that clinical, operational and financial decisions are made consistently across the health system rather than independently by individual locations. Technology and AI will certainly change how some of our work gets done, but I believe the more important organizational question is how we redesign roles around what people uniquely contribute. By 2030, I expect our structure to be more centralized operationally, more integrated clinically and much less defined by the walls of an individual hospital or pharmacy.
Kathleen Kane, PharmD. Assistant Director of Pharmacy, Compounding Integrity and Compounding Regulatory Compliance at UChicago Medicine: Our organizational structure will continue to evolve in alignment with our ELEVATE 2035 strategy, which is focused on positioning the organization for long-term sustainability, innovation, and exceptional patient care. As healthcare becomes more complex, success will depend on stronger integration across clinical operations, quality, regulatory compliance, technology, and business functions rather than traditional departmental silos. We are building structures that encourage shared accountability, data-driven decision-making, and collaboration across disciplines to improve outcomes and operational performance. Equally important is investing in our workforce by empowering frontline teams and developing leaders who can navigate rapid change. Through EVOLVE 2030, we are intentionally creating a more agile organization that can adapt to emerging challenges while remaining grounded in quality, safety, and the needs of our patients and communities. I believe organizations that strike that balance between standardization, innovation, and people-centered leadership will be best positioned for sustained success through 2030 and beyond.
Jason D. Trahan. Executive Director of Pharmacy Business at ECU Health (Greenville, N.C.): Looking forward and developing strategies from now through 2030, I believe successful healthcare organizations will be far less siloed and far more integrated around the patient journey. Traditional structures organized around individual departments, sites of care, or service lines will continue to evolve into interconnected models that bring clinical, operational, financial, and digital capabilities together to improve outcomes and reduce friction for patients.
At ECU Health, we are already moving in that direction. Within pharmacy, our focus is on building a centralized and scalable infrastructure that connects acute care, ambulatory services, specialty pharmacy, home infusion, mail order, medication access, revenue cycle, analytics, and supply chain functions into a coordinated ecosystem. This structure allows us to better support patients across the continuum of care while creating the operational efficiency and financial sustainability required in a rural health environment.
We will also see organizational structures continue to become increasingly data-driven, with greater emphasis on automation, advanced analytics, and multidisciplinary teams that can quickly adapt to changing patient needs, reimbursement pressures, and workforce challenges. Ultimately, for us to continue on a growth trajectory through 2030 we must align people, technology, and care delivery around the common goal of making healthcare more accessible, affordable, and seamless for the communities we serve. This is in direct alignment with ECU Health’s current strategy of leveraging analytics, automation, operational efficiencies, and integrated care delivery models to support long-term sustainability and patient access.
Scott Knoer, PharmD. Pharmacy Executive: Managing technology proactively will need to be highlighted in the Pharmacy org chart in the future. Organizational structure needs to continue to evolve to adjust to technological needs. While informatics started a decade or two ago, the field is advancing logarithmically. AI now allows us to automate things such as prior authorizations and 340B audits. On the revenue side, we are now able to better ensure contract compliance and drug pricing and reimbursement, which is extremely important in these challenging economic times for health-systems. We need leaders able to not only oversee these trends but to identify new fronts to attack proactively leveraging this new technology. Then there is the clinical component. With tools like Open Evidence, the things that pharmacists and physicians do get a lot easier. This mass availability of clinical literature distilled for you significantly streamlines decision making and makes current guidelines easier to implement. We can also rapidly digest data to better manage population health. We can see who could benefit from specific drug therapy based on the information in their EHR. Of course, now patients are also much more educated with tools such as ChatGPT, so we need to be able to communicate with those who self-diagnose, but not always accurately. I was recently able to accurately diagnose a friends’ lateral meniscus tear before the MRI by inputting her symptoms into Chat GPT, and I have never had an anatomy class.
Elaine Huang, PharmD. Associate Chief Pharmacy Officer of UW Medicine (Seattle): Our structure will need to continue evolving from a primarily site- and entity-based model toward a more integrated, system-level approach that enables us to operate as one organization while maintaining strong local leadership and accountability. We are already seeing this evolution within Pharmacy at the executive level. The recent change in the UW Medicine Pharmacy leadership structure has created a more integrated leadership model and, importantly, gives Pharmacy a true seat at the table as part of the Executive Team. This represents an important shift from viewing Pharmacy primarily through an individual hospital lens or as a supportive function to recognizing Pharmacy as a strategic enterprise partner with a role in driving growth, access, innovation, and financial performance.
I believe this same evolution will be necessary more broadly across the organization through 2030 to allow us to better leverage our collective expertise and make it easier to move resources and best practices across the organization. A similar approach would be having a system-wide workforce model for pharmacists and pharmacy technicians in a shared coverage pool and the ability to flex resources across hospitals based on demand.
Nicole Shoquist, PharmD. Chief Pharmacy Officer of JPS Health Network (Fort Worth, Texas): The staffing math doesn’t work, and I don’t think it gets fixed by hiring harder. 88% of pharmacies and 74% of hospitals report technician shortages, and 60% of hospitals report gaps in frontline pharmacist roles. PharmD graduates are down 15% from the 2018 peak, and applications to pharmacy schools are at a near 20-year low. At JPS, our structure has to be built around that reality instead of waiting for it to reverse. I see three shifts.
1) From site-by-site staffing to a networked operating model: Rather than every location carrying its own full complement of team members, we’re moving toward shared services across our inpatient, outpatient, ambulatory and specialty footprint. We’re centralizing order verification, benefits investigation, prior authorization and revenue cycle support and bolstering our central fill/mail order model. That lets scarce clinical talent be deployed across the enterprise instead of trapped in one building.
2) From backfilling vacancies to building talent pipelines: Technician shortages are expected to grow by nearly 50,000 openings a year v. a 6% workforce growth. Our structure needs defined technician career ladders (registered to certified, certified to advanced roles), residency and student pipelines and pharmacists practicing at the top of their license, with technology absorbing the repeatable work.
3) From reporting on the business to predicting it: Technology-enabled services are how we grow volume without growing headcount. That means predictive analytics for demand, inventory and staffing so we can address gaps before they turn into overtime. It also means automation of tasks like prior authorization status, refill outreach, medication history and documentation. Take the repetitive work off the team’s plate. At JPS we are working on integrating AI-enabled platforms to build scale without adding headcount.
The goal by 2030 isn’t smaller teams. It’s teams where every person spends their time on work only a person can do, while the operating model scales around them.
Fatimah Muhammad. Director of 340B Pharmaceutical Services, Specialty Pharmacy, Drug Replacement, and ADM Pharmaceutical Services at Saint Peter’s University Hospital (New Brunswick, N.J.): Our organizational structure must become more integrated, agile, and accountable across traditional departmental lines. At Saint Peter’s, sustained success through 2030 will depend on organizing around the patient journey, with pharmacy, finance, clinical operations, technology, and patient access teams working from shared priorities and data. We will continue moving away from siloed program management toward an enterprise model that connects 340B, specialty pharmacy, medication access, compliance, and revenue optimization. Clear ownership and measurable outcomes must remain centralized, while frontline leaders are empowered to respond quickly to operational and patient needs. Technology, automation, and advanced analytics will also need to be embedded into the way we work, rather than treated as separate initiatives. Equally important, our structure must create leadership pathways that develop talent, strengthen succession planning, and preserve institutional knowledge. The organizations that thrive through 2030 will not simply add more departments; they will redesign how decisions are made, how teams collaborate, and how strategy translates into value for patients.
Vince Sung, PharmD. Market Director of Pharmacy, Oncology and Infusion at Ascension St. John (Tulsa, Okla.): Through 2030, we will continue to evolve from organizing our work around departments and functions to organizing it around the patient journey and experience. Pharmacy, nursing, operations, finance and IT will all work together in developing an ecosystem that improves care delivery, streamline operations, expands access while maintaining financial stewardship. We’ll use AI and automation to handle repetitive administrative works, allowing our clinical teams to focus on high value and high impact activities. In oncology and infusion, as the demand for high-cost specialty treatments continues to grow, we will leverage data analytics to manage drug spend, optimize inventory, identify trends and maximize margin. We’ll continue to build a pipeline of future leaders by giving people clear career paths and opportunities to grow. Sustainable success won’t come from adding layers of management, but from clear ownership, smart investment and making sure our teams have the tools they need to succeed.
John Mildenberger, PharmD. Specialty Pharmacy Manager, Senior Clinical Lead Pharmacist and Compliance Officer at Sidney Regional Medical Center (Neb.): At a 25-bed Critical Access Hospital, we don’t have the luxury of treating pharmacy as a cost center. Over the past several years we built a dual-accredited specialty pharmacy alongside our retail and ambulatory services, and the clearest lesson has been that pharmacy is often the most durable connection a patient has with their health system. A patient may see us once for a procedure, but they fill a prescription every month. Through 2030, our structure will reflect that reality, with pharmacies operating as an integrated outpatient enterprise that has a direct voice in strategic planning rather than functioning as a support department. That model keeps patients connected to local care and diversifies revenue in a market that badly needs it. We’re also clear-eyed that specialty margin is exposed to 340B and drug pricing changes, so the goal is a broad base of pharmacy services rather than dependence on any single stream. If a rural hospital our size can build this, the model is within reach for almost any organization.
Nephthalee Edmond Tefera, PharmD. Director of Pharmacy at MedStar Harbor Hospital (Columbia, Md.): As I think about 2030, I believe sustained success will depend not only on how well we plan for the future, but also on how prepared our leaders and organizations are to respond to what we cannot predict.
COVID-19 was a powerful reminder of that. Almost overnight, we had to rethink how we worked, communicated, and delivered care. Virtual care expanded; hybrid work became a reality for many roles, and leaders had to make decisions without having all the answers. It reminded us that while a strategic plan gives us direction, our ability to adapt is just as important.
I believe that the same thinking needs to shape how we structure our organizations moving forward. In pharmacy, we’ve already seen the profession evolve well beyond traditional dispensing into a more integrated role in patient care. That requires greater collaboration across disciplines, more flexible care models, and stronger alignment between clinical and operational priorities.
We’re also seeing a shift in our workforce. As experienced professionals approach retirement, a new generation is entering with fresh perspectives and different expectations. There’s tremendous value on both sides. We need to preserve the knowledge and experience of those who have helped build our organizations while creating opportunities for the next generation to grow and lead. In my own leadership experience, I’ve seen the importance of developing new workforce pathways, including opportunities for students and aspiring pharmacy technicians.
And of course, there’s AI. We may not know exactly how it will reshape healthcare by 2030, but we do know that leaders will need to be prepared to evaluate new technologies, help their teams adapt, and ensure that patient safety and human judgment remain central to care.
Ultimately, I don’t believe success through 2030 will come down to who predicted the future best. It will come down to who invests in developing adaptable leaders, building organizations that can respond to change, and remain focused on the people and communities we’re here to serve.
Margaretta L. Kearson, PharmD. Clinical Pharmacy Manager of Memorial Regional Hospital (Hollywood, Fla.): Our organization is well-positioned to sustain success through 2030 and beyond by advancing local decision-making, expanding centralized services, and enhanced shared governance. Key strategic priorities include expanding Centralized Specialty Infusion (CSI), establishing centralized pharmacy operations, strengthening multidisciplinary Pharmacy Value Analysis, and optimizing system-wide Pharmacy and Therapeutics (P&T) and medication formulary governance, while fostering collaboration across our pharmacy enterprise and with medical staff, nursing, and ancillary leadership.
John Pastor III. President of Fairview Pharmacy Services (Shoreview, Minn.): Through 2030, our organizational structure will evolve around the patient’s journey, owning the complexity for our patients ensuring timely access, optimal outcomes, and financial sustainability.
At the heart of that evolution is a more human-centered, proactive approach. We want to anticipate what patients and caregivers need, engage providers earlier, and work with payers and vendor partners to resolve barriers before they delay therapy. That requires connected teams, clear ownership, and shared information from the prescribing decision through the first fill and ongoing care. Patients should experience one coordinated team, without having to navigate the handoffs themselves.
Technology will support that model by automating routine administrative work and helping teams identify coverage gaps, denial risks, and interruptions in therapy earlier. This creates more time for pharmacists, clinicians, and access specialists to listen, build relationships, and address complex needs. We will also expect vendor partners to work alongside our teams, with accountability for improving the patient experience and delivering measurable results.
Sustained success will depend on a structure that makes proactive, seamless care part of everyday work, supporting the patients and communities we serve and the teams who care for them.
