Ascension VP on shifting priorities for hospital pharmacies, next generation of pharmacists

Though the majority of pharmacy jobs are shifting to retail settings, hospital pharmacy is still growing and expanding on what it means to be a pharmacist. 

Jeff Oliver, PharmD, is on the front lines of the changing hospital pharmacy industry as the vice president of pharmacy for Ascension's Florida division, overseeing pharmacy services for Ascension's acute care facilities, retail pharmacies and infusion centers across the state. 

Dr. Oliver recently discussed with Becker's Hospital Review the most pressing issues facing hospital pharmacy leaders as well as what the future holds for the industry. 

The issues hospital pharmacy leaders are dealing with right now 

Dr. Oliver said one of the most pressing issues for hospital pharmacy leaders right now is figuring out how to shift pharmacy staff focus from acute care to ambulatory care. 

Most health systems have a majority of their pharmacists employed on the acute care side, but the hospital industry is shifting its focus toward ambulatory care. The challenge is how to align and train staff to deal with that shift. 

The question health system pharmacy leaders should be asking themselves is: How do we create internal programs or work with the American Society of Health System Pharmacists to develop programs to help pharmacists transition from an acute care background into more of a transition-to-care or ambulatory care pharmacy role?

"It's really trying to develop a revenue structure for pharmacy in that care setting," Dr. Oliver said. 

Figuring out how to standardize pharmacy practices across a health system is also a top concern. Dr. Oliver said standardization is about maximizing not only the quality of care, but bringing down the cost of care. 

"I think we have first and foremost a financial responsibility to the organization as well as to our patients to provide cost-effective care," Dr. Oliver said. 

Reducing variability in care across a health system allows pharmacists and other providers to give patients the highest quality care, he said. 

The future of hospital pharmacy

The pharmacy industry has seen a lot of rapid change in recent years and isn't expected to slow down any time soon. 

The types of jobs available to pharmacists have shifted dramatically in Dr. Oliver's 15 years of experience as the industry shifts its focus to outpatient pharmacy services.

When Dr. Oliver was going through his training, many pharmacy students were training to become clinical pharmacists for an expanded hospital workforce. Today, most pharmacy jobs are for retail pharmacy positions at chains like Walgreens or CVS, not in hospitals, though retail pharmacy is also undergoing significant changes. 

"We're getting to a saturation point where, even folks who've done residency or specialized training, are finishing up and there aren't the available jobs that maybe they thought 10 to 15 years ago would be there for them," Dr. Oliver said. 

The opioid crisis has also shifted the expectations of hospital pharmacists. There's now a much greater focus on drug diversion and prevention as well as treatment for patients who have been affected by the crisis. 

"We've played a role, obviously, in dispensing those medications for our patients, and now I think we're uniquely positioned also to try to help improve the impact [the opioid crisis] has on our society," Dr. Oliver said. 

Pharmacy is also much more involved in supply chain logistics and management than it used to be, Dr. Oliver said. Pharmacists are much more involved in the full product life-cycle for pharmaceuticals within the health system environment. 

Ascension has placed a focus on expanding clinical pharmacy services, but Dr. Oliver said there's still a lot of opportunity for hospital pharmacists to create collaborative practice agreements with physicians that allow pharmacists to prescribe under the agreements. 

Dr. Oliver also predicted the pharmacy industry will continue to see a shift toward telehealth.

At Ascension, the pharmacy department has implemented technology to improve the consumer experience. For example, the department has remote dispensing kiosks instead of a full-scale retail pharmacy, allowing patients greater access to their prescriptions while still having access to pharmacists when needed. 

Ascension also started a virtual medication history program that allows it to reach facilities it didn't previously have the manpower to reach.

"Pharmacy's going to continue to adopt technology both to enhance our reach clinically and also to optimize what we're doing on the operational side," Dr. Oliver said. 

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