How hospitals can accommodate pharmacy's expanding role

As the shift to value-based care marches on, many hospitals and health systems are turning to the pharmacy for help to improve patient outcomes and achieve their strategic goals.

As a result, hospital pharmacists are tasked with more responsibilities than ever before, performing crucial activities such as patient discharge counseling, medication reconciliation and technology implementations.

With pharmacists taking on an expanded role in their organizations, hospital pharmacies may begin to feel a pinch when it comes to time and resources, explained Kelly Morrison, director of remote and retail pharmacy services for Dublin, Ohio-based Cardinal Health.

"With the increasing responsibilities, every hour of pharmacists' time has a growing list of priorities all vying for attention," explained Ms. Morrison.

Here, Ms. Morrison discusses the new services pharmacies are undertaking amid the shift to value-based care and shares how hospitals can redeploy resources to ensure pharmacists have adequate time and resources to complete these new responsibilities.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What industry trends are affecting the hospital pharmacy?

Kelly Morrison: One of the largest forces reshaping the hospital pharmacy is the shift to a pay-for- performance reimbursement model, because many pharmacy-led initiatives impact patient outcomes, medication adherence and continuity of care. This trend has increased the need for expanded pharmacy services throughout the hospital, ambulatory care settings and even when the patient is discharged back into the community. Medication adherence post-discharge is one of the most effective strategies to reduce unnecessary 30-day readmissions, and the pharmacist is the provider who can best ensure that patients understand their medications and take them as prescribed.

Q: What are some examples of the types of new services that pharmacies are being asked to provide? What challenges do these services pose on the pharmacy?

KM: Pharmacists are now recognized as an integral part of patient care teams and are actively collaborating alongside other healthcare providers and patients, which contributes to the need for more pharmacy services.

Here are some examples of common services that pharmacies now are being asked to provide:

  • Implementing new technologies to drive patient safety and quality outcomes.
  • Establishing clinical programs such as medication utilization initiatives and antibiotic and pain management stewardship programs.
  • Helping with patient care services, including medication reconciliation, discharge counseling and more.
  • Spreading expertise into the community as hospitals and health systems look at developing a retail strategy to improve quality and transitions of care.
  • Managing drug costs, especially as specialty drug spend continues to increase for health systems. Hospital pharmacies are expected to spend more and more time on drug cost control to offset these limited-distribution, high-cost specialty medications. 
  • Tracking and managing data across often disparate hospital and retail locations and technologies.

Overall, the pharmacy's role is expanding to help organizations reach their systemwide goals, which puts pressure on the pharmacy’s time and resources.

Q: What impact do mergers and acquisitions have on hospital pharmacy operations?

KM: In working with many hospitals and health systems that merge or are acquired, we found that the pharmacy department experiences many of the same challenges as other areas of the hospital. The pharmacy also must overcome the integration of cultures, operational processes and technology systems. Across newly affiliated hospitals, pharmacy technology, standard formularies, physician preference items and group purchasing organization agreements often vary significantly. Integrating these areas and creating a systemwide pharmacy and therapeutics committee can take a substantial amount of pharmacy staff time and focus, often making it difficult to maintain the same level of service that was provided prior to the integration.

Many of the hospitals we work with are now re-evaluating the pharmacy workflow, staffing models and other opportunities with a goal to redeploy resources to address this ever-growing list of demands for the pharmacy. Alternate staffing models and blended staffing models utilizing both on- and off-site resources, such as remote pharmacy models, are increasingly becoming attractive, viable options to help pharmacies expand their services.

To learn more about Pharmacy Services at Cardinal Health, click here.

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