Insights

Two pharmacy leaders share insights on how systemness is driving transformational change in their organizations.

The healthcare landscape is changing rapidly, often in unpredictable ways. So what does the future look like for today’s pharmacy leaders, and how can they prepare for it? By using systemness as a guide to help reimagine where and how work gets done in their organizations.

Systemness is an approach that brings services together from multiple facilities to drive improved healthcare operations and cost savings. Visante sat down with Staci Hermann, PharmD, MS, Chief Pharmacy Officer at Dartmouth Health, and Melissa Ortega, PharmD, MS, Vice President of Ambulatory Pharmacy Services at Tufts Medicine, to discuss their personal experiences with systemness. Here are four key takeaways from our discussion with these two industry trailblazers. 

Recruiting and retaining talent continues to be a persistent challenge. Health systems will need to think outside the box to solve it.

As the workforce shortage continues to challenge health systems nationwide, what can be done to address it? Dartmouth Health has found success through its apprenticeship program, where technicians can sit for their Pharmacy Technician Certification Board (PTCB) or certification courses.

“It has been wildly successful for us,” said Hermann. “In fact, our specialty program would not have grown at the pace it has without this program. It helped us find these individuals who may not have known about pharmacy as a career and allowed us to grow.”

The health system’s latest strategy involves using technology to help with simple tasks so that staff can focus on high-value activities. For example, they’ve recently deployed robots to help run medication deliveries to the floor so that technicians can spend more time on higher value activities that only technicians can complete.

“We’re trying to find that nice balance where technology can help us while we’re working through additional recruitment strategies with our training program,” said Hermann.

Tufts Medicine is also focused on technician development to help cultivate the advanced skills needed within its pharmacy program. But the organization is also looking at how workforce needs are evolving, and what can be done to meet those demands.

“Yes, we have a shortage, but we’re also getting different asks,” said Ortega. “We’re getting requests for more work from home, so how do we build a practice model that allows for that type of flexibility, and how do we sustain it?”

Pharmacy leaders can leverage systemness to help reimagine where and how work gets done.  

Dartmouth Health covers an expansive geographical area within its rural New Hampshire health system. As they looked for a solution to the workforce shortage, the organization began asking a simple but powerful question: “Does this job have to happen here?”

They found that inpatient pharmacies had often just picked up jobs because they were historically asked to do so, such as clinic filling of medication requests. So the organization dug deeper to understand what tasks had the potential to be done as part of a shared service model.

“We had these conversations about what has to happen locally and what can happen centrally,” said Hermann. “And then we designed the system to allow for the centralization of activities, more like a hub and spoke model. This really helped us as we’ve moved forward with our system integration work.”

As Dartmouth began to develop a shared service center, they intentionally located it within a more densely populated area, in a central part of the system. This provided access to a much larger talent pool and drove more successful recruiting.

While systemness is often synonymous with centralization, Ortega also sees its value as a unique opportunity for pharmacy leaders. She believes they are uniquely equipped to drive transformational changes because of their distinctive skills and diverse experiences.

“What’s unique to pharmacy leaders is that we speak many languages,” she said. “If you think about what it takes to build a new pharmacy program, whether that’s contractual, licensing, collaboration with supply chain, internal buy-in…that’s an important component that adds to our success from a system perspective.”

Relationships are more important than ever to the success of any pharmacy enterprise.

Relationships are key to any successful business, but they have perhaps never been more important for pharmacy leaders amidst today’s industry changes. For both Ortega and Hermann, building relationships and influencing key stakeholders is an ongoing priority that can’t be understated.

“I meet with all our site executives quarterly to discuss the biggest pharmacy initiatives they need to be aware of, and what’s coming on the horizon,” said Hermann. “I know many of them may not be in regular contact with their local pharmacy leader. So I feel it’s my job to advocate for them. For anybody who’s in a system role, building those relationships is vital to push the pharmacy objectives forward.”

For Ortega, the power of influence is a key factor in relationship-building for today’s pharmacy leader.

“We’re not going to have direct oversight over every program,” she said. “But we do have the creative thought process to know where pharmacy programs can complement an initiative and be part of the strategy. The ability to speak multiple languages doesn’t mean that we can do it all by ourselves – it’s important to invite others to the table to help push that initiative forward.”

Pharmacy leaders face critical challenges in today’s rapidly changing industry landscape.

What challenges are pharmacy leaders most concerned about as they look toward the future? For Ortega and Hermann, they’re evaluating these three issues most closely:

• The changing 340B environment
• The continued rise in payer mandates
• The evolving retail and Pharmacy Benefit Manager (PBM) space

“For me, what’s important is having a solution for every episode of care,” said Hermann. “With the shifting payer landscape, it won’t be an option for us to decide what the right site of care is for patients. So it’s important to have a solution in place so that you can ensure continued care.”

“The landscape of where we have market share is rapidly changing,” added Hermann. “So we need to be prepared for that. We need to be thinking through how this will impact our patients.”

Interested in learning more?

Listen to the full episode of our Visante Innovators podcast, where Visante Senior Director David Hager joins Hermann and Ortega to take a closer look at systemness in pharmacy. You’ll learn even more about how today’s pharmacy leaders can leverage systemness to solve current challenges and uncover new opportunities.

Systemness in Health System Pharmacy: Perspectives from Two Transformational Leaders

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