Hospital Pharmacies: Leveraging Tech to Improve Efficiency and Care

By Matt Phillion

Hospitals with on-site pharmacies can be drivers for improved patient care, better processes, and increased profitability for healthcare organizations. As new technology emerges, what can these pharmacies do make much-needed improvements in areas like patient readmissions or medication adherence?

“I think as an industry, healthcare is struggling, but pharmacies can be a part of the solution for hospitals that are 340b eligible,” says Joel Wright, president of VytlOne (formerly Maxor). “You have a lot of payers trying to pull services out of them, but we’re focused on changing the pharmacy from a cost center to a profit center.”

Pharmacies are one of the top two drivers of profitability in healthcare organizations, Wright notes, alongside surgery.

“It’s amazing that a lot of health systems are breaking even or even losing money on outpatient pharmacies,” says Wright.

There are a lot of strategies put into place years ago that no longer work, Wright explains.

“As a result, some health systems have a lot of sunk costs in their large, centralized pharmacies and are suddenly locked out of getting value,” he says. “We want to help them with this, and tech plays a huge part in getting there.”

Wright notes that emerging technologies can help with a particular challenge area when it comes to staffing hospital pharmacies.

“I think pharmacy staffing is better than it has been for ambulatory and outpatient pharmacy, with the work environment and schedules helping us with recruiting, and the number of stores closing creates an opportunity for us. But pharmacy techs can be a different story,” says Wright. “They’re doing a lot of the tasks we’re talking about AI being able to do, whether it’s simple data entry or being able to take information from a fax and transcribe it into the system to be able to populate it for the patient. That’s where the technology is rapidly moving forward.”

But not without proper caution and care, he notes.

“There’s what I’d call appropriate trepidation,” says Wright. “AI is such a buzzword, and you have so many people pushing it that you need governance for appropriate use. If you’re going to have an agent with access to patient information you need that to be very tightly controlled and kept within your four walls. When AI use is brought up to a health system, you see them bristle. They want to fully dig through and know how it will touch their data before signing off on anything, and I think that’s appropriate.”

The idea is to make sure the technology is used the right way to enhance the staff, not take over—more of a co-pilot than a solo agent, Wright explains.

Improving efficiency

Technology already exists that can help pharmacies move more quickly to assist patients. It’s not entering the prescription that impacts things like turnaround times, but more likely things like prior authorizations, Wright explains.

“If you send an order for a specific medication with a prior authorization the prior authorization gets returned almost immediately. But if you have to wait for a person to actually dig through those records, go through the EMR, find qualifying data and the diagnosis code, you’re counting on that individual to have the proper knowledge about which codes get covered and which gets paid,” says Wright. “You can have the right system score that. For example, this code is approved 98% of the time. It can help avoid of having the order rejected and needing to appeal if they pick the right drug up front.”

This results in faster turnaround times and from there, better patient care and satisfaction.

“Studies have found your last interaction with a healthcare system is the most impactful about how the patient thinks about patient satisfaction, and often getting your medications is the last interaction they have as they leave the health system,” says Wright. “A bad experience can taint the way their entire experience is viewed.”

It can also help with those pivotal interactions that maintain medication adherence.

“Every day that goes by, the percentage that patient is never going to pick up that prescription increases,” says Wright. “If you are able to get them onboarded quickly, they will start that therapy, but if it’s seven days or two weeks later, they’re feeling better and won’t ever take that medication.”

Standardization is key

Perhaps the biggest barrier to implementing technology that on-site pharmacies can leverage for better efficiency is the EMR itself.

“Getting the data out of the EMR in a usable format is still really challenging for a lot of systems,” says Wright. “Even with Epic, I like to say if you’ve seen one Epic setup you’ve seen one Epic setup. They’re all different, all customized, so getting data out of them you can use to make that pharmacy successful can be difficult.”

This can lead to barriers not to success but to being able to assess success.

“We talk about specialty medications and what your capture rate is, which should be super easy: scripts written, scripts filled in the pharmacy. But we’ll often hear ‘We don’t have any way of tracking that,’” says Wright. “But we have tech that can help sort and capture that data so they can take action against leakage.”

VytlOne has a readmission reduction program called Impact that works with health systems identifying disease states where they have significant rates of readmissions for which they are being penalized. For example, diabetes, COPD, or congestive heart failure.

“Honestly, there is a huge prevalence in these cases where if you really understand what the drivers are, just putting the right tools in place can solve those,” says Wright. “Typically, this involves technology that scores those diseases for risks where the most likely patients to readmit are and bring improved service around those areas, such as pharmacy or nurse intervention so those patients can stay healthy outside the health system.”

The benefits to the patient are tangibly transferrable back to the system, Wright explains.

“No money, no mission. art of that is figuring out how to save organizations money through something like our Impact program or looking at how their pharmacy can help them generate money,” says Wright. “We typically start with the pharmacy director or ambulatory services director, but we know it’s not going to happen until the CFO says yes, and typically the CFO becomes our biggest fan.”

Which isn’t to say this overtakes the mission side of things.

“With pharmacy directors, we usually get two reactions: one is to ‘come help us do a better job taking care of our patients,’” says Wright. “The other is ‘I can do this on my own,’ but for them, it’s about talking about supplying the kind of expertise we can bring in. Directors have huge amounts of responsibilities and often the ambulatory pharmacy is not at the top of their priority list.”

Wright sees the industry heading in the right direction to get to a better place for information access.

“We’re using technology to expedite very arduous processes, but we have medical authentication agents calling a system that is answering with an AI agent. Why can’t we plug these two together and exchange information?” Wright says.

The more pressing problem, he notes, is how to help those organizations that don’t have unlimited funds—the county or rural hospitals that don’t have access to AI experts to get to that point.

“The pressures on them are incredible,” says Wright.

And with cuts to Medicare and Medicaid, the pressure will continue, he notes. Those patients will still be seeking care, but that care will be unfunded, shifting costs but not eliminating them.

“If you had true system interoperability and the ability to take data extracted from systems and have them easily talk to each other; if you have a unified patient record across any system we could do so much to improve care,” says Wright.  “One of the big misses we face is discontinued meds. They leave the system and they don’t know the medication has been discontinued, but retail pharmacies are still calling them to tell them their refill is ready. How do we get a unified record that everyone who knows and is supporting the patient is on? That would be my panacea to get to.”

That unified connectivity would solve so many issues, says Wright.

“As we come out with new products and life-saving medications hospitals have to be the center of care,” he says. “There is such an opportunity to both drive profitability and get significantly better outcomes for patients.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.