As the healthcare landscape undergoes accelerating change, almost every clinical and operational area within health systems must evolve to keep pace, including pharmacy operations. Managing medications across an increasingly complex health system is both challenging and expensive, with pharmacy teams often spending too much time managing medication and not enough time with patients. Many health systems are leveraging technology and data to help them better manage resources and medications while also gaining analytics-based insights to improve operational efficiency.
At Greenville Health System, an eight-hospital system based in Greenville, South Carolina, pharmacy operations leaders have deployed an enterprise software solution designed to provide real-time visibility and actionable insight to improve pharmacy operations. Greenville Health System pharmacy teams currently manage an increasingly complex pharmacy landscape with ambitious drug savings goals, several 340b facilities and 200 physician offices and all eight hospitals to support.
In February 2017, Greenville established its Greenville Pharmacy Consolidated Service Center (PCSC), with the overall goal to build a model pharmaceutical supply chain and pharmacy business center to manage GHS resources and assets on an enterprise-wide level.
Matt Parker, PharmD, manager of consolidated pharmacy services at Greenville Health System (GHS), says there are a number of supply chain and operational challenges facing pharmacy operations. “The first thing that comes to mind when you look at a large integrated delivery network such as ourselves is logistics, and efficiently moving product from point A to point B, within a large health system. You know you have X number of locations, with all the pharmacy needs and pharmacy services, and you have to move that product around, and it’s not always necessary to have a pharmacist or complete pharmacy at all those locations. So, you have to rely heavily on technology, whether it’s an automated dispensing cabinet or some other type of technology that gives you visibility into the inventory there, but also helps you get inventory from point A to point B,” he says.
In addition, increased pharmacy costs, regulatory pressures and decreased reimbursement also are challenges facing chief pharmacy officers and pharmacy supervisors, he says. Health systems will see a 7.61 percent price increase for pharmaceutical purchases in 2018, according to estimates from Vizient's July 2017 Drug Price Forecast.
Matt Parker, PharmD
“We know that right now healthcare is in a point of turmoil and change, and the pressures from a regulatory standpoint, from a decreased reimbursement, and then the escalating cost of pharmacy items, all that mixed together, was something that we just had to get our hands around,” Parker says. “Hospitals were the land of milk and honey for quite some time, and they didn’t have to look everywhere for cost savings, but, we are at a point in healthcare today, where, literally, we have to turn over every rock, to see if there is savings there. I think pharmacy has been one of the hidden gems, as there is a lot of cost in pharmacy, and there is a large potential for savings.”
To get this initiative underway, Parker and other clinical leaders put together a strategic business plan. “We started with, first, we needed to know how much we’re spending on pharmaceuticals as an entire system. We need to know where that spend is going within our organization. We need to know if that is the right contracted price, or not. We need to know if the quantity in any given location is correct, or not. And, by managing all of those pieces together, we’re able to produce a ROI. We’ve produced a business case, we went to senior level leadership and said, ‘Here’s the problem, pharmacy inventory is costing hundreds of millions of dollars to the health system on an annual basis.’ And we feel like we can take percentage points away from that by better managing our inventory; doing things that for-profit corporations have been doing for years, looking at streamlining the supply chain.’”
Parker adds, “We want to apply those concepts to hospital pharmacy integrated delivery network-type work. And, so that’s really the case that we made. That we can do things better, more efficiently, we can increase our inventory turns, and by doing so, we can bring savings, or least working capital, back into the organization.”
The health system worked with Mountain View, California-based Omnicell, a provider of medication automation, analytics and medication adherence solutions, to implement the pharmacy performance center to leverage enterprise software solutions to centralize pharmacy services, standardize workflows and processes across the health system and leverage medication use analytics for cost/benefit evaluation of different medication regimes. The supply chain and distribution side of operations are provided out of an 8,000-square-foot facility, while at the same time, the technology platform is providing business operations and insights.
“It’s a wide net that’s capturing a lot of operational data, it’s putting it into one place, and then the data scientists are going in and creating rules and queries that are writing language, it comes back to us, it takes our data, and moves it from being data and turns it into information, and then take that information a step further, and turn it into knowledge,” Parker says. “We’re able to take data elements from across our system, merge them together, and then are able to tell a story that we haven’t been able to tell before, by having this software available for us.”