Dr. Hillary Blackburn


Beckers Panel – Health IT Cost Savings and More – June 16, 2019

Hillary:    00:01    Welcome to the talk to your pharmacist podcast. We’re dispensing stories of success from across the continuum of care. I’m your host, Hillary Blackburn. Thanks for joining us to learn from leaders throughout the pharmacy industry. This podcast is sponsored by thorough works relief. Many of you get sore, achy legs from standing all day or get asked about painful foot and leg cramps. If so, you’re going to want to hear about their works. Really a clinically proven topical phone that prevents and relieves muscle cramps and soreness. Learn more@theirworksrelief.com

Alia – Becker’s:    00:42    and I’m really excited to be here today to moderate this panel. We have, uh, Caitlin is a very diverse perspectives from across the country on and just really excited for our conversation. They are called it in Pharma and I wanted to start by just kind of going over the agenda for today. Um, we’ll start with introductions. I’ll work through my questions, but throughout the conversation, please feel free to raise your hand if you have any questions and we want to make sure that the conversation is interactive and everyone’s questions get, get addressed and will also reserve probably five minutes at the end of the hour as well for, um, additional questions on. But for now I’m going to go ahead and start with introductions and I’m just going to go ahead and have the panelists introduce themselves today with their title and tell them, I’ll tell you a little bit about their organization so that you can kind of appreciate their perspectives as you move through the conversation. So I’m going to start on the end with you, Susan, as she would like to add.

Susan K:    01:39    Sure. Uh, my name is Susan [inaudible]. I am the Corporate Pharmacy Manager for Pharmacy Informatics that New York Presbyterian. I’m helps us stem out in Manhattan, New York. Um, we’re actually a very giant organization with multiple campuses and several regional hospitals. Um, I’ve been in my role now for, it’ll be six years in June. Um, and prior to that I have been in practice for now almost 15 years in pharmacy and various different,

Brandon:    02:07    Brandon’s Zarharof, I’m the director of optimization at shield’s health solutions. So I run our software team working with a are you know, over 20 health system partners and their specialty pharmacies across the us.

Brad Myers:    02:23    Good afternoon. My name is Brad Myers and I’m the executive director of pharmacy lab and pathology at the University of Missouri in Columbia, Missouri. So if you would pull out on the map in Missouri and actually find it on the map, we’re kind of located dead center between St Louis and Kansas City are incredibly, we’re a five hospital systems so we’re kind of a small system, which was neat today for our discussion. Kind of have all different size of health systems in different perspectives. Uh, for our discussion today we are a rural academic health center, uh, which is very different. You’re typically in large cities but not on where we are located at now. We also, as part of our consciousness station today, we’re closely integrated with Cerner and Cerner is about two away from us. We are one of the value creation offices for Cerner.

Hillary:    03:03    Hey, Hillary Blackburn, I’m the director of pharmaceutical services at dispensary of hope, which is a ministry of Saint Thomas Health and ascension and where are the nation’s leading terrible medication distributor. So we’ve assembled a collaborative of most of the largest generic pharmaceutical companies and most of the largest health systems who are serving uninsured low income patients and are able to get that donated medication to those health systems so that they can dispense it to their patients in need. Great.

Alia – Becker’s:    03:36    Thank you so much. Um, and as you can see, like Brad said, did we have different size organizations from across the country? So if it’s kind of what I wanted to touch on for the first question, um, I know that there are some national trends that are probably affecting all of you, but I want, I would love to hear from each of you a little bit about the specific challenges, um, pharmacy challenges you’re facing in your market and just talking a little bit about how you’re using tech, leveraging technology to kind of address those issues and overcome those challenges. And I would love to hear from a few of you. Um, Hillary, I can start with you or Susan. Um, whoever would like to chime in there.

Hillary:    04:14    Sure. Okay. I’ll go ahead and start. Um, so yeah, so medications are continuing to be one of the major drivers of healthcare expenditures that about 17 or 20%. And we’re all seeing drug prices are continuing to be on the rise and we keep seeing an increasing number of drug shortages due to consolidation and product rationalization. It’s happening. So it dispensary of hope, it’s really important for us to have access to realtime data to know which manufacturer weight makes which products. So it seems to change almost by month or at least by the quarter. And um, so in order for us to know and go after and recruit these manufacturers to be able to get access to all of the meds, we tend to know who makes which products that we have on our formulary. So we’ve been able to partner with, uh, someone who, uh, has access to all of that. They aggregate all of that information and that’s been a, and will be a big game changer for us from that sense. Uh, we also collect data to help best manage our formulary. So, um, medications are offered every month, uh, and, uh, those are then to order by our network. So, um, you know, we have to be able to know what’s coming in and what’s going out. And all of that goes into the analytics to help make the best decisions each quarter as we manage our formulary. Um, to best support our network of over 170 pharmacies and clinics across the country with their essential medicines, um, were also affected by drug shortages. So we use predictive analytics to help determine which medications are going to be consistently available for our partners so that they can help best plan and manage their inventories. So we use technology to help with that. And so I guess the biggest takeaways, um, that I would say to sum all that up is that there’s a lot of opportunities within the pharmacy department to bring value to manage, uh, the hospital budget and control overall health spending. Uh, best to be proactive and strategize with your team on potential shortages and an analysis of cost is necessary in close management of your formulary is essential.

Alia:    06:28    Great. Yeah. And do you ever knew, Susan, I know that you might have a little different perspective or different challenges?

Susan K:    06:36    Yeah, I mean I agree with everything Hillary saying. I think, um, you know, out of looking at all the different challenges, I do have to say, so how many of you in the audience, you’re going to raise your hand if drug shortages are the bane of the pharmacy world, right? We deal with that on a day to day. So I’d like to meet basically comment regarding our day to day functionality of how to kind of approach this challenge in terms of leveraging technology. So you know, we hear all these fancy terms, I’m like artificial intelligence, blockchain, all of the technology. But what I’d like to say to you is always look at in the process is broken, no amount of technology is going to be able to fix it. So by that is that at New York Presbyterian we have a very well oiled machine. When it comes to drug shortages in terms of we have our drug information center that does, or due diligence, looking at the data to see what is actually available, which I’m kind of what Hillary touched on. Secondly, we have a drug shortage committee that we meet every week. Um, and we work very closely with our it department. So between those, those three teams, along with our frontline and our operational managers, sometimes with things like those guys, we have to go back to the basics. You know, like with pharmacy, our day to day functionalities, technology can do something, but we all have to kind of work on creating that stable and from workflow prior to kind of dumping their technology. So now the second piece I’m going to actually talk about is the technology PD. So how do we leverage our technology to do that? Our it team on a weekly basis, we work with all of those teams that I mentioned to create alerts in the system to kind of say x drug is not available. This is the alternative that you need to work on. You know, you need to switch to. The other thing is working very closely with our operational managers is dead, you know, in our automatic dispensing cabinets, making sure that the inventory matches what we’re doing to the system. Now on a global or a longterm solution. What I would suggest is to kind of build order sets for drug shortages that’s actually worked well in several models across the country is you know, instead of constantly changing your system every week I’m creating an order said towards that’s geared towards pharmacy that contained some of these drugs. And then of course, you know, you have to stay abreast of what’s happening and you can’t, you know, you can be reactive, you have to be proactive. So what our committees do is we kind of look at what’s coming down the pipeline and making adjustments and kind of preparing our providers of what’s coming by creating, you know, drug alerts and sending that communication. Now communication is super important. Um, especially for all of our teams and especially being such a large health system, you just have to be a really good while oiled machine that we are. And that’s actually been very, very helpful.

Brandon:    09:11    Can I jump in as well? Um, so I think one of the things, sort of going to the other part of the question around rising drug prices. I mean, we all know there’s many sort of high priced medications, especially on the specialty side of the equation, but really the, the question is first and foremost, how do we make sure those high prices don’t result in negative patient care or poor patient outcomes? And really it’s this idea of financial toxicity and not letting it actually affect the patient experience and counteract all the hard work that physicians and pharmacists are working to get the medications or the right medications to patients at the right time. And really one of the things that we do is I employ recommendation engines to, uh, automate sort of matching patients with our financial assistance sources to make sure they’re getting copay assistance that really is aligned both with their personal financial situation as well as the, the medications they’re focused on to really keep that financial toxicity component out of the pharmacy experience. Particularly when you have a, an integrated delivery network.

Brad Myers:    10:15    But I want to add on brandon did as well as that. I think he’d only a good point there is that we, we all do really good job inpatient wise. However, I think most of us probably spend a big chunk of our time outside the walls in the hospital. We’re actually you with colleagues from Novant today and that was one of our discussions was how do we take the data and the in the clinical tools that we’ve built in our it systems apply that to our employer group or to certain populations outside the walls of the hospitals. I really do think that’s our future going forward is here kind of got the inpatient, not perfect but decent good. But how do we apply it to the inventory spaces? It’s going to be next, next phase of what we’re currently doing.

Alia – Becker’s:    10:52    And I, I love that there were some common themes there and then some, some diet diverse, um, you know, input there. I think that, um, they key takeaway I had from like Susan and Hillary is just the importance of being more proactive than reactive and not just throwing technology on top of, of kind of shoddy processes. But I thought, I thought and hand did someone have a question in this area? Okay. I just want to make sure I didn’t miss anyone’s questions. So, um, for the next question, it’s more focused on, on data analytics and so broad. I’m going to start with you for this question and I’d just love to hear from you. Um, if you could just kind of do a little bit, provide a little bit of detail about the ways that your organization is leveraging data analytics to improve park the pharmacy process.

Brad Myers:    11:37    Absolutely. Data is power, that’s for sure. A part of our job is think I’m looking at name badges, mostly pharmacists in this room. I think for the most part, uh, so part of our students where we had to do is take that data and provide a story to write stories of data with a soul. Uh, but to, to have that story, we have to have strong analytics. So some of the areas that we’ve been working on, one is just benchmarking externally but also internally. So as we go through cost accounting or DRG based cost accounting, how can we like to start procedures that are driving calls or even start positions within that provided maybe the same type of procedure. We put a lot of energy in. It’s amazing the difference that you always see with both outcomes as well as costs when you dig deep into Drg based cost accounting. Um, the other areas that we’re looking at is, is how do we provide better clinical decisions support as well. I mean, even though you sometimes people see clinical decision forum here in data analytics, but it is part of your data analytics is driving clinical decision support that’s actionable and it provides value versus something that docs threw their hands up or the pharmacist every time. If you don’t work pop up through. We spend a lot of energy of trying to use data to, to find actionable and meaningful alerts. Um, going forward. And as I mentioned, Brandon hit hit it earlier with the [inaudible]. It’s really more of an inventory type of environment or discharge environment is that, how do we take all this data to apply it to, you know, who are high risk patients that are driving the cost for our health system, uh, which has been challenged with not easy and it seems like it’d be pretty easy, but it’s definitely been tough, um, to figure out who those patients are. They, how would you manage that population?

Alia – Becker’s:    13:10    Yeah. And so how, can you, can you talk a little bit more about that, about how you’re, how you’re identifying those patients and then kind of the next steps after. And then, so once you are able to identify them, so what are, what are the next steps then to kind of help drive the next steps in the process, I guess, and how that’s improved over the years?

Brad Myers:    13:29    So our strategy has been is to bring in the medical and PBM data had been tied with our clinical. So we haven’t, we’re privy to have all the clinical data for our patients, but we’re not privy to have that clean medical and pharmacy benefits data. So that’s where we’re trying to do is how do you merge the two together. In a perfect world we would have, we would have our own PBM, we have our own medical insurance and where you have our, our clinical data to tie it together. So that’s where we’re at in terms of trying to figure out, I knew we can reach, see the clinic side is or ed often who’s coming to our urgent cares, she’s been hospitalized. How are we going to get, we’re trying to tie the two together. Forgot which are a high risk population drop in cost. Yes.

Ayla- Becker’s:    14:10    Thank you so much. And it did. Does anyone else, um, have want to weigh in on that question as well about how you’re acting maybe on how NY Presbyterian is leveraging data analytics? I’d love to hear from you.

Susan K:    14:20    So we actually have an FTE that does help with data analytics along with, um, someone on the it team. That does do, I’m a data poll for the day to day kind of stuff. Um, so I think having an FTE to really help, um, you know, utilize, um, and kind of get that data for your department really does help, um, versus kind of relying on systems because you can pull data all you want with different technologies when you really need someone to analyze that process and make it meaningful. And I think having a person that does that has really, really been beneficial to our department. Um, and kind of along the chains of like the future of our profession. Like where’s it going? I think one of the biggest things that we need to be looking at is data sharing and, you know, blockchain, um, that’s huge. That can be really beneficial for, um, pharmacies nationwide. Is he using that concept or really help with data sharing? Um, we all kind of, um, as different health systems we work in silos, if we can kind of bridge together, um, and do a lot more data sharing. We could you be doing a lot more for our patients to leverage that data?

Ayla- Becker’s:    15:24    Yeah, and I, I saw you shaking your head throughout that

Brandon:    15:27    I hundred percent agree with sort of the, the points from, from Susan and Brad. And I think one of the important things to focus on is the investment in Ehr is over the past 10 20 years have really brought this great asset, this really rich data set. Unfortunately I think it’s, it’s not always used to its greatest potential. So really being able to employ data warehouses, data lakes that make it easier for the folks within the health systems to access that knowledge is critical. And one specific example on the pharmacy side that we do with our health systems is using a lot of those drivers across not just EHR data but pharmacy management systems and a few other data sources we pull in. Um, you know, ADTs etc. Is being able to proactively identify potential sources of medication nonadherence and use those sort of predictors to automatically sort patients into different sort of buckets in order to sort of cue additional followups from the care team all in an automated manner using software. So really using a lot of that data, not just relying on the manual analytics behind it, but actually building up those automated workflows through software really helps. I, us and a lot of our health system partners, uh, deploy that knowledge and that data asset that’s being built up.

Hillary:    16:44    I’ll just kind of sum it all up. Um, so I think everyone’s kind of hit on different ways that they’re using technology. And just, just kind of summarize. I think it’s really important that you’ve got to have analytics to help inform your clinical decisions so how you’re managing your formulary, how you’re trying to reduce waste. Um, you know, looking at at benchmarking yourself against yourself or other organizations. Um, identifying trends, you know, looking at patients who are the outliers and how maybe you could maybe make some clinical interventions on, uh, lowering their drug costs, cost therapy. Um, and then just kind of finally, the importance that it is for pharmacists to be able to speak up about this. You know, we’ve been seeing, um, drug prices and drug shortages that are a huge thing in the news right now. We’ve seen a couple of different players from the industry come in and have been interviewed on the hill and next week there are several pharmacy leaders from health systems that are going to be sharing that story and you bet, they’re going to be using data to support what they’re telling.

Hillary:    17:54    Speaking of education, are you aware of the 2014 drug disposal of controlled substances ruling that regards safe disposal of unused medications? Well, we’re lucky to have rx destroyers sponsoring the talk to your pharmacist podcast, rx x destroyer ready to use chemical drug disposal systems are safe, easy and affordable products which protect the environment and can save thousands and fines to get more information on products, training and medication waste compliance. Check out www.rxdestroyer.com/talk to your pharmacist.

Ayla- Becker’s:    18:30    Yeah. And I think that, um, and I don’t know if it’s just, this is probably something that you all have been dealing with day in and day out for years, but it just seems like the, um, the, the drug, the rising drug cost in the conversation around it is really just like, it’s been not only been in the news but you know, there’s so much happening with the testimony in Congress. So that should be exciting to see hopefully, um, what happens there if anything happens. Um, and so I have, I actually want to stick with you for the next question, um, to start off here. And I remember, I believe it was last week when we were chatting on the phone a bit. And I think it was either, it was talking a little bit about farm, the importance of having a pharmacy informatics team and was that you? I would love to hear from you as well. Um, but Susan, I’ll start with you then for this one. Um, can you talk a little bit about that, um, your experience in New York Presbyterian with that type of team, why it’s important to have it and you know, advice for other systems as well.

Susan K:    19:38    Sure. So I guess I want to just kind of take it back to I’m old school, I’m back in the day when I was a pharmacy intern. I’ll in south Philly at Methodist hospital, it’s in on broad street in Philly. Back in like 20 years ago, if you asked me if you needed a pharmacy informatics person for your department, my answer would be completely different from what it is today. Back then I remember running the floors to grab those yellow papers. I don’t know if you guys remember to actually manually transcribe and write the prescription on to, um, you know, and dispense into a log, not even a computer. Then we kind of trended and when towards technology and now you can’t do anything without the computer. So anything for any of the departments, you really need somebody on the backend. Um, and pharmacy informatics is huge because it’s departmental resourcefulness. It really is. Um, and as my career grew, like, you know, being in this role for several years, I’ve noticed like one of my biggest impacts that I’ve been able to do is safety. You know, you can really use your technology to help with patient safety and you know, basically strategize in your computer systems how to a future errors. Um, same thing with formulary. You strategize how to plant, you know, items in your formulary so that you don’t drive up drug costs, you are able to control it a lot better. Um, and so now because we’re not paper anymore, we’re all electronic. Um, you know, pharmacy informatics is so important in a department for those reasons.

Susan K:    21:08    And also for patient optimization. Um, those are like the four main things that I would say. So safety, departmental, resourcefulness. As we’re getting more and more technology, you know, um, machines can only do so much. Do you have to program these machines to know the smart things to do? And I would completely agree with smart pumps. You know, they’re not that smart unless the person that’s, you know, kind of building it has all the, you know, safety guardrails planted into it to make it smart to work. Um, so I would say that those are like the biggest key things that every department really for pharmacy really needs a pharmacy informatics person to help, you know, use those technologies efficiency, um, efficiently and safely.

Ayla- Becker’s:    21:51    Okay. And so this is something that’s really common. I like how many of your organizations have like apartments, the informatics person or team. Okay, thank you. Is that it just helps you with perspective. Um, but would anyone else want to kind of weigh in?

Brad Myers:    22:07    I just want to echo on Susan’s thoughts on safety and it’s, you were one of the few industries where we use education as our primary tool for change and we all know how education works, right? It works well for the first two or three months and then we’re back to baseline. So I think it as we become wiser with using technology to drive safety to me is one of the keys for us as it has or not only the pharmacy profession, which just in healthcare in general, because when the few ways you can actually hardwire a process outside of trying to educate, which we all know, does’t work? Locked arms, if you gauge fee plus hardwire, then you’ve got a winner. Okay.

Susan K:    22:37    Right? And the ISMP recently I think within the past year or they made a statement that, you know, you can educate your providers, you can educate your clinicians all you want, but they really think that technology is more beneficial in preventing errors then relying on education and you know, human error.

Hillary:    22:55    I mean we are in the information age, so it’s really important to have clinicians, pharmacists who can speak that language and make important, uh, decisions with your it people, uh, to help roll out, you know, your EHR and your other programs to build in those order sets, online labs, um, helping to reduce order fatigue, um, with all of those different popups. And of course they should be involved in any types of data stewardship initiatives, whether it’s antimicrobial stewardship, opioid stewardship, pharmacogenomics. Um, so I think that really we’re going to start seeing a shift even towards more of the digital practitioner with more of these apps and wearables. I think that pharmacists are going to be really helping to help patients know what the information is that the apps are telling them. So

Brandon:    23:49    and, and just to, to build them. Then I think there’s two other things that we focused on with our, uh, pharmacy informatics teams. One is really this automated data and reporting to get access to different payer populations, a different LDD access populations in going through URAC and ACHC accreditation, uh, to make sure that, you know, these great hospitals, pharmacy programs are really serving the broadest patient population possible. And really that’s impossible without a lot of these automated reporting structures that you really need that in house, in pharmacy expertise in order to focus on. And then once you really have access to that population and you start enrolling patients on this great program, you know, it’s how do you make sure everyone’s staying on therapy, how do you make sure they’re retained within the program? Uh, and really that making sure, you know, no patients getting left behind sort of falling through any of the cracks. You can really use data in a powerful way. if you have someone solely focused on, you know, identifying those patients at risk of sort of slipping away.

Alia – Becker’s:    24:53    Great. Thank you all so much for your perspectives there. And I think we, today we’ve talked a lot about, um, so far toward the technology you’re currently using, um, and, and sort of how that’s evolved over the years. Um, so where do you see like the biggest opportunity, maybe even like this year or over the next few years? Like, what are some of new innovative technologies and, and how are, where are your, um, organizations looking right now? Brad or Susan again, Brad?

Brad Myers:    25:22    Sure, I’ll, I’ll start it. Um, we’re talking about the data us. I still think that last question related kind of leans forward with how do we use technology to drive operations work flow, um, as we have to, pharmacists costs a lot of money. So as we go forward, we’re not gonna be able to plop a pharmacist in every clinic and every floor in the, in your hospital as we’ve got to figure out how do we better leverage the, your electronic medical record or your technology to make the pharmacist more efficient. You know, always say that we should be able to build a system. So say 80% of the stuff that should really be thoughtless, like your basic IV to PO for cost containment or some of these things should be built within your system and let the pharmacist do the hard work, the other 10 or 20% of the hard stuff on. So I think going forward that’s going to be key is how do you drive efficiencies, efficiencies through technology? And let the computer work for us. You know, we’re kind of stubborn, usually pretty all pretty much type A, he cannot shake your heads is fine. So we, we tend to like, you know, trust only ourselves. So we’ve got to change our thoughts and our profession to it. Technology help us to be more efficient. Um, the other pieces I mentioned earlier is how do we take all this good work? We’ve done all the within the four walls of the hospital and then apply that to the ambulatory space. That is our future within pharmacy is, is I’m going to hospitals or costs payment model that we’ve kind of perfected, but how do we take all this technology and drive it to our inventory space? Um, even down to a payer level. So Aetna is different than, Humana. Uh, so that’s, that’s one of the key areas I sequence for. I don’t know what it looks like, but we’ve got to figure out a good way to leverage technology to figure out this patients we need to touch, which clinics do we need to get into because they’re potentially high revenue generators for specialty pharmacy or whatever business model you’re looking at. I think that’s, that’s the keys going forward.

Ayla- Becker’s:    27:09    Thank you so much, Brad.

Susan K:    27:11    I can piggyback off of that. So what I have dreams about at night now is artificial intelligence in the ambulatory space, especially the specialty pharmacy. Um, I think we could really use artificial intelligence to, um, help with some of these day to day functionalities that, you know, take up a lot of time, especially prior authorizations for specific medications. Um, now I want to just point out like I’m a disclaimer. I think technology can only enhance your role. Like technology can help us this to make your role more efficient. It doesn’t take away jobs. It’ll just help you practice at the top of your license versus replacing your, job itself. And the other things that are, I think that are in the trend, um, especially of what’s happening now is, um, you know, clinical decision support a lot more and systems. Um, I think there’s a lot of EHR and burnout. There’s a lot of, um, space for optimizing a lot of your Ehr, ours. Um, I think that you can use technology, you know, and build so many rules in it, but we really need to be going to words, a model of really having that clinical practice again, you know, and not relying on technology so much for the clinical aspects but a lot of the day to day things like approvals and things on the back end like scheduling and all of that can be done through technology vs. Dot. Clinical piece to it. Um, I think also with um, you know, our EHR is coming. I think data sharing, that’s like a model that we should really be looking at. I know a couple of years ago there was a system called Rio. I don’t know if anybody’s heard of Rio. I was like the regional health optimization where they were trying to share data between a couple of different health systems. I think data sharing is words and we really need to be going towards that to really give that I’m one stop shop where you can really see all of the data for our patients so that we can give them, you know, better care. Like, if they’re getting, you know, prescriptions on an outpatient basis at a Walgreens or at a cvs or some independent pharmacy or specialty, like we need to have all of that data together to really know what’s going on, on to prevent errors and, you know, hospital readmissions. Um, so I think all of those things, you know, blockchain is a one thing that we can really use to highlight the data sharing piece to it. Um, and I think as just pharmacists in general in terms of just trends, you know, how are some of these other professions really able to really make, um, you know, some breakthroughs like, look at the banking industry. Like we don’t even use checks or anything like that. Everything’s electronic. So really thinking outside the box and bringing in these unique ideas, um, into the pharmacies base, we can really do a lot more in.

Ayla- Becker’s:    29:42    And just one we call the question. When you were talking about the importance of data sharing, what do you see as the biggest barrier to do data sharing and why are organizations doing that? Is it because they’re competing with each other or are they just the technology isn’t there yet? You know, my motto or my mantra for pharmacy itself is collaboration versus competition. You know, we really need to be collaborative towards patient care. Yeah. As I understand it’s a business model. You know it’s all a business you need to have sustainability but you can also create unique ways to really create revenue. Generation for your health system. You don’t necessarily need to compete. So you know some aspects of things you can really be collaborative.

Brad Myers:    30:22    I just going to add to that though. One of the areas of that not concerned with the challenges is sometimes we use not always apples, apples with our data. So it’s Kinda like Granny Smith in a Fuji Apple right there apples. But there’s still different as that’s one of the issues I see. It’s sort of day to day or try this when we tried to share with our colleagues it’s not working with the same data set sometimes.

Hillary:    30:40    Yeah, I completely agree with the collaboration type of mindset, but I think the lack of interoperability is such a huge issue. We’ve got one system on this and somebody else is using this and how do we, you know, that’s a really big initiative for CMS is to help drive towards interoperability. So I think that that’s going to be a really be able to unlock a lot of this stuff that we want to do. And kind of to just, uh, go back to our earlier question on the, the biggest trends. I think embracing technology as you all mentioned, so that we can practice at the top of our license is really important. So just to kind of re rethinking that mindset. Um, so one of the biggest things that I’m excited about are, um, related to medication adherence. So it’s a hundred to $300 billion of avoidable, um, you know, healthcare costs issue every year. And Harvard Business Review actually came out with an article in January talking about how pharmacists can play a big role in that. And so we have a lot of ways that we can do that, but we can’t do that by leveraging some technologies such as medication synchronization. Uh, we’ve got lots of different devices. You’ve got like the Spencer that’s actually downstairs. I go check that out. There’s a lot of them. Um, digital pills. So you know, Bill, uh, Abilify my site and smartphones like just, you know, text reminders and things like that. So I think that’s going to be a really big, um, way to impact pharmacy. Um, I think blockchain is going to be a really huge, um, game changer, not only for the health care space but also within the pharmaceutical supply chain is we’re trying to, to move towards um, uh, being ds, CSA compliant or track and trace compliant. How do we share all of that data because manufacturers don’t necessarily want the health systems to see everything that they’re doing and distributors, vice versa. Um, yeah, AI. And then just kind of other interesting things. I think the Gig economy is going to be really big, um, there. And then like online prescribing of meds. I just think there are things that we need to be tracking

Brandon:    32:50    Just, I think the, that’s a lot of, I think really exciting things just to build on that. And also, uh, we have like, I think some of the remote patient monitoring and Telehealth, which, you know, has it been around for awhile but really still being fleshed out by the entire hospital pharmacy industry. And really as you think about the paradigm shift from these very controlled environments like Brad was talking about with inpatient pharmacy clinical trials to now where a lot of pharmacies actually being prescribed out of the hospital outpatient clinics, you have to factor in, okay, what are the additional tools at our disposal that we can use to not just collect data but really bring a lot of this control back to the environments that the patients are now existing and taking their medications. So being able to evaluate not just sort of the clinical factors, but also the behavioral and environmental factors that we all know are still impactful on sort of patient outcomes now. And really a lot of the technology we’re seeing a lot hard, our partners work with telehealth and remote patient monitoring in order to to bring that clinical controlled environment level of data to the outpatient, uh, or really at home setting now.

Alia – Becker’s:    34:03    Great. So many great takeaways there. I think that that’s always the goal with the, with the panel discussion is to have some key takeaways and you have, you all provided so many today. Um, I was wondering if it looks like we have about five minutes left in our session and so I wanted to open up the floor to questions. If anyone in the audience has questions about anything we’ve talked about today or any other yeah or any other questions for the panel, I would love to make sure we get to those before we wrap things up today.

Audience:    34:32    How do you incentivize sharing of data because you know, everyone considers Datas, capitalism money and um, how do you maintain that equilibrium there and between patients? So with the privacy insecurity as well.

Alia – Becker’s:    34:50    The question, that’s the question is how do you incentivize data’s here, name your data.

Brad Myers:    34:55    I think we all want to or just scary to within health from health system, the health system. But that’s my sort of land just helps us from the health system because it’s, um, you know, benchmarking. It’s tough. We are visit clients so we can compare ourselves to visit. Um, however, you know, we can compare ourselves to our regional competitors. We can compare ourselves to, I think we want to, we’re just scared to because of honestly competition. And then, um, how do you match it? So it’s apples, apples, and they were both granny Smiths

Hillary:    35:24    yeah. And I mean think about companies like 23 and me, like people are willingly sharing their data to know their results and then they’re taking that to help with drug discovery.

Susan K:    35:36    I mean what did we all go to school for? I’m thinking back to, you know, the whole load, like what do we, you know, what are we doing every day? Like we get so caught up in, you know, technology and all the innovative ideas. Like the basic concept is that at the end of the day we’re still providing patient care. So why not?

Brandon:    35:53    Yeah. And I think this is really where having a, an intermediary can be very helpful and in addressing a lot of the sort of hospital to hospital competitive issues that, that folks mentioned, uh, really being able to say, okay, we’re going to do the heavy lifting of, you know, making sure it’s, you know, Fuji to Fuji and, you know, really being able to apply out the, the insights from all of that data being collectively gathered, you know, gives everyone the incentive to share in those best practices from real data across many, many, uh, hospitals and health systems to get this great cross section. Uh, because one of the things we have learned is there’s so many permutations of patients and medication regimens and conditions. Really no one case is, you know, sort of the the same. So you really just need this broad breadth of data because you know, if you haven’t seen it, probably someone else has seen something a lot closer than something you’ve already seen. So being able to draw on the broadest set of, of data and really patient experiences think has shown some, some real benefits for us.

Susan K:    36:53    But I think we’re in the right steps because look at all the large health systems on these, you know, within a large health system you don’t have multiple different things. We’re kind of going towards one EHR. So let’s start there. All the VA systems across the country, they’re all connected so you know where starting somewhere, I don’t think it’s going to be perfect tomorrow, but I think we’re kind of going in that direction because people are going to want to push for the best care that they want. You know? And well thank you so much. I think that, um, are there any more questions for our was today? I think that’s a really great note to end on.

Hillary:    37:29    And if you enjoy this episode, be sure to check out the show notes@www.pharmacy advisory.com. Thanks for listening to this episode of talk to your pharmacist produced by the pharmacy advisory group. If you liked this episode, let us know by subscribing to the podcast rating and reviewing it, share it with friends. And if you want to be a guest or know a pharmacist, a leader, he has a great story to tell. Connect with me Hillary Blackburn on linkedin and check out our Facebook page pharmacy advisory group for updates on new podcasts. Thanks for listening.