“In 2012, the hospital pharmacy will have a critical role in helping the hospital to do more with less,” said Mark Eastham, senior vice president, McKesson Pharmacy Optimization. “By partnering closely with the hospital pharmacy to capitalize on clinical and business opportunities, McKesson will enable hospitals to leverage the hospital pharmacy as both a profit center and a key driver for clinical excellence, advancing the hospital’s mission of providing the best possible patient care to its community.”

2012 Hospital Pharmacy Trends

  1.     The need for increased connectivity between the inpatient and the outpatient settings will intensify. The hospital-reimbursement paradigm has changed as we move toward a pay-for-quality system. Key market dynamics, such as outcome-based payments, emphasis on the patient’s continuum of care beyond hospital discharge, and the actualization of accountable-care organizations, are forcing hospitals to maximize existing hospital assets to manage the paradigm change. This includes the role of its pharmacy. 

Focus on Ambulatory Pharmacy: Ambulatory pharmacies are unique environments capable of generating revenue for health systems as well as contributing significantly to the care and outcome of the patient. Leading, visionary health systems fully understand the importance of connecting patient data between the inpatient and outpatient settings.  

2.      The Pharmacist’s Role in Meaningful Use. A large component of meaningful use is the closed-loop medication cycle. The pharmacy touches all the components in the loop and as a result, can and should be involved in implementing the most effective computerized physician order entry (CPOE) for the hospital. Not only do pharmacists understand how physicians order drugs in their organizations, but the pharmacy information system has the ability to help reduce transcription error and confusion.

Focus on Attaining 100% Dispensing of Barcoded Medications: Many hospital pharmacists are heavily involved in the implementation and rollout of barcode medication administration (BCMA) at their organizations because every medication that they stock needs to have a barcode. This is being driven by incentives contained in the American Recovery and Reinvestment Act (ARRA). As part of meaningful use Phase II contained in the Act, these medications need to be bar-coded for scanning at the bedside. However, the challenge is that not all medications purchased have a barcode and pharmacists are looking at cost-effective solutions to repackage them.

McKesson has tools to help pharmacists maximize purchasing of manufacturer-available barcoded medications. In addition, the McKesson Pharmacy Optimization team is working closely with hospital pharmacies to minimize the resources and time spent on repackaging so that their pharmacists can focus their attention on clinical care, and get their hospital to 100% barcode readiness. 

3.     There will be a spotlight on the hospital pharmacy to help reduce readmissions. Hospital executives need to have a better understanding of the pharmacy’s role in reducing or eliminating hospital readmissions. Many studies have shown that the primary reason patients visit an emergency room or are readmitted to the hospital is due to non-adherence with medication therapy once the patient is at home. The hospital pharmacy can have a significant impact on the reduction of hospital readmissions by proactively educating patients on the proper use of their medications.

An ambulatory pharmacy is ideally suited to help the hospital identify patients who are at high risk of non-adherence or may be managing chronic diseases at the point of discharge, and provide support required to help patients adhere to their prescribed drug regimens.  

4.     The hospital pharmacy will be closely scrutinized and expected to decrease costs and increase revenues. In most hospital departments, operating cost is usually composed of 80% labor and 20% supplies; it is inverted within the pharmacy with 80% drugs and 20% labor. The director of pharmacy can help keep budgets in check by looking at innovative services that enhance revenue.

Offsetting Indigent-Care Costs: Hospitals are treating more uninsured patients and looking for ways to recover the cost. Pharmacy-Assistance Programs (PAPs) offered by manufacturers are available to help offset the cost, but many hospitals find them too complex to manage.

The McKesson MedSource program maximizes the savings that hospitals can recover. In 2010, the MedSource program resulted in nearly $3.3 million in savings for participating hospitals across the U.S. and since program inception, has saved its health-system customers nearly $35 million.

340B Contract Pharmacy: The multiple-contract pharmacy option that is part of the 340B program offers an opportunity for hospitals to expand their reach in the community to capture a greater number of prescriptions. While the option to have multiple contract-pharmacy relationships is relatively new, McKesson customers who have implemented a contract-pharmacy strategy are capturing prescription fills nearly five times more than with a single pharmacy.

In addition, hospitals will look for ways to provide employee Rx benefits utilizing their own resources and purchasing agreements.

 5.     Expect the growth in the specialty-pharmaceutical segment to influence the pharmacy’s revenue and profits. Specialty pharmaceuticals, while impacting only a small population of patients with specific diseases, represent the largest average cost at $1,500 per dispense. Estimates are that growth in the specialty segment will range from 16–20% each over the next several years, until 8 out of 10 of the nation’s top prescription-revenue items are considered specialty pharmaceuticals. With access to group purchasing organization prices, its breadth of drug-distribution services and enhanced reporting solutions, McKesson is helping customers to develop strategies around the unique set of challenges emerging from the growth of specialty products.

Having an ambulatory pharmacy within a healthcare facility assists discharged patients with their medication regimen and helps improve medication adherence driving better quality patient care. It also can help drive higher revenue for your hospital.

Read full article 

Starting an ambulatory pharmacy is often new territory for healthcare organizations and deciding on the right areas of focus is not always an easy task. McKesson offers a suite of solutions that can help.

Most of the 20,000 attendees participating in the Midyear Meeting would agree with the ASHP in describing “…the mission of pharmacists is to help people make the best use of medications.”

Our colleagues enter the profession because they are passionate about patient welfare and quality of life, and because they believe that by providing medication therapy they can contribute to both.  I would wager a far smaller number entered pharmacy because they wanted to be financial managers, keep charts of accounts or become Six Sigma black belts.

And yet an increasing amount of pharmacists’ time and energy are focused on business and financial challenges.  They are looking at every aspect of their operation to squeeze out inefficiencies and gain some additional contribution to margin and profit.  They are learning about supply chains and just-in-time inventory.  And they are spending inordinate amounts of time managing the administrative details that allow them to recoup costs through 340B and similar programs. 

We’ve built the Business of Pharmacy on a foundation of patient welfare, operational efficiency and financial performance.  And we are reminded every day that the latter two are essential to providing the former.

This week at Midyear, we’ve introduced three new product offerings that touch each base of the foundation – our Ambulatory Pharmacy Solutions for extending the continuum of care and reducing preventable readmissions; our ExpressRx^TM Track, a compact central fill and mail solution to generate new revenue streams; and our new AcuDose-Rx^TM automated dispensing cabinet, to help ensure the accuracy and availability of drugs for patients.

Response on the floor and at the booth has been very positive.  Equally gratifying, we’re having deep conversations with pharmacists who are engaging us in the challenges of ensuring great outcomes for patients while also contributing to the economic viability of their hospitals.  These are the kinds of conversations that fuel product and process innovation at our company.  And these are the kinds of conversations that have made our time together at Midyear so productive.  Thanks to everyone who stopped by our booth and for all the great feedback.

I can’t believe that ASHP Midyear is almost over.  New Orleans has been a great host, and I’ve enjoyed the variety of opportunities to meet and talk with many of you.

This year’s meeting focused on the challenges that are impacting hospital pharmacy operations today – fluctuating inventories and shortages, changing government regulations, growing demands on staff, expanding clinical responsibilities, increasing financial pressures, and of course quality and patient safety.  Today’s pharmacy needs to find flexible solutions that alleviate some of these pressures to let you focus on what’s really important – taking care of patients.

More and more hospitals are looking to innovation to meet these challenges.  At McKesson, we’re continually working to ensure that our products anticipate customer needs – now and into the future.  That’s why we’re launching a new monthly webinar series to keep these important conversations continuing post-ASHP Midyear.  This Thought Leadership Series will feature pharmacy leaders who are facing many of the issues you are dealing with on a daily basis. It’s an opportunity for all of us to learn from existing best practices and identify new solutions for the future.

Featured topics include medication inventory optimization, the role of bar codes in achieving Meaningful Use, and narcotic diversion detection.  Save the dates now!

Hope you can join us!  

This week at the Midyear Clinical Meeting, I’ve had the opportunity to catch up with a lot of old friends and colleagues.  We’ve talked about the great restaurant experiences here in New Orleans and what’s happening with our families, the CE sessions and news from the event.  And it seems almost invariably the conversation turns to the very significant challenges facing the healthcare industry, and how pharmacists’ roles must change in response.

Many of the pharmacists I’ve talked with here participated in or paid close attention to 2010’s Pharmacy Practice Model Initiative (PPMI), led by the ASHP Research and Education Foundation.  And many said they are eager to learn about the successes, failures and challenges colleagues may have experienced in implementing some of the PPMI solutions.

Our Pharmacy Optimization team is in close contact with hundreds of Directors of Pharmacy, and we’re seeing an increasing involvement on the part of pharmacists as direct providers of patient care.  Investments in technology, such as for automated dispensing systems and BCMA, improvements in efficiency and using products, such the McKesson 340B Manager, each free up administrative time so pharmacists can spend more time with patients.

These steps are definitely in line with some of the recommendations of the Summit.  And yet we know there is more being done, and more to be done.

Please comment this blog, drop me a note or stop by our booth (713) to say hello.  We are vitally interested in your thoughts about the future and how you adapting to the challenges our profession is facing.

Yancey Casey
(404)338-2468
yancey.casey@mckesson.com  

Business of Pharmacy to be Showcased at 46th ASHP Midyear Clinical Meeting

ATLANTA, Dec. 5, 2011 – McKesson Corporation, a Fortune 15 healthcare-services and information technology company, has launched three new solutions designed to help hospitals and health systems achieve better financial performance and operational efficiency as well as improved patient care. More than 20,000 pharmacy experts will learn about these new initiatives and McKesson’s Business of Pharmacy^SM (BoP) approach during the 46th ASHP Midyear Clinical Meeting (Booth #713) in New Orleans.

New solutions that will be showcased include:

McKesson Ambulatory Pharmacy Solutions – a portfolio of purchasing, inventory, retail, reimbursement and consulting services designed to help hospitals capture new revenue, improve workflow efficiency and extend the continuum of care for improved clinical outcomes.

ExpressRx^TM Track – an automated, high-speed conveyor-based solution for pharmacies dispensing up to 3,000 prescriptions per shift. ExpressRx Track solution offers a small footprint and an affordable price, plus it is scalable to meet the needs of any pharmacy that is interested in centralizing pharmacy dispense efficiency with a mail order, specialty or central fill model.

The new AcuDose-Rx® automated medication dispensing cabinet – operating on the latest version of the Connect-Rx® software platform, the cabinet provides pharmacists even greater control over cabinet inventory management to ensure that the medications nurses need are always available.

“McKesson is advancing the future of the hospital pharmacy – both inpatient and ambulatory – through industry-leading strategies and expertise that support world-class medication distribution and integrated automation and IT solutions, resulting in better business health for our customers,” said Mark Eastham, senior vice president, McKesson Pharmacy Optimization.  

ENHANCING FINANCIAL PERFORMANCE

Ambulatory Pharmacy Solutions Improve Hospital Financials and Advance Continuum of Care

Ambulatory pharmacies enable hospitals to capture new revenue, in addition to extending the continuum of care and driving medication adherence for their patients. McKesson’s new Ambulatory Pharmacy Solutions offering builds on the company’s unmatched experience in retail and hospital pharmacy services to help health systems identify and leverage the right solutions for their ambulatory pharmacy strategy.

“Outpatient pharmacies are playing a larger role in the continuum of care for health systems,” said Coray Tate, clinical research director, KLAS. “Health system executives are also looking at these facilities as a way to increase revenue at a moment when they are being financially challenged.”

INCREASING OPERATIONAL EFFICIENCY

ExpressRx Track^TM  Increases Ambulatory Pharmacy Prescription Volume

The new ExpressRx Track is a central fill and mail solution that helps improve efficiency in pharmacies dispensing up to 3,000 prescriptions per shift. The automated, high-speed conveyor-based solution is compact enough to fit a hospital campus footprint and enables pharmacies to consider adding specialty and mail order services while freeing pharmacists to focus on other areas of patient care. With ExpressRx Track, ambulatory pharmacies can consider adding new revenue streams that also support the financial goals of the greater hospital.

“We designed ExpressRx Track with the flexibility to meet many different pharmacy configurations,” said Michael Jordan, senior vice president, McKesson High Volume Solutions. “Our goal is to help health systems realize high revenue generation while contributing to the continuum of care.”

The ExpressRx Track solution frees pharmacists’ time, allowing them to play a larger role in patient care and provide medication reconciliation services for discharge patients and medication therapy management services that improve patient medication adherence.

IMPROVING PATIENT CARE

New McKesson Automation Solution Reduces Medication Stock Outs While Improving Efficiency

With the new AcuDose-Rx medication cabinet, operating on the latest version of the Connect-Rx software platform, hospital nurses are dispensing medications faster and more efficiently, while pharmacists now have greater control over cabinet inventory management.

The exclusive RightStockTM feature, the backbone of the new functionality, tracks in real time the daily usage trends for AcuDose-Rx® automated medication dispensing cabinets, per medication and per pocket, preventing costly medication stock outs. With RightStock, pharmacists can dynamically adjust inventory levels to ensure that the medications nurses need are always available.

“This information and control lets us better manage the amount of high-value medications we stock in each cabinet, and has resulted in a 70% reduction in medication stock outs,” said James Toohey, director of pharmacy at Aultman Hospital in Canton, Ohio.

Meet BoP^SM. McKesson’s Business of PharmacySM.

Currently helping more than 2,000 hospital pharmacies nationwide, the Business of Pharmacy (BoP) is McKesson’s evidence-based approach to optimizing the financial, operational and clinical performance of hospital pharmacies. Harnessing McKesson’s superior distribution, BoP extends across the entire business of hospital-pharmacy operations and provides the services and solutions to transform the pharmacy into a center of operational excellence that supports optimal patient care. For more information, please visit mckessonbop.com.

About McKesson

McKesson Corporation, currently ranked 15th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit mckesson.com

If you are attending ASHP Midyear, have you seen our Cabinet Central News?  If you haven’t, we would love for you to stop by our booth (713) to watch our live newscast and see all the cool new features of our AcuDose-Rx cabinets and Anesthesia-Rx carts.  You’ll hear from customers who are realizing reduced stock outs, better inventory optimization and improved pharmacy and nursing workflows through our latest Connect-Rx software upgrade. 

Following the newscast and product demonstrations, I’ve been talking with current customers as well as those that do not use any McKesson Automation solutions to hear their perspectives on our products. The consensus is that our cabinets have evolved to a faster, more intuitive solution that meets the needs of both pharmacy and nursing. 

It’s really exciting to hear how people are reacting to the new features and functionality.  We’ve done extensive research over the last 36 months to develop this latest version.  But we’re not stopping there. We understand the critical role that medication dispensing cabinets play in hospitals, and we want to continue to grow and adapt to the ever-changing challenges hospital pharmacies and nurses are facing.  The feedback we receive from you during this show, and from many others throughout the year, continues to propel us forward.  

Speed, ease of use, and making sure that nurses have the medications they need at all times continue to be important topics for all of you.  I also am hearing how critical it is for pharmacy staff to keep their nurses happy by ensuring that they are not dealing with operational inefficiencies like stock outs and missing medications. And those topics fall right in line with our RightStock™ system, the backbone of our new Connect-Rx release.   This feature gives you a real-time picture of inventory, virtually putting an end to stock outs and improving patient care by ensuring that nurses always have the medications they need, when they need them.

It was another great day here at ASHP.  I really enjoyed talking with so many people today and am excited to see what tomorrow will bring.

Healthcare system providers looking for new revenue streams are increasingly exploring ambulatory pharmacies.  Our customers are convinced these facilities can help reduce preventable readmissions and extend the continuum of care.

The financial case is equally compelling:  our modeling shows that a 400-bed hospital with typical prescription volumes can realize a profit contribution of about $300,000.  That’s a meaningful number for a hospital otherwise dealing with significant financial pressures.

And by helping reduce preventable readmissions, an ambulatory solution can reduce or eliminate the penalties attached to readmissions that take place within 30 days of a patient’s discharge.

The interest in ambulatory pharmacy facilities is also in keeping with the ACO trend, where more hospitals are taking responsibility for a patient’s entire episode and have compensation tied to the patient’s outcome and welfare.

This week in New Orleans, we’re featuring a full-scale live demonstration of an ambulatory pharmacy facility at our booth, number 713.  And we have on hand a team of our pharmacy experts to talk about the patient, process and financial considerations that go into building and operating such a facility.  Please join us and stop by.

It’s day two at ASHP Midyear. Yesterday I heard quite a bit about bar-code readiness. Today, the buzz has moved to cabinets and anesthesia carts. 

I started my day attending the “Automating Medication Use in Operating Areas” breakfast symposium.   I hope you were able to join this session.  Doug DeJong, Senior Director of Pharmacy and Mark Steinbeck, Pharmacy Operations Manager at Saint Luke’s Hospital discussed why it’s important to consider using automation in surgical suites, what to look for when choosing automation, best practices and challenges faced during implementation, and the benefits of automating.  

This is an important topic for hospitals.  Only about 20% of hospitals are currently using automation in the OR.  With all the benefits that hospitals realize from pharmacy and nursing automation, that number should be higher.  Automating the OR is a natural extension to automated medication dispensing cabinets. And if you are considering automating your surgical suite, it’s important to involve your Anesthesia team right from the beginning.  You can read more about Saint Luke’s Hospital success in adopting Anesthesia-Rx for their OR automation.  If you are interested in seeing a demonstration of Anesthesia-Rx, please stop by our booth (713). I look forward to seeing you there.

Many of our colleagues attending the Midyear meetings participated in Monday morning’s CE on “Business Case for Barcode Readiness.”  It was an excellent session.  And it points to a renewed emphasis in our profession on implementing the technology, processes and best practices around it.

Widespread adoption of a barcoded medication administration process will dramatically reduce errors and, ultimately, save lives.  And it will improve efficiency while driving better financial results.  In other words, it’s a can’t miss proposition.

And yet pharmacy professionals have been making the same case for barcoding for much of the past two decades. 

Healthcare professionals know the numbers all too well – estimates of 100,000 deaths and a million preventable errors a year.  And Healthcare professionals also know that these preventable errors are most often not the result of sloppy or inattentive staff, but rather are more endemic to a highly complex healthcare delivery system, magnified by the sheer size and number of patients served.

The stakes will soon get higher. Federal guidelines call for a zero harm environment beginning in 2013. The ASHP Health-System Pharmacy 2015 Initiative calls for 75 percent of hospitals to use machine-readable coding to verify medications before dispensing. The initiative also calls for 75 percent of medications to be automatically recorded prior to administration.

Monday’s CE session explored the role of pharmacy in being change agents within the hospital, and in building the processes and workflow that support BCMA.  It addressed pharmacists’ role in creating an environment of continuous improvement, and an approach that relies on both investments in technology and also investments training and best practices.

We each have a stake in getting to a zero harm environment.  At McKesson we are leading the charge to deliver flexible solutions for every hospital leveraging our years of expertise, best practices and leading-edge technologies to help you get there.  Please see us at booth 713 to continue the good conversation about BCMA from yesterday’s CE, and to share your experiences in this vital area.