What happens when: A regional hospital rebuilds their pharmacy to house both retail and specialty operations with state-of-the-art robotic technology?
Hint: They become a best-in-class national model for innovation, high touch patient care and improved drug access for patients
A regional hospital in the south turned to the Azina team when they realized that their inhouse retail pharmacy needed operational improvements and had a huge opportunity to gain new revenues within the specialty pharmacy space. The retail pharmacy was not able to keep pace with 21st century demands on its hospital operation, and it was also ill positioned and a potential liability for the hospital’s capacity to achieve its broader strategic goals.
That included the ability to leverage its retail pharmacy to build a specialty pharmacy capability within the pharmacy. They knew that with the right pharmacy, it would allow them to provide specialty medications to their patients inhouse, gaining greater control over the patient experience and care integration, and keep revenue streams in house rather than losing them to outside third-party pharmacies.
There was a lot of work to be done. Before partnering with Azina, the hospital’s retail pharmacy was a small 500-square-foot space that could only process scripts manually using an outdated pharmacy management system, had no inside access for patients and could accommodate drive-through only. Because of this, it was not unusual to have dozens of cars waiting in line for service. Hospital leadership was ready for a complete reinvention of their pharmacy capabilities.
The Azina team of experts started by conducting a full assessment on everything from A to Z including workflow, staffing, medication inventory processes, and customer service protocols, to technology, equipment, infrastructure, and space. The resulting comprehensive plan included:
New Retail Pharmacy Build-Out:
We designed and supervised construction of a new custom 1,200-square-foot retail pharmacy that reflected the strategic needs of the hospital then and well into the future. The redesign addressed the shortcomings that the hospital knew of all too well, and others that Azina revealed in the initial assessment. As part of the buildout, Azina delivered:
- A formal business plan to guide the operation strategically and tactically, that is supportive of and integrated into the hospital’s overarching plan
- IT infrastructure, software and robotic automation that can house the top 200 meds, and robotically count out and label the drugs
- Detailed capital equipment plan
- Workflow systems such as an integrated will-call system that highlights the patient’s name to speed service and processes
- Inventory management processes
- Clinical programs forged from decades of experience across hundreds of hospitals and health systems
- 340B strategies for increasing drug access
- Staffing models at all levels
- Patient experience strategy including easy access, low wait times, a patient app, and a private onsite consult area
The Specialty Pharmacy:
With a state-of-the-art retail pharmacy as the foundation, Azina built a specialty pharmacy capability with an initial focus on specialty drugs for neurology and infectious diseases. Having its own embedded specialty pharmacy has helped the hospital realize new sources of revenue, retain and grow the patient base, drive access to limited distribution drugs (LDD) and continue to improve patient care outcomes.
Azina helped the hospital achieve dual accreditation, which is a critically important next step in the evolution of their specialty pharmacy. Dual accreditation demonstrates to payors, drug manufacturers and other key stakeholders that the specialty pharmacy is qualified to be an important component of providing quality patient care with highly trained, expert personnel driven by effective policies, procedures, and advanced technology.
Specialty Drug Access Program:
A central strategy in Azina’s approach to specialty pharmacy is helping hospitals win contracts with payors so they can expand their medication services for patients, and gain access to critically important LDDs from key drug manufacturers. Azina has already helped gain access to over a dozen specialty drugs and increased script volumes across the program, including provider education component so patients have more access to effective medications and the pharmacy realizes greater pharmacy performance (capture rate; gross margins; patient satisfaction; etc.). And it’s just the beginning (see What’s Next below).
Azina created a pharmacy operation for the future, one that improves medication adherence, lowers readmissions, improves patient satisfaction, reduces employee drug costs, and boosts bottom line performance.
- Over the last six months, average hospital revenue and gross margin increased and in fact the last month set a record for both gross revenue and gross margin.
- In one year, daily average specialty pharmacy gross margin increased from $502 to $11K and daily script count more than doubled.
- Neurology and HIV lead the way for highest capture rates in 2021, leaving plenty of room for expansion to support other specialty conditions.
- We’ve also seen huge operational improvements:
- Call Abandonment Rate target was 5% or less; we achieved 2.2%
- Average Speed of Answer by a live person target goal was under 30 seconds; we achieved 6.2 seconds
- Patient Satisfaction rate target was over 80%; we achieved 96%
What's Next For This Hospital:
A pharmacy platform of the future gives Azina and our partner hospital a lot to work with in terms of exponentially improving clinical, operational, and financial results, such as:
- Continuing to drive revenue and gross margin by targeting inflammatory, neurology and oncology medications, as well as neurology and infectious disease scripts.
- Creating additional provider and patient engagement by adding a liaison position that rotates between clinics and engages providers and educates patients on medication compliance.
- Continuing to gain access to additional payor specialty networks that expands access and choice for patients and providers, as well as access to LDD manufacturer catalogs.