Integrating Pharmacy Services and Preparing for Change at Michigan Medicine with Karen McConnell, PharmD

Summary

Episode Summary: Integrating Pharmacy Services and Preparing for Change at Michigan Medicine with Dr. Karen McConnell, PharmD

Podcast: Becker’s Healthcare Podcast
Host: Paige Twenter, Becker's Healthcare
Guest: Dr. Karen McConnell, Chief Pharmacy Officer, Michigan Medicine
Date: March 14, 2026

---

Overview

This episode centers on how Michigan Medicine is integrating its pharmacy services across campuses, the challenges and innovations of such large-scale integration, and how pharmacy leadership is preparing for continuous change in healthcare. Dr. Karen McConnell shares her experiences from her first year as Chief Pharmacy Officer, the system-wide efforts on pharmacy and therapeutics (P&T), adjusting to regulatory and market changes, and the importance of building resilient, high-caliber pharmacy leadership teams.

---

Key Discussion Points & Insights

1. Dr. Karen McConnell’s Background & Michigan Medicine Overview

• Career Highlights:
  • Began as a clinical pharmacy specialist in cardiology at Kaiser Providence (15 years).
  • Held clinical director role at Cardinal Health.
  • Advanced to Assistant Director at Catholic Health Initiatives, then Chief Pharmacy Officer at Common Spirit Health.
  • Joined Michigan Medicine a year ago.
• About Michigan Medicine:
  • Academic health system: 11 hospitals, 3M+ clinic visits/year, 2,000 active clinical trials.
  • Academic medical center recently ranked 12th in the U.S.; College of Pharmacy ranked 2nd nationally.
  • “[I’m] really proud of the clinical care that we provide here as well as the high level of education.” (Dr. McConnell, 01:52)

2. Integration Across Campuses & the P&T Committee

• Current Integration Effort:
  • Three campuses: UM Health at West (Grand Rapids), Sparrow (Lansing), and Ann Arbor AMC.
  • Launch of first System Pharmacy & Therapeutics (P&T) Committee: “Bringing everyone together has been an exciting journey. For example, we just kicked off our very first System Pharmacy and Therapeutics, or P and T committee, so that we can form one formulary and one direct library across the system.” (C, 02:55)
• Committee Structure:
  • 16 subspecialty subcommittees (infectious disease, cardiology, oncology, etc.), composed of frontline clinicians.
  • Recommendations pass from subcommittees → System Clinical Pharmacy team (SCRIPT) → System P&T Committee for consensus and voting.
  • “We really make sure that we are hearing our frontline clinicians and we're making the best clinical decisions for our patients.” (C, 05:45)

3. Operational and Clinical Pharmacy Initiatives

• Key Growth Areas:
  • Specialty pharmacy, home infusion, community pharmacies.
  • “Having that quality, integrated care for our patients has really helped us grow our business here.” (C, 04:32)
• Importance of Financial Acumen:
  • Financial savvy is critical, especially with the rise in high-cost gene and cell therapies.
  • “As a pharmacy leader, you definitely have to have a strong financial acumen. I got my MBA several years ago just to make sure…” (C, 06:25)

4. Preparing for Change & Ability to Pivot

• Evolving Healthcare Environment:
  • Rapid regulatory, technological, and clinical shifts require agility.
  • “One of our big priorities is just being well prepared for whatever might come down the pike, both operationally and employing all of our advocacy routes.” (C, 07:39)
• What Pivoting Looks Like:
  • Annual strategic planning, adjusting timelines and priorities as new legislation or requirements emerge.
  • Example: Adapting to Inflation Reduction Act (IRA) implications for drug pricing and reimbursement.
  • “Pivoting looks like, what's our current strategic priorities? What's this new thing that we need to take into account? And then how do we work that into our current plan?” (C, 08:20)
• Regulatory Readiness:
  • Adjusting for state/federal changes, e.g., IRA’s expansion to Part B drugs in 2028.
  • “Even if we figure out how to incorporate Part D drugs. Part B is a totally different way of billing medications…” (C, 10:20)

5. Leadership, Team Building, and Recruitment

• Building Resilient Teams:
  • The key challenge: balancing workload with resource allocation and communication.
  • “The sheer number of things... it's really incumbent upon us to make sure that we are communicating well, we're resourced appropriately…” (C, 11:09)
  • On team support: “The way I've done it is to surround myself with wonderful teams… very high quality leaders to help me navigate these troubled waters.” (C, 11:44)
• New Leadership Roles Recruiting:
  • Adding Associate Chief Pharmacy Officer roles in ambulatory, business operations, and clinical/quality spaces.
  • “So we're really excited to have those additional leaders in place so that we can... continue to diversify and be really strong in pharmacy.” (C, 12:24)

6. From Clinician to Leader: Perspective Shift

• Transition from Direct Patient Care to Leadership:
  • “When you become a leader, it's more of a long term play and it's not that instant gratification anymore.” (C, 12:52)
  • Never specifically foresaw her current role, but always wanted to pursue leadership.

7. Opportunities for Organizational Growth

• Specialty and Ambulatory Pharmacies:
  • Strong provider-pharmacist integration.
  • “Our specialty Pharmacies are continuing to service more patients because the value of continuity that we have with our providers...” (C, 13:50)
  • Growth in transplant and ambulatory care.
• Education and Research:
  • Residency program: 33 residents; celebrates 100th anniversary next year (oldest in the country).
  • College of Pharmacy’s 150th anniversary.
  • “Our research pharmacy... one of the biggest in the country, over 600 studies.” (C, 15:10)

---

Notable Quotes & Memorable Moments

• On Clinical-Operational Integration:
  “Pharmacy encompasses both clinical and operation work. So I'd say that might be our most exciting clinical work that we're doing right now, really bringing together all of our clinicians... to work within system PNT.”
  — Dr. Karen McConnell (04:05)

• On the Need for Agility:
  “One of the hardest headwinds in healthcare right now is how quickly it's evolving and changing. It feels like every day there's new things...”
  — Dr. Karen McConnell (07:22)

• On Team Leadership:
  “The way I've done it is to surround myself with wonderful teams. And I'm so lucky here at Michigan to have very high quality leaders to help me navigate these troubled waters...”
  — Dr. Karen McConnell (11:44)

• On Educational Leadership:
  “We have 33 residents here at Michigan and in fact, we are the very first residency in the country. And next year we're going to be celebrating our 100 year anniversary here at Michigan.”
  — Dr. Karen McConnell (14:34)

---

Timestamps for Important Segments

• 01:06 – Dr. McConnell’s background and Michigan Medicine overview
• 02:39 – Integration journey across three campuses
• 04:01 – What’s most exciting in Michigan Medicine pharmacy today
• 04:52 – Structure and function of the System P&T Committee
• 06:25 – Role of financial acumen in modern pharmacy leadership
• 07:22 – Ongoing headwinds and adapting to constant change
• 08:10 – Example of pivoting strategy following regulatory change
• 09:22 – Preparing for state and federal policy changes (IRA)
• 11:09 – Leadership challenges and importance of team building
• 12:13 – Expansion of pharmacy leadership roles
• 12:48 – Clinician to leader: reflections on career path
• 13:48 – Growth opportunities: clinical care, research, education

---

Summary Takeaway

Dr. Karen McConnell provides a deep dive into the complexity and opportunities within integrated pharmacy services at Michigan Medicine, emphasizing team cohesion, system-wide clinical alignment through P&T committees, operational flexibility, and leadership in turbulent times. The conversation underscores Michigan Medicine’s role as a leader in pharmacy innovation, education, and research—poised to address the changing landscape of healthcare with a unified, agile pharmacy strategy.

Transcript

[A]

The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit, and more, the conversations get real. Leaders will share how they're scenario planning for policy shifts, breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.

[B]

Hi, my name is Paige Twenter. I'm an assistant editor here at Beckers. Welcome to the Becker's Healthcare Podcast. I'm joined here today by Dr. Karen McConnell. Dr. McConnell is the chief Pharmacy Officer at Michigan Medicine and and without further ado, I'd love for her to briefly introduce herself and tell us about her career and organization.

[C]

Sure. Thank you so much, Paige. It's nice to be invited to participate on this podcast. Like you said, my name is Karen McConnell. I am the Chief Pharmacy Officer at University of Michigan Health, Michigan Medicine. I'm also the Associate Dean at the University of Michigan College of Pharmacy. So a little bit about my career. I started out as a clinician. I was a clinical pharmacy specialist in cardiology at Kaiser providence for about 15 years before I became a clinical director at Cardinal Health for a few years. And then I started as Assistant Director of Clinical Pharmacy Services at Catholic Health Initiatives, which is a health system, a Catholic health system of about 100 hospitals at the time. We then merged with Dignity Health and became Common Spirit Health, which at the time was about 142 hospitals in 24 states. And I became the first Chief Pharmacy officer there, which was a role that I held for about four years. And I've been here at Michigan Medicine for about a year. A little bit about Michigan Medicine. So we are an academic health system. We have 11 hospitals and we have about 3 million clinic visits every year and nearly 2,000 active clinical trials. Our academic medical center was just recently ranked number 12 in the US and our College of Pharmacy is ranked second in the United States. So I'm really proud of the clinical care that we provide here as well as the high level of education.

[B]

Well, how has the past year been in the new role?

[C]

It's been great. The people here at Michigan Medicine are awesome. They always strive for high integrity, high quality care for our patients. There's a lot of curiosity here and innovation to do what's best for everyone involved. And that's a really exciting place to be. I have really enjoyed being here because they're currently on a journey of integration, which, through my previous role, I have quite a bit experience doing. So we have three campuses here. We have our University of Michigan Health campus at west, which is in Grand Rapids. We have our Sparrow campus, which is in Lansing, and then of course, our academic medical center and the clinics here in Ann Arbor. And so bringing everyone together has been an exciting journey. For example, we just kicked off our very first System Pharmacy and Therapeutics, or P and T committee, so that we can form one formulary and one direct library across the system. And that's been really rewarding work.

[B]

Would you say the integration work between the three campuses, the PNT committee, or mysterious third thing would be the most important initiative you led in the last year. I'm kind of interested to hear, like, number one thing you're most excited about over the past 12 months of Michigan Medicine.

[C]

You know, I'm excited about a lot of things. I would say it's super hard to pick one. You know, pharmacy encompasses both clinical and operation work. So I'd say that might be our most exciting clinical work that we're doing right now, really bringing together all of our clinicians, physicians, nurses and pharmacists to work within system pnt. Operationally, we're really excited to continue to grow our specialty pharmacy, our home infusion pharmacy, our community pharmacies and home infusion. So we are out on the forefront here in pharmacy making impacts. And really having that quality, integrated care for our patients has really helped us grow our business here.

[B]

Can you kind of take me through the P and T committee of, like, how that was all organized?

[C]

Sure. So we have subgroups, subcommittees that go up to P and T. And each of those subcommittees are comprised of various subject matter expertise. So, for example, we'd have infectious disease subcommittee. We have cardiology subcommittee, oncology subcommittee. I think overall we have about 16 different subcommittees. And the composition of those subcommittees are really frontline clinicians, both physicians and pharmacists that are treating patients that are specialized in that area, that know the primary literature and the guidelines really well. And those are the folks that are making the recommendations for our System P and T committee. And those are clinicians that are from our different campuses across the state. And so once they make those recommendations, they then go up to our System Clinical Pharmacy team or script committee, where we have consensus building to make sure that everybody's on the same page and then it goes up to the System P and T committee for voting. And that is a great way to do it because we really make sure that we are hearing our frontline clinicians and we're making the best clinical decisions for our patients.

[B]

And I know they're even more vital just with the huge pipeline of very expensive medications, including gene and cell therapies, which could cost or usually cost up to millions or multi millions. So it's not only important for the kind of clinical alignment with the front line, but also financial acumen, right?

[C]

Oh, absolutely, yes. As a pharmacy leader, you definitely have to have a, a strong financial acumen. I got my MBA several years ago just to make sure that I was fully up to speed on all of the important things that we need to know about finances. But cell and gene therapy is an excellent example. You know, that's really important to stay on the cutting edge and to be a center of excellence to make sure that you're able to provide all of the care that patients might need in a large academic medical center, as well as provide a venue for our world renowned subspecialists that they can provide the care that they would like to for our patients.

[B]

Now, I asked you earlier a very hard question of your most important initiative that you led. So while our next question is a bit wider scope, don't want to narrow you in looking ahead. What would you say are the biggest priorities and headwinds you're focused on this year?

[C]

So I think one of the hardest headwinds in healthcare right now is how quickly it's evolving and changing. It feels like every day there's new things that we need to take into account. We need to understand and potentially change the way we're doing things. And then pharmacy is in the center of so many of those different things. So one of our big priorities is just being able to pivot and being well prepared for whatever might come down the pike, both operationally and employing all of our advocacy routes so that we are advocating for what we believe is best for not only pharmacy, but for healthcare and certainly for our patients.

[B]

What would a really good pivot look like or has looked like?

[C]

So, you know, for example, every year we put together our strategic priorities and we have work plans and task lists and people are responsible for each of those things so that we can stay on track. And let's say a new law is passed and it requires us to do something different and to plan for doing that something different into the future. Well, anytime that we're doing something that requires A change. It takes a lot of planning and it takes a lot of prep. So pivoting looks like, what's our current strategic priorities? What's this new thing that we need to take into account? And then how do we work that into our current plan? So does it replace something that we're already working on? Does it just bump something down? Can we actually move that to later in the year and work on it later? So really understanding what the priority is for the new thing that we're pivoting for, and then when in the future would we need to address it?

[B]

Is there anything specific, either in Michigan or on the federal level that you're preparing your best to be able to pivot too? If there's, you know, I'm thinking of a few federal drug pricing changes, but I don't know, you're concentrated on just Michigan right now?

[C]

No, I mean, you know, we get to do both. Right. We get to pivot for federal changes and we get to pivot for state changes. So, you know, IRA is a, is a good example of way that things have changed and how we, you know, at the maximum fair price and how we can accommodate that and how we need to, you know, take the different pricing into account to make sure that we're being fully compliant, which is absolutely, you know, number one priority, as well as, you know, making sense of how things flow on the business end as well.

[B]

Yeah. And I believe it's 20, 28 is when the IRA or maximum fair price cycle will include Medicare, Part B drugs or hospital administered drugs, if I'm correct. I'm like 80% sure. Correct. Yeah. Yeah. Which I'm sure will have even more direct impact on your strategic plan than you'll have to pivot to, so.

[C]

Right, that's exactly right. So, you know, even if we figure out how to incorporate part D drugs. Right. Part B is a totally different way of billing medications. And so then we'd have to take a deep dive and make sure that we are doing that fully compliantly and in the best business way possible.

[B]

What would you say is the hardest thing you'll have to do this year? Whether it's related to feel like we're using the word pivoting a lot, whether it's related to pivoting or not. Yeah.

[C]

It's funny, you know, when I was, I was preparing the questions in advance, when I filled out this question, it said, what is the hardest thing you'll have to do this year? I literally wrote the word pivot. So it's so funny that that came up earlier in our conversation. And I would say the other thing that's really challenging is the sheer number of things that we have on our plates. And I'm sure probably every pharmacy leader that would potentially listen to this would agree. We have a lot of things coming at us at all times. And you know, it's really incumbent upon us to make sure that we are communicating well, we're resourced appropriately, and that we are addressing things the best way we possibly can to set up our organization the best possible way. And really the way we do that and the way I've done it is to surround myself with wonderful teams. And I'm so lucky here at Michigan to have very high quality leaders to help me navigate these troubled waters at times to make sure that we have really great outcomes for our patients and our health system. And I'm really excited I'm getting to recruit some additional leaders here at Michigan Medicine because we are growing so fast that the additional leaders within my org structure will really help us get to where we need to be in the next phase of healthcare.

[B]

In what areas are we recruiting new pharmacy leaders?

[C]

So I have an associate chief pharmacy officer open for in our ambulatory space. I have one in our business operations and I have one in our clinical and quality space. So we're really excited to have those additional leaders in place so that we can utilize, you know, different points of view to continue to diversify and be really strong in pharmacy.

[B]

All those years ago when you were working at Kaiser in the kind of cardiology pharmacy area, did you think this is what you would be doing today?

[C]

That's a really interesting question. You know, I loved being a clinician. It was very, very rewarding for me because when you treat a patient and you help them right then you get that instant gratification that you're helping somebody that day. When you become a leader, it's more of a long term play and it's not that instant gratification anymore. And you have to really understand yourself as a person and how you can be most successful as a leader. So I would say initially probably no, I wouldn't think that I would be the chief pharmacy officer at University of Michigan Health. But I did always want to be a leader because I felt like I could could bring that and be beneficial to others as a leader. So I'm really happy that I was able to get here.

[B]

Well, I have one more question for you before I let you go. Where do you see the biggest opportunity for organizational growth this year?

[C]

So our specialty Pharmacies are continuing to service more patients because the value of continuity that we have with our providers, our pharmacists have access to our patients medical records which allow our process to be streamlined and well coordinated. The same can be said for our home infusion and our infusion business lines. The connectedness that is possible from services that are provided from within our health system can improve how well our patients are cared for. We're also growing our ambulatory care clinical pharmacy footprint in areas such as transplant because having those transitions of care are really important to make sure patients are not only well cared for within the hospital, but also on the clinic side as well. We have really strong ambulatory pharmacy clinical services as well. I'm also super excited about our education and training. We have 33 residents here at Michigan and in fact we are the very first residency in the country. And next year we're going to be celebrating our 100 year anniversary here at Michigan. And so that is really a notable place to be for our residency program. And not only that, our college of pharmacy is also 150 years old. So we have a lot of landmarks coming up really soon. So not only are we helping lead pharmacy within clinical and operations, but also education and training too. And I would be remiss if I also didn't mention our research pharmacy, which is one of the biggest in the country, over 600 studies. So I'm very proud of what we're doing here at Michigan.

[B]

Well, thank you so much for joining us on the podcast. Unfortunately, that's all the time we have today, so let you go. But I really appreciate you sharing your time and expertise with us.

[C]

Well, thank you so much for the invitation and I'll just end by saying go blue. Thank you so much. Take care.