Becker’s Healthcare Podcast
Episode: Digital Innovation in Specialty Pharmacy with Dr. Mark Mackensen, PharmD
Date: December 21, 2025
Host: Ella Jeffries

Episode Overview

In this episode, Dr. Mark Mackensen, Senior Director of Outpatient Pharmacy at Mount Sinai Health System, discusses the rapid digital transformation occurring within Mount Sinai’s specialty pharmacy operations. The conversation focuses on how technology and AI are streamlining manual processes, improving both staff workflow and patient outcomes, and envisioning the future role of digital tools in healthcare. Dr. Mackensen also shares practical insights on overcoming implementation barriers and the critical importance of building trustworthy digital experiences for patients.

Key Discussion Points and Insights

1. Introduction to Mount Sinai’s Outpatient Pharmacy (00:33)

• Dr. Mackensen oversees outpatient specialty pharmacy operations for a large academic medical center with 7 hospitals and 500 outpatient clinics in NY, NJ, and CT.
• 7 outpatient pharmacies; 3 are specialty accredited.
• The service began in 2020 and is now integrated with 90% of the system’s practices.
• Primary Goals: Ensure patients’ care remains within the system (“continuum of care”), which leads to better outcomes, decreased length of stay, improved compliance and adherence, and reduced readmission.

2. Approach to Digital Innovation (02:24)

• Mount Sinai is shifting from legacy, manual platforms to a digital-first strategy.
• Patient Experience: The aim is to make pharmacy interactions as streamlined as popular online platforms (e.g., Amazon, CVS).
  • Creating a “front end digital platform” for medication refills, delivery scheduling, and clinical resources, all integrated with patient electronic health records.
  • Vision of a unified digital health “ecosystem.”
• Operational Efficiency: Focus on automating repetitive backend workflows (e.g., benefits investigation, prior authorization, financial assistance).
  • Target: enable pharmacy staff to “work at top of license” and be patient resources, not just task processors.
• Quote:
  “We are really quickly moving towards a digital first strategy…Developing a front end digital platform where a patient can log on, interact with their medication refill, check out, schedule delivery, things of that nature. But then going a step further…how can they use the health system’s digital presence to answer all their healthcare needs?” — Dr. Mackensen (03:03-04:00)

3. Most Impactful Technologies and Tools (06:17)

• AI-powered Prior Authorization:
  • Automates extraction of clinical answers from medical records and populates payer-specific authorization forms.
  • Results in ~50% (targeting 75-80%) reduction in processing time (from 20–25 minutes per authorization).
  • Improved “first pass” approval rates; gets patients to therapy faster.
  • Staff can now focus on more valuable, patient-facing work.
  • Quote:
    “By bringing in an AI solution…it pulls the appropriate form and populates it, so answers the questions with reference for the individual…This leads to a significant decrease in the time to complete a prior authorization.” — Dr. Mackensen (06:30-08:20)
• Digital Front Door:
  • Integration with MyChart delivers a retail-like “shopping” experience for prescriptions, notifications, and clinical info all in one portal.

4. Defining Success in Digital Innovation (09:41)

• Metrics: Patient experience and ongoing engagement with the health system are primary indicators.
• Operational Success: Ability to redeploy staff from routine administrative tasks to more impactful roles (e.g., financial navigation, patient outreach).
  • Example: If 20 liaisons do GLP-1 prior authorizations, automation could “repurpose those 15 liaisons to do more financial navigation.”
• Quote:
  “Any, any goals that we set for ourselves is always with the patients at the heart of it and ensuring that the patients outcomes and experience are our best for sure.” — Dr. Mackensen (10:38-10:45)

5. Implementation Challenges & Solutions (11:23)

• Governance: Navigating institutional processes and getting buy-in is time-consuming, especially with new AI technologies as “the governance is being built as we speak.”
• Vendor Partnerships: Need for mature, proven solutions over “not fully baked products” from vendors.
• Collaboration: Success depends on tight partnerships with IT, legal, and internal transparency.
• Quote:
  “Really working with your partners within your organization, specifically your IT partners, your legal partners, is so important in order to be efficient and get some of these products to market and to a live state.” — Dr. Mackensen (11:49-12:07)

6. Transformation of Patient Experience (13:30)

• Transparency and Access: Digital platforms allow patients more transparent, streamlined ways to interact with pharmacy services.
• Financial Navigation: Digital tools help link patients to available financial assistance (manufacturer discounts, foundations) for specialty therapies.
  • Specialty medications are increasingly expensive and complex, making such navigation crucial.
• Quote:
  “Really utilizing the digital front door to give that patient that trusted source for financial information and then backing that up with our liaisons who can do that financial navigation, that’s the thing that I’m most excited about.” — Dr. Mackensen (14:10-14:38)

7. Future Opportunities for Digital Specialty Pharmacy (15:47)

• Trusted Information: Health systems can become the go-to source for reliable health information, counteracting misinformation online.
• One-Stop Digital Experience: Envisioning a patient portal as the central hub for all medical, pharmacy, and health education needs.
• Quote:
  “There is a lot of untrustworthy information out there…So having a trusted source that they can always come back to—that is fully capable of leading the patient on that care journey—is so important…That’s where I see the future of digital specialty pharmacy within the health system.” — Dr. Mackensen (15:48-17:35)

Memorable Quotes

• “We’re a pretty young operation as a whole, but we’ve grown exponentially over the last five years… [Our] overall goal…is really to keep the care of the patients within the continuum of the health system.” — Dr. Mackensen (00:40-01:35)
• “Imagine a world where a patient can log on to their health system portal and access any kind of information that they want about their health…The health system name and logo is always a trusted resource.” — Dr. Mackensen (16:15-17:35)

Noteworthy Timestamps

• 00:33 — Dr. Mackensen introduces himself and Mount Sinai’s specialty pharmacy structure
• 02:24 — Digital innovation overview and goals; shift to digital-first
• 06:17 — Specific impactful AI/automation tools and measured outcomes
• 09:41 — How success is defined and measured (patient experience and efficiency)
• 11:23 — Challenges in implementation and importance of governance
• 13:30 — Digital tools’ impact on patient experience, especially financial accessibility
• 15:47 — Future vision: health system as patient’s trusted digital hub

Tone

The conversation is pragmatic, visionary, and candid—balancing optimism about technology’s potential with the realities of large health system bureaucracy. Dr. Mackensen is enthusiastic about patient-centered outcomes and staff empowerment, repeatedly returning to the core mission of trust and care continuity.

This episode offers a concise yet comprehensive insider’s look at how one of the country’s largest health systems is reimagining specialty pharmacy through technology, focusing not just on operational efficiencies but also on truly improving the patient journey.