← Becker’s Healthcare Podcast
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- [00:00]
A
This is Laura Deardle with the Becker's Healthcare podcast. I'm thrilled today to be joined by Nilesh Desai, Chief Pharmacy Officer at Baptist Health System. Nilesh, it's a pleasure to have you on the podcast today.
- [00:10]
B
Thank you, appreciate it and a pleasure to be here.
- [00:14]
A
Absolutely. Well, I'm excited to connect with you because I know there's so much happening right now in health care and certainly in the pharmacy space. Just a lot of innovation. And so I'm excited to hear more about what you're doing at Baptist Health System. But before we dive in, I was wondering, could you tell us a little bit more about yourself and the organization?
- [00:31]
B
Yes. So I've been the chief Pharmacy officer for last five years at Baptist. I joined right when Covid started. So you could imagine what kind of fun I had during a new role in a new organization, Baptist health. We are 10 hospital system to our managed hospitals and our joint venture and then eight hospitals within our system. You look at all different bed sizes that we have. Pharmacy wise we are a full length pharmacy enterprise, inpatient services, outpatient specialty pharmacy, retail pharmacies. We have 13 retail pharmacies across our all the different sites and even outside of the hospitals. And then last year we went live with our big 102,000 sq ft Central Pharmacy Services center, one of the first autonomous pharmacies services center that we built more keeping in mind with regards to prescription fulfillment and inventory management for all our sites. So that project was a three and a half year project right from business planning to all the way down to execution and opening of the building.
- [01:56]
A
Wow, that's huge. And certainly what a great accomplishment to build kind of that type of pharmacy center in something that's really going to make a difference for the broader organization. That's really amazing to hear. And we think about a long project like that, three years from kind of conceptualizing and then, you know, being able to realize that and make it a reality. What does it take from an organization both resource wise financially as well as time, effort and energy in order to put something together like that? And then making sure you're staying updated with technology and just, you know, the right type of workflows to realize the efficiencies that you need from a center like this?
- [02:40]
B
Yeah, absolutely. I mean, you know, I'll start off with the organization commitment to, you know, really look at the full spectrum from, I mean if you look at the industry, you know that there is drug shortages, you know, hundreds of that that's out there. Then you have pharmacy deserts which is a larger issue. A lot of pharmacies are closing or they're closing, they're having early hours where they close by 5, 6 o' clock in the evening and then you have your staffing shortages. You know, we've been dealing with pharmacy technician shortages for the last 15 years or so. And then now you're seeing more and more pharmacist shortages depending on what markets you're at. So overall when you start putting things together and then you say, well, you know, what's the biggest challenge that when you have all this is medication access to our patients. If someone has to drive miles to get a medication from a pharmacy or if the pharmacy is closed, then how do they procure their medication? Especially some life saving medications. When we planned this whole service and we started to look at the big picture, we said there's things we have to do. With all that I said about staffing shortage, et cetera, how do we best economies of scale? Do we plan? What are we, you know, what are we going to do to be more efficient and provide access to our patients? So hence the central pharmacy came into play. And you know, the commitment was there or from the organization when we really put the whole plan together. A very strong team. You know, when I started it was just me at Baptist, it was an inaugural chief pharmacy role. And then really one after another I built a team. And that team really, you know, I have to say we all worked day, nights, you know, blood, sweat, tears I call it. It was a very, one of the happiest moments when the building opened up. And since then we're live, we went live with prescription fulfillment, we are live with inventory distribution at our hospitals now. So it's really a problem. You know, when we filled our first script to. I think we're filling in the high 2000s now per day and a goal is to even go higher and really be accessible. I've been to many meetings or I've talked to a lot of patients depending on where I'm traveling and heard nothing but very positive comments about our central pharmacy services.
- [05:19]
A
That's amazing to hear and thank you so much for walking us through that. What a proud moment indeed. Now I'm curious, what are some of the other trends that you're watching currently? I know you've mentioned some of the staffing shortages of course and you know, other challenges related to pharmacy access distribution as being important. What else is on top of mind for you?
- [05:38]
B
Well, I mean if you know, continued 340B challenges, you have payer access, payer networks, PBM, internal PBM, external PBMs. I mean, it's a continued, you know, drug costs. No matter how much you do for a drug cut, it's never enough. But it's continued work that we always have to be very cognizant. Newer therapies that are coming, high cost drugs, gene therapies. I mean, there is tremendous opportunity from a pharmacy perspective on what we can do. Medication reconciliation, meds to beds, value based care, where pharmacy can play a big role. I mean, some of these items are. Drug diversion, I would say is another big item. Some of these items keep you always in the run because you know, before you think you're settling down, you know, something else pops up. But it's always, you know, the larger picture we look at is how do we make our patients life easier? How do we get, you know, our patients to be adherent to the medication so that, you know, their quality of life improves. And then on the flip side, it's all our staff, how do we, all the clinicians and all the pharmacy technicians, everybody, how do we make their lives comfortable so that they are able to perform those services in an efficient way? So having the right technologies, selecting the right technology, this is something our teams are very, we work very, very hard to really go out and look at other industries and see what's out there. And then we brought these technology companies in and actually worked for the first time in, in the pharmacy space. And as AI gets into the picture, a lot of work on the data front so that once our data gets normalized, then hopefully we'll get into that where AI can really help us in many ways. So a lot of work to be done, but definitely we are on a good track where hopefully in the next few years we'll be able to some of the outcomes that we've been projecting out.
- [07:52]
A
Absolutely, that's great to hear and you know, definitely appreciate the overview of some of the things you're looking at. Exciting to know about the technologies and really see how that evolves over the next few years. Again, I'm curious to know, you know, some of the challenges. Obviously you mentioned the 340B program and how do you plan for the future? I know so many hospitals and systems have a varying degree of reliance on 340B, but for those who have benefited from that in the past and now the future is uncertain. What can you do in order to just plan for the worst and then hope for the best?
- [08:30]
B
I mean, yeah, it's a continued challenge. We're monitoring obviously, end of the day we want to save money and provide the best care to our patients. Again, my main goal is patients should have access to their medications when they need to at the right time. They should not, because end of the day, it's the quality of healthcare that we provide to our patients in our communities. And it's very, very important that we don't lose sight of that. So, you know, challenges will happen. We'll have to work through that, work with pharma, work with our friends in the high level in the government and see what is it that we can do to really preserve what we can. And there are changes, obviously we'll have to see what we can discuss and where we can have that middle ground. Obviously, financial situations always puts everybody in a conundrum where things get compromised, but we don't want that for our patients. This is going to be a continued challenge for all health systems across the country and we all have to do what is needed. Again, end of the day, it's our patients that we need to take care of.
- [09:47]
A
That's really great perspective. Thank you so much for digging a little bit deeper there. Now, looking into the future, what are you most focused on and excited about?
- [09:57]
B
I think in the next few months, a lot of specific growth in our home infusion area. We're looking at our data warehouse where a lot of data normalization, building all the different data metrics out and then really getting into the AI space. I think probably the next two, three years, that'll be a big. And again, continue our work on the technology front where we can leverage technology so that we can free up clinician time and really have the clinicians focus on being in front of the patients. That's a continued goal that I'm going to have. Wherever we can do that, I think we should do that. My goal is how do we make lives easier? The other piece that I would say what I think is how do you create the next level of generation, the students and the leadership, et cetera, how do we develop them to really move on to that next level? Because I see a trend that not a lot of people want to go into leadership. There is a handful of folks who want to go to leadership and how do we create this path? Because it's not easy being a leader, but you have to have a certain grid, you have to have a certain base to really move to that next level. But we need folks to be educated so that they can then move into that space, also make it a little easier. Unlike my generation, we fell, we learned and we got up and then we moved on. Whereas the more we can prepare the next generation for this, I beneficial, absolutely.
- [11:45]
A
That makes a lot of sense and definitely, you know, is helpful to think about where the pipeline is going, where those next leaders should be focused on, and really how they can make the biggest impact on healthcare as they're moving forward. I wanted to ask you too, what are you most proud of from the last six to 18 months or so? What really has worked out well from your perspective?
- [12:09]
B
Well, I think the biggest accomplishment as a team at Baptist, when we opened our central pharmacy services center and then yes, we opened the building last year, but I think when we went live with our prescription fulfillment and then literally a few weeks ago, we went live with our inventory distribution to all our sites and then really, if you think about the biggest, I call it the return on investment is when I hear the comments from our patients, from our providers, from our staff that, you know, how positive our service is. And they, you know, we do a survey and we to find out, you know, that 90, 98% of our patients wants to stay with us. They don't want to go to any other pharmacy. So that itself speaks volume about, you know, what we planned out, what we set out to do and where we are. And there's continued opportunity. So really it's a team effort all the way, top down, and very, very proud of every achievement that we have done. We're not done, we have a lot to do, but definitely our team is poised to really achieve those things.
- [13:29]
A
That's amazing. Here. Thank you so much, Nilesh. Now, before we wrap up, I wanted to ask, what advice would you give to evolving leaders in the healthcare space today?
- [13:38]
B
Yeah, I think stay focused, look left, look right, look top, look bottom, because there are many, many opportunities. Are you going to have bad days? Absolutely, yes. But I always look at half glass full versus half glass empty. So in every, you know, if there is something that, let's say, didn't work out, you always look for an opportunity within that and see what is it that you can maximize. Challenges are going to become, you know, that's part of the roads. The bumps are always going to be there. But how do you manage those bumps? How do you manage those challenges is going to be the key and really you create an opportunity within a problem. That's the way I look at it and that's the advice I give to leaders is, yeah, it's not going to be easy, but can you make it? Can you work on it and see what you can do? Different to create that opportunity because it's possible. You know, there's always a way to figure out a solution. There's always a way to negotiate and create something. So I would say, you know, as leaders, never give up, always find a way, because I know there is a way. All the time, we just are not thinking. And sometimes if you don't think about it today, you know, I always do this. I go on a walk in the morning, you know, I'll wake up early, I'll walk, and I go. I said, what is my biggest challenge today? And I'll say, what can I do different? And as I'm walking, I'm thinking, and I come up with the best ideas during that time. And sometimes I talk to my kids, and sometimes I'll say, here's a problem. How would you resolve? Because, you know, the newer generation thinks very differently, so. And sometimes they poison, they give a idea and I go, huh, I never thought it that way. So sometimes your best answers are around you.
- [15:37]
A
I love that. That's such an inspiring way to leave us. Thank you so much, Nilesh, for your time today and dedication. I really appreciate it. I look forward to connecting with you again soon.
- [15:46]
B
Thank you. Appreciate having me. Have a good.