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Becker’s Healthcare Podcast
Nilesh Desai, MBA, BS, RPh, CPEL, CPPS, Chief Pharmacy Officer at Baptist Health System
00:15:42
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- [00:00]
A
Welcome to the Beckers Pharmacy Leadership Podcast. I'm Ella Jeffries, pharmacy reporter with Becker's Healthcare. Today I'm joined by Nilesh Dazai, Chief Pharmacy officer at Baptist Health System. In this episode, we'll be discussing the headwinds pharmacy leaders are navigating today along with the opportunities emerging for pharmacy teams as healthcare continues to evolve. Nilesh, thank you so much for joining me today. To start us off, can you share a bit about your role as chief Pharmacy officer and what's top of mind for you as you lead pharmacy across your system today?
- [00:30]
B
Thank you, Ella, for having me. So, nileshasai I'm the chief Pharmacy Officer at Baptist Health. I've been here almost six years now. I oversee all of pharmacy services across our health system. We are eight hospital system, we have 12 retail pharmacies. We have a big central pharmacy that we just went live last year and we're in the middle of completing our implementation across our system. You know, as we have done a lot of work in the pharmacy space, we really brought pharmacy to the forefront at Baptist with all our initiatives and as recent as opening the 100,000 sq ft Central Pharmacy. But there are obviously a lot more headwinds 340B space with all the changes, the inflation reduction act, all the initiatives that are kicking off 1,126with the 10 drugs or 9 drugs and then ongoing changes with 340B Medicaid reduction in Medicaid patients that is resulting in some issues on the dish percentage. And then really medication access continues to be the biggest challenge as a lot of these pharmacies are closing and are going to close depending on how the financial viability turns out. You know, end of the day, we still have to figure out a way how to provide patients with access to medications. You know, a lot of our retail pharmacies are not open 247 except, you know, we may have some weekend coverage here and there at a couple of the sites. So we're looking at other options where, you know, we can deploy kiosks or some type of technology where you can have at least the top medications that folks, when they come to the ED and they need some medications, we can have those medications be available for them. So those are the kind of things that we're looking at right now, again, sustaining the growth, sustaining and maintaining or increasing growth. But it's just that I want to make sure that pharmacy continues to contribute to the health of our patients and then really to the bottom line from a health system perspective.
- [03:00]
A
Great. Thank you for sharing that was really helpful context. You mentioned 340B and those pressures. What is your health system doing or what are you doing with your team to prepare for those?
- [03:10]
B
Yeah, a lot of preparation in order to get our data sharing and everything that we need to do and leveraging technology again where we can. You know, one thing we don't want to do is keep adding FTEs because as you all know, there's a shortage of staffing as it is. You know, we've been dealing with pharmacy technician shortage for the last 50 years. Years. And that hasn't improved significantly. So that continues to be a challenge. We're also dangerously entering pharmacist shortages. So, you know, we want to make sure that judiciously use our staff. So the goal is if we can leverage technology to, you know, continue to do what we need to do. Because these requirements that are out there now, you know, I know a lot of vendor community that's out there. They're trying to work on a solution here to help us out. So we're exploring the right partnership so that we can do things the right way.
- [04:16]
A
For sure. Thank you for sharing that. But given all that, it does sound like there's a lot competing for attention. How are you prioritizing where Pharmacy focuses its time, resources and leadership energy right now?
- [04:27]
B
Yeah, as a team, we now have a lot of projects. What we have prioritized. And then really we continue to evaluate these projects periodically to say, you know, what is important. Obviously, anything that is patient safety or regulatory, I mean, those always are up there. But even, you know, financial projects, that affects the bottom line. So anything that we can be efficient, anything that we can grow our services, these three kind of always rise to the top, but not forgetting everything else that we need to do. From an employee engagement perspective, if you do those things first, financials always follow. But you also have to make sure you're prioritizing or reprioritizing or adding new projects timely. So this way you're not stuck in a document or a project list all.
- [05:29]
A
The time, for sure. And as you look into 2026, are there any new projects or new things that your team is prioritizing that you're really looking forward?
- [05:38]
B
I mean, there are many projects that we're looking at our pump IV pump interoperability with our emr, we're thinking about many other improvements to our financial assistance with our patients. So we're looking at applications, we're looking at many other initiatives from inventory management perspective to streamline those things so that we're not spending A lot of time reconciling invoices and payments and all that stuff. That really takes hours and hours and a lot of resources on the back end. So you know, and then, you know, like I said, the big thing is the 340B changes. All of that is a big to do because we know it's not gonna stop here. I know there's another 15 drugs coming up on 1127 and then continued every year, but more drugs coming on board. So we need to have systems in place. We're looking at how other systems can come into say more integration, more interoperability so that we're not chasing. And then the other piece is data is, is the key where we're normalizing a lot of our data, building a lot of dashboards out and getting prepared for the AI. You know, I call it the AI invasion, but it's more how do, how do we leverage AI? How do we utilize AI so that we can become continually become more efficient?
- [07:10]
A
For sure. Thank you for sharing. And now stepping back a bit to a more broader picture. Where do you see the biggest opportunities for pharmacy to lead, innovate or expand its impact within health systems?
- [07:22]
B
I mean, pharmacy definitely now, you know, if you compare 10, 15 years ago to what it is today, it's literally apples and oranges. Pharmacy now is at the forefront. You know, whether you talk clinically, whether you talk quality, whether you talk safety and you know, you know, now revenue generation and all the medication access initiatives that we're working on, Value based care now with addition of car T cell therapy and or cell and gene therapy, pharmacy is now really at the forefront leading a lot of those efforts to make sure that the health systems are now up there trying to provide those streams of care, I call it. And then really you want to make sure you're viable. So negotiating with pharma, negotiating with payers, negotiating with our providers, hiring the right provider network, creating those specialty and assisting in those spectrums with our health system so that we continue to become that center of excellence in many facets to really provide more opportunities to grow and again improve our health system and access to our patients.
- [08:41]
A
And where would you say pharmacies influence is growing the fastest right now?
- [08:45]
B
I think the more if you look at specialty pharmacy continues to grow, community pharmacies with meds to beds and all the other initiatives that are out there? Obviously from an inpatient perspective, everything that we're doing, I think that continues to evolve. But a lot of clinical care, antimicrobial stewardship is another big area. In the initial years, antimicrobial stewardship was more inpatient driven, but now we're seeing a lot more value on the outpatient side with many OPAT and Copad and all these additional stuff that goes on. Obviously that requires resources, but that's a big quality impact on our patients and making sure we're taking the right antibiotics. So these things are really big area. And I think the other big area of focus is home infusion. This is a big, big opportunity for health systems to look at where home infusion can play a big role in providing closing the last step of the care. So that's another big area where we're focusing on as well.
- [09:52]
A
Thank you for sharing. And for pharmacy to fully capitalize on those opportunities you just discussed. What does pharmacy need to demonstrate today to be seen as a growth driver, not just a cost center within health systems?
- [10:05]
B
Yeah, I mean, you know, we have already demonstrated over the last few years of what pharmacy can bring to the table. Not only revenue and all that, but also services. Our patient satisfaction, you know, our retention rate with our patients, our provider satisfaction, you know, how we're reducing the administrative burden for our providers so that they can focus on seeing more patients. So a lot of that really, and then, you know, even growing new business plans, writing those business plans that are more effective and seeing that we're not only cost efficient, but also growing services in areas that we have not ventured into. I think a lot of that focus for pharmacy is going to be in those areas.
- [10:51]
A
And how would you say that conversation has changed over time?
- [10:56]
B
Definitely, if I had to think many years ago, bringing pharmacy initiatives, when we were specifically across center to what it is today is night and day difference, how things have evolved, discussions have involved and on how we approach subject, I think chief pharmacy officers now have a larger role to play on how to grow services, how to build that infrastructure, how to build all the things that are necessary from a medication management perspective. These things have really changed the way of how we operate and look at pharmacy. And also to show the leadership that what pharmacy can bring to the table, being at that seat, trying to gain trust and demonstrate the results that come out of it, that really shows where pharmacy can make inroads and really deliver other results. So this overall, I call it the 360 or the quadruple aim, you know, we've delivered on every front, whether it's patient satisfaction, provider satisfaction, financial bottom line, et cetera. This has shown where, you know, where pharmacy can make an impact. And this continues to evolve as we continue to grow our services.
- [12:26]
A
Definitely. And as you look ahead, what's one change or shift you think would make the biggest difference for pharmacy over the next few years?
- [12:35]
B
I think pharmacy getting involved in many of the other service areas, I think by showing what we can do, improving our systems, aligning and not getting stuck in the stereotyping of systems or going outside of the industry to see what is out there, and I think taking a big leap forward on those fronts, I think it's going to help then with AI coming in, I think that's going to be a great initiative. I would say we have to be careful. While we want to leverage AI to really improve our operations, become more efficient, all of that, but we also want to do it right. That information kind of is more safer and it provides more appropriate timing for our staff. This is an opportunity where you can reallocate staff to do other things. And as I spoke about staffing shortages and drug shortages and pharmacy deserts, these are going to continue to be a challenge. So for leaders, it's how you assess how you make an impact. Leveraging technology, leveraging AI, all these things are going to be a big, big challenge for us, but it's a way of mitigating these challenges as well.
- [14:01]
A
And in terms of AI, what are some areas of AI governance that Baptist Health is looking into for 2026?
- [14:09]
B
Definitely at Baptist, what we have done is we have proactively created our AI infrastructure. We have committees, we have pharmacies, a big part of it. And really what we have done is anytime we want to bring an application that provides some type of AI functionality, then we really go through the process of vetting them out to see what that advantage of, of bringing an AI application in it, and then really look at what's the roi, what are we trying to achieve by bringing this AI application in? And then really, if we can start measuring outcomes, that's even a better benefit. So that's another focus point on what are the data metrics that we can collect and then really show what the value of it is. Because I think you just don't want to bring an application in without some type of ROI in place, whether it's improving quality of care, whether it's improving our employee satisfaction, or even, you know, end of the day, some financial gains. I think there needs to be some outcomes that we need to measure so we can drive and bring in more AI applications in all the different facets of what we practice pharmacy in.
- [15:21]
A
Definitely. Well, Nilesh, this has been such an insightful conversation. Thank you for sharing your perspective and experience with us. That's all for today's episode of the Becker's Pharmacy Leadership Podcast. A big thank you again to Nilesh for sharing his insights on the headwinds pharmacy leaders are currently navigating. Thanks for listening and we'll see you next time.
- [15:39]
B
Thank you.