← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Thomas Carey, PharmD, Senior Director, Pharmacy Services, UW Northern Illinois
00:17:36
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- [00:00]
A
This is Laura Dearda with the Beckers Healthcare podcast. I'm thrilled today to be joined by Dr. Thomas Carey, Senior Director of Pharmacy Services at UW Northern Illinois. Dr. Carey, it's a pleasure to have you on the podcast today.
- [00:12]
B
Thank you very much. I'm excited to be here.
- [00:14]
A
Absolutely. And you know, this will be a great and very timely discussion because I know there's so much change happening within the pharmacy space and you know, really it's becoming a transformational department for the hospitals and health systems. So I'm looking forward to learning more about what you're doing at UW Northern Illinois. But before we begin, can you introduce yourself and just tell us a little bit more about the organization?
- [00:34]
B
Sure. Thank you again. My name is Tom Kerry Thomas Carey. I'm the Senior Director of Pharmacy for University of Wisconsin in Northern Illinois. Within our health system that spans across both Wisconsin and Northern Illinois, I oversee all of our clinical and operational activities in both our ambulatory and acute care settings. UWNI is the tertiary care hub for University of Wisconsin in the Northern Illinois region. And as the primary disproportionate share hospital in Northern Illinois, we have one of the largest emergency departments in the state, seeing just shy of about 80,000 emergency department encounters per year, the largest labor and delivery unit, mental health unit and oncology center in the region. Our senior leadership team really has recognized the value of pharmacy and in supporting our approximately 150 team members across each of our healthcare entities located across the Northern Illinois region.
- [01:38]
A
Well, it's amazing to hear, you know, really impressive to think about all the different services you're covering and truly the populations and communities you serve. Now, when you think about the last year, what was the most important initiative that you led? What did you do and what were the results?
- [01:54]
B
Yeah, as I mentioned, as we are, we are the largest provider for economically challenged patients within the region and as such we implemented a really concerted effort to expand and support and really optimize our discharge medication delivery initiative, otherwise known as a med to bed program. The medived program had been in place for really decades, but we wanted to really take it to a new level, not only to make sure that we're optimizing the patients that we can reach out to, but do so in a way that we can be most efficient for the resources, that is our staffing that we had available. So we created a multidisciplinary team which included obviously our, our outpatient pharmacy staff, our acute care clinical pharmacists, our medication history techs, Our nursing staff, case managers, our hospitalists, and I'm sure countless others over the course of the year to assure that patients who were prescribed either high cost medications, but also patients who we identified as high risk for readmission, were able to provide medication at the time of discharge and do so in a thoughtful manner. We sometimes hear about trying to make sure that we get as many patients to receive prescriptions at the time of discharge as we can, but we sometimes are limited in being able to be able to do that with the resources we have. So attempting to find a balance was one of our goals. In addition to make sure that we can provide as many prescriptions as we as we could. Obviously, the theory behind Med2VED program is attempting to eliminate the barrier of access to medication. And in doing so, we'd be able to reduce this as a potential cause for readmission. The effort paid off. Over the past year, we've been able to quantify a nearly 30% reduction in our 30 day readmission rate, 30% reduction in our 30 day Readmission Rate over the year for patients who had their prescriptions billed in our outpatient pharmacy versus external retail pharmacies. So it's been a tremendous success. Not only are we making sure that we are supporting our Med to bed program, making sure that patients, particularly those who have challenges getting medications because of access, can get those prescriptions filled with, but do so in a thoughtful manner from the perspective of utilizing the limited resources we have to be able to be able to support that and obviously ultimately being able to show that we can actually reduce, we can actually demonstrate that we can reduce that 30 day readmission rate.
- [04:50]
A
That's amazing to hear. And, you know, really, really strong results when you look at the 30 day readmission rate is something that's so critical right now, especially in thinking about how much capacity hospitals and health systems are trying to, you know, really manage that. More thoughtful and then costs as well as of course, better outcomes for patients. So I think that makes a lot of sense. You know, when you look at a Med to bed program like the one you have, what does it take to set up, what type of resources do you need and leadership is necessary in order to make this happen.
- [05:22]
B
Yeah, it's a good question. Obviously. First and foremost, having a hospital owned or an entity owned outpatient pharmacy I feel is critical. Certainly contracting with external vendors can make the process certainly turnkey. We feel strongly that having our own outpatient pharmacy with our own staff, where we have the informatics systems, where they use whichever electronic health record that you use that is integrated between the outpatient pharmacy and your inpatient pharmacy provides a tremendous amount of efficiency, particularly in eliminating some of the red tape and the logistical challenges that can occur with outpatient pharmacies. So we believe that's key. We also have leveraged learners, whether it's our residents, interns or students. We are fortunate to be close to the University of Illinois Chicago Rockford campus. And this is a tremendous opportunity for our student learners to be able to not only learn the business of pharmacy from the outpatient perspective, but be able to provide education for patients in a unique setting. So not at the back of the store, but more so at the bedside. And to be able to appreciate the challenges patients have with being able to afford medication and then to see what we do to make sure that the ability to pay is not an issue, to make sure patients get medication. So leveraging, having that ownership, having that vested team that is in your outpatient pharmacy but is well integrated into the inpatient patient flow and that transition, to me, I think is key and can really optimize that particular workflow.
- [07:16]
A
I love that. I think that makes a lot of sense and it's really helpful to understand what's been critical for you in order to make the program work. Now, looking ahead, what are some of the big priorities and headwinds you're focused on for 2026?
- [07:29]
B
Well, as I mentioned, as, as we are a disproportionate share hospitals, like everybody else, we are following the 340B World and Regulations on a regular basis, on a regular basis, on a daily basis. It seems like these days our incredible team is, is well led, it is exceptionally prepared, and most importantly, we are phenomenally agile to respond to all the different changes that we're being faced with with pharmaceutical industry and regular bodies. And this week is no exception to that, where we've had to make multiple pivots with regards to the rebate initiative. And so all that has to be done quickly. And you need a team that's very agile to be able to make sure that you can be proactive in the decisions we're making related to 340B. Obviously, the 340B program allows organizations like ours stretch our limited resources to provide these services, like I mentioned before, with our MED2VET program, to patients who are most vulnerable. And that being said, with the, with the volatility and the challenges that we are faced with with the 340B program, organizations like ours and staff like ours who have our frontline workers who are doing things every single day to make sure that we can provide that direct financial impact to patients. Whether it's subsidizing medications, whether it's providing blood pressure cuffs, whether it's providing needle and sharps containers. This is a tremendously challenging time for those individuals and then subsequently stressful because we don't really know what the impact may be of the 340p program from, from a day to day basis. So as leaders, this is a huge challenge, but it is so important, so necessary to that why we are planning for the worst, that we are continuing to not only provide the current level of care that we're able to provide, but continue to expand that and utilize those resources to make sure that we are supporting those who are in the greatest need, especially as we go from one calendar year to the next. And we recognize that the out of pocket challenges patients have are the most significant this time of year.
- [10:02]
A
Absolutely. I think that's such a critical reminder, especially thinking about how you can really make an impact on the way patients receive care and their whole journey of care with some of these things. I appreciate that you bring up the 340B program as well. I know that's something we're continuing to watch very closely at Beckers and so many leaders across the country are trying to plan around and understand what's going to happen next. And so when you look at the teams that you're working with, how do you stay agile, especially amid so much uncertainty, not knowing exactly where some of these funding is going to come from or where these programs might go?
- [10:38]
B
I'm biased, but I think that we've got a tremendous structure within our organization for University of Wisconsin. We have a tremendous team that represents all of our different areas with regards to 340B. And we meet every Friday to discuss not only our compliance, the value that we're providing, local, state and national regulatory challenges, but also program expansion. So it's really easy to become a little jaded, particularly in these days with 340B, to spend all of your effort on making sure we're well prepared for these particular challenges, whether it's a rebate program or ADM or other regulatory issues. However, and as important as it is to continue to focus on those, you still have to focus on continuing to expand. Patients are still here every single day. So we can't keep our, we can't lose track of the most important thing which is continuing to expand while also keeping one eye on, on the regular challenges. So to me, creating that team that has that focus of looking at each one of those particular aspects and representing not only our dish locations, our clean sides, our mixed use, our physical inventory locations, having internal and external regulatory bodies, and having that multidisciplinary team that comes together on, on a weekly basis and is very engaged. And I guess equally important is making sure senior leadership is well informed and up to date on all those particular issues as well is obviously critical as well.
- [12:33]
A
That makes a lot of sense. Thank you so much for going a bit deeper there. Now, what do you think the hardest thing you'll have to do in the coming year will be?
- [12:42]
B
I think from the hardest thing that I'm looking at, you know, in the next year and maybe one of the hardest things as, as a senior leader, I guess I would also probably cheat and say it's probably for me the most fun thing, which is to predict the future as a leader. It's critical that we are creating that roadmap and the vision for our team, identifying and being able to illustrate for our leaders and the team that works, that we work with what the profession looks like in three to five years in providing that vision. Being confident in that, knowing what the future is going to look like, and really probably a better way of saying is that getting an educated guess and being right about what the profession looks like over the next three to five years builds trust in our leaders and subsequently their teams. Without this, you know, our leaders are continuing, continuing to, you know, put their thumbs in the dam and just really trying to get through day to day. We are all faced with sometimes the walk into work and then you leave work that same day and you spent the entire time just getting through that particular day with that and missing out on, on the vision and working towards the future. So I think it's important that we always keep our eyes on where we're going in the future and aligning our teams to make sure that there is a good sense of direction on what that vision is and where we're going and why that's important is that I think that helps prevent complacency, but it also importantly it fosters innovation for our leaders. So that as our senior leaders are identifying, this is where we need to get to. It is critically important that our leaders and our team members are identifying innovation to see how we actually are getting there. So to me, I think that's the hardest challenge because obviously you have one chance on getting it right. You want to make sure you're leading your team in the right direction while still being able to get through your day to day.
- [14:57]
A
Activities that makes a lot of sense. And I love that kind of focus on the opportunities there, the places where innovation can happen, and really thinking about all the different possibilities in the future and continuously planning and just, you know, getting right after it. So that's really helpful to know. And speaking of the future, where do you see some of the best opportunities for organizational growth?
- [15:21]
B
Yeah, I. To me, I think and being in the profession for more than a couple years, I think a concentrated, strategic, energized effort and working as a system to create that autonomous pharmacy, that pharmacy where we are eliminating steps and some of our handoffs, embracing technology and kind of that marriage of technology and automation, I think is going to be critical. And it's necessary to be able to support our most important commodity, which is our staff, while at that same time creating that overall infrastructure to provide the most safe and the most efficient operation ultimately for our patients. And obviously, this is easier said than done. It entails finding people who are much smarter than you, providing that support and that knowledge to explore where we need to get to. And as a senior leader, it's then our job to make sure that we get there. But again, creating that vision and then the other challenging piece of that, which is quantifying that incredible financial impact which is going to be necessary to be able to provide that automation and technology infrastructure, unfortunately provides very little margin for error, but I think ultimately it establishes us to not only create that infrastructure to be able to support our staff, provides the structure to make sure that we are providing the safest environment possible for our patients, and also making sure that we then can be recognized nationally as a destination for top staff across the country.
- [17:21]
A
I love that. Dr. Carey, thank you so much for joining us on the podcast today. This has been a really amazing conversation, very informative, and I look forward to connecting with you again soon.
- [17:31]
B
It would be my pleasure. Thank you very much.