When Summa Health decided that clinic-based specialty pharmacy services was the right model for its population health vision, we knew there could be a challenge with getting everyone, especially physicians and nurses, on-board. Too often new healthcare initiatives disrupt workflows or add burden to already-stretched staff resulting in slow adoption.

Yet, providers’ response to the Summa Health Specialty Pharmacy services has been overwhelmingly positive. In fact, since launching specialty pharmacy services in our HIV clinic this April, we have quickly expanded into six other clinics including gynecology oncology, dermatology and rheumatology. We expect to onboard as many as 22 clinics by the end of the year.

Strong partnerships with doctors and nurses are a cornerstone of our rapid growth. We’ve succeeded in gaining their support by:

• Enhancing patient care and clinic workflows
• Using a collaborative implementation approach, and
• Empowering staff with our culture of transparency, flexibility and teamwork to ensure concerns are openly addressed.

One of the first steps in the Summa Health partnership with Trellis Rx was to fully explain the service model to our senior leadership team. With their endorsement, we engaged service line leaders and introduced providers to the program. In each clinic, we’ve observed existing processes, proposed new workflows, mapped out concerns, and arrived at solutions together.

As the Summa Health Specialty Pharmacy services enters its sixth month, we wanted to get a few providers’ opinions about the experience first-hand. Here’s what they said:

Question: What were the biggest specialty medication challenges you faced before the Summa Health Specialty Pharmacy program began?

Amy Hite, M.D.: After 16 years in our HIV clinic, I’ve had lots of experience with specialty medications. We’re pretty progressive and get excited about new medications that are better for our patients, but because of restrictive formularies, trying to get approvals was a constant battle that took a significant amount of time away from me and my nursing staff.

Eileen Simcox, RN, clinical coordinator: The field of gynecologic oncology is evolving with more patients receiving oral medications following IV chemotherapy. Before the specialty pharmacy was launched, it would take 1½-2 weeks for patients to receive their drugs because the authorization process relied on printouts and faxes. Nothing went through the EMR. For cancer patients, that delay creates a lot of anxiety and fear. It’s nerve-wracking for them when treatment isn’t happening.

Question: How has a clinic-based specialty pharmacy changed your experience with specialty medications?

Lou Ann Vaughan, RN, case manager: It’s taken such a load off of the nurses in our office.  Our specialty pharmacist handles the entire authorization and appeals process, so I can spend my time taking care of patients.

Eileen Simcox: There’s more communication and a more interdisciplinary approach with Summa Health Specialty Pharmacy. Before, I had zero direct contact with a specialty pharmacist. Now we’re working with our own team; we can all connect about a patient’s care through the EMR or direct conversations.

Question: What improvements in clinical workflow have you experienced with Summa Health Specialty Pharmacy?

Dr. Hite: The efficiency it brings to the office makes the best use of our time clinically. It lets us fulfill our roles. Our doctors can be doctors, our nurses can be nurses, and our pharmacists can be an integral part of the care team.

Eileen Simcox: We see a patient in the clinic, send a prescription to the pharmacy, and 15 or 20 minutes later they walk up and hand the medication to the patient. Plus, I have more time for follow-up calls with patients, so I can intervene faster and focus on the clinical aspects of care.

Question: What are the biggest benefits your patients have gained from access to a clinic-based specialty pharmacy?

Dr. Hite: Safety. Summa Health Specialty Pharmacy is integrated directly into our office, with access to all clinical documentation and other information. Just this week, for example, the pharmacist alerted me to a potential drug interaction issue as a patient was being walked to their exam room. So, before I even saw the patient, we were already working together to switch him to a safer medication regimen. The result was greater patient safety, plus efficiency for my nurses and myself. Everybody benefitted.

Lou Ann Vaughan: Patients get the medications their doctors prefer, and faster — often before they leave the clinic. Since many of our patients have to walk or take the bus, that’s huge. They know financial assistance is taken care of too, so they don’t worry. The whole process helps show them how much they matter to us as individuals.

Question: If you were talking with colleagues, what thoughts would you want to share about the benefits of a clinic-based specialty pharmacy?

Lou Ann Vaughan: I can’t say enough good things about it. I have a pharmacist on the care team to use as a reference and a resource. Specialty pharmacy is what they do; they’re experts at it. They just make your job a thousand times easier.

Eileen Simcox: Patients get safer, more personal care. Even when our specialty pharmacy can’t fill a patient’s prescription (because of a lock-out, etc.), they still watch for side effects, assist with financial burdens and help educate patients. Summa Health Specialty Pharmacy provides continuity of care.

All of these responses are gratifying and reassuring. For us, it’s tremendously rewarding to be able to show providers how a high-touch health system specialty pharmacy program truly can deliver better patient care with less administrative burden.

Register for our upcoming webinar, Health System Specialty Pharmacy: 5 Strategies for Building Successful Provider Partnerships, to hear firsthand from Summa Health and Trellis Rx pharmacy leaders on how to achieve similar success at your health system.  

About the Authors:

• John Feucht, BS Pharm., MBA, is the System Director of Pharmacy Services at Summa Health System. He is passionate about improving patient safety and efficiency in the medication management process.
• Stuart Deal, Pharm.D., is the Manager of the Summa Health Specialty Pharmacy. He has dedicated his career to enhancing the specialty medication experience for patients and their providers.

Contributors include:

• Amy Hite, M.D. is the Director of Summa Health System’s CARE Center, where she has dedicated her career to the treatment and prevention of HIV.
• Eileen Simcox, RN, BSN, OCN, MBA, is the RN Clinical Coordinator for Gynecology Oncology in the Summa Health Cancer Institute. She is committed to ensuring patients receive the highest quality care and the right medication at the right time.
• Lou Ann Vaughan, RN, has been the Case Manager of Summa’s CARE Center for the past fifteen years. She is dedicated to providing exceptional care for those clients affected by HIV and also preventing the spread of HIV through the use of PrEp.