Stepping Stones: 4 Steps to Integrating Specialty Pharmacy Services into Outpatient Clinics

Published 07/11/2019
by Denali Cahoon

Health systems can enhance care for patients requiring specialty medications by integrating clinical pharmacists and pharmacy liaisons into outpatient clinics to provide face-to-face, personalized support. Yet effectively embedding specialty pharmacy team members into existing workflows requires significant change-management. In my experience developing and managing clinic-based health system specialty pharmacy programs, I’ve found that following this four-step process helps build a pathway for sustained success:

  1. Understand the opportunity. Whether starting from scratch or looking to expand an existing program, begin by obtaining the data and information required to analyze your organization’s opportunity. In addition to characteristics like patient and specialty prescription volume, you must understand other factors like clinic concentration. A health system with clinics scattered across a large geographic area will need different processes than one with a few clinics located in close proximity to each other.
  1. Learn about the people. Once you determine which clinics to prioritize, you’ll also need to get to know the providers and staff. What key stakeholders should be engaged? Who are the influencers that will advocate for the program? These people can be physicians, but they are often clinic managers and nurses too. Knowing the potential naysayers is important so you can proactively address dissent or objections. Use stakeholder analysis to map out the potential interests, needs, and objections of key providers and staff. Then, set up conversations to learn about them and get their assessment of the current specialty pharmacy processes. Ask lots of questions to understand opportunities and pain-points. Formally ask for their support of the program to start building momentum to drive success.
  1. Get to know the current processes. The next phase is focused on information-gathering. Leverage your stakeholders to set up conversations with other clinic staff, including but not limited to nurses, physicians, medical assistants, financial advocates, and schedulers. Your goal should be to map out current clinic processes so you can identify how to integrate specialty pharmacy workflows. In addition to face-to-face conversations, I recommend shadowing people to ensure you fully understand how the clinic currently functions. Along the way, start socializing the program so people understand what it is and how it will benefit them and their patients. Be sure to be sensitive to concerns and objections – change is often difficult, no matter how positive it is.
  1. Communicate and iterate: Once you’ve launched specialty pharmacy services and introduced new workflows, communication is essential to success. We recommend over-communicating initially. Be sure to share successes to instill confidence and excitement in the program. Also, as you take on specialty pharmacy responsibilities, individuals who previously managed these tasks will want to be kept up-to-date on status and progress. Over-communicating is probably the best strategy initially. Ask yourself:
      1. What information needs to be shared?
      2. Who needs to know it?
      3. When should they be informed or consulted?
      4. Through what channels should we communicate?

    Last but not least, be prepared to iterate. Processes that made sense in a conversation or presentation may not work as expected on-the-ground. Adapt and change quickly, but seek feedback on the improvements from stakeholders.

Ultimately, this process is just the first step in the complex journey to build or grow a specialty pharmacy program. Read our recent Stepping Stones blog posts on gaining payor and LDD access to gain more insights from our team. If your organization needs support to accelerate your success, schedule a conversation with me or with our team to discuss your opportunity.