Professional English and Academic Editing Support, 2318 Mill Road, Suite 800, Alexandria, VA 22314, © 2020 American Society of Clinical Oncology. FPs were split on the question of whether pharmacy technicians will have education and training comparable to that of staff in other fields or be compensated similarly (Figure 2, item 2). During the strategic planning process, the Pharmacy Forecast can be used as a provocative springboard for brainstorming and discussion; however, those leading strategic planning discussions should be open to opinions that differ from those expressed by the Forecast Panel members and the chapter authors. Search for other works by this author on: Ambulatory and Transitions of Care Services, Department of Pharmacy, Johns Hopkins Health System, Address correspondence to Dr. Swarthout (, Professor of Epidemiology and Medicine, Division of General Internal Medicine, Department of Medicine, Johns Hopkins Medicine, Diane B Ginsburg, B.S.Pharm., M.S., Ph.D., FASHP, Clinical Professor and Associate Dean for Healthcare Partnerships, Pharmacy Practice Division, The University of Texas at Austin College of Pharmacy, McCombs School of Business, The University of Texas at Austin College of Pharmacy, Associate Vice President and Chief Pharmacy Officer, Senior Vice President of Operations, Wake Forest Baptist Health, Director – Pharmacy Patient Care Services, The Johns Hopkins Health System, William Greene, B.S.Pharm., Pharm.D., BCPS, FASHP, FCCP, Chief Pharmaceutical Officer and Member, Pharmaceutical Department, St. Jude Children’s Research Hospital, Senior Director, Adjunct Associate Professor, Drug Information and Support Services, University of Utah Health, Department of Markets, Public Policy and Law, Questrom School of Business, Boston University, Director of Innovation and Activation, Indiana University Health, Senior Vice President and Chief Information Officer, Indiana University Health, and President, Indiana University Health Plans, James M Hoffman, Pharm.D., M.S., BCPS, FASHP, Chief Patient Safety Officer and Associate Member, Pharmaceutical Sciences, St. Jude Children’s Research Hospital, The black swan—the impact of the highly improbable, STRATEGIC RECOMMENDATIONS FOR PRACTICE LEADERS, Shared decision making—the pinnacle of patient-centered care, Patient Protection and Affordable Care Act. While it is possible that new supply chain entities will assist with some shortages, it is doubtful that they will have the capacity to address the hundreds of shortages that exist today. In the field of health care today, a long-term plan will likely address no more than the next 3 years. Their ability to identify and form partnerships with entities outside pharmacy (even outside healthcare) will also be essential to develop truly innovative ventures such as insourcing pharmacy benefits management for employees to keep revenue within the health system. Approximately half of FPs believe that a publicly accessible hospital charge master will provide value to consumers (Figure 6, item 5). Taleb’s exposition1 includes rules for mitigating negative black swans and exploiting those that are positive. During the module of Basic Health Management, each participating management team performed the first SWOT analysis of their hospital. This year, we chose to explore a facet of strategic planning dealing with our ability to respond to unexpected, unpredictable events known as “black swans.” 2 As you will read in the section of the Pharmacy Forecast written by Bill Zellmer, Scott Knoer, and James Hoffman, black swan events pose opportunities and threats to health systems. These issues include job vacancies, salaries of pharmacists and technicians, and other trends that will affect health-system pharmacy in the future. While drug shortages had long been an issue, most pharmacists likely believed that the pharmaceutical supply chain was fundamentally secure. Barnes T, Winfrow M, Laboi P, Wilkie M. Vermeulen LC, Eddington ND, Gourdine MA et al. Implement strategies for increasing the use of biosimilars, including techniques that have historically been useful in increasing use of conventional generic medications, such as actively correcting misinformation about safety and effectiveness of biosimilars and encouraging payers to offer patients lower out-of-pocket costs for those agents. CancerLinQ The future of federal and state reforms, the continued emergence of value-based payment models, and disruptive phenomena affecting healthcare are all examined. Responses were received from 283 (an 87.1% response rate, up slightly from the 85.4% response rate in 2019). Address correspondence to Dr. Fox ( Two out of three FPs indicated they do not believe health systems will assign pharmacists to provide education and support to parents who are uncertain about vaccinating their children (Figure 1, item 6). Despite the constancy of change in the healthcare marketplace, the demand for patient-centered care shows no signs of abating. An audio interview that supplements the information in this article will be available at We then asked FPs to predict, using a linear analog scale from 0 to 100%, how prepared they feel they, their organizations, their patients, and their communities are to successfully respond to black swan events that will occur in the coming 5 years. Does the department’s planning process engage all team members in strategic thinking?5, Do pharmacy leaders periodically facilitate “what if” discussions about how the department could respond to a seemingly improbable event?e. The complexity of this new therapy also required immense effort to get organized for its use. The term relates to the centuries-old assumption that all swans were white, which held until a black swan was discovered in 1697, forever changing the assumption about the color of swans. A majority of FPs (64%) agreed that changes in federal policy to regulate marijuana and medical cannabis in a manner similar to alcohol was very or somewhat likely (Figure 4, item 6). Published online As value-based reimbursement becomes more common, it is also possible that initiatives emphasizing continuity of care may make health-system SPs attractive to insurers contracting for the total care of select patients. In the pharmacy department’s planning process, increase the relative attention given to long-term strategic issues (versus near-term operational issues); use annual Pharmacy Forecast reports to stimulate this shift. Many of the FPs hold the title of chief pharmacy officer or director of pharmacy (13% and 16% of FPs, respectively). Importantly, the process of strategic planning should not be limited to an annual process, producing a strategic plan which is then largely ignored until the following year when a revised plan is created. In the United States, the nongovernmental, not-for-profit Institute for Clinical and Economic Review (ICER) analyzes drug effectiveness, cost-effectiveness, and budget impact. Forecast Panelists’ responses to the question, “How likely is it that the following will occur by the year 2024 in the geographic region where you work?”. Finally, as pharmacists are increasingly relied upon to provide system-wide leadership, the Pharmacy Forecast addresses many issues that are relevant well beyond the traditional boundaries of pharmacy and the medication-use process. Leverage the unique skill mix of pharmacy leaders by seeking leadership roles outside pharmacy (taking on other departments, institution-wide committees, etc.) The members of the Pharmacy Forecast Advisory Committee were instrumental in considering hundreds of factors that may influence the future of health-system pharmacy and distilling those ideas into a coherent survey. Organizational restructuring can foster collaboration among pharmacists across settings, encouraging alignment that enhances communication and shared ownership of clinical outcomes. Genomic testing has evolved into the standard of care at many health systems, resulting in the incorporation of molecular tumor boards, pharmacogenomics services and clinics, and medical genetics services. These results are interesting, but simply disclosing prices will have little effect on accessibility to medications. in strategic management of the organization to organizational growth. (Pharmacy Leadership). Lead the management of genetic modification therapies, ensuring that required expertise is made available (in some cases in partnership with other departments) for cell-derived therapy. Meghan D. Swarthout, Pharm.D., M.B.A., Division Director, Ambulatory and Transitions of Care Services, Department of Pharmacy, Johns Hopkins Health System, Baltimore, MD. Congressional hearings featuring parents of children who have died due to insulin rationing resulted in commitments to support the launch of an authorized generic for insulin, which may lead to more affordable care. aBased on 2010 U.S. Census population data (estimated). New products, particularly in the specialty categories, are priced not based on value but on what price the market will bear.8 The FPs were almost evenly split on whether government reimbursement rates for high-cost medications will be based on cost-
effectiveness analyses (Figure 5, item 6). While the cost of healthcare, and specifically the out-of-pocket financial responsibility borne by patients, is a critical issue in this section, several key areas surrounding patient decision-making, including an exploration of where patients choose to seek care in the future and concerns regarding vaccine choices, are addressed as well. Actively participate in discussions around increasing the transparency of medication and healthcare costs to the public, and contribute to the development of mechanisms of helping patients make more informed healthcare decisions. Forecast Panelists (FPs) differed as to whether any increased patient burden from the demands of engagement may decrease health outcomes (Figure 1, item 1). Sustaining delivery of care in rural areas is an important necessity of our healthcare systems. They argue that involvement of suppliers, customers, shareholders and employees in strategic change easens the strategy implementation by reducing the level of resistance and opposition to strategic implementation process. Pharmacy is responsible for preparing and distributing some hazardous products. Schumock GT, Stubbings J, Hoffman JM et al. Address correspondence to Mr. Zellmer ( According to U.S. News & World Report, physician assistants made a median salary of $104,860 in 2017; the top quartile made $124,200 that year, while the lowest quartile made $87,980.4. Engage in organizational dialog around meaningful quality metrics, lead the development and reporting of data most applicable to the patient populations treated and services provided at your institution, and actively pursue research around the relevance of specific metrics. For significant savings to occur, more products are needed, along with greater discounts from the originator prices. Pharmacy departments should take advantage of institutional resources aimed at managing that risk but should also focus on prevention of events that are unique to their physical space and their staff workflows. JOP DAiS, ASCO University The vision statement must express the company’s core ideologies—what it stands for and why it exists—and its vision for the future, that is, what it aspires to be, achieve, or create.2. However, price controls for a few specific products will not have a meaningful impact on the overall challenge of the extraordinarily high cost of medications. Acute care pharmacists should document discharge summaries for community and ambulatory care pharmacists, paralleling physician documentation in EHRs, to make this process efficient. Strategic planning (SP) is one of the more popular management approaches in contemporary organizations, and it is consistently ranked among the five most popular managerial approaches worldwide (Rigby and Bilodeau 2013; Wolf and Floyd 2017).Typically operationalized as an approach to strategy formulation, SP includes elements such as analysis of the organization's … Under fee-for-service, providers seek more reimbursement from payers, while capitated value-based systems seek opportunities to cut spending without compromising quality. A large group of FPs (16%) listed their primary position as “clinical pharmacist – specialist,” and another 13% described their primary role as faculty. Without a strategic plan, leaders are forced to hastily react rather than thoughtfully respond to each new challenge, without the benefit of a guide making the best course clear. As another election cycle begins, many stakeholders are discussing ways to reduce drug prices. Both examples represent troubling milestones in resetting the definition of “expensive drug.”. ASHP Research and Education Foundation, Bethesda, Maryland, Jannet M. Carmichael, Pharm.D., BCPS, FCCP, FAPhA, American Society of Health-System Pharmacists, Bethesda, Maryland, University of Michigan, Ann Arbor, Michigan, University of Utah Health, Salt Lake City, Utah, James M. Hoffman, Pharm.D., M.S., BCPS, FASHP, St. Jude Children’s Research Hospital, Memphis, Tennessee, University of Virginia Health System, Charlottesville, Virginia, Cedars-Sinai Medical Center, Los Angeles, California, Pamela L. Stamm, Pharm.D., BCPS, BCACP, CDE, FASHP, Ross W. Thompson, B.S.Pharm., M.S., FASHP, Tufts Medical Center, Boston, Massachusetts, Robert Edward D’Eramo, Pharm.D. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (, William A Zellmer, B.S.Pharm., M.P.H., FFIP. The 2020 Pharmacy Forecast is intended to assist with strategic planning efforts by health-system leaders. products, necessitating a specially trained and certified pharmacy workforce. Across the board, staff, and volunteer ranks, we … Most SPs and other stakeholders, such as manufacturers and payers, are invested in providing quality service (today defined by process indicators such as time to fill; adherence; outcomes specific to certain therapies, such as hepatitis C; or patient service indicators, such as abandoned-call rates). The Pharmacy Forecast has been developed to provide guidance to anyone participating in strategic planning activities and it is recommended that the report be reviewed by all involved. Also similar to the 2019 survey, FPs reported that their primary organizations offered very diverse services, including home health or infusion care (54% of FPs), specialty pharmacy (61% of FPs), ambulatory care (82% of FPs), pediatric care (61% of FPs), and hospice care (41% of FPs). The remainder of FPs included leaders and practitioners at varying levels and with varying titles. Establish methods for identifying patients at risk for negative outcomes due to lack of access to essential medications or exposure to substandard-quality medications. Dr. Knoer and Mr. Zellmer are contributing editors of AJHP. Multiple shortage meetings held in 2018 provided recommendations for ensuring the adequacy of prescription drug supply.1–3 Notably, after one such meeting, the National Academy of Sciences recommended an evaluation of the adequacy of prescription drug supply as a matter of national security,2 and a final report on the work of the Food and Drug Administration’s Drug Shortages Task Force is due to Congress by the end of 2019. Forecast Panelists’ responses to the question, “How likely is it that the following will occur by the year 2024 in the geographic region where you work?”. DOI: 10.1200/JOP.0936501 Journal of Oncology Practice (The Black Swan). In a continuing discussion of the future of pharmacy education and pharmacy workforce issues, Diane Ginsburg and Katie Pritchett provide a section exploring a number of challenges that will face health-system pharmacy leaders in the coming years. Certification programs of the Board of Pharmacy Specialties (BPS) and the Pharmacy Technician Certification Board (PTCB) are now available for practitioner certification.1,2 The Joint Commission (TJC) has developed a Medication Compounding Certification program to assess compliance with standards for preparing sterile and nonsterile products.3 Michigan became the first state to require certification by TJC, with over 75 hospitals certified.3 This certification may become the best practice for compounding sterile i.v.
2020 strategic planning in healthcare scholarly articles