In this episode of Visante Innovators, Jim Jorgenson talks with Pharmacy Stars CEO Keith Streckenbach. Keith is an innovator in sterile drug compounding and passionate about helping pharmacies reach their compliance goals and meet increasingly complex standards. With USP Chapters 797 and 800 becoming compendial, and therefore enforceable by boards of pharmacy or other regulatory agencies, quickly reaching compliance with these standards is critical. Keith and Jim discuss how to assess your situation and design a compliance roadmap, and where to go for the most helpful resources. They also cover some of the more challenging aspects of 797 and 800 compliance, how to handle workforce challenges and staying on top of cybersecurity issues. Listeners will be interested to hear about what Jim and Keith see for the future of compliance in this area, such as more frequent use of Current Good Manufacturing Practice (CGMP) standards. Pharmacy Stars Website: pharmacystars.com Resources: 5 THINGS YOU NEED TO KNOW ABOUT USP CHAPTER 797 AND 800 REVISIONS 2023 USP 797 Pharmaceutical Compounding – Sterile Preparations Briefing   2023 USP 795 Pharmaceutical Compounding – Non-Sterile Preparations Briefing  

In this episode of Visante's Innovators podcast, successful pharmacy leaders, Melissa Ortega from Tufts Medicine and Staci Hermann from Dartmouth Health, join Jim Jorgenson for an in-depth discussion on the greatest challenges and opportunities facing the contemporary pharmacy leader.   Dave Hager moderates the discussion with these two phenomenal pharmacy trailblazers for an intriguing, timely listen for all current and future health system and pharmacy leaders.  

It’s a familiar theme in healthcare: the movement of traditional acute care to a variety of ambulatory settings. Infusion therapy is one of the fastest-growing examples of this transition, and the market continues to shift as a result of this strong growth. In this episode of our Visante Innovators podcast, we take a deeper look at what’s driving the expansion of the infusion market. Join Visante CEO Jim Jorgenson, University of Maryland Director of Home Infusion Services Chris White, and Visante Senior Director Erick Siegenthaler as they discuss infusion changes and challenges, plus how health systems should be thinking about their overall infusion strategy in today’s evolving landscape.

Why has an important quality and financial element like medical adherence flown under the radar all these years? Professor William (Bill) Kelly from Taneja College of Pharmacy at USF, joins our host, Jim Jorgenson, to discuss why pharmacist interventions and medication adherence are crucial to patients' quality of life. In the episode, Bill dives into his most recent publication on adherence and gives us a sneak peek of his upcoming studies about quality and safety. Click Here to read Bill's publication  Contact Bill: [email protected]  

Health systems have been plagued by shortages of pharmacy technicians and many fear it will continue to get worse. Rico Powell, Senior Consultant at Visante and Managing Partner at Professional Pharmacy Technician Academy, joins our host, Jim Jorgenson, to discuss the pharmacy technician crisis. In this episode, Rico highlights technicians’ role in medication safety and what pharmacy leaders can do to help mitigate the high turnover. Professional Pharmacy Technician Academy: www.pptaacademy.com Contact Rico Powell: [email protected] White Paper: The Pharmacy Technician Workforce Crisis         Transcript:  Jim Jorgenson, Visante CEO  00:04 Hello, and welcome to today's edition of the Visante pharmacy innovators podcast. I'm your host Visante CEO Jim Jorgensen. You know, one of the critical areas of importance for the US healthcare system is the labor pool. And this was significantly challenged and shortages exacerbated by the pandemic and in pharmacy I think this has been felt most acutely in the pharmacy technician market. And having a high-performing pharmacy technical staff is really critical to the effective and efficient operation of pharmacy. And it's also a key element of medication safety. And today, I'm really excited to have with us as our guest, Rico Powell, certified pharmacy technician and Senior Consultant here at Visante to discuss the technician shortage crisis. So welcome Rico. To start, can you please give our audience some additional background on yourself?   Rico Powell  00:56 Yeah, I'm from Memphis, Tennessee. I've been a certified pharmacy tech through PTC for 20 years now. I'm a husband and father of two amazing young men who both started college and also a bouncing three-year-old boy. I'm currently working as a senior consultant on automation projects here with Visante  supporting health systems on various implementation projects.   Jim Jorgenson, Visante CEO  01:22 Great, before we jump into the tech shortage issue, I'm interested to hear what led you to your current focus on automation and informatics.   Rico Powell  01:32 Actually, automation and informatics was introduced to me from great leaders during the time practice model changes to get pharmacists closest to the bedside was high priority. Leaders developed a tech manager role. Current DOP (Director of Pharmacy), Dr. Allison Apple was taking the lead on these practice model changes and developed the tech manager role. In this tech manager role, I developed really key leadership skills that really took me a long way. In the same health system, you had forward-thinking pharmacy leaders develop this pharmacy automation analyst role. Dr. Brennan Erickson, and I'm thankful for him, he had a vision of me being in this role and leading IT initiatives for the system and at LeBonheur Children's Hospital.   Jim Jorgenson, Visante CEO  02:39 Great! Well, we're very thankful you're in that role as well. As a pharmacy tech, and someone that works in a variety of hospitals now for Visante , you get the chance to talk with your peers, what  are you seeing firsthand in the field in terms of tech shortages.   Rico Powell  02:55 Yeah, you know, one thing I'm seeing in regarding tech shortages is all that hard work that pharmacies did across the United States to change practice model changes to put the pharmacists more to to the bedside are now being reversed back. I'm seeing these pharmacists are now taking on these technician roles due to the tech shortage. The high turnover is now massive. There's a lot of stress that's been placed on the pharmacists to do dual roles when, before the tech crisis, you had technicians filling these roles. Also, I'm seeing a lot of pharmacy tech agency work being done which brings a new variable when it comes to a patient safety risks when you have untrained technicians filling in just to stop the bleeding with this tech shortage that's going on.   Jim Jorgenson, Visante CEO  04:01 What do you think the most impactful area is right now in terms of the tech shortage and pharmacy operations?   Rico Powell  04:09 You know, I think the most impactful thing is overall the med safety piece of it. My biggest fear is that the shortage is not only impacting pharmacy operations, but it's also introducing patient safety risks. This is the untold story of how critical the tech role is to the patient safety's overall ecosystem. You often hear about in a retail setting of the pharmacy, the store manager or the pharmacist in a retail setting, and in acute care setting you hear about the physician, the nurse, the pharmacy, or the respiratory therapist, but the technician is so valuable in this role in the overall makeup of medication safety.   Jim Jorgenson, Visante CEO  05:00 I couldn't agree more, you know, maybe a story from my personal background when I was a chief pharmacy officer. We had two patients on the same chemotherapy agent, one receiving a very diluted dosage, and they were a bone marrow transplant patient, the other receiving almost full strength, and they were a prostate cancer patient, and the pharmacist for the day mixed the two doses up. So the bone marrow transplant patient was going to receive the full strength which would undoubtedly would have killed the patient. The IV Pharmacist gave the bag to the technician and said, run this upstairs, the technician looked at the color and said this doesn't look right. And the pharmacist checked and said, No, that's right. Take it up. So the technician went to another pharmacist and said this doesn't look right. And the other pharmacist said, well, it was checked by the IV room pharmacist, so it must be right take it up. So the technician went to the nurse and said this doesn't look right. And the nurse said, No, it's labeled, right. It's the right drug. But he refused to give the dose to the nurse, he came back down. And he brought the drug to my office. And he said this doesn't look right. And I took one look, I went oh my gosh, you're right, this isn't right. And so we were able to avert a medication error that most certainly would have killed that patient. And three times the easy course of action would have been to let it go. And each time the technician refused to do that. And ultimately saved that patient's life. I am so thankful for that technician still today. So what what do you see as primary drivers for that technician shortage situation?   Rico Powell  06:46 Well, I mean, I think it's quite simple. You know, you have low wage working employees contributing long hours away from their family, they're now choosing other fields to help support and, you know, the online model, a wave that hit after COVID, really opened Pandora's Box.   Jim Jorgenson, Visante CEO  07:08 Are you seeing things in the market that seem to be working well, to help improve the recruitment and retention of pharmacy techs?   Rico Powell  07:18 Yeah, it's funny, you should ask. I'm currently supporting a pediatric hospital here in Memphis, Tennessee, that could actually write the white paper on things that are working well, you know that this system has competitive pay scale, very low turnover, you know, engaged happy pharmacy technicians, there's innovative job descriptions, and just overall great culture and work life balance. And I think those are all the key ingredients to things working well.   Jim Jorgenson, Visante CEO  07:50 You hit on a number of  really important points there. And you know, as a tech yourself, what are the most important things to you and your career when you think about whether you want to stay in a position or not?   Rico Powell  08:04 Yeah, not only for me, I hear way too often from pharmacy technicians, I would say career advancement, and there's a lot of moving parts to that. I will also say work life balance, and fair and competitive pay scales being developed.   Jim Jorgenson, Visante CEO  08:23 Yeah, that one is really frustrating. You know, when we look across the country, almost invariably, when you put the pharmacy technicians on the technician work scale with RAD techs or ultrasound techs or lab techs, they always end up on the bottom, which is really frustrating, because in many states, they have to be licensed, and they have to be certified. They have to complete the formal course of training and education. And yet they're invariably on the bottom of that tech scale.   So what do you think are maybe the top three things that every pharmacy operation should be considering to better support their technical workforce? You know, if you had the magic wand, and were vice president for the day, what would you do?   Rico Powell  09:08 Yeah, and this is a really hard one, when you know, there's a lot of things that are going on with with pharmacy leaders and the responsibilities that they have to take on but if I did have the magic wand, one, I would say, develop some standard way in consensus for pharmacy leaders to know how to have these crucial conversations with the C-suite, explaining the importance of the role of patient safety. And when it comes along with pharmacy technician, just really letting them know how important this role is in the overall ecosystem of taking care of patients. And this way we could shore up the the discrepancy with the pay. I just think that story isn't told strongly enough and it's a difficult one to have. Along with that, develop and define job description descriptions and create innovative roles.   Jim Jorgenson, Visante CEO  10:07 Yeah, I think what's frustrating is watching across the country and seeing the same mistake made multiple times in multiple hospitals, it's almost like organizations refuse to learn from the misfortune of others, how many times are we going to make that heparin error before we eliminate that. And almost invariably, every time that error has been made, it starts with a technician. And so they're critically important to the overall patient safety movement, for sure.   In addition to your work at Visante, I know you're also taking direct action to help the tech crisis as one of the ownership partners and program directors of the professional pharmacy technician academy. So tell us a little bit about what you do at PPTA.   Rico Powell  10:53 Yeah, and I'll back up a little bit over my 20-year career as a pharmacy technician, I've been blessed and placed in situations to gain exposure and provide my input on things. PTCB in 2017 invited me to attend a pharmacy meeting to explore the consensus and the standard of pharmacy technicians. Our very own Steve (Rough) was also a keynote speaker at that meeting in 2017. And the Industry Day pharmacy technician stakeholder meeting, the conference brought together over 100 pharmacy and pharmacy technician professionals on site and 350 by webinar. I never forget hearing about hearing about a story from Christopher Jerry, one of the other keynote speakers and president of the Emily Jerry Foundation, describing the tragedy he suffered when his two-year old daughter lost her life at the pharmacy technician medication error. One thing Chris said in his keynote speech touched me, having young kids, you know, during this time. He stated that the pharmacy profession in this room must develop standards. And the state boards must understand the importance of the profession to public safety. And he literally asked everybody in that room, if we didn't come up with a consensus do something on your own, to really show that you care. And that just went all over me. And to this day, so that developing PPTA was a direct result of that speech, actually. I wanted to do something about it. And PPTA is  a model that offers flexible, high quality, fully online foundation courses to help organizations promote in-house during the impact of the tech shortage. We also have our first advanced course, which is a medication safety course, which requires you to be a certified technician already. Some medication safety with TPV. I'm very excited about this course, I'm very passionate about this, because we also even partnered with the Emily Foundation to contribute 6% of the proceeds for anyone who's enrolled and using a code. We never forget to honor Chris's daughter on behalf of all the pharmacy technicians that are doing great work and are really involved in medication safety more than anyone would ever know.   Jim Jorgenson, Visante CEO  13:33 So are these certificate programs, then Rico when the technicians complete them?   Rico Powell  13:38 yes. They are certificate programs, and we develop our model on the PTCB model. Our course allows the certified technicians to sit for PTCB's technician product verification certification.You have to be approved program through PTCB. And we're State Board approved through Tennessee which allows technicians to enroll in our course across the United States as well.   Jim Jorgenson, Visante CEO  14:11 Good and then do the technicians qualify for technician continuing education through your program?   Rico Powell  14:16 That's correct. They qualify for 25 hours of continuing education, which is a great thing. And also it allows them to gain advanced pharmacy technician credentials. You know, PTCB has this amazing model where you have the base, pharmacy technician and then they've developed all these advanced practice certificates that fall underneath and after working as a foundation technician and acquiring two of these Advanced Certificates there's this this new, advanced pharmacy technician role and I think they've done did an outstanding job developing this model.   Jim Jorgenson, Visante CEO  15:01 That sounds wonderful. So if any listeners are interested in PPTA, how do they contact you?   Rico Powell  15:07 Yeah, directly, you can see us on our website at pptaacademy.com. And if you want to get in touch with me directly email me at [email protected].   Jim Jorgenson, Visante CEO  15:24 Thank you, this has really been a great discussion. Rico, thank you for all you do for our team and our clients. And also thank you for sharing your perspectives on the pharmacy technician workforce challenges. And this really is an area where Visante is working hard to support our colleagues in their technician recruitment and retention efforts. And to that end, we recently published a comprehensive white paper on the topic. And we've made that available on our website for anyone that wants to access it as an additional resource. So any parting words of wisdom Rico.   Rico Powell  15:57 I'll just say, for all the technicians that are out there working in the field, constantly and continue to be impactful. And regards to your role in medication safety, and for the pharmacy leaders, we know that there are very caring and entrusted techs and leaders out there. And once again, not to sound redundant, please continue to tell the story about the vital role of technicians and safety, and let's not have a tech crisis anymore.   Jim Jorgenson, Visante CEO  16:26 Absolutely. Thanks, everybody for listening and certainly good luck to everyone out there with this crucial issue.

Maria Kossilos, Assoc. Chief Pharmacy Officer at Cambridge Health Alliance, joins Kristin Fox-Smith (340B ACE), Managing Director at Visante, to discuss how pharmaceutical manufacturer restrictions – some as recent as last week – put enormous financial pressure on health systems and covered entities who are doing what they can to care for vulnerable and underserved patients across America.   Kossilos and Fox-Smith describe why the 340B outlook is somewhat bleak, as the fear of continuing to lose 340B savings could well become a reality in the coming 18-24 months. However, they also describe real solutions such as utilizing 340B ESP in ways to leverage data in exchange for 340B price restoration, where possible. Fox-Smith describes Cambridge Health Alliance as the perfect case study for an organization that has figured out what works well, how to hold vendors accountable, and how to stay on top of ever-changing restrictions and requirements while restoring lost revenue without draining its internal resources.   In this episode, you will hear from two leading 340B experts who are passionate about taking care of patients – especially those that cannot afford it themselves – and advocating for the organizations on the front lines. Jim Jorgenson, Visante CEO, moderates the discussion and provides insight into the legal aspects and impact on the future of the program.

In this episode of the pharmacy innovators podcast we have Ghalib Abbasi and Gee Mathen. These two innovators are making major breakthroughs in pharmacy automation and making it safer for patients! Let's see how they're doing that...

In part 3 of our series on automation, we're going to be talking about the optimization of the automation solution that has been selected.

In the first of our series on pharmacy automation we talked about initial planning...now, we discuss implementation!

In the first of four parts of our series on Pharmacy Automation Projects, we're going to discuss what goes into initial planning.