Letter from the Chief Pharmacy Officer

  • Robert T Adamson
    Robert T. Adamson PharmD, FASHP
    Chief Pharmacy Officer

Welcome to the 2nd Annual Report of the RWJBarnabas Health Pharmacy Enterprise. This report provides an overview of the depth and breadth of pharmacy services offered within the health system and all of the accomplishments in 2016. This past year saw unprecedented growth and change with the merging of Robert Wood Johnson Health System and Barnabas Health in April of 2016. The Pharmacy Enterprise grew from 15 to 21 divisions across two distinct service lines, Acute Care and Integrated Services. Our Acute Care Service Line is comprised of 13 hospital pharmacy divisions and our Integrated service line is comprised of eight divisions: 340B, Reimbursement, Retail Pharmacy Network, Informatics and Qualitas, our wholly owned pharmacy services company which provides four unique services; Home Infusion, Hospital Compounding and Repacking, Employee Mail Order Prescriptions and Specialty Pharmacy. Contained in this report is a profile of each of these division services and leadership.

In order to ensure a successful integration of all of the respective legacy pharmacy teams, many significant milestones needed to be executed. The timeline on pages four and five highlight the milestones that our team accomplished which were instrumental for creation of infrastructure, a strategic plan, and harmonizing of the team. The most significant imperative was creating a three year integration savings opportunity target of 15.5 million dollars. We are proud that in the first 8 months, 14.5 million dollars of initiatives have been launched with 5.7 million dollars already realized. The five global cost savings strategies that were employed were: maximize the 340B financial benefit, leverage product specific contract terms due to consolidated volume, migrate to a single wholesaler with universal contract terms, therapeutic medication substitutions and utilize Corporate Pharmacy oversight in lieu of external consultants.

Beyond integration, our three year strategic plan for 2016, 2017 and 2018 can be summed up in three words: Elevate, Extend and Redeploy. I would like to highlight examples of the 2016 word of “Elevate”. Twenty-one teammates achieved the Board Certified Pharmacotherapy Specialist distinction and six others achieved sub-specialty certification in Critical Care, Cardiology, Infectious Disease and Psychiatry. In fact, 35% of all Critical Care and Psychiatry Board Certified Pharmacy Practitioners in the state of New Jersey are members of the RWJBarnabas Health Pharmacy Enterprise. Seventeen of our pharmacy technician teammates successfully passed the Pharmacy Technician Certification Board exam. Twenty-two and 24 members of our Pharmacist team successfully completed the American Pharmacist Association Pharmacy-based Immunization Delivery Certificate program and certification for Medication Therapy Management respectively. In order to elevate our Enterprise exposure outside of the health system, 12 members of our team have been appointed to National and Regional Pharmacy Society committee leadership roles. Our talented team submitted their valuable activities in our documentation software resulting in nearly 2.2 million pharmacist activities and 910,000 pharmacy technician activities, resulting in a cost avoidance of 9.4 million dollars. The team’s medication safety vigilance in 2016 prevented 60,000 medication errors and 21,000 adverse drug reactions from occurring to our patients. In our Home Care Infusion Division, our dedicated nurse teammates provided home infusions to 6,000 patients with a remarkable 0.3% infection rate with an increased profit of 17.5%. Our 340B Division established a compliance and audit team this past year completing 205 audits of our facilities and creating a net benefit of more than $38,000,000 to help offset the $800,000,000 of in kind care the health system offered in 2016. Our Reimbursement Division this past year through continuous surveillance was able to capture 7.4 million dollars representing a 130% increase from 2015. Our Informatics Division made 2,100 safety enhancements to our health systems Clinical Information Systems which serves as the foundation for all care providers when treating our patients. Our Mail Order Division and Hospital Compounding & Repacking Division successfully created the infrastructure to begin performing employee mail prescriptions and insourcing of medication repacking respectively for the RWJ team. Our Specialty Pharmacy Division continues to grow by securing insource and outsource business opportunities resulting in an 8% growth and 103% increase in profit. Lastly, our Retail Pharmacy Network has been instrumental in helping expedite discharge and continuum care this past year with the establishment of a medication to the patient’s bed service and delivery to their homes.

The Pharmacy Enterprise is guided by nine core principles: advocacy, care continuum, community, education, financial, quality, regulatory, research & publication and technology. The highlights of each principle can be found within this report but I would like to take a moment and highlight three of them: Community, Quality and Research and Publication.

Our Community principle saw 125 unique outreach programs performed representing a 140% increase from the year before. The Quality portfolio within the Enterprise focused on four initiatives: decrease venous thrombosis by 25%, increase transition of IV to Oral diuretics in congestive heart failure patients, decrease the use of proton pump inhibitors by 10% and decrease the utilization of Cervidil for induction of labor by 25%. I am proud to announce we exceeded all targets for each of these initiatives. We had a strong year of research and publications within our Enterprise with 71 manuscripts and book chapters and 187 abstract and poster presentations locally and nationwide representing a 74% increase from 2015.

As our health system expands to population health and increasing the ambulatory focus, our pharmacy team word for 2017 is “Extend”. We look forward to extending the talents of our team further into the community practice outside of our acute care facilities. It is our intention to be at the forefront of taking care of patients regardless of care area. It is with deep pride that on behalf of my 961 co-workers within the Pharmacy Enterprise I submit our 2016 Annual Report.