UNC Medical Center Pharmacy Services
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UNCHCS PHARMACY SERVICES
UNC Medical Center
Pharmacy Services
History
UNCHCS PHARMACY SERVICES
Start Today
1947 1952 1989 1995-2009 2013-2017
The NC General 2013-UNC Hospitals at
1995- NC
Assembly funded NC Memorial Renamed UNC WakeBrook opened in
Neuroscience
construction of North Hospital Opens Hospitals Raleigh
Carolina Memorial Hospitals opens
Hospital
2002- NC Women’s 2015-UNC Hospitals
& NC Children’s Hillsborough Campus
Hospital move to opened
free-standing facility
2009- NC Cancer UNC Medical Center
Hospital formally now part of a growing
dedicated health system across
the state
UNC Eshelman
School of Pharmacy
UNCHCS PHARMACY SERVICES
North Carolina
Children’s Hospital
Memorial Women’s
Hospital Hospital
Neurosciences
Cancer Hospital
Hospital
UNCH Surgical Tower – Coming in 2021 UNCHCS PHARMACY SERVICES
Chapel Hill Region
UNCHCS PHARMACY SERVICES
UNC
Hillsborough
Hospital
UNC
WakeBrook
Chatham
Campus
Hospital
1. Materials Management 2. Home Health 3. Purchasing / AP 4. Pharmacy
UNCHCS PHARMACY SERVICES
The UNC SSC
will be the
Value–Based
Provider of
Revenue
Shared
Services for
our Enterprise Quality
and the 4
Customers and Service Expense
Communities
We Serve
4
4
Health System Overview
UUNNCC H
HECASL TPHH A
C ARRME ASCYYS TSE EMR V I C E S
UNC Health Care Today
UNCHCS PHARMACY SERVICES
Alleghany Camden
Ashe Northampton Gates Currituck
Warren
Surry Caswell Person
Stokes Vance Halifax Hertford Pasquotank
Rockingham
Watauga Wilkes Perquimans
2011 2017
Granville
Alamance
Yadkin Forsyth Guilford Orange Franklin Bertie Chowan
Mitchell Avery
Durham Nash
Caldwell
Yancey Alexander Davie Edgecombe
Madison
Iredell
Net patient $2.0B $4.9B
Wake Martin Washington Tyrrell Dare
Burke Davidson
Randolph
Wilson
Haywood
Buncombe
McDowell
Catawba Rowan
Chatham Pitt Beaufort revenues
Hyde
Swain Johnston
Greene
Licensed 1,530 3,400
Lincoln Lee
Rutherford
Graham Jackson Henderson Cabarrus Harnett Wayne
Cleveland
Macon
Transylvania Polk Gaston
Stanly
Moore
Lenoir Craven beds
Montgomery
Cherokee Mecklenburg Pamlico
Sampson
Clay
Union Hoke
Cumberland
Duplin Jones Employees 14,000 31,500
Anson Richmond
Scotland
Onslow
Carteret
Robeson Bladen Employed 2,110 3,200
Pender MDs
Surgeries 60,000 120,000
Columbus New Hanover
Clinic visits 1.1M 3.0M
Brunswick
UNC Pharmacy Services
UUNNCC H
HECASL TPHH A
C ARRME ASCYYS TSE EMR V I C E S
UNC Medical Center Department of Pharmacy
UNCHCS PHARMACY SERVICES
369 FTEs (404 employees)
• 120 pharmacists FTE
• 136 technicians FTE
• 74 administrative staff FTE
• 39 pharmacy residents FTE
Decentralized, service-line based
model of pharmacy practice
Fully automated distribution system
24/7, multi-campus operation
>$1 billion in revenue annually across
acute, infusion and retail
operationsOur Purpose is ATTRACTIVE.
UNCHCS PHARMACY SERVICES
Mission:
–To provide patient-centered
medication management that
optimizes outcomes through an
alignment of practice, education,
research and leadership.
Vision:
–One Pharmacy Community
pursuing national and international
excellence as the leading,
innovative Department of
Pharmacy.Our Passion is on the Patient.
UNCHCS PHARMACY SERVICES
On a quest to place Pharmacy at all aspects of care.
Medication
Discharge Assistance
Acute-Based Medication Program (MAP) Discharge
Care Reconciliation Prescription
and Patient Services via
Education Carolina
Admission Med
History and Acute Care @
Reconciliation Clinical Home
Pharmacy Post-Acute
Services Pharmacist
Post-Acute Visit
Care
Community Based
Care
Population Health:
Carolina Assessment Pharmacy
of Medications Retail:
Assistance • In-Store
Program (CAMP) Clinic-Based
Program • Central Fill Clinical Pharmacist
(PAP) • Mail-Order Practitioner (CPP)
• SpecialtyOur Plan is the Pharmacy Enterprise.
UNCHCS PHARMACY SERVICES
Acute Discharge Medication
Clinical Reconciliation and
Pharmacy Patient Education
Services Bedside Discharge
Admission Med Prescription
History and Services
Reconciliation
Post-Acute
System Pharmacy Telepharmacy
Visit
Pharmacy Population
Strategic Assets
Health Support
Medication Assistance Clinic-Based
Retail:
Programs (MAP) Clinical Pharmacist
Initial and Refill
Practitioner (CPP)
Central Fill
Mail-Order
Specialty
Bush PW, Daniels R.. NC Med J. 2017 May-Jun;78(3):177-180.Our Programs support our Strategy Framework.
UNCHCS PHARMACY SERVICES
Acute &
Acute Care Oncology, Medication
Regional Education & Ambulatory HR &
& Retail Infusion & Use Policy &
Hospitals Research Care Clinical Finance
Operations IDS Analytics
Services
Drug Information
Oncology
Residency & Policy
UNCMC Acute Care Operations HR
Chatham Programs
Hospital Formulary
On & Offsite Management
Infusion
PIPC WakeBrook Ambulatory Care 340b Medication Safety
MAP
Quality
Hillsborough
Hospital
CC@H & Med
Research Retail Business office
History Services IDS
AnalyticsExisting Times..
UUNNCC H
HECASL TPHH A
C ARRME ASCYYS TSE EMR V I C E SMedication Therapy Continues to Shift Off-Site
UNCHCS PHARMACY SERVICES
McCreary Cancer Center, a Rockingham Cancer UNC Hospitals
service of UNC Hospitals - Center, a service of UNC Hillsborough Campus -
Lenoir Hospitals – Eden Hillsborough
(Summer 2018)
Alleghany Camden
Ashe Northampton Gates Currituck
Warren
Surry Caswell Person
Stokes Rockingham Vance Halifax Hertford Pasquotank
Watauga Wilkes Perquimans
Granville
Yadkin Forsyth Guilford Orange Franklin Bertie Chowan
Mitchell Avery Durham
Alamance Nash
Caldwell
Yancey Alexander Davie Edgecombe
Madison
Iredell Martin
Wake Washington Tyrrell Dare
Burke Iredell Davidson
Randolph
Wilson
McDowell
Buncombe Catawba Rowan Chatham Beaufort
Haywood Pitt Hyde
Swain Johnston
Lincoln Lee Greene
Rutherford
Graham Jackson Henderson Cabarrus Harnett Wayne
Cleveland
Stanly Montgomery Craven
Transylvania Polk Gaston Moore
Macon Lenoir
Cherokee Mecklenburg Pamlico
Clay Cumberland
Union Jones
Hoke Sampson
Anson Richmond
Duplin
Scotland
Hayworth Cancer Center, a Onslow
Carteret
service of UNC Hospitals - Robeson Pender
Bladen
High Point
UNC Hospitals Therapeutic
Columbus Infusion Center - Chapel Hill
UNC Hospitals Therapeutic New Hanover
Brunswick
Infusion Center - Pittsboro
Hazardous Non-Hazardous
• Greater than 150 infusion chairs • > 6 sites across locationsSystem IDS- Future Growth Opportunities
UNCHCS PHARMACY SERVICES
Current State Future State
>500 Active Studies >600 Active Studies
1 Centralized IDS Contract with Nash Other Entities Interested In Signing
Centralized IDS Contract
UNC Medical Center
UNC Medical School
UNC Dental School
UNC Pharmacy School
Clinical Translational Research Clinic (CTRC) Growth of Web-Based Accountability System
Environmental Protection Agency (EPA) Other UNC Health Care Entities
UNC Nash Health Care Outpatient Clinics Across North Carolina
One IRB. One Contract. One IDS.Retail Pharmacy Services Exist Across the State.
UNCHCS PHARMACY SERVICES
UNCHCS Owned Hospital
Affiliated Hospital
Hospital in development
UNCHCS Shared Services
Center
Outpatient Retail Pharmacy
Employee Retail Pharmacy
Independent Retail
Pharmacy Network Partner
2016
Net Revenue Total
(in millions) Employees
UNC Hospitals $1,590 10,575
UNC Rex $950 5,950
UNCFP $485 1,300
High Point $315 2,625
Wayne $265 1,875
Nash $220 1,850
Johnston $195 1,525
Pardee $190 1,400
Lenoir $110 950
UNCPN $105 1,100
Caldwell $100 825
Chatham $30 225
$4,555 30,200Our Specialty Pharmacy Services are Rated Among the
Best!!!
UNCHCS PHARMACY SERVICES
Net Promoter Score
100
90
89
80
80
70
60 66
50
40
40
30
32 32
29
20
10
0
UNC** Amber Pharmacy* CVS* ACS* Avita* Diplomat* Option Care*
UNC** Amber Pharmacy* CVS* ACS* Avita* Diplomat* Option Care*
The NPS is calculated by subtracting the number of Detractors (those who gave a rating of 0 to 6 in terms of their likelihood to recommend)
from the number of Promoters (those who gave a rating of 9 or 10). In this case for UNC, NPS = 92% – 3% = 89%.
* Zitter Health Insights Patient Satisfaction Survey – Q4 2016
** UNC SSC Patient Satisfaction Survey by Xcenda - 2016…will continue our pursuit of UNCommon Excellence. UNCHCS PHARMACY SERVICES
The Opportunity of nurturing the “Big Data”
UNCHCS PHARMACY SERVICES
To thrive, modern health care organizations must become data driven
Multiple data sources currently available across continuum of care
Ambulatory
EMR
ED and
Payer Claims
Inpatient EMR
Provider Long Term
Billings Patient Care
Healthcare
Homecare and
System
Telemedicine
Operations
Provider Info
Population Health Community Primary Care Extended Care Acute CareData mapping within Carolina Data Warehouse UNCHCS PHARMACY SERVICES
We want to get there first…Assess Value, Measure Impact
UNCHCS PHARMACY SERVICES
Pharmacy Analytics
UNC Eshelman Team
School of Pharmacy Pharmacy Services
Collaboration ORBIT
Pharmacy Analytics,
Outcomes, and
Impact
Education/Research Pharmacy System
Enterprise Data Governance
Pharmacy Strategy and
QualityIntegrated Pharmacy Management Services
UNCHCS PHARMACY SERVICES
Population Health Management
MTM, Transitions of Care, Targeted Interventions
Potential Annual Savings: $800K
Pharmacy Benefit Management
Pharmacy expense reduction through plan design and formulary modifications.
Potential Annual Savings: $500K
Optimize
Pharmacy
Spend &
Improve
Outcomes
Prior Authorization Program
Clinical review of medication access to ensure appropriate utilization Clinical Program Development
Potential Annual Savings: $400K Programs that enhance clinical outcomes while maximizing cost savings (e.g.
340B Disease State Programs)
Potential Annual Savings: $600KEducation Research Enterprise - Evolution
UNCHCS PHARMACY SERVICES
Service Residents
Residents and
Students
Service Students Residents Research
Students
Strategy
Research
Strategy Research Service
Strategy
Pre-2009 Current State Future StateResident and Student Training Programs
UNCHCS PHARMACY SERVICES
• Over 80 preceptors actively participate in the execution and delivery of
education to residents and students
• 39 Residents • 47 PY4/APPE students
• 12 PGY1 • 12 currently in research track
• Pharmacy Practice, Ambulatory
• 60 immersion students
Care
• 10 combined PGY1/PGY2 • Health system
• Health System Pharmacy • Ambulatory Care
Administration, Pharmacotherapy • Acute Care
• 17 PGY2
• Ambulatory Care, Cardiology,
Critical Care, HSMM, Hem/Onc, ID,
Peds, Psychiatry, SOTPartnerships are Required to Seek the Opportunity
UNCHCS PHARMACY SERVICES
Collaborative/ Alliance/
Transactional
Cooperative Partnership
• Increasing communication
• Increasing joint activity
• Increasing potential impact
• Increasing effortUNC Medical Center Department of Pharmacy
UNCHCS PHARMACY SERVICES
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