Medication Management Profiles in Leadership

Carving out a new frontier with pharmacy BI tools in Montana

Vital Statistics

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Billings Clinic Billings, MT
Staff beds 304
Employees 4,200
Medical Staff 450
Surgery Center 1
Cancer Center 1
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Kyle Townsend, PharmD, MBA, BCPS

Director of Pharmacy Services
“I want to see a national hospital standard that shows what pharmacy productivity looks like in a mixed operational and clinical world.”

Kyle Townsend’s service area stretches through most of Montana, northern Wyoming and the western Dakotas. The rugged, rural landscape presents a variety of unique medication management challenges. His responsibilities cover a variety of practice types, ranging from hospital/clinic to retail to specialty to ambulatory services and long-term care pharmacies.

A key focus area: data analytics and metrics. With a 12-person pharmacy information technology (IT) team, Townsend leverages data to create business intelligence tools that managers use to enhance clinical and operational outcomes.

Q: What are the basic challenges you’ve found in extracting meaningful data?

A:

In the pharmacy world, Billings Clinic is fairly well integrated from a technology standpoint. Even with all of the data points available to us, once we extract the data, we need a format that is useable. You can put data in front of managers all you want. But if the data is in a non-real-time format, like a spreadsheet, people aren’t going to take the time to open it.

We need to put the data into some sort of real-time, business intelligence format that makes it meaningful to leaders in order to make appropriate, sustainable changes. It needs to be a format that’s easy for them to use, where they can drill down and find data important to them. That’s the kind of challenge that gets me excited.

Q: What prompted you to develop your own business intelligence (BI) tool?

A:

About 1½ years ago, Joint Commission questioned some range orders administered for pain management. The nurse leaders came to our team looking for data. They wanted to know what was out of range, why it was out of range, who was involved and so forth. Our leaders wanted that data in front of them in real-time so they could talk with the nurses and change behavior.

The reports we had at the time couldn’t answer those questions. So, our leadership team challenged the pharmacy IT team to come up with a better solution. They built a real-time, business intelligence dashboard in a graphical format with drill-down capabilities that now all of our nurse leaders are able to use. That’s how we’ve enabled our nursing colleagues to drive positive behavior change at the front-end user level.

Q: How is your pharmacy IT team able to build those kinds of tools?

A:

We’ve hired people specifically who can write code in our EMR to extract data, reliably warehouse that data, and then build reports or BI dashboards based on the leader’s vision.

I’ve got a good feel for what data is usable and what’s needed; I don’t always have the best feel for how to extract the data and put it into an actionable form. That’s where I rely on our pharmacy IT team.

Q: What other BI tools have you built?

A:

The pharmacy IT team built a barcode med administration dashboard which tracks utilization by location and nurse, allowing nursing leaders to use the real-time feedback to bring about a culture of change with their staff.

As a result of feedback from a Leapfrog Survey, the pharmacy IT team built a barcode med administration dashboard that tracks utilization by location and nurse, allowing nurse leaders to use the real-time feedback to bring about a culture of change with their staff. Additionally, they built a dashboard that tracks our progress and utilization on clinical decision support out of the EMR.

Since those tools were put into place, we completely turned around the situation with the use of real-time data. We went from a poor score to a superior score with the work the team did based on the data that was readily available.

Q: How have you used metrics to improve pharmacy productivity?

A:

Well, internally, we continue to look at productivity. We previously used multiple data sources to develop a mixed, clinical-operational pharmacy dashboard, but only focused on the pharmacists as individuals. Right now, I’m looking to optimize technician scheduling by analyzing the data points coming out of our Omnicell technology and additional contributor systems.

For instance, we want to analyze when the technician took the medication out of our Central Pharmacy Manager carousels, took it to the Omnicell cabinet, put it into the cabinet, and when it made it to the patient. What can we do with all of these data points? Can we use them to determine how long it takes for the average person to fill a cabinet?  What’s the best time to fill them? Are there more value-add tasks this person could be doing?

Q: What surprised you the most since you started down this path?

A:

Well, two things. First, just how difficult it is to get the data and put it into a format that's usable by the majority of leaders. Second, once we had the data, I was surprised at how many leaders willingly used it as a kind of cool, new, exciting tool to help hold their teams accountable and to lead change. Of course, some leaders needed to be pushed and prodded a bit, which led to a tool for the accountability and governance of the leaders.

Q: What are the next steps for you and your team?

A:

We’ll continue to monitor and refine the tools. Probably the next step is to transition into a leader accountability tool, where leaders can also show that they're holding their staff accountable. Accountability is a big piece. Once you get the data, what do you do with it? So, leader accountability and data governance, I would say, are probably our next steps.

Q: Where do you see pharmacy business intelligence moving to over the next 3-5 years?

A:

I just went through that this year when I looked at our productivity stat for our hospital pharmacy cost center. I think there’s strong, growing interest for developing national pharmacy health system standards and benchmarks. People want to be able to compare their performance against others. I want to see a national hospital standard that shows what pharmacy productivity looks like in a mixed operational and clinical world. Being able to tie operational pharmacy and clinical pharmacy components together in a mixed staffing model is very tough.

Q: What’s your definition of the Autonomous Pharmacy?

A:

Well, for me, it starts with data points. From the day the dose leaves the wholesaler, it is tracked all the way until it is administered to the patient. And then potentially take it even a hair further than that—to include the patient outcome. So, I think it starts with the data, with extremely minimal (or even no) human manipulation of the medication throughout the process.

Updated Date: Sep 03, 2019

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