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Speaker 1: Welcome to the Becker's pharmacy leadership podcast. I'm Ella Jeffries, pharmacy reporter with Becker's healthcare. Today, I'm joined by Joseph Pinto, vice president of pharmacy operations at Mount Sinai Health System. In this episode, we'll be talking about key pharmacy initiatives from the past year, the priorities and headwinds leaders are navigating as they plan for 2026, and where opportunities for organizational growth are emerging. Joseph, thank you so much for joining me today.

To start us off, can you please introduce yourself and share a bit more about your role at Mount Sinai Pharmacy Organization?

Speaker 2: Sure. Yeah. Thank you, Ella. So, yes, as Ella mentioned, my name is Joe Pinto. I'm the, vice president of pharmacy operations, here at the Mount Sinai Health System in in New York City.

So Mount Sinai is a large academic integrated health system with, eight hospitals, with approximately a 150,000 inpatient discharges and more than 400 outpatient practice locations with approximately 5,700,000 outpatient visits. We do have a growing ambulatory and specialty pharmacy footprint and one of the nation's, most active research enterprises. My my role here is really enterprise focused, responsible for overseeing pharmacy operations, automation, informatics, workforce strategy and medication across the system. And, you know, what's exciting right now is that pharmacy sits at the intersection of clinical care, digital innovation and financial stewardship. And we're increasingly expected, to lead across, all three.

Speaker 1: Definitely. Thank you so much for sharing that context. Now looking back over the past year, what was the most important initiative that you led? What did you focus on, and what results did you see?

Speaker 2: Sure. Yeah. So I'd say one of the most important initiatives, I led this past year was a system wide modernization of, our pharmacy operating model. So that entailed combining supply chain, transformation, automation, and digital workflow, redesign. So that the probably the major part of that was, our wholesaler transition.

So we expand and expanded use of automation such as IV robotics and dispensing technology, and tighter integration with EPIC to reduce manual work and variability. So and, you know, when we when I look at at those initiatives, this past year, the goal wasn't just, you know, in in savings. Right? It was reliability. You know, we focused on improving resiliency, medication availability, and predictability for our frontline teams.

So I I think that's, you know, important that we were able to support our our frontline teams, in making sure that we are anchored in everything I just went through. And the results were measurable. Right? We experienced significant cost savings with our transition. We had improved turnaround times, new operational disruptions, and probably a more scalable pharmacy platform that really positions us for future growth in specialty and advanced therapies.

And I think those were the major initiatives that that we, encountered last year that I was leading.

Speaker 1: Great. Thank you for sharing, and it's great to hear those positive results you guys are seeing already. I'm curious. When you were undergoing that, you know, major transition, what lessons did you take away from that experience?

Speaker 2: I I think I'd invest even earlier in the change management and and data transparency. I think people will adopt faster when they can see the why in real time. Just for example, our our wholesale transition, I think we probably did in in record time. You know, we had an RFP that went out. We made our decision sometime in mid February to to make the change, and we were alive within three months of that of that decision.

A change like that generally will take six to nine months given, the complexity of our system and and the dollar volumes that really, you know, we put through our our wholesaler. So I think, you know, like I like I mentioned earlier, just invest in a little early in that change management process.

Speaker 1: Definitely. That's a great lesson I think other leaders will would like to hear. Now looking ahead, what are the big priorities and headwinds that you're focused on as you plan for 2026?

Speaker 2: It's a good question. And, you know, there's there's always competing priorities. Right? So I think looking ahead in '26, priorities that I'm looking at fall into really three buckets, digital enablement, right, specialty you know, especially pharmacy growth, and readiness for advanced therapies. On the digital side, I said we're I think we're we're focused on leveraging AI and advanced analytics, as I think most health systems are, right, as AI is growing.

And that's to to support our order verification, inventory optimization, and, you know, clinical decision making. And and this opportunity is not replacing clinicians. Right? But removing the low value cognitive work so that they can focus on our patients. That that's the goal of what we're looking to do when when we look to implement technologies and and and AI.

So that that's really the goal of that piece. I think specialty pharmacy and infusion continue to be major growth areas for us, both clinically and financially, and that requires tighter integration between pharmacy, you know, providers, payers, and our revenue cycle team. So, you know, it's a big coordination between the different departments and and disciplines within our health system. And then there's a very common topic, you know, when when you when I speak with, you know, colleagues from around the country and, you know, and then there's this cell and gene therapy. Right?

That's these therapies are transformational in treating patients, but operationally, they're very comp complex. So I I think, you know, we need infrastructure that includes clinical, financial, digital, right, to to safely and sustainably support support these these, you know, these the, these advanced gene therapies. So and then, you know, when I when I think about headwind, that's the pace. Right? So technology and therapeutics are are moving faster than traditional operating models.

Right? So where we think and how pharmacy scales responsibly, that's that's the major headwind for us. Like, the these technologies and therapeutics are are coming at us fast and furious. So I think we need to we need to figure out how we scale that responsibly in the pharmacy department.

Speaker 1: Definitely. Now along with those priorities and headwinds do come some tough decisions. What's the hardest thing that you're gonna have to tackle in the coming year as a pharmacy leader?

Speaker 2: So many. But so I I think as leaders, we have to be disciplined about sequencing. Right? So for for me, it's strengthening our core inpatient operations first, including medication safety, our workforce stability, As I mentioned earlier, digital infrastructure, so, you know, growth elsewhere is sustainable, right, rather than being reactive. I I think we need to build that core first, that that strong foundation.

And then, you know, for inpatient pharmacy in particular, that means, as I mentioned, you know, and that you'll you'll hear me say this probably a few times if you haven't already is using AI and automation as as force, multipliers, reducing the cognitive and operational burden, hardwiring safety, and freeing pharmacists and technicians to focus on, clinical decision making and direct patient care. And all of this, right, is happening in an environment of real financial uncertainty, especially with the pending changes to the three forty b rebate program and the downstream effects of the Inflation Reduction Act. So so those shifts are changing how and when value flows back to the health system. And so it's not just impact in especially pharmacy margin, but also how we fund all their services, technology investments, and and our and our staffing models. So it it it has a very big, you know, big impact, influential impact on how we do do business.

So the challenge becomes balancing financial stewardship, regulatory compliance, and and patient access across the entire continuum. And often this happens, without incomplete information, alright, and evolving rules. So upcoming years is going to be interesting. I think that's why we're we're being very intentional, invested in better data and analytics, aligning inpatient and outpatient strategies, working closely with finance, compliance, nursing, and and medical leadership. And and you know what?

Sometimes that means saying not yet instead of no. Right? So making sure technology adoption, AI enablement, and program and program growth are purposeful, they're aligned, they're resilient, rather than just being driven by urgency or reactive at at that time.

Speaker 1: For sure. And speaking of resiliency, how are you preparing your team for these challenges ahead?

Speaker 2: So, you know, we have to be transparent and consistent. Right? So I mentioned earlier, like, getting ahead of it, and I think, you know, we explained the why. Like, show how ideas fit into a broader road map and reinforce the prioritizations is about sequencing and not shutting things down. So, you know, when when teams see that decisions are thoughtful and aligned to patient care and sustainability, I I think our our engagement stays high.

So I, again, I think that's the the key is being very transparent and being and planning ahead, and not rushing in and being reactive to what's happening around us.

Speaker 1: Yeah. That's great advice. Thank you for sharing. Now even with those challenges, there are still areas for growth. Where do you see the best opportunities for organizational growth moving forward for Mount Sinai?

Speaker 2: So I you know, the the the strongest growth opportunities, I I think, are where pharmacy expands its clinical and strategic influence. So, you know, specialty pharmacy infusion and advanced therapies, as I mentioned earlier, are are probably obvious areas. Right? But growth, to me, anyway, comes from be being better integrated across the continuum of care, from inpatient to ambulatory to home. So digital capabilities, as I mentioned, are a force multiplier.

So when you combine a a a clinic, a strong clinical program with the right technology, pharmacy becomes a driver of access, right, quality and financial performance. So I think, ultimately, growth isn't just about the about volume. Right? It's about building a a strong pharmacy enterprise that I mentioned earlier, right, that's resilient, data driven, and prepared for what's next. And I I think that's where the our growth lies, like, being prepared for what's next.

So it's not always about the volume. I I think it's just building a a strong resilient team.

Speaker 1: Mhmm. Definitely. Well, Joseph, this has been such a great conversation. Thank you so much for sharing your perspectives and insights with us. That's all for today's episode of the Becker's Pharmacy Leadership Podcast.

A big thank you to Joseph Pinto for joining us to discuss pharmacy priorities, challenges, and opportunities at Mount Sinai Health System. Thanks for listening, and we'll see you next time.