- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Regina Schaumberg,
system Director of Pharmacy, retail,
and specialty pharmacy at Atrium Health.
Regina, it's a pleasure to have you on the podcast today.
- Thank you for inviting me.
- Now, I know we have a lot to talk about.
There's so much happening in the healthcare space
and in particular, I'm excited to learn more about
what you do at Atrium.
I, I know one of the, um,
most well-respected health systems in the country,
so that'll be great to hear more from you.
But before we dive into that discussion,
can you tell me a little bit more
about yourself and your background?
- Um, absolutely. I, I am Regina Schaumberg, as you said,
and assistant director for our retail
and specialty pharmacies, um,
at Atrium Health at Wake Forest Baptist,
and some responsibilities in the Charlotte market.
Um, but that's not all I've done in,
in my professional career.
Um, I've been a licensed pharmacist for close
to 32 years now,
and throughout that, back throughout that time,
I've had numerous opportunities, uh,
with the healthcare system
to learn about all aspects of patient care.
So training from University
of North Carolina at Chapel Hill,
and then started working in, in direct, um, hospital
practice soon after that.
So, worked with providers in internal medicine.
I've worked as a specialist with kidney pancreas
and solid organ transplant.
Been a clinical manager for the department, um, as well
as heavily involved in student and residency training.
I was a residency coordinator
for our PGY one pharmacy practice program for close
to 14 years, and then started a PGY one community-based
residency program where I served as the RPD for eight years.
So a lot of investment in learning
and preparing those pharmacists in the future.
Um, over 10 years ago, I made the transition to the retail
and specialty area.
It was beginning to, uh, just take off, um,
especially pharmacy at the time.
We needed a lot of focus with accreditation
and really growing that business that we know has become,
um, even a greater, uh, growth volume
through throughout the years.
So I think my training and background's quite interesting
because I have seen all transitions
of patient care from the acute care space
to starting a transitions of care program in a meds
to beds program, and now looking more in the ambulatory
space and retail specialty pharmacy.
So really seeing the, the patient management
and the patient life cycle full circle.
Um, from a professional standpoint,
been involved in a SHP committees
and work for numerous years,
and in 2010, I also served as the president
of our North Carolina Association of Pharmacists.
So a, a lot of, a lot of different opportunities came
through, um, my ability to say yes
and discern what really drives me in my pharmacy career.
- Fascinating. And it seems like you've got such an amazing
background in pharmacy as well as connecting with patients
and really being able to learn the continuum of care.
So I can imagine that is really helpful.
In your current role, um, in, in, in that vein,
what are some of the top trends you're
following in healthcare right now?
What's really top of mind for you?
- Oh, wow. That, you know, a loaded question.
Um, there's a lot of internal drivers, external drivers, um,
and headwinds and tailwinds that we're having
to, to keep track of.
But if I could narrow that down to a few, uh,
one would be pharmacy workforce or,
or healthcare workforce for that matter.
Um, covid has changed a lot of the ways that we practice,
um, allowed us to leverage different opportunities
and different ways to meet the patients where they are.
Um, but with also, with, with those changes,
we've become competitors, um, with other, um, different
for our, for our same talent pool.
So we are really trying to figure out
what does pharmacy look like now and in the future,
and what does our workforce demand, um, to,
to remain within the profession.
So retaining that great talent that we already have,
and then learning about training opportunities
and pharmacy school enrollment is down
for the first time in decades, so what is
that gonna look like in the next 20 to 30 years?
Um, how are different AI technologies going
to assist pharmacists, not replace pharmacists,
but assist pharmacists in our role?
And then take thinking about the heavy impact
on pharmacy technicians.
The pharmacy technician workforce is a growing workforce,
um, but it also is one
that's being shared across multiple types of care.
Um, so learning about how we can train,
how we can start from perhaps you, the middle school,
the high school area, for folks to start to understand
that pharmacy technicians should be a career
path, not just a job.
And, and we want that great talent so we can continue
to provide you the best care.
So pharmacy workforce is something
that we think about daily.
Um, we can't grow without, without people.
The second would be technology
and really the race for healthcare to keep up
with the private sector, uh,
and along with technology comes data.
And so what does that data look like?
You know, you can, you can look at data,
but what does it mean and how do we discern that data
to make great decisions, um, from how we take care
of our patients to
how well we're performing when we take care of our patients?
So I think in healthcare, we need to be open, um,
to using data open to what technology is out there, um,
and realizing that maybe it doesn't look like we thought it
would with technology,
but just be open to that, to that growth mindset.
And one of the last things I I think about a lot would be in
specialty pharmacy, particular,
the pipeline that's out there.
You know, when I graduated pharmacy school, there weren't
as many medications as there are now.
And really it's keeping up with that pipeline.
With the pipeline comes the treatment strategies
and even the access to the medications.
You know, if we're doing the research on the,
these medications with our patients in our facilities,
then we want to, we want to ensure that we have the ability
to provide those medications from a specialty pharmacy
standpoint and not just joint patient care
by sending those patients elsewhere.
So we need to align closely with their manufacturers.
We need to tell our story better of how we take care
of our patients and
how we can contribute to positive outcomes.
- I love that. I, I think it makes so much sense,
and certainly just fascinating to kind of think through all
of those trends, whether it's looking at the workforce,
having a strong pipeline in place to continue to grow
and develop, and then adding that technology
and integrating it into your current
operational flows and systems.
I, I really appreciate you talking about the growth mindset
because I think so many aspects
of healthcare today really need to, uh, embrace that
and figure out how, um,
to do things differently than they ever have
before to solve big problems.
When you look at your teams
and, um, how you're trying to innovate and grow and develop
and embrace that growth mindset, what does it take to
change the culture, whether a little bit
or a lot in order to really, um,
get yourself into a position that everybody is, um,
thinking in the same way
and really excited about the future?
- Well, I would say that's a loaded question,
but change doesn't happen overnight.
Um, you know, it's, it's, uh, small turns.
Um, it's just developing a sense of community where we have
that open mindset where all ideas are welcome,
where we challenge the, the norm to, to your point, uh,
when you say, you know, healthcare is changing
and we need to be open to those technologies
that may not have been ones
that we would've considered in the past.
Um, but we, we know we're either gonna be limited on, on,
um, teammates, limited on resources,
and we need to design a way to do that.
I think that open mindset starts from the top down.
We have to have leadership that recognizes
that change is inevitable,
and we need to be a positive part of
that change versus driving against that change.
Looking at our frontline staff,
looking at their suggestions.
They're the ones that are, are interacting
with those patients on a day-to-day basis.
We need to recognize that they're the experts in those
fields and we need to support them as leaders
for the technology that they might need,
the additional support they might
need as well as our patients.
We need to listen to our patients.
Um, I think providers have done a good job
for years having patient advocacy groups, um,
inviting patients, um,
or patients, um, caregivers to be part of, of those groups.
And we need to do the same in pharmacy.
We need to listen to our patients, meet them
where they are at providing what they need
because it just might not be what was needed 10 years ago.
- That's such an excellent point,
and, you know, fascinating to think about.
Now, along those lines,
how has your pharmacy program evolved over
the last two to three years?
What's really different today than, um, it ever has been?
- Oh, wow. Um, well, for specialty pharmacy in particular,
that term or concept 10 years ago did not exist.
Um, and to, to, um,
the conversation earlier about my background, you know,
I had been a clinical pharmacist
with a solid organ transplant team where I would interact
with just one or two specialty pharmacies, you know,
15 years ago that would provide those immunosuppressants
and those medications for those newly transplanted patients.
And if you think about how
that has evolved in the past 10 years is over 50%
of the medications that are prescribed now are
deemed specialty medications.
Um, and so there's a lot of opportunity for those patients
for rare disease, um, for oral oncolytics,
you think about medi, uh, treatments for patients that used
to only be in infusion centers or in an acute care bed
or facility have now moved
to the outpatient outpatient setting.
And that is absolutely wonderful if you do not have
to go into a hospital
or into an infusion suite to receive your therapy and, and,
and heal at home and,
and be seen at home even with some
of our hospital at home opportunities.
But really it's the volume growth.
Um, over the past two to three years in our retail
and specialty pharmacies, we're seeing, you know,
double digit growth in volume, not just prescription volume,
that this is an incredibly lucrative revenue stream.
So inter hospital enterprises are looking
to expand those health system specialty pharmacies
because they understand not only do they prevent
fragmentation of care for the patient
that they're seeing all under the same providers, um,
pharmacy, et cetera, within that same locale.
Um, but they're also generating that revenue that gives back
to other patients in the facility that helps sustain, um,
enterprises in a, in a positive financial manner.
That in addition to immunizations, if,
if you think about the covid vaccine response,
there were very limited folks who could give vaccines,
but pharmacists were one of them.
So we were really called to, to service immediately.
We had to be creative with how we were providing vaccines,
how we were getting medications to patients, um,
a little bit unorthodox, a little bit, a little bit,
it felt unusual or might might not be something we were
accustomed to, but those dire times calls for, called
for creative measures and we were able to do that.
Um, you know, and the shifting the patient care into the
ambulatory setting is, is something that's really evolved.
And we, in the specialty and the,
and the retail pharmacy are beginning more so to be involved
with those provider discussions, even as far as looking at
where providers need to be hired,
what specialties do we need to have?
Because if you don't have clinic opportunities for patients
to be seen for six to nine months,
then they can start therapy
and they, they cannot, um,
resolve the issues that they're having.
So again, I think the background, um, I have in acute care
positions me greatly and my team, it provides them
that support and that comfort level
that we can have those conversations with providers as well
as conversations with hospital, um, c-suite type leadership,
um, that what we,
what we say in our knowledge is very important
to the entire spectrum of patient care.
- That's truly fascinating
and definitely I love kind of that story of
how things have evolved so quickly
and then embracing the change and innovation
and, um, really, you know, moving to in a direction that is
so impactful and important to continue
to care for communities.
Now, before we wrap up here, I'm wondering
where do you see some of the best opportunities for growth
and adding value to the system overall?
I know you talked a a little bit about, um, just how,
you know, having that specialty pharmacy focus can really
make a difference and be impactful.
And I would just love to hear from your perspective
where you see all that headed.
- Oh, sure. I, I think it's going to be even more impactful,
um, moving forward in the next three to five years.
Many integrated delivery network opportunities.
I know I've said several times use the term preventing the
fracturing of patient care,
but it really is important to adherence and compliance.
And you, you think about if you have five
or six medications, you're seeing three
to four different providers
and maybe your healthcare insurance is mandating you use two
or three different pharmacies.
I mean, even if you don't have many medications,
that's still difficult to keep up with.
So for some of our patients that have a plethora
of medications with multiple disease states,
that's even more confusing.
So we need to understand that we don't need
to contribute to that confusion.
We need to augment that with ease for patient care, um,
one stop shop, if you will, and make that possible.
I think there's, there's no limit to
what we can do from a health system
to provide the best care to those patients.
It's really telling our story to those outside the,
the walls or the confines of the IDN
or a health, a health system network.
Those are the payers, those are the manufacturers.
Um, I, I think we, we need
to tell our story, we need to tell it better.
We need to tell it more often,
and we need to tell it to anyone who will listen about
what we do it, it's quote, the elevator speech,
the executive summary, what whatever term you wanna use.
Um, pharmacy in itself has not been a great advocate for it
for themselves over the years.
And, and I know just during my time in the career, um,
if there's a, if there's a news story, what do they show?
They show a pharmacist counting pills on it
or tablets on a tray.
Um, but that's not what pharmacy is anymore.
And we're responsible for marketing who we are
and what we can do, um, to the, those payers,
those manufacturers, to those executives
as well as to the patients.
Um, patients know that pharmacy is a reliable profession.
They, they ask us many, many different questions.
We can provide more time with them than
unfortunately their providers can.
Um, so we just need to continue to advocate through those,
those different types of forums about what we can do.
And I think we've done a good job.
I mentioned immunizations previously.
There's, um, there's support in different states.
There's, um, certified pharmacy practitioners that can serve
as mid-level practitioners.
There's the ability for pharmacists to prescribe.
Um, there's ability for pharmacists
to administer long-acting injectables.
So we're getting out there.
Um, but we're having to do a little bit slowly
and we're facing some political pushback,
but I think just we continue to, to push forward.
We can do, do some amazing things for the system overall.
- That's fascinating to hear.
Regina, thank you so much
for joining us on the podcast today.
This has been a really fun and interesting conversation
and I look forward to connecting with you again soon.
- You're very welcome. Thank you so much.