How to Choose a Specialty Pharmacy Program Partner - A Webinar Q&A with Children’s National Hospital

Allison Arant, Senior VP, Client Development & Marketing
April 1, 2023

Clearway Health’s Allison Arant, senior vice president, client development and marketing, recently hosted specialty pharmacy acceleration clients Eric Balmir, M.S., PharmD, CIM, vice president and chief pharmacy officer and Marc DiFazio, MD, MBA, vice president of ambulatory services of Children’s National Hospital for a webinar on “How to Choose a Specialty Pharmacy Program Partner.”

Children’s National Hospital is a pediatric academic health system serving patients in Washington, D.C. and the surrounding metropolitan area including Maryland, Northern Virginia and from across the country. The webinar was held to discuss the success of Children’s National Hospital’s partnership with Clearway Health in building a specialty pharmacy program. The partnership was formed in 2022 to serve patients and families in specialty care areas across the health system. Below is a synopsis of some of the important questions and answers from this webinar.


Question and Answer:

Q: Why did Children's National Hospital decide to take this journey to create a specialty pharmacy program?

A: Eric Balmir: Pharmacy has grown to be so complex over the past decade. A hospital like ours, with over 50 contracted pharmacies to help serve us in a very urban care setting, it becomes quite tricky. Our decision was to move to a single, more focused, one-stop shop pharmacy that could navigate the prescription flow for our patients.


Q: You've talked about the impact, not just on patients, but also on staff wanting to embark on this specialty pharmacy partnership journey. Please tell us a little bit about what that means.

A: Marc DiFazio: As far as this relationship with your organization, it's been fantastic. There has been a lot of work done at Children’s focusing on access to care, facilitating throughput, patient experience and compliance with medications, which are all leading to better health outcomes. All these things are certainly a priority, but we all know, clinical and pharmacy staff are also experiencing a lot of additional stressors given what the last 36 months have entailed. Anything we can do to facilitate the work of the front line staff and help to streamline their work takes some of that burden off them and leads to better engagement and retention. So it's really very critical that any initiative like this be considered.


Q: Why did you chose a specialty pharmacy partner to build a cohesive strategy for the entire health system, and why was it was important to you?

A: Eric Balmir: I think simply, we needed experts. The landscape of specialty pharmacy is changing. The last 36 months has also brought additional staffing challenges. We've lost subject matter experts in areas such as attaining prior authorizations, and it's shifted the work to other members of the clinics. Pharmacy is in the right position to assist healthcare providers in leading the integrated care team across the hospital health system.

I've been on this journey for almost three years, and I think the clue in selecting the right partner is working with a company that can decipher and interpret the data so they can give you the best projections for your hospital, not just financially, but clinically and operationally as well. That balance is so important, and choosing a partner that really cares is really important.


Q: You have been advocates in talking about the importance of an extension of specialty pharmacy partner, not just clinically, but operationally and financially. Can you expand on this?

A: Marc DiFazio: We are focused on being as efficient and revenue responsible as possible. I think the clear evidence of improvements in clinical outcomes, in facilitating the work of the clinician by improving productivity, is essential. If my appointments or medications are slowed down by this work, authorizations are not obtained efficiently enough, it requires our clinician’s hand in that work, and that takes them away from the frontline and patient engagement. I think the demonstration of what was done by Clearway Health in the past at previous centers was very convincing.


Q: Are there other goals that Children’s National is planning in the future with the specialty pharmacy program?

A: Eric Balmir: We started with the five liaisons, but news travels fast. The good work that has been done in the last few months by these five liaisons is just immeasurable. Now we have requests, email after email, asking: when can I get a liaison? I think staff are seeing the benefit all around. And patients are getting through the door and we're keeping them healthy.

A: Marc DiFazio: In this moment, where a lot of us are resource-challenged, to say to a clinician, I'm going to support your work with a pharmacy liaison who has the area of expertise to help make your day more streamlined is absolutely invaluable. It takes the pressure off so you can go care for patients.

As staffing levels are challenged, and as we transition out of the pandemic, the volume of patients goes up, there's a safety risk. The ambulatory care environment is just as prone to serious safety events. A lot of those have to do with medication dosing errors, transcription errors. Clearway Health’s pharmacy staff helps to facilitate a focus on safety.


Q: Can you expand on the partnership implementation with Clearway Health and timing of how quickly we have achieved these results? What do you see as the next steps for this program?

A: Eric Balmir:  We just had our sixth liaison start last week and they're up and running already in a week's time. In order to really put this in full swing, I need about 20 pharmacy liaisons, so I can position them in all the ambulatory clinics across all three jurisdictions. I will be planning that expansion in a systematic way and showing the return on investment to defend adding these liaisons. Opening our own pharmacies is another step. We're planning for one, but in reality, the numbers are showing so favorably, we may be planning for two - one in Maryland, and one in DC or Maryland and Virginia. We have an opportunity to close the loop on our prescription program.

A: Marc DiFazio: Allison, you mentioned, the rapidity of this program. This has been a really short runway for Dr. Balmir to accomplish this along with your guidance and assistance. It’s been amazing. Oftentimes we are promised things, you know, this new solution is coming. This was real. And while we are looking to realize additional financial gains in the future from some of Eric’s work, this is a real benefit today.


Q: What advice would you give to another hospital or health system considering, expanding, strengthening, or even starting their specialty pharmacy?

A: Eric Balmir:  One of the things that has really led to our quick success is how we honed in on the data. We've been on the journey for quite some time, and it took us a lot of time to get the data right. That is one of the key things you should get right from the beginning. We started with five liaisons. Now, we have six, and you heard me earlier, I want 20, right? I think if I knew what I know now, I probably would have went for ten first. If anyone is thinking about partnering with Clearway Health, the ROI is strong, and working that data to get that demonstration is key.

A: Marc DiFazio: Aside from the ROI, from a financial standpoint it’s clear. We've got all the clinical rationale. The things that I would say to the executive leadership would be, map your current state, know where the gaps are, and listen to your clinicians as far as pre-authorizations or work being done, to ensure it is not fulfilling top of license responsibilities. It takes one safety issue or error to frustrate and concern everyone. If it’s related to a medication error that’s preventable, that’s a selling point. This is a real value added program and a real benefit to the entire team.

For a full version of the webinar please visit the Clearway Health website here.