Hospitals incorporate health system specialty pharmacies (HSSPs) to drive efficient, collaborative care and improve health outcomes for patients with complex, resource-intensive conditions. Specialty pharmacy teams, made up of clinical pharmacists, pharmacy technicians, and ancillary staff, provide vertically integrated, comprehensive, and coordinated care. Benefits of HSSPs to patients and health systems include improved utilization of medications (ie, access, initiation, and adherence) and enhanced health care services. Strategies for expanding the footprint of specialty services have not been well described. The purpose of this report is to share a model of HSSP clinical services and a framework for service expansion that ensures sustainable and equitable care across the health system. UC Davis Health established an internal HSSP to deliver comprehensive clinical services to 12 specialty therapeutic areas. Further service expansion was vital to ensure comprehensive and equitable services were provided to all patients. Service location was identified as a primary source of the disparities in care between hospital- and community-based clinics. Remedying these disparities required recognition of service gaps and barriers, strategic planning, stakeholder engagement, and workflow modification. Standardized therapy-specific outcomes (TSOs) were developed in collaboration with pharmacists and physician champions. Legal counsel and 340B Health resources guided compliance with regulatory standards. Information technology facilitated the implementation of the new operational workflow. Outcomes of the initiative included referral and enrollment rates, time to treatment, patient cost savings, medication adherence, and provider satisfaction. This report describes a model for expansion of an HSSP framework that supports growth of comprehensive and equitable pharmacy services, meaningful metrics and tracking, and patient outcomes. Beneficial outcomes included time to treatment, patient cost savings, medication adherence, TSO tracking, and provider satisfaction.
Shi et al. (Sat,) studied this question.