The Rise of Health System Specialty Pharmacy Remote Call Centers: Out of Office…For Good?

The University of Illinois at Chicago Specialty Pharmacy Services (UI-SPS) is a URAC- and ACHC-accredited health system specialty pharmacy serving patients with complex disease states, such as cancer, inflammatory conditions, neurologic conditions, and hepatitis C. An important aspect of accredited specialty pharmacies is a robust quality program, including tracking and analysis of quality and performance metrics. Employee satisfaction is an important metric to track and analyze within UI-SPS’s quality program and is useful for employee engagement and retention.

The employee satisfaction survey at UI-SPS is completed anonymously via an online survey platform. The survey asks employees to rank their level of agreement, using a 5-point Likert scale, with 11 statements including the clarity of their goals and expectations, open communication, feeling respected and valued, time-management, professional growth, and opportunities to receive and give feedback.

With the onset of the COVID-19 pandemic in 2020, UI-SPS implemented a remote-work model foremployees in accordance with COVID-19 restrictions. UI-SPS consists of 3 branches: the Prior Authorization Center (PAC), the Clinical Care Center (CCC), and the Fulfillment Center.

The PAC and CCC are conducive for remote work, as their operations require no face-to-face patient interaction. These teams transitioned to remote work spring of 2020. An assessment of employee satisfaction with remote-work capabilities was added to the employee satisfaction survey in June 2020, and then included annually thereafter.

The employee satisfaction survey serves as an important and effective method to gauge employee opinion regarding the workplace. Assessment of the survey results is crucial to understanding and improving the work environment, as they can lead to the implementation of processes to improve staff engagement and retention while ensuring a culture of safety and high reliability in providing patient care. At UI-SPS, these results have been used to enhance remote-work opportunities for employees.

The results of the employee satisfaction survey in 2020 and 2021 indicated that a majority of employees preferred remote work as their new work environment. In 2020, 16 employees completed the survey, including 7 pharmacists and 9 technicians.

A total of 16 employees once again completed the survey in 2021, including 6 pharmacists, 7 technicians, and 3 student externs. Overall employee satisfaction with remote work was at an average of 66% between 2020 and 2021.

Satisfaction was determined by the number of employees who responded, “mostly agree” or “completely agree” to the statement “I prefer remote work over working onsite.”

Employees highlighted benefits of remote work, including the flexibility to work from home or onsite if needed, avoidance of long commutes, fewer distractions, and a reduction in the risk of spreading infectious diseases, such as influenza or COVID-19. However, employees stated that the major drawback to remote work was delays in communication with the onsite pharmacy-based team members. For this reason, many suggested having a hybrid model that allows employees to work remotely or on-site.

Remote work has been a growing trend across many different areas of pharmacy. A study conducted in 2021 assessed the extent to which pharmacy school faculty worked remotely during the COVID-19 pandemic. A 28-question online survey was sent to more than 6000 members of the American Association of Colleges of Pharmacy (AACP).¹

The survey found that 97% of respondents were permitted to work remotely during the COVID-19 pandemic, showing the increase in remote work opportunities in the pharmacy field.¹ In addition, 81% of administrators in the study did not notice a change in productivity, while 85% did not notice a change in effectiveness.¹

The results of the study emphasize the viability of remote work, and its growing prevalence around the industry. Furthermore, institutions such as the Seattle Cancer Care Alliance have adopted a similar approach to UI-SPS. Their oral chemotherapy clinic is now fully remote with no centralized space, while their anticoagulation pharmacy works remotely 90% of the time.² The staff comes onsite to see patients who need additional follow-up and close monitoring.² Their model demonstrates that pharmacies have the capability to operate a hybrid model while still effectively serving patient needs.

Employees have consistently shown high levels of satisfaction with the opportunity to work remotely. An analysis conducted of 36 different health care services by The Advisory Board ranked pharmacy 34 out of 36 in employee engagement, highlighting the need to implement workflow processes that are more beneficial to pharmacy employees.³ Satisfied and engaged employees can provide better service to patients, while also creating less employee turnover for the organization.

The results of the employee satisfaction survey at UI-SPS align with the increased prevalence of remote work throughout the pharmacy industry and demonstrates the effectiveness of implementing a hybrid model of onsite and remote work for specialty pharmacy employees. Based on employee suggestions from the survey, a hybrid model allowing employees to work remotely while also coming onsite as needed for patient care would be most beneficial to ensure high levels of employee satisfaction while minimizing the physical space needed for the pharmacy.

Although communication challenges were highlighted in the survey, the implementation of new workflow methods helped to combat these issues. Methods such as using secure chat functions, increasing staff accountability for various duties, and direct phone calls to individual team member extensions helped with establishing standard communication. There is also an ongoing evaluation to the new workflows to ensure clear communication among all team members.

The future of pharmacy continues to evolve, and remote work capabilities appear to be the next step for a more successful future in pharmacy. The implementation of remote-work capabilities in specialty pharmacy settings on a wider-scale could significantly impact the future of specialty pharmacy, allowing employees to complete a wide variety of tasks remotely while limiting the use of physical space in the pharmacy.

Some challenges related to remote work include establishing clear communication among team members and other departments. Robust communication processes and clear standard operating procedures will allow employees to work remotely with clear expectations.

References

1. Prescott WA, Kennedy DR, DeLuca J. Remote work in pharmacy academia andimplications for the new-normal. American Journal of Pharmaceutical Education. https://www.ajpe.org/content/early/2022/02/03/ajpe8950. Published February1, 2022. Accessed October 15, 2022.

2. Shaw G. 3 Centers Show Best Practices In Hematology/Oncology Telepharmacy. Specialtypharmacycontinuum.com. https://www.specialtypharmacycontinuum.com/Pharmacy-TechnologyReport/Article/09-22/3-Centers-Show-Best-Practices-In-Hematology-OncologyTelepharmacy/68432. Published October 20, 2022. Accessed October 21, 2022.

3. Sharon M. Enright RP. Rethinking Pharmacy Employee engagement. Pharmacy Times. https://www.pharmacytimes.com/view/rethinkingpharmacyemployeeengagement. Published June 18, 2015. Accessed September 27, 2022.