Personalized Pharmacy Care Comes to Southern New Hampshire Health

In this episode of On Call with Southern New Hampshire Health, we sit down with Michael Kleinschmidt, chief operating officer, and John Berard, director of ambulatory pharmacy services, to discuss the new Southern New Hampshire Health retail pharmacy. Together, we explore how a health system-based pharmacy can make care more effective, personal, convenient, and connected for patients.

Learn more about the Southern NH Health Pharmacy

Complete Transcript: 

Host Keith Baldi: Welcome to On Call with Southern New Hampshire Health. I'm your host, Keith Baldi. On Call delivers the latest health care news and updates, along with insights into the latest medical innovations and technologies. Southern New Hampshire Health is a nonprofit system serving the communities in greater Nashua, New Hampshire and northern Massachusetts. The health system includes a 188-bed hospital, one of southern New Hampshire's most comprehensive teams of primary and specialty care providers, and five walk-in Immediate Care locations open seven days a week for urgent needs. 

Southern New Hampshire Health. Expert care close to home. Thanks for joining us for this episode of On Call. Today, we're talking about how healthcare system-based retail pharmacies are making treatment more convenient, more personal, and a whole lot less frustrating. With me to discuss this are Michael Kleinschmidt, chief operating officer here at Southern New Hampshire Health, and John Berard, director of ambulatory pharmacy services at Southern New Hampshire Health. 

Thanks for both being here, guys.  

Mike and John: Thanks for having us.  

Keith: So, Mike, interesting thing, you're the senior vice president and chief operating officer at Southern New Hampshire Health, but you're a pharmacist. Tell me a little bit about how you got into that and your career path.  

Mike: Yeah, that's right. I started my career as a pharmacist and picked pharmacy. It kind of ran in my family. 

My grandfather was a pharmacist, my aunt's a pharmacist, but my dad's in business. And with that kind of wanted an opportunity where I could interact with people, make a difference that was tangible in health care, but also kind of bring in some business aspects to that. So started my career working clinically in an academic medical center, and then from there I had different opportunities to do leadership roles in other parts of things outside of pharmacy. 

Kind of brings me to New Hampshire here today.  

Keith: Oh, that's interesting. John, you've been here for a while. Tell me a little bit about your role in Southern New Hampshire Health, what you do.  

John: Yeah, sure. So, I'm the director of ambulatory pharmacy services here at the health system. And my responsibilities are kind of all things outpatient. We do the retail pharmacy. We have an MTM service, which is medication therapy management service run by pharmacists on referrals from providers. And then, you know, I also still have parts in the inpatient pharmacy to help serve out patients. 

Keith: Interesting. And so it's something that you clearly have liked, the ability to serve patients and, you know, get kind of get to know where they're at in their health journey. 

John: Absolutely. You know, and the patients are why we're here and the reason why we do what we do. So they are our end goal. 

Keith: Absolutely. Throughout our health system, always very impressed with people's dedication to that. So Mike, just to start, you know, there are health systems, more health systems across the country, having retail pharmacies. Why here? You know, why at our health system? And why did you decide to open the pharmacy?  

Mike: Yeah, that's a great question. And when I think about the ways to best serve southern New Hampshire, it's comprehensive care.  

It's connected. It's we're all working together for that betterment of the patient. And the one thing we've been missing is a retail pharmacy. So, as many of our listeners probably know, we have Foundation Medical Partners that work adjacent to the hospital and help with all things Southern New Hampshire Health. We had not a single one of their prescriptions. And so, when I start to think about those volumes, it's over half a million prescriptions a year that we were not providing to our patients. 

So, the end goal of keeping patients in the system, providing connected, comprehensive care was really the behind-the-scenes as to why we wanted to do that, and preventing readmissions, increasing patient satisfaction. All of those pieces tie into a lot of the decisions as to why we decided to open that retail space.  

Keith: That makes sense, John, you know, how is this type of pharmacy going to help patients? I know you obviously just mentioned it. This is what we want to do, right? We always want to have that total care for patients. 

John: Yeah, absolutely. I mean, when you look at it, people come to Southern New Hampshire Health for all sorts of stuff, for their care, for their x-rays, for their lab services, but they haven't been coming here for their pharmacy services. And that opens up such a huge gap in care that, you know, Mike brought up the idea of reaching a pharmacy. 

And I was so excited because for a good part of my life, I was a retail pharmacist. And that's always been, you know, a great thing for me. I loved it. So, you know, when we had the opportunity to do it and, you know, really complete the care for the patient, it was a no-brainer for us. It just made perfect sense. 

Keith: Absolutely. You know, we're touching on patient experience, right? And that's in everything we do. When people come to the medical center, we want to make sure that, you know, we're walking alongside them and making sure they feel comfortable. They're getting expert care. When you go to see your primary care provider, whatever it is, it's all about patient experience. 

But, you know, sometimes the patient experience at these larger retail pharmacies, not calling anyone out in particular, but these, you know, big box stores of retail pharmacy, if you will, they can be a little frustrating. I just had a recent experience with my daughters, and I was trying to get one of their prescriptions refilled. They're adults now, and we sat on the phone for so long it was insane. 

We could not talk to a regular person, and it became kind of a joke because we're like, "How long is this going to take before we can talk to someone?” So, you know, with that in mind, you think to yourself, okay, this is potentially half of the health care experience for someone, right? I mean, you see your doctor or your nurse practitioner, physician's assistant, you get a medication, but then it just kind of goes out there into the ether. 

You know, John, what does having this pharmacy in the system do, you know, for those patients? 

John: Well, it helps our continuum of care for our patients. And more importantly, I think this pharmacy is really going to establish itself as a place where patients can come and get that personalized care, just like when they go to their provider's office or their nurse practitioner's office. And they say, hey, Joe, welcome in today. You know, what can I do for you? 

And I've been recruiting staff, pharmacists, and pharmacy managers for this role. And I've gone back to the people that I know are strong and that can really work to build that confidence and that relationship within those patients. So, it's really about being that kind of mom-and-pop pharmacy that, you know, you think about back when you were a kid. 

I grew up in Lowell and, you know, there was a corner pharmacy. It was called Bailey's Pharmacy. And I remember going in there with my mom and my dad, and the pharmacists would come out front and talk to you, and that doesn't happen anymore. I'm a pharmacist. I go to my local retailer to pick up a prescription, and I'm frustrated. They're not even filling it within the store right now. 

They're filling it in the central pharmacy and sending it in. So, sometimes it's not even there when they say it's going to be there. So I want to change that perception with the retail pharmacy that we started here, and make sure that patients know they can come in and just say, hi. 

Keith: Right. I was going to say, you know, that's a big part of it. They always say, well, do you want to have a consultation? It's almost like a perfunctory checkbox. And it's like, you know, I guess that seems like a big deal, so I'm not going to do it. But this, what you're talking about here, there will be a name you can ask for, so-and-so. 

You can have a discussion and they will say, this is Johnson, whoever, you know, this is what I'm seeing with your prescription. 

John: And, you know, it's not the pharmacists' fault within those big box retail pharmacies. But the volume is so high, and they're so driven by metrics that it's hard for them to break away. I want the focus to be on the patient. The metrics will come afterwards, but it's really focusing on our patients and their needs and building those relationships. 

Keith: And excuse me, what you're saying about volume and that, you know, Mike, obviously being the COO, you're always balancing that, right? Patient care with efficiency. You know, we're a not-for-profit system, so we can't just be throwing money out the window. But those things can go hand in hand, right?  

Mike: Absolutely. I mean, we can't have one without the other. 

You know, I think there are a lot of things here at Southern that lend themselves to being efficient, most importantly, being our culture. You know, if you were to come in to get a prescription filled, you're not going to be number X, you're going to be Keith. We're going to know your name. We're going to know your meds. You're going to know us. 

So, I think having that trust built in allows for efficiency. But from an efficiency perspective, you know, the years of service and retail pharmacy of folks that are going to be working there is over a hundred years inside of this pharmacy. So, we have people who have been there and seen it in a variety of areas. I think that's important. 

They've seen what works. They've also seen what doesn't work. So we're going to take those lessons and apply them. We've worked with a variety of consultants to build out probably the most efficient pharmacy footprint I've ever seen. I've been fortunate enough to open a few pharmacies, but this one is the best use of space I've seen in quite some time, so looking forward to seeing how that plays. 

And I think the best thing about the Southern culture that’s going to breed some efficiencies with this is if something doesn't work, and it's not all going to work on day one, we listen, we tweak, and we'll change. I think that's very important. So it's a process, but I think we got the right crew to do it. Oh, absolutely. 

Keith:  And speaking of, you know, crew, there's the personal aspect of it. But then there's, you know, the technology aspect of it too, right? I mean, we're at a time where medical records can be integrated. But when we talk about big box retailers, if you will, they don't have access to those records. That's just not how things integrate in our system currently, for good or bad. 

But here we will be. If there's a provider within Foundation or within the health system, the medical center, they'll be able to look at those records and integrate them. How important is that? 

John: That's super important. You know, when you think about these big box retailers, they all have their primary software to process prescriptions, but they don't have the key link that links that software back to the electronic medical record at the provider's office or at the health system where they receive their care. Here, we're going to have that link. 

We are going to run the same system with an outpatient product. So, we'll be able to see the last time the patient was in for labs or the last time the patient was hospitalized, God forbid. So, it gives us more insight than they get at their local retail pharmacies in the big box retailers, so that, you know, we're going to be able to elevate the care we're able to provide by having that information. 

Keith: Well, it's interesting too. When you get a prescription, you see on there, if you have a reaction or something, call your doctor or your pharmacist. And, you know, you wonder, do people call their pharmacist for that? But what you're saying is when you have that relationship and when you have that integrated medical record, then you could call your pharmacist. 

They could put a note in there. The doctor would know. I mean, this is, yeah. 

John: And we're even going to make it easier. You don't even have to talk to the person on the other line. You'll be able to send a message through Epic MyChart and that will route its way to the pharmacy. So, if it's not an urgent issue, we'll be able to respond, you know, with a note or whatever. But it takes that extra function of having to make a phone call. 

Keith: Yeah. That's great. You know, Mike, nowadays it seems like everyone expects things to be integrated. You know, it's important we don't see that in the retail world. John talked about it a little bit. So this is, you know, this is really a game-changer here for patients. It just makes it more convenient, but also safer.  

Mike: Absolutely. With Epic there are a lot of different opportunities that our electronic medical record, John alluded to a lot of them. 

But really, having everything in one spot. I don't think people realize that when you go to some of the larger big box chains, they can't see your medical record. There's a certain level of assumption that they can see it. Insurance, you can see. They cannot. And so having all of that collectively together provides a care package that's a lot more specific and detailed for that person. 

So individualized medicine is something that we're able to do with this integration with our medical record.  

Keith: And as you said Epic, and John referred to that as well, we're talking about the electronic medical record system that we have here at Southern New Hampshire and patient-facing, they see it as MyChart. You know, and that's so important now. 

Right. You get the app. People are accustomed to that. It's just part of our life. You open the app, and you see what’s in there. And then you can see when the last time you took a medicine was. And maybe that's the next time you see your doctor, the pharmacist said, oh, you know, I have taken this before because you don't remember. 

Maybe it was three years ago. I mean, that's just the way, you know, but that it's helpful and, you know, Mike you were talking on this, it does cost a lot of money to integrate things, but it's such a part, like I was just saying, it's such a part of our lives. It's super important. 

Mike: Oh, absolutely. We'll spend the money to provide the best care for the patients. And with the way that health care is becoming more and more complex, I feel like every time I turn on the TV, John, you've probably seen them too, the different commercials for different medications. It's just comprehensive everywhere. We're trying to invest to make it easier, simpler for the patient. 

So when the end product for them is easier, it provides more comprehensive care. Because if folks don't understand what they're treating, how they're treating it, they're probably not going to get better. And so, our investments are always geared at making it more accessible and easier for the patient.  

Keith: And that ease too, you know, we have providers not only, I mean, we're going to have the parking spots that people can come here, get their prescriptions. 

But there are doctors and offices right next to the medical center, right next to where the pharmacy will be. So, talk about convenience. Someone can fill it. You can walk a hundred yards, get it, and walk to your car. That doesn't happen.  

Mike: Park one time, you can go see your provider, pick up your meds, and head home all in one stop. 

And if you need to stop for your meds, you hit it right on the head. We're going to have some dedicated parking spots right out front. You can run in, pick up your meds, and head out so you don't have to deal with the headache of parking.  

Keith: Yeah, no. That's great. You know, John, there's this regular patient component to this. 

The employees can get, you know, scripts filled. But I know you've been doing this for a long time within the medical center, too. And there's a component to that. When it comes to a patient being discharged, it's important to be able to hand someone to talk about that. 

John: Absolutely. So, you know, we have patients who experience all kinds of challenges upon discharge. You know, they may not have transportation to get to the local pharmacy or even to get home sometimes. So, we're able to provide a higher level of care and service to be able to dispense prescriptions right from our retail pharmacy, bring them up to the patient's bedside, and say, Mr. Jones, here's your prescriptions. 

Let me talk to you about them. And then he has, or she has, the medications to go home with, because, you know, one of the opportunities in the community is that we discharge a patient who's almost, you know, there. And then, you know, the other component becomes that they've got to take their medications when they get home and they can't or they don't. 

So that causes readmission. Now the poor patient's back in the hospital again. So, you know, it provides that extra level of care so that they feel confident going home. 

Mike: Yeah. What John is describing is what we'll end up calling Meds to Beds. You're going to hear that throughout. And it ties back to the central theme that we've been talking about, the patient experience, making it simpler. Meds to Beds has been proven to increase patient satisfaction kind of across the industry. It's been proven to decrease readmissions. Why? 

Primarily, it's been easier. It's easier for the patient. You don't have to go somewhere else. There's not one more step post-discharge. All of that's taken care of for you before you leave the hospital. So as we're trying to be the easiest, the most connected and the best care for southern New Hampshire, this is just one more way to do it. 

Keith: That's excellent. Right. Well, as we wrap up, I just want to mention the phone number for the new Southern New Hampshire Health retail pharmacy. It is 603-598-MEDS. It's a great one. That is 603-598-6337. The pharmacy is open Monday through Friday from 7 to 7 and from 7 to noon on Saturdays. 

Michael Kleinschmidt, Southern New Hampshire Health chief operating officer, and John Berard, director of ambulatory pharmacy services at Southern New Hampshire Health. Thanks so much for joining us for the discussion.  

Mike and John: Thanks for having us, Keith.  

Keith: Okay. Well, thank you so much. As we wrap up, I just want to mention that Southern New Hampshire Health has a great way to make sure that you can find the best primary care provider available. 

You can call 1-603-880-EASY. That's 1-603-880-3279, and you'll be matched with someone who best fits your needs. You've been listening to On Call with Southern New Hampshire Health. For more information about the health system, or to learn more about some of the topics featured in this podcast, visit us on social media and on our website SNHHelath.org.