Download Full Text (777 KB)

Publication Date



oregon; portland; psvmc


Pharmacy and Pharmaceutical Sciences



• The number of specialty pharmacy medications has increased and is only projected to grow as more medications are approved for complex, chronic disease states 1,2 • Specialty medications are associated with high costs, high risks, and high complexity requiring extensive time and efforts to make medications safe and affordable for patients. • Much of this health system based specialty pharmacy’s productivity has been measured using a weighted scoring system for new vs. refill prescriptions. • With updated specialty pharmacy accreditation standards, stricter payer requirements, and shifting limited distribution medication complexities, there is a substantial focus on quality, clinical outcomes, patient monitoring, customer service metrics, and reporting that is incorporated into the workflow.


To evaluate the work processes at a large health system based specialty pharmacy • Create a standardized productivity tool that will be used to ensure safe pharmacy practices and justify future full time equivalent (FTE) approvals


Determine time spent on staff tasks based on specific job function and evaluate staff productivity at a large health system based specialty pharmacy to create and implement a standardized productivity tool • Determine a standard daily workload range for staff based on specific pharmacy team roles


• IRB status • Exempt • Study design • Single centered quasi experimental implementation study • Time study for each pharmacy team • Study timeline • Evaluation of pharmacy workflow: October December 2020 • Creation of productivity tool: January March 2021 • Analysis of endpoints: March April 2021 • Inclusion criteria • Specialty pharmacy staffing pharmacists and pharmacy technicians • Exclusion criteria • Specialty pharmacy leadership team, data analysts, pharmacy billing specialist, pharmacy purchaser, and front desk staff


• A specialty pharmacy productivity tool that represents the team specific tasks involved in specialty pharmacy workflow may be more reflective of specialty pharmacy productivity compared to a flat weighted scoring system for new vs. refill prescriptions as specialty pharmacy requirements and complexities expand. Limitations • Due to time constraints and the frequency of each task occurrence, some tasks were only timed and recorded four times. More common tasks were timed and recorded at a higher frequency. Although the average was generated from these recordings to provide a more accurate representation, observing the less common tasks more frequently would provide an even more accurate calculation of task completion time. • The results of this productivity tool were reflective of prescriptions and tasks from the year 2020. Other years may have variable results, notably a year that was not impacted by COVID 19, limiting the external validity of the productivity tool. • This study was conducted at a single centered specialty pharmacy. • The productivity tool does not account for every possible scenario and unforeseen pharmacy issues. This calculator provides a conservative estimation for FTE requirements. It is important to anticipate FTE threshold limits and plan for variability and turnover.


• This study suggests that a weighted tool that merely assesses refill vs. new prescriptions may not capture the plethora of specialty pharmacy activities that are required for a single specialty prescription/patient • A standardized productivity tool, such as the one created from this project, may be utilized to evaluate specialty pharmacy FTE requirements based on specific job function • As specialty pharmacy continues to grow, covering more disease states, providing quality patient services and more enhanced clinical services, FTE productivity calculation tools should be restructured to reflect the true time spent providing safe and effective specialty pharmacy patient care.




Graduate Medical Education

Conference / Event Name

Academic Achievement Day, 2021


Providence St. Vincent Medical Center

Evaluation of specialty pharmacy productivity metrics to create an updated standardized productivity tool