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Pikeville Medical Center (PMC), a 348-bed facility located in southeastern Kentucky, has been dedicated to providing quality care in Kentucky for 97 years. 

Today, PMC employs 3,000 individuals and offers more than 400 services, including every major specialty and most sub-specialties. Technology and innovation, combined with service and vision, are rapidly driving PMC toward its goal of being a national leader in health care.

It’s this objective that prompted PMC to partner with Azina (formerly SPARx, the specialty pharmacy division of Comprehensive Pharmacy Services) to improve drug access for patients, innovate all services, enhance patient care, and increase revenue.

“We wanted to leverage our existing retail pharmacy to build an innovative specialty pharmacy,” explains Kandi Justice, COO, Pikeville Medical Center. “Our goal was to provide specialty medications to patients quickly and efficiently. This would enable us to greatly improve the patient experience, as well as keep revenue in-house, instead of relying on numerous third-party pharmacies.”

She adds, “Our existing retail pharmacy was a small, 500-square-foot space that used an outdated pharmacy management system to process all prescriptions manually.  The pharmacy didn’t have inside access for patients — only a very crowded drive-thru kiosk. We knew we needed to completely overhaul our pharmacy capabilities, and we turned to Azina for help. There was no question that their decades of experience working with hospitals and health systems would be invaluable to us. It became a very strong and collaborative partnership.”


The first step was to conduct a thorough assessment of PMC’s pharmacy operations. “The team examined the medical center’s existing technology, infrastructure, equipment, staffing, workflow, dispensing systems, and customer service frameworks to develop a detailed redesign plan,” explains John Petts, PharmD, Azina vice president. “We had our work cut out for us — especially during a global pandemic. While the pandemic definitely created roadblocks for our team, we were able to navigate these barriers and get started immediately.”

The next phase of the project involved working with a team of architects and engineers to design and oversee the construction of a new 7,100-square-foot pharmacy design to include a 1,200 square-foot retail pharmacy and a specialty pharmacy space.  

The redesign entailed several key pieces, including:

A new workflow structure to increase the speed and efficiency of medication pick-up.

New refrigeration systems.

A stronger, integrated 304B program to increase drug access.

Improved staffing.

The creation of a private consultation area for patients.

Installing software and robotic automation to count and label all drugs.

Adding an inventory management system.

New, updated software.

Once the redesign of the retail pharmacy was underway, the team began work on building a specialty pharmacy. “As the region’s only specialty pharmacy, we wanted to develop a unique and much-needed service for patients who have rare or complex health problems, including cancer, Crohn’s disease, hepatitis C, HIV, multiple sclerosis, osteoporosis, psoriasis, and rheumatoid arthritis,” explains Lina Abdallah, PMC director of outpatient pharmacy. 

In addition to focusing on the administration of medications used to treat these complex and rare health conditions, PMC’s new specialty pharmacy also concentrated on the special handling of these medications, such as refrigeration, as well as support with prior authorization, financial assistance, education, adhering to drug regimens, and side effect management. 

“Our aim was to improve the overall patient experience by connecting chronically ill patients to the care they require. We needed to provide them with specialty medications — including limited distribution drugs from key drug manufacturers — close to where they live and where they receive treatment,” says Abdallah. “Now, they no longer need to wait days, and even weeks, to receive their meds by mail.”

The Azina team also worked hand in hand with PMC to achieve dual accreditation — URAC and ACHC. This dual accreditation is extremely important for PMC’s specialty pharmacy. 

“While achieving these accreditations can typically take up to three years, we were able to receive this high standard of care in just 11 months with Azina’s guidance,” explains Abdallah. “This accreditation is crucial because it establishes PMC as a qualified care provider for all of our patients.” 

Adds Justice, “We could not have reached this high level of accreditation without Azina’s help and support. Their expertise in this area was invaluable to us.”


Since the beginning of PMC’s pharmacy improvement project, the medical center has experienced impressive results, becoming a national model for innovation.

PMC has been able to achieve a time to fill of 2.26 days which is well below the industry average.

Furthermore, PMC’s patient satisfaction rates, which were targeted at 80%, achieved a whopping 96%. Call abandonment rates, which were targeted at 5% or less, came in at 2.2%. And average hospital revenue and gross margin numbers increased significantly.

The partnership between PMC and Azina exemplifies a very successful collaboration — even during a global pandemic. “We set out to improve patient care and increase revenue for the hospital, but we achieved so much more,” explains Justice. “Azina’s expertise, guidance, support, skills, and turnkey solutions have been absolutely critical to our success. We have accomplished so much.”

She adds, “Complex diseases often bring many complications for patients, so our job is making life easier for them. It comes down to being there when patients need us most. And we are now able to do just that.”

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