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Future and Pharma: Standardization and Automation
Episode

Jonathan Ogurchak, CEO and co-founder of STACK

Future and Pharma: Standardization and Automation

Technology should lend itself to the specialized nature of what healthcare needs today.

 

In this episode, Rich Prest interviews Jonathan Ogurchak, CEO and co-founder of STACK, a  startup focused on the challenges of running pharmacies. Licensed pharmacists manage their pharmacies their way, but what if they could get all the data organized? Jonathan offers STACK, a platform that manages information and automates tasks to improve pharmacy operations. He discusses the need for actionable interoperability tools to address the disconnect between where patients receive a diagnosis and the management points like pharmacies, keeping those patients on treatment. Jonathan talks about his passion and involvement in the academic community and explains why he believes the educational aspect of the pharmacy industry is woefully underserved.

 

Tune in to learn how STACK targets the challenges of running pharmacies!

Future and Pharma: Standardization and Automation

About Jonathan Ogurchak:

Jonathan Ogurchak is the Co-Founder & CEO of STACK, a pharmacy information management platform designed to simplify the “outside of the dispense” complexities associated with running successful pharmacy organizations. He is also a Managing Partner of Rhythm Group, consulting and technology solutions organization, and is a Certified Consultant with Accreditation Commission for Health Care (ACHC).

Jonathan has designed programs and services for both Accredo and PANTHERx Specialty Pharmacy focusing on implementing innovative uses for technology, including high-touch pharmacist-driven programs focused on dosing efficiency, clinical monitoring of patient outcomes, and integrated patient engagement.

Jonathan is on faculty for the Master of Pharmacy Business Administration (MPBA) program through the University of Pittsburgh, leading the Specialty Pharmacy Management curriculum. He currently serves on the editorial board for Specialty Pharmacy Times, holds CSP Certification through the Specialty Pharmacy Certification Board, and serves as an Educational Consultant for the National Association of Specialty Pharmacy (NASP). He also serves as President of both the Duquesne University Alumni Board of Governors and as President-Elect of the Duquesne University Pharmacy Alumni Association.

 

OR_Sempre Health_Jonathan Ogurchak: Audio automatically transcribed by Sonix

OR_Sempre Health_Jonathan Ogurchak: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Rich Prest:
Hello everyone, and welcome to Sempre Health Outcomes Rocket podcast, where we talk with healthcare leaders and the state of the industry, patient engagement, and technology innovation. I’m your host, Rich Prest, and today, we’re fortunate to be speaking to Jonathan Ogurchak, who is the CEO and co-founder of STACK, which is a really interesting startup focused on the challenges of running pharmacies that Jonathan had observed earlier in his career. So Jonathan, welcome to the podcast today.

Jonathan Ogurchak:
Hey, thanks so much for having me, Rich.

Rich Prest:
It’s great to have a chance to chat again. So yeah, it just might be to help our listeners know you better. Maybe you could share if you had a dream career when you’re growing up and a short summary of the path that led you to where you are today.

Jonathan Ogurchak:
Yeah, sure, so, you know, strangely enough, I never thought that I was going to be in pharmacy, let alone a pharmacist. In high school, always thought that I was going to be an architect. And we went through that whole process of, went to shadow, and I’m going to learn and what to do, and it wasn’t until the night before my capstone project was due for senior year of high school that I shadowed an architect and as they were designing a bathroom for a church and they said, this is what I do now, I don’t get to design buildings, I design church bathrooms. He’s like, don’t go into this, this is the line of work. And I said, oh, crap, maybe I shouldn’t do this. And so I ran the register for a family friend who owned a pharmacy. And I just so happened to be working that night and I’m like, can I shadow you? Because I don’t want to work on a project that I don’t see a future in. And one thing led to another, went to pharmacy school, graduated, and here I am today actually practicing pharmacy to a certain degree.

Rich Prest:
Oh, it’s awesome. Yeah, I can affirm that, having been an architect earlier in my life, that, yes, there is, stairways and bathrooms are definitely a key part of an early architectural career, so I definitely dodged that bullet. Well, very cool. And so tell us a little bit about STACK and what sort of was your original vision for the company, and how that’s evolved since starting it? Because you’re … four years in, right?

Jonathan Ogurchak:
And yeah, exactly, because, you know, I used to own a specialty pharmacy. That’s where you and I were introduced in the first place. And one of the things that I realized, having worked at several specialty pharmacies, is that technology doesn’t really lend itself to the specialized nature of what healthcare needs today, and so we saw this as an opportunity. Let’s find a way that we can build a small use case. Let’s see how we can implement it and then see how we can look to grow it from there. And that’s really what STACK was, it was kind of a sandbox for us to see how can we take and apply technology to an area that’s very untechnological, like running a pharmacy or running a trade association, and see if we can gain some improvements. And so we built STACK as a, we call it, a professional information management platform. It’s a way for us to curate content based on what we know about running businesses in the industry and sell that to clients so that way they can come and download a framework from us and allow it to automate and run their businesses. And it’s, a way that we felt was very meaningful and purposeful, as a pharmacist, I get licensed every other year in Pennsylvania, the exact same way as every other pharmacist. But if you walk into any pharmacy with a licensed pharmacist, they all track and manage and maintain those things their own way. So we said, why don’t we just make it easier and let’s put some technology in place to do that? And so far, whatever this desk is made out of fake wood or whatever, it’s been going well, it’s been received really well, and we’ve taken some of those technology pieces that we’ve built, and we’ve now moved that into more of a digital patient facing sort of approach. Let’s see what we can do to actually take technology and apply it to that patient experience. And even if we apply it to the caregiver experience upstream, whether that’s spouse, loved one, whether that is provider, whether that’s prescriber, if we can find ways to make it easier for everybody, then the patient wins at the end of the day, and that’s ultimately where you would expect healthcare to be in 2022.

Rich Prest:
Yeah, that’s for sure. It’s, I think that was, one of the things I always found very intriguing about what you were doing was that you, I think so often with automation, people will look at the tasks that take most of the time in a day and almost look to just automate that task. And I think what’s really intriguing about, it’s like you step back from the trees to see the whole forest and said, okay, there’s some activities that kind of overlay that happen periodically that no one’s really paying any attention to, and these need to be solved and addressed and could be done in a better way. so I was…

Jonathan Ogurchak:
Yeah, I mean, it’s not the most glamorous of stuff that people are dealing with, but it’s mission-critical to run a pharmacy. You know, if you’re not licensed, if you’re not accredited, if you’re not contracted appropriately and compliant, it all goes out the window. You can’t take care of patients if there’s no patients coming to your front door. So we found ways that if we can solve that problem and do it in an effective way, then people can trust the work that we do, and so far it’s been going well.

Rich Prest:
That’s awesome. So looking forward, if there was one thing you could be remembered for, what would you want that to be?

Jonathan Ogurchak:
You know, it’s a very timely question, Richard. So I was reflecting on that this past weekend. So my dad actually passed away about five years ago from ALS. So it was one of those things where he was a young guy, relatively healthy aside from that, but eventually passed away from the fatal disease. And he was honored this past weekend because he was inducted into his high school’s Hall of Fame, and he had worked there his whole career as well. And so it was something where, as I’m driving back from that event, where it was just awesome to see him being remembered in such a way that it got me to thinking like, what is it that someday, not to be thinking of death, bit morbid in that regard, but you know, it’s one of those things where, you know, at the end of the day, it’s really what you stand for and what your integrity is throughout the course of your career that stands up. So it’s kind of that moment for me, like if somebody were to be eulogizing me, what would they, what I want to be remembered for? And I truly think that it is looking at the care of patients and finding a better way to do that. I want people to take a step back and say, you know what? He was able to crack one of those nuts that was always out there and trying to fix this puzzle of the patient experience or the provider experience or something to that effect, because right now it’s tough. It’s tough in any walk of a patient or a caregiver experience to see that you’re doing something in a meaningful sort of way. So if I’m, at all successful and I’m looking back on it in my career someday, I’d love to be remembered for the fact that, hey, he was able to figure out how to drive outcomes longitudinally across care. He was able to make one patient’s life better, you know, something like that where I could show that there’s a little bit more of a meaning than just making a couple of bucks and building a company that turned itself over or something like that.

Rich Prest:
I like it. No, that’s great. I mean, it’s certainly a pretty complex industry we operate in. What’s something that you think most people don’t understand about healthcare in the US?

Jonathan Ogurchak:
I think people underestimate the number of hands that are in the pot when it comes to taking care of you as an individual patient. I mean, you don’t necessarily think about it. And a lot of times when you think of healthcare, you see these little anecdotes, these little clips, these little soundbites in the media about certain elements of things. And I always find it very interesting when people like, oh, well, if we lower the cost of medications, it’s going to solve the healthcare crisis. Well, no, it’s just going to shift that focus somewhere else because the entire system is so interconnected. And I think that’s where people tend to lose sight of that. The interconnectivity of what a patient brings to the table is oftentimes lost on the general public. Like you see it as I need my script for Amoxicillin, I need this one particular need and get an authorization approved so I can get an MRI. Like you don’t see the big tangled web of mess that healthcare truly is. And the more that you start to unwind it and unravel it, it’s incredible in how complex it truly is in our market.

Rich Prest:
Yeah, I think that’s so true. If you had a magic wand and you could change some aspect, what do you think you’d want to be able to shift overnight? Yeah.

Jonathan Ogurchak:
I think the overnight shift for me would be finding a way to drive value between inpatient and outpatient care. And when I say inpatient, I’m talking about point of diagnosis, even in a clinician’s office. But take a step back and think about it. If you were diagnosed with that, and I’ll use myself as an example. So I’m now technically I’m a specialty patient. I’ve had high cholesterol my whole life, and I was on a statin, nobody was checking me to make sure that my levels were what I needed, if I was non-compliant, I was non-compliant. But, you know, if I had a cardiac event and I ended up in the hospital, nobody’s checking to make sure that that statin that I’m taking on the outpatient side is actually helping to keep me back out of the hospital. There’s a huge disconnect between the outpatient pharmacy-focused care model and what happens at point of diagnosis and point of ongoing maintenance. If there was a way to create that common thread between the two, that solves your value-based care. And so right there, that solves how real-world evidence and outcomes are actually trackable, because there’s no way right now if patients started on a med for their blood pressure and they show up in the hospital with a cardiac event, there’s not a tie between the two. And to me, if I had that magic wand, it would be time-solving that piece of things to tie it all together, to look at you as a patient, not as an outpatient versus an inpatient, and then …

Rich Prest:
And do you think that’s a data type issue? Like if we had that famous patient record that we carried around with us for all of the care that we had received over our lives that, and all the tests we’ve done, etc., that there may be that that would help bridge that gap?

Jonathan Ogurchak:
I think that’s a huge step in the right direction. It’s one of those areas that you tend to forget about. You know, I did a program ….. In code, I did a program at Harvard Business School a couple of years ago, related to value-based care. And they’re talking about all of these great cases where we’re going to prove value in healthcare and we’re going to prove value and showing efficiencies and outcomes in all of these things. But everything was related to the inpatient side, it was, oh, well, if you had a knee replacement, did you come back in because you were hospitalized due to a complication from the surgery? Not, we stayed out of the hospital because we had an anti-coagulant that allowed us to keep that joint and not go back into the hospital. And I was the only pharmacist in the group, I’m like, wait a second, hey, what about us over here? Because we do a lot on the outpatient side to make this work. And it was like that question like, oh, we never really thought about that. Like, it’s not the surgeon’s responsibility after they put that new joint in to keep track of you at home, there’s not that connectivity there. So I think you’re right, I think finding a way to create that universal patient identifier or one of those like synergistic, I’m looking at me as me, you know, actually the last week, some of the effects of the 21st Century Cures Act went into effect is, it’s allowing patient data ownership to roll back to the patient. I think that’s going to be huge. I think that’s going to be one of those ways to help solve those things. It’s just taken us way too long to get there.

Rich Prest:
Yeah, yeah. But it does seem that some of this transparency is starting to gradually chip away and give, shine a light in many places where there was no clarity at all about what was going on and what the prices were. So I think it’s good, but it’s going to take time.

Jonathan Ogurchak:
I agree.

Rich Prest:
Are there any other key, sort of, trends or developments that you’re seeing that you think are going to have a significant impact in the next few years?

Jonathan Ogurchak:
I think, it’s been a hot-button word for a number of years, but things like interoperability, especially when it comes to digital patient care and engagement, we’re finally at a point now where there’s some teeth behind it. And when you’re looking at some of the ONC initiatives to actually push data interoperability, not just at the individual patient level like we just mentioned, but more broadly speaking, now that there’s standards out there, things like Smart on Fire and things where before it was largely up to the individual vendor to say, I’m going to create my data standard and whether it plays nice in the sandbox or not, we’re going with it. Now that there’s some parity for those things, I think that’s going to be a huge opportunity and it seems like that’s the trend that we’re moving towards. You have a lot of individual providers that may have had a partial solution to something that it didn’t fit into the whole big puzzle of healthcare, but you needed to have a 1-to-1 relationship. I was going to call Rich and say, hey, Rich, I need to integrate with you. Now, if we’re all playing by the same set of rules and using the same language, I think that’s really going to open up the door for some of these next-generation changes for things. If I could put a smart device in a patient’s home and it doesn’t matter who their EMR provider is at the doctor’s office or what pharmacy they went to, and it’s now talking that same language, yeah, I’ll put a smart blood pressure cuff in that patient’s home and now it’s going to track that patient’s blood pressure now that they started an antihypertensive and prevent that cardiac event from happening. I think it’s finally, kind of like you said, starting to put those pieces together. I think the concept of interoperability has matured enough to a point where it’s going to be actionable interoperability.

Rich Prest:
And then it will look like an overnight success story, even though it’s been.

Jonathan Ogurchak:
Hey, look at you know, you and I are recording this on Zoom right now. Think back to when we used to do these calls like, oh, it was so cool and oh, we’re doing a video conference and everybody got sick of it, and they got the Zoom fatigue or whatever. It became that overnight standard of care, and I’m hopeful that that happens to a certain degree with some of these healthcare-related elements.

Rich Prest:
No, it would be super cool, yeah, so it’s awesome. It’d be really interesting to hear about, as a founder, now, you’ve obviously seen some of the challenges of introducing and scaling innovations. I’m curious if you can share sort of any lessons that you’ve learned through that.

Jonathan Ogurchak:
Don’t start a company going into a global pandemic. I joke, but we launched our first product STACK in September of 2019 and we had the tiger by the tail, we were going for it, and then all of a sudden, not so much. So again, not that you could predict the future, would not go through that again. I think the lesson that I’ve learned that’s been the most telling for me as not only an entrepreneur but as an individual, like just personally, is finding a way to meet the consumer where they are, and finding a way, you know, I could think that there’s a really good solution and I could think that what we’ve built has been the best possible solution, but not everybody is a Steve Jobs in the sense that, people didn’t know they wanted all of their devices in one place until he gave it to them. There’s a lot of resistance to change in the marketplace, and we saw that very early on with our STACK product. There was, looking at the specialty industry, there’s about 500 newly accredited specialty pharmacies when we launched our product. And I’m thinking, here we are, White Knight, we’re going to help you out, make this easier. Well, clearly they had a process in place to become accredited, and it’s not like we were going to totally upend their existence just because we’re not here as a solution. So it’s finding a way to be humble enough to recognize that there’s a process in place, but also know that you have to maybe change the approach to bringing a blue ocean type of concept into the market, because a lot of people aren’t used to that.

Rich Prest:
Yeah, the status quo is pretty formidable competition and it could take quite a bit to get people to shift to a new way of doing something,

Jonathan Ogurchak:
That’s for sure, and it was always telling to me because I would do a demo for an organization of this product. And of course, I’m all in, I’m ready to go, everybody loves it, but then you had one person in that organization that looked at it and said, oh, man, a computer is going to take my job like one of those bad sci-fi movies from the seventies and the eighties. Like, that’s not the intent. The intent here is to help to empower you to be effective. And it was like learning through that process, like, how do we change? How do we make sure that the messaging is such that people can see it as a benefit as opposed to, I’m going to be getting a pink slip because the computer is stepping in to do my work for me.

Rich Prest:
Yeah, exactly. That’s definitely something to be aware of when you try to introduce these new innovations, very cool. So I’m also amazed to you, you’re quite involved in the academic community as well, and I’m wondering if you can share any tips on how you’ve managed to find the time to balance this, running a startup and also being engaged on the academic side.

Jonathan Ogurchak:
You know, that’s a great question. And honestly, right outside of pharmacy school, I was still not sure how I wanted to practice, and heck, I was going to be an architect. And like we said, I know career aspirations to dive into any one area of pharmacy. And so I ended up finding myself in the position I was in a teaching fellowship outside of school, and it was great. I learned a ton of from the experience, but I didn’t actually complete the fellowship. And part of the reason why was because I had what they now today call that … Concept of imposter syndrome. I felt like people could see right through my big white lab coat because they knew that I just graduated, they knew that I didn’t have that firsthand experience, but I really liked the teaching aspect. Maybe it my dad being a teacher rubbed off on me, but so I left. I quit the fellowship and I went to start to work in specialty, and I found my way back into it because I saw that from an educational perspective, this aspect of the industry was so woefully underserved. There wasn’t enough knowledge of what it was or how it was to get enough people to buy into it, to what that was. So certainly, getting involved in the classroom setting, you know, how many students graduate from pharmacy school every year and they’ve never heard of specialty pharmacy as a career.

Rich Prest:
Right.

Jonathan Ogurchak:
It’s incredible, you didn’t really think about that. So later on, and so it was one of those things that it kind of those lightbulb moments for me to say that if you can educate people and you do it in an appropriate way and in an agnostic sort of way, so that way people can understand what they need to know, helps people to make better decisions later on. And so I’ve kind of taken that approach in teaching in master’s programs and doctoral programs and helping to consult and teach and all of these areas where that’s a common thread across any part of a healthcare industry is knowledge. And if there’s a way that we can help to elevate everybody’s knowledge about a particular topic, whether it’s clinical, non-clinical, operations versus not, then everybody can get a little bit better as a result. And so I still dabble, I still help to do educational things from here and there, but to me, it’s important to have that as a backbone. And actually, we have just recently launched STACK into the educational sector as well, just because we said, hey, it’s a way that you can help create standardization for a largely unstandardized approach. And if we can be a catalyst to help change that, then why not?

Rich Prest:
Well, that’s really cool. Well, I guess you’re seeing a lot of young folks sort of making their start in industry through these academic connections. Do you have any career recommendations for people getting going in the industry?

Jonathan Ogurchak:
The biggest recommendation that I always like to leave my students with, whether coming with me on a clinical rotation or if they’re just awesome teaching is your career doesn’t define where you are at that point in your life. The job that you have doesn’t always do that. A lot of times, especially nowadays with the market in such fluctuation for pharmacists, you can get a job as a pharmacist. It may not be that dream job that you thought you were going to get, but you’re going to sit back and retire in 20 or 30 years and not say, that’s the only job that I had coming out of college. It’s going to be, looking at it from a sum, you’re going to say, hey, I took this position and it got me to here and it got me to there, and you’ll be sitting on a beach drinking a mimosa day saying my career was a sum of all of these things. And I try to instill that in a lot of my students to say, yeah, this might not be where you want to be. You might not want to have to do this, you might want to have to take this, but look at it, you have to take something from that experience. Let’s find a way to take the positive from that that you can grow from, so that way it gets you to that next point in your career.

Rich Prest:
Yeah, I like that a lot, it’s good. Favorite books or podcasts?

Jonathan Ogurchak:
Well, obviously this podcast is one of my favorites. You know, right now, I actually, I just started reading a book. I have it right here. It’s called From Me to We by Riccardo Ernst, is through Georgetown University Press. And it’s really, really interesting because it’s talking about creating shared value within an organization and funny ways that you can take an idea that you have, and looking to grow that for the value of an organization as a whole. And so to me, that’s like a pretty meaningful approach to driving culture within an organization. If you can say, hey, this is my idea. I have foresight enough to quit my job and start a tech company, even though I had no business doing that. Like, let’s find a way that I can get you on board to believe in that as well. And it’s been really, really meaningful and impactful from that perspective.

Rich Prest:
Well, that’s great. I will have to check that.

Jonathan Ogurchak:
Yeah, yeah, I say prior to that, another good read, I try to look a little bit of everything, I just finished, of all things, Jim Henson’s biography, Jim Henson from Muppets. And it was phenomenal for me because as an innovator, people think, oh, he just made a bunch of puppets, but he was very, very insightful. Another person gone too soon because he passed very early in his lifetime, but some of the insights that he had related to building that culture within an organization and implementing that, actually implementing that were phenomenal. So it was a really, really interesting read for me, not just because you ….. Watching the Muppets and things like that as a kid, but it was just looking at the insight of a person and how they were able to take something that wasn’t an industry.

Rich Prest:
Right.

Jonathan Ogurchak:
And turn it into the phenomena that was.

Rich Prest:
Another great example of finding ways to bring innovation to an industry, so yeah, absolutely. I can see, I could see that. Cool, where can listeners find you and connect with you online if they’d like to do that? Yeah.

Jonathan Ogurchak:
Yeah, absolutely, so one of two places, you could look at our website ManageWithStack.com, that’s where you can learn more about the business, link to contact me directly, either via email or LinkedIn is there. The other thing is always LinkedIn. Yeah, I’m a huge proponent of leveraging that technology not only to create those interpersonal connections, but to see where those activities can exist that you didn’t even think about in the past. So just search for me, Jonathan Ogurchak, you’ll find me. And there aren’t too many Ogurchaks out there, so it’s not, if you could spell it, you can find me.

Rich Prest:
Yeah, that’s great. Well, Jonathan, thanks so much for the time, and always a pleasure to catch up.

Jonathan Ogurchak:
Likewise, appreciate it, Rich.

Rich Prest:
Yeah, no, really great. And to our audience, thank you so much for tuning in. I hope you enjoyed this episode as much as I did. And if you did, please don’t forget to review the Sempre Health podcast on your favorite streaming service. It really helps others to find and enjoy the show. So goodbye and we’ll catch you on the next one.

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Things You’ll Learn:

  • You need a license to run a pharmacy. Accredited, appropriately contracted, and compliant.
  • Lowering the cost of medications will not solve the healthcare crisis, as the system is interconnected, and another issue would come up as a consequence somewhere else.
  • All pharmacies have an established process for their operations, so working with them requires recognizing that.
  • Many students graduate from pharmacy school without hearing of specialty pharmacy as a career.
  • Your career doesn’t define where you are at any point in your life.

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