This article is sponsored by Enclara Pharmacia. In this Voices interview, Hospice News speaks with Enclara’s SVP of Patient Care Operations, Erin Harris, PharmD, about how Enclara’s contact center supports hospice nurses in delivering exceptional care. She discusses the impact of pharmacist clinical support and customer service, including how Enclara’s quality assurance program is continuing to help hospices work more efficiently.
Hospice News: Share a bit about your background and the path that led you to your current role.
Erin Harris: My journey in this field began with retail pharmacy, but my passion for hospice care led me to Enclara Pharmacia. Witnessing the compassionate, collaborative efforts of hospice teams during my great-grandmother’s end-of-life care inspired me to transition into this field. I joined a predecessor to Enclara Pharmacia more than 20 years ago, and I have since advanced from a clinical pharmacist to leadership roles overseeing various teams and initiatives and helping to build what is today the market leader in hospice pharmacy services. While I have worn many hats over the years, the common thread throughout my career has been a focus on leveraging technology to enhance patient care and streamline processes.
You must have seen a lot of changes over two decades with the same organization. What stands out the most to you?
I oversee Patient Care Operations, which is the nerve center for Enclara. Our contact center encompasses customer service and pharmacist clinical support for a range of products and services including our mail order pharmacy, which ships over a million prescriptions directly to patients each year. Over the years, our business has evolved significantly. Previously, we primarily operated as an inbound call center, but today, we handle a considerable amount of outbound outreach to assist clients efficiently.
While we still spend a lot of time on the phone, clients can now reach us through various channels, allowing us to support them proactively in multiple ways. Our pharmacists, for example, receive prescription orders through our E3 Pro™ mobile and web-based medication management hub. Nurses transmit dispense requests digitally, allowing pharmacists to review them and follow up if needed. So, for example, if we see an order that may be contraindicated due to allergy or drug interactions, we will reach out to discuss that.
While our processes and workflows have changed, our commitment to empowering hospice clinicians to deliver exceptional care has only deepened over time. We strive to infuse all of our digital interactions with the same level of empathy and respect nurses expect when they reach us by phone.
You mentioned that much of your focus is on leveraging technology. Can you share some examples?
Enclara has always been a very innovative organization, particularly when it comes to the technology hospice nurses use to coordinate medication access for their patients. While innovations like E3 Pro, Enclarity™ business intelligence and our electronic medical record integrations have dedicated internal development teams, our contact center generates valuable data and insights that enable the rest of the organization to continuously improve the nurse experience and enable the highest quality patient care. For instance, when it comes to those outgoing calls regarding potential medication interactions with allergies listed in the patient record, we found that the nurse and prescriber were aware of the contraindication but determined the medication was still appropriate for that patient. We presented these statistics to our product team and eventually implemented an allergy interaction evaluation system at the point of entry. This allows nurses to identify potential contraindications immediately and document their decisions for pharmacists, reducing unnecessary follow-up calls and improving workflow efficiency. We recently conducted a survey among nurses to gather feedback on this feature, and the response was overwhelmingly positive. It’s all about empowering hospice clinicians to provide timely, reliable, and appropriate medication access for patients.
It sounds like your department does a lot. What do your day-to-day operations look like?
It is definitely a lot. Our customer service team works extended business hours helping with general inquiries such as order status and basic tech support for E3 Pro and electronic prescribing. Other functions operate 24/7/365 because we know patient care can’t wait. Our inpatient unit team manages automated dispensing systems for facilities in a number of states, remotely dispensing prescribed medications. We have a local pharmacy support line to handle any issues around claims processing. Pharmacists and technicians support our mail order function, offering next-day and second-day shipping. They also apply their specialized knowledge of hospice pharmacology to support hospice nurses to caring for individual patients.
We are committed to enhancing the customer experience with our dedicated training and quality teams. Every call or message creates a case that feeds into our newly developed dashboard. The dashboard categorizes cases by type, subtype, and client, allowing us to identify trends and areas for improvement. One major initiative we tackled last year was implementing single sign-on (SSO). Previously, a significant portion of our case volume consisted of nurses requesting PIN and password resets. By analyzing data and prioritizing SSO implementation, we have significantly reduced these calls and improved efficiency while also improving the nurse experience. Our training team further enhances the nurse experience, providing customer interaction training for associates, modeling skills and behaviors that promote collaboration, listening and empathy to ensure exceptional customer service.
When you say pharmacists are supporting patient care, what does that entail?
Symptom management consultations are a major part of our incoming calls. Nurses frequently seek guidance on pain management, anxiety, and depression. Our pharmacists provide expert advice, considering factors such as kidney and liver function, age, and the patient’s ability to swallow medications. Nurses typically consult prescribers first to understand their preferences before reaching out to pharmacists for dosing adjustments and medication conversions. For example, if a patient can no longer swallow a tablet, pharmacists guide nurses in transitioning to another route of administration, ensuring continued comfort. Another key area of support is formulary alternatives where we assist nurses in identifying cost-effective medications, helping transition patients from high-cost or non-formulary drugs to alternatives that can provide similar or even superior symptom relief. For example, we know many patients are no longer able to breathe in deeply enough to get the full benefit of an inhaler and do better with nebulized medications, which also tend to be less expensive.
Another crucial part of our clinical support is the provision of drug utilization reviews (DURs) required under Medicare Conditions of Participation. Formal DURs are available upon admission and at regular intervals. Pharmacists document essential patient-specific concerns, providing clear and consistent information for nurses and prescribers. Our internal algorithm prioritizes potential drug allergies, drug-disease interactions, and contraindications based on severity, ensuring pharmacists focus on the most critical issues first while still getting a full picture of each patient’s overall pharmacy regimen. Last year, we enhanced the system by incorporating color-coded alerts to improve visibility and streamline the review process. We are always looking for ways to better support our pharmacists and hospice clients.
What makes the clinical support from Enclara stand out in the market?
We believe that our associates are our greatest asset and one of our key differentiators is that all our staff, including pharmacists, are in-house and available 24/7. Unlike some competitors who outsource, our dedicated team ensures continuity of care. Notably, 60 percent of our Patient Care Operations associates have over five years of tenure, demonstrating their deep expertise and commitment to hospice and palliative care.
Our high retention rate is also a testament to the support and professional development opportunities we provide, including a rigorous and ongoing training program. For new hires, it starts with assessments to gauge initial knowledge, followed by disease-state-specific training modules. Throughout their tenure, pharmacists continue learning and refining their skills, particularly in symptom-based medication management. Given the often short length of stay in hospice, we have a limited window to optimize patient comfort, so our goal is always to provide the right medications promptly to ensure the best outcomes. Since hospice and palliative care are not extensively covered in pharmacy school, our training focuses on the unique needs of end-of-life care, including deprescribing, which is a process of stopping drugs that are no longer beneficial or in alignment with the patient’s goals of care. We are currently working on increasing pharmacists’ expertise in palliative care, differentiating it from hospice care, and developing training modules to support this growing need.
Overall, we continue to innovate and refine our processes to better serve our clients, improve patient care, and enhance operational efficiency. By embracing technology, fostering a highly trained team, and prioritizing customer experience, we remain dedicated to our mission of providing exceptional hospice and palliative care support.
Complete this sentence: In 2025, the hospice landscape will be reshaped by…
…the convergence of hospice, community-based palliative care and home care models, particularly in the context of accountable care innovations.
Editor’s note: This article has been edited for length and clarity.
As the nation’s leading pharmacy solutions provider for the hospice and palliative care community, Enclara ensures timely and reliable medication access in any care setting through a comprehensive network of retail and institutional pharmacies, a national patient-direct dispensing program and dedicated inpatient services. To learn more, visit www.enclarapharmacia.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].
