4:1 ROI + Budget Neutral at Riverside
How Riverside used InpharmD to accelerate drug information, P&T support and shortage management while remaining budget neutral.
4:1 ROIguaranteed, with budget neutral funding
82%same-day drug information responses 17new drug monographs completed 11-dayfaster median shortage plan turnaround Introduction
Riverside Health System's pharmacy team began piloting InpharmD in December 2022 to speed up drug information, strengthen P&T support and manage shortages more efficiently. By spring the service had spread from three clinical leads to specialists and operations leads across IV, ambulatory care and specialty pharmacy, and Riverside built a case to keep it without growing the budget.
The Challenge
Literature search, review and analysis is the backbone of evidence-based practice, and it's slow. A single drug information question takes about 4 hours; a monograph or drug class review takes 20 to 40 hours. As demand for pharmacists at the bedside grew, that time kept shrinking. The team needed a scalable way to:
- Answer a growing volume of drug information questions (DIQs)
- Support P&T with monographs, class reviews and therapeutic interchanges
- Get primary literature beyond manual library requests
- Identify and plan for drug shortages faster
Dedicated drug information staff aren't viable for most community systems, and GPO services mostly push generic content instead of answering the organization's own questions.
The Solution
Riverside implemented InpharmD, an AI-assisted clinical support service backed by expert pharmacists, for on-demand drug information, formulary support, compounding and operational questions, shortage support, payer coverage and team CE.
Riverside's formulary was loaded into InpharmD so shortages could be flagged proactively, matched against FDA reports and shortages reported across the InpharmD network, with alternative plans tailored to Riverside's active shortages.
Results
The pilot saved 1,464 pharmacist hours, about 1.2 FTE, and changed how quickly the team could act on formulary and shortage work.
82%DIQs answered same day
97%Answered within 1 day, incl. nights and weekends
29Compounding recipes completed
+41%Projected formulary additions in 2023
P&T Activity Before and After
P&T Formulary Changes by Year
Shortage Turnaround: Identified to Plan Developed
Median turnaround fell from 14 days to 3; shortages exceeding the 8-day target fell from 57% to 23%.Detailed Impact
| Metric | Outcome |
|---|
| Return on investment | 4:1 guaranteed, with roughly half the cost recovered from existing budget lines |
| Drug information questions | 82% same day, 97% within one day; 644 hours saved (0.53 FTE) |
| Monographs and P&T | 17 monographs, 3 class reviews, 2 therapeutic interchanges; 820 hours saved (0.68 FTE) |
| Shortage management | 11-day median reduction in plan turnaround; 34% fewer shortages taking more than 8 days |
| Special projects | IVIG class review, perioperative anticoagulation gap analysis, promethazine removal, chemo beyond-use dating |
Key Takeaways
- Guaranteed 4:1 ROI while remaining budget neutral
- Same-day answers for 82% of drug information questions
- Faster monograph, class review and interchange delivery
- Shortage plans in a median of 3 days instead of 14
- About 1.2 FTE of pharmacist time freed for strategic work
What's Next
Riverside expects 50–75% more monograph and class review demand from its streamlined P&T structure and growth in specialty drugs and biosimilars. Next up: ACPE CE for all pharmacists and technicians, MUE support, optimizing the Virginia payer coverage library, and a shortage prediction model.
About Riverside Health System
Riverside Health System's pharmacy enterprise spans acute care, ambulatory care, IV, specialty pharmacy and a system P&T committee. The InpharmD business case was submitted by Katherine Koehl, PharmD, BCPS, BCNSP and Tyler Sledge, PharmD, BCPS.