ASHP Foundation Pharmacy Forecast 2021: Strategic Planning Advice for Pharmacy Departments in Hospitals and Health Systems.

Joseph T. DiPiro, PharmD, FCCP, FAAAS, Dean, School of Pharmacy, Virginia Commonwealth University, Richmond, VA Address correspondence to Dr. DiPiro (ude.ucv@oripidtj). An underlying assumption supporting the need for the Pharmacy Forecast is that many factors influencing our profession and pharmacy services are not directly under our control, yet we can take actions that enhance the likelihood of favorable outcomes within this environment. Those influencing factors may be as a specific state or national policy or regulation, or as nebulous as the trend toward globalization (or anti-globalization). Other than the COVID-19 pandemic, the influencing factors such as the prominence of “big data,” issues of personal privacy, financing and health access are not new and have emerged over time. Within that context, then, we have greatest control over the scope of our pharmacy enterprise and the workforce within that enterprise, and some control over those factors where we can advocate to the decision makers (such as health-system administrators, legislators, and government agency officials). The perspective gained from reading the 2021 Pharmacy Forecast is most effectively used within the process of strategic planning as part of environmental scanning or when identifying strengths, weaknesses, opportunities, or threats (SWOT). In addition, the recommendations provided below can be part of the institution’s strategic planning action steps. FORECAST METHODS The methods used to develop the 2021 Pharmacy Forecast were similar to those used in the previous editions, drawing on concepts described in James Surowiecki’s book The Wisdom of Crowds.1 According to Surowiecki, the collective opinions of “wise crowds”—groups of diverse individuals in which each participant’s input is provided independently, drawing from their own locally informed points of view—can be more informative than the opinion of any individual participant. This process is particularly valuable when addressing phenomena that are not well suited to quantitative predictive methods. A critical requirement for successfully creating crowd-based knowledge is establishing a systematic method of combining individual beliefs into a collective opinion—the Pharmacy Forecast uses a survey of carefully selected pharmacy leaders to derive our environmental scan. The 2021 Pharmacy Forecast Advisory Committee (see membership list in the Foreword) began the development of survey questions by contributing lists of issues and concerns they believed will influence health-system pharmacy in the coming 5 years. That list was then expanded and refined through an iterative process, resulting in a final set of 7 themes, each with 6 focused topics on which the survey was built. Each of 42 survey items was written to explore the selected topics and was pilot tested to ensure clarity and face validity. As in the past, Pharmacy Forecast survey respondents—the Forecast Panelists (FPs)—were selected by ASHP staff after nomination by the leaders of the ASHP sections. Nominations were limited to individuals known to have expertise in health-system pharmacy and knowledge of trends and new developments in the field. The size of and representation within the Forecast Panel were intended to capture opinions from a wide range of pharmacy leaders. The Pharmacy Forecast survey instructed FPs to read each of the 42 scenarios represented in survey items and consider the likelihood of those scenarios occurring in the next 5 years. They were asked to base their response on their firsthand knowledge of current conditions in their region, not on their understanding of national circumstances. The panel was carefully balanced across the census regions of the United States to reflect a representative national picture. They were asked to provide a top-of-mind response regarding the likelihood of those conditions being very likely, somewhat likely, somewhat unlikely, or very unlikely to occur. This year we chose to present (in related articles in this issue of AJHP) additional insights on Pharmacy Forecast topics in the light of major societal factors, the U.S. presidential election, the COVID-19 pandemic, and racial equity and social justice within our country. William Zellmer was invited to reflect on the developing political environment after our national election and how it could impact healthcare.2 Suzanne Shea was invited to address the effects of the COVID-19 pandemic on selected topics within the Pharmacy Forecast survey.3 And Bruce Scott was invited to address the intersection of racial equity and healthcare.4