WEST MILWAUKEE, Wis. — Dean Gruber of altScripts Specialty Pharmacy in West Milwaukee, Wis., and Owl Specialty Pharmacy in Covina, Calif. — a member of the CARE Pharmacies Cooperative board of directors, has pharmacy in his blood. Gruber’s great uncle and cousin were both pharmacists and owners of a group of pharmacies in the Twin Cities area of Minnesota These early role models set the stage for school and a career in health care.

Dean Gruber, altScripts Specialty Pharmacy, 1636 Miller Park Way West Milwaukee, Wis. 53214, www.altscripts.com

University of Wisconsin School of Pharmacy was a building block in this journey.

One of Gruber’s distinct memories of pharmacy school included a class called pharmaceutical marketing. The professor, the late Joe Wiederholt, substituted The Wall Street Journal for textbooks. Each week they had dynamic discussion of the business of pharmacy and health care and how it relates to patient care.

The Pharmacy Society of Wisconsin (PSW) taught Gruber the value of finding mentors and being involved in boards and committees to be an active part of practice, innovation and change.

Gruber’s professional career in pharmacy started in 1998 in hospital and clinic oncology. Transitioning out of the health system Gruber accepted an opportunity at a large chain to advance diabetes and immunization services.

A connection from PSW led Gruber to an independent pharmacy called Marshland Pharmacy with a dynamic husband and wife owner team. All of these encounters brought mentoring and an appreciation for different types of practice.

Eventually Gruber accepted an opportunity to practice at a specialty pharmacy that focused on oral oncology. His background in health system oncology and retail practice turned out to be the perfect fit. New oral therapies were growing along with specialty pharmacy to match the patient and provider need.

Gruber’s last transition happened eight years ago, then practicing at a privately held, regional specialty care-based pharmacies in both Wisconsin and California as vice president of trade for Owl and altScripts Specialty Pharmacies. “I am so thankful for the team I practice with. The culture, team, mission, respect and trust make it all worth the effort.”

Gruber noted that the pandemic was hard, yet it opened collaboration with other health care professionals and business platforms for process improvements. A contact-minimized environment and labor shortage provided the opportunity for practice change. “The collaboration with other health care professionals has seen growth in delegated services such as administration of non-vaccine injection by pharmacists and enhanced business technology including telephonic, text and video services as well as conveniences in payment and delivery for patients.”

Gruber had found in CARE Pharmacy chain the same trusting atmosphere as PSW. “CARE Pharmacy and the leadership of Mike Wysong and his team is best described as a foundation. They assist in functions that enable time and energy to be diverted back into patient care. CARE’s team builds trust by sticking to the mission to serve the members. From purchasing opportunities to connections in innovative business opportunities with preferred partner organizations.”

Gruber noted that Mike Wysong has been a mentor and friend who builds relationships. “These relationships are built on trust and commitment. This culture of CARE Pharmacy.”

Gruber’s cornerstone values are to deliver opportunities for patients and providers to maximize outcomes by being part of the coverage, financial acceptability and clinical journey of the medications. “The best medicine on the shelf is still only a potential until it is accepted by the patient.” He added that some tasks are typically assigned to the patient, provider or others on the health care team. “What we have found is that the person assigned to these tasks may not always have the time, or their skills may not be best suited to take care of the tasks. Delegated authority can help to shuffle the deck on which tasks get done by each part of the health care team and the patient. Our pharmacists understanding the needs of other health care professionals create opportunities to advance each practice further than either of us could do on our own.”

Innovation is often sparked or accelerated by the practice affiliation with schools of pharmacy. Gruber notes that the practice encourages APPE and IPPE rotational programs and pharmacists to be preceptors. A new addition is a PGY-1 community residency program where the resident practices at a federal qualified health system (FQHC) two days a week, altScripts two days a week and the Medical College of Wisconsin (MCW) one day a week.

Gruber’s current residency project involves Remote Therapeutic Monitoring (RTM). The team is working with a company called RxCaps to administer RTM. The technology enables them to assist patients and providers in monitoring how often a medication has been taken and act when a patient is struggling. Service billing opportunities need to be part of the future of pharmacy, and RTM is a CMS billable service. “Projects like these build on each other. The residency grew from a relationship with PSW and MCW. The RxCap partnership grew out of a CARE Pharmacy preferred vendor. The delegated service grew out of our relationship with the health clinic.”

Gruber says he values his role in leadership in his current organization. “When I can find a new technology or set up a new agreement that allows our team to service patients in a unique way, I am happy.”