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Transforming Healthcare Delivery with Systems Thinking

Healthcare Business Review

Dr. Timeka Russell, Senior Director of the Pharmacy Enterprise Procurement, Inventory, Billing, and Finance at the NewYork-Presbyterian Enterprise
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Throughout my career, I’ve prioritized roles that stretched my ability to lead at scale. Early on, I focused on mastering the 340B Drug Pricing Program which forces and understanding of clinical operations and regulatory compliance. Leading a turnaround in compliant 340B hospital pharmacy operations at a high-volume academic medical center was pivotal. It taught me how to balance efficiency with excellence under pressure.


From there, I transitioned into multisite oversight, where I developed system-wide protocols for medication safety and cost containment. Each step deepened my understanding of enterprise strategy, culminating in my current role, where I lead across the continuum of care at one of the most complex health systems in the country.


Streamlining Hospital Pharmacy Systems


I anchor my focus around patient impact and system risk. If a cost-saving measure undermines safety or compliance, it’s not a true gain. I rely heavily on data from trend analysis, compliance dashboards and cost-performance ratios to identify pressure points. But I also spend time on the ground, listening to staff and my colleagues. That qualitative insight often flags issues before the metrics do. Ultimately, it’s about constant reprioritization: knowing when to push a cost initiative forward and when to pause for a compliance recalibration.


Many leaders still see 340B purely as a financial lever rather than a strategic care access tool. Yes, it generates revenue, but when reinvested into outpatient expansion, behavioral health access or underserved care, it becomes a multiplier for community health outcomes. Misunderstanding its intent leads to poor messaging and misalignment with compliance safeguards. The most effective 340B strategy is one rooted in mission preceding margin.


Revamping Supply Chain Processes For Standardization


The hardest part of standardizing supply chain processes in health systems is culture, data inconsistencies and drug shortages. Standardization means change, and frontline teams often fear losing autonomy or local nuance. Getting buy-in requires not just policies, but meaningful dialogue explaining the “why” and adapting the “how” to local realities. Data fragmentation across EMRs and procurement systems also makes it hard to create a clean baseline. We’ve had to build integration bridges before even talking standardization.


Harnessing Human Expertise with Tech-Powered Workforce Management


As more systems embrace predictive tools and automation in pharmacy, the biggest shift is happening hands down in workforce planning. Predictive tools are changing how we schedule, upskill, expand access and even hire. Instead of staffing reactively, we’re moving toward demand-driven models that forecast peaks based on patient acuity and therapeutic mix. It’s also helping us identify when to retrain staff for higher-value roles as automation takes over repetitive tasks.


This shift isn’t just operational; it’s philosophical. It’s about redefining the value of human expertise in a tech-augmented environment.


A Mindset Shift for Implementing System-Wide Strategy


Learn to zoom out without losing touch. At the site level, success is about fixing and optimizing. At the system level, it’s about aligning and influencing. I had to stop being the problem-solver and start being the frame-setter, creating clarity, building capacity in others and trusting staff to execute. That shift from doing to enabling was critical.


There’s one piece of advice for someone stepping into a system-wide leadership role for the first time, especially if they’re coming from a clinical or operational background. Don’t rush to prove yourself by doing everything. Listen more than you act in your first 90 days. Map the political landscape. Understand the pressures other leaders are under. Then find one high-leverage initiative that aligns across functions and delivers visible impact. That first win should position you not just as capable, but as collaborative.


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