Pharmacy Workflows and Operational Readiness in Community Oncology: Jody Agena, PharmD

Pharmacy workflows, operationalization, and implementation are important considerations for pharmacists to consider amid rapid therapy innovations, a key talking point at the Washington, DC, Institute for Value-Based Medicine^® (IVBM) on July 25, 2026.

The panel discussions addressed advancements in pharmacy workflows and operationalizing new therapies, specifically in oncology care. Pharmacists’ communication efforts should be vigilant in their communication—and for those with their own practice, staffing efforts—to provide continuous high-value care for patients, Jody Agena, PharmD, a panelist at the IVBM and director of pharmacy operations at Virginia Cancer Specialists, said in an interview with The American Journal of Managed Care^®.

In this interview, Agena, with his background in pharmacy and business administration, explains the challenges pharmacists and practices face structurally as they try to adapt to the rapid evolution of new therapeutics.

This transcript was lightly edited for clarity.

AJMC: As oncology therapies become increasingly personalized and operationally complex, what metrics do you rely on to determine whether your pharmacy workflows are truly improving patient care rather than simply increasing efficiency?

Agena: There are so many different aspects to operationalizing or implementing a new therapy. A big priority at our practice is cell therapy, more specifically, chimeric antigen receptor T-cell therapy. First and foremost, without looking specifically at pharmacy operations, we have to make sure there's buy-in across the board, especially with the physicians, the nursing staff, the ancillary staff, and the pharmacy staff. Making sure that infrastructure and policies are in place, standard operating procedures (SOPs) and related legal ramifications, and whether we're able to implement something or not.

Lastly, which is equally as important from a payer’s perspective, is making sure that the landscape checks the box and making sure there's reimbursement involved. I'm involved in the revenue cycle, and from a community oncology practice, the revenue cycle portion is definitely a huge point to make.

AJMC: From an operations perspective, where do you see the biggest communication gaps between pharmacy, nursing, and providers, and what processes have been most successful in closing those gaps before they affect patient care?

Agena: I think from our perspective, especially when you’re implementing something like a cell therapy program, it’s about making sure that everyone is on the same page. In the past, in general, pharmacy has—we’re all guilty of this—operated in a silo. You can’t do that with a lot of the newer therapies and more complex therapies.

Communication and overcommunication are definitely key because we all need to know what the other hand is doing at all times. It’s been challenging, but it’s been rewarding in terms of understanding. We have a better understanding of how to tackle the next problems and the next therapies that come about.

AJMC: As new therapies continue to launch at a rapid pace, how do you evaluate whether your practice is operationally ready to implement them? Are there specific infrastructure, staffing, or education benchmarks you look for before bringing a new therapy into routine practice?

Agena: There definitely needs to be not only pharmacy infrastructure but also staffing in the pharmacy and the ability to mix something appropriately. That sounds great, and we can pretty much do all of that. Physician buy-in and nursing buy-in are definitely big portions as well. I say physician buy-in because every physician wants the latest and greatest therapy, especially if it’s going to benefit their patients in the long run. But when I say physician buy-in, a lot of it is that they have to be bought in. There’s a lot of time spent; there’s a lot of counseling involved. You can’t just check a box and have the nursing staff take over—you really have to be involved with the SOPs.

For example, how we brought up our CAR T program. Our physicians and our hematologists are very involved. They often have to be because without their direct involvement, the other staff or physicians are not going to be able to implement XYZ therapy if the hematologists taking care of these patients aren’t involved with the cell therapy program.

AJMC: With your background in both pharmacy and business administration, how do you balance investments in pharmacy infrastructure—such as technology, staffing, or clinical services—against increasing financial pressures on community oncology practices?

Agena: I understand from a pharmacy standpoint, yes, we can compound pretty much anything. We can mix anything from your intravenous piggybacks and any type of subcutaneous administration all the way up to cell therapy or CAR T programs. But just thinking outside of the box, we need to make sure that we’re able to invest in technology and able to invest in staffing. We need to take a step back and look at it from a big-picture perspective—which is always important.

AJMC: Looking ahead, what do you think will most fundamentally change oncology pharmacy operations over the next 5 years: advances in therapeutics, automation and artificial intelligence, reimbursement changes, or something else entirely?

Agena: From a community oncology standpoint, I think even today, with the technology that we have, we could do a lot better. Health care, in general, could do a much better job in terms of how we implement current technology into our workplace. To answer your question, 5 years from now, I certainly hope it has improved a lot as far as utilizing the tools that we have available, especially AI. Maybe not only coming from the pharmacy automation side of things, but also being involved with—or kind of dabbling in—patient assistance, using AI in the clinical review and insurance authorization side of things, and speeding up that process. I think there are so many opportunities where we can harness the current tools to make our workflow a lot more efficient.