Since 2010, ASHP’s Practice Advancement Initiative (PAI) has provided pharmacy leaders with a clear road map to meet the demands of future practice. But how well are health systems tracking those aspirations?
To find out, five members of the ASHP New Practitioner Forum (NPF) conducted a national benchmarking study highlighting the profession’s strengths and actionable areas for improvement.
“I’ve been interested in pharmacy practice advancement since pharmacy school,” said lead researcher Mitchell N. Muskat, postgraduate year 1 (PGY1) resident in health-system pharmacy administration and leadership (HSPAL) at University of Michigan Health and MBA candidate at the Ross School of Business in Ann Arbor. “I really wanted to use this opportunity to better understand how health systems across the country are actually aligning with the PAI 2030 recommendations.”
ASHP established PAI to drive pharmacy practice change at a local level. Building on this foundation, PAI 2030 encompasses 59 recommendations to advance pharmacy practice by the end of this decade. The initiative includes a self-assessment tool to help pharmacy teams assess their alignment, identify gaps, and create a tailored plan to implement change.
The NPF Practice Advancement and Advocacy Advisory Group — all less than five years out of pharmacy school — analyzed 351 anonymized PAI 2030 self-assessments completed between March 2021 and January 2025. They then mapped the responses to the five PAI 2030 domains: patient-centered care; the pharmacist’s role, education, and training; technology and data science; the pharmacy technician’s role, education, and training; and leadership in medication use and safety.
“We were all eager to go above and beyond,” Muskat said of the NPF workgroup. “And I don’t think I would have been able to do this research without my volunteer involvement within ASHP.”
The results showed strong alignment in inpatient, patient-centered care, as well as leadership in medication use and safety, especially around comprehensive medication management and transitions of care. But there was also room for the profession to grow in areas such as pharmacist education and training, technology and data science, and elevating the role of pharmacy technicians.
The contrast was surprisingly clear, Muskat said.
“The progress isn’t consistent across all settings where patients experience care … and it starts to go down as you move further away from the walls of the hospital,” he explained.
The research points to several factors that may hold the profession back, including the absence of widespread pharmacist credentialing and privileging; underrepresentation of pharmacy services in outpatient, community, and long-term care settings; limited engagement in pharmacogenomics; and insufficient progress in pharmacy technician workforce development and technology integration.
Muskat’s take: The PAI 2030 benchmarking results parallel the overall trajectory of the pharmacy profession. Success comes more readily where pharmacy expertise is well-established, and it evolves more slowly in new frontiers. But he’s optimistic that things are heading in the right direction, as more people witness pharmacists’ impact on patient care outside of traditional inpatient settings.
“Patients see the benefit when we add a pharmacist to the healthcare team, and I think providers are advocating for having pharmacists in these roles. That really helps with the growth,” he said.
With these insights in hand, Muskat hopes health-system pharmacy leaders will reassess their progress against the PAI 2030 recommendations and adjust strategic plans accordingly. In particular, the research emphasizes the need to embrace emerging technologies and treatments, such as artificial intelligence (AI) and cell and gene therapies, and to create meaningful opportunities for pharmacists to practice at the top of their education and training.
Also, health systems should not overlook the potential for pharmacy technicians to improve patient care. “Advocating for pharmacy technicians is as important as advocating for pharmacists — because as technicians can do more, pharmacists can do more,” said Muskat.
The group presented their work as a poster at the ASHP 2025 Midyear Clinical Meeting & Exhibition in Las Vegas, Nevada, sparking conversations about where pharmacy is headed.
“I enjoyed discussing the findings and hearing how others connected the results to their own practice settings. Everyone could relate to it,” said Muskat.
This research will also help shape how ASHP leaders reimagine the PAI 2030 for a new target year. That collaborative work is already underway to help pharmacists adapt even more nimbly to complex changes in the healthcare landscape.
But as Muskat and his fellow new practitioners have gleaned from studying the progress of PAI 2030, long-term success boils down to patient access.
“The future of pharmacy practice is not just about expanding what pharmacists and pharmacy technicians can do but also making sure pharmacy services are accessible to the patients, healthcare teams, and communities that need them most,” he said. “Access is equal to impact.”
