Transcript The Role of Pharmacy Technicians in Automation

Pharmacy Informatics
Presented by:
ASHP Section of Pharmacy
Informatics and Technology
Executive Committee 2010
Who are Pharmacy Informaticists?
Anyone who works in pharmacy or related fields that
support the flow of information to better take care of
patients.
Dedicated specialists involved in the computerization and
automation of the medication-use process
 Directors of Pharmacy and Managers
 Clinical Pharmacists
 Industry/Vendors
 Pharmacy Technicians
 Specially trained and on-the-job trained Practitioners
What is Pharmacy Informatics?
The use and integration of data, information, knowledge,
technology, and automation in the medication-use process
for the purpose of improving health outcomes.
Medication Use Process
J Osheroff 2009
Medication Use and Informatics
Outcome Feedback Loops
Used with Permission: Siska, Mark. 2007 Med Use Cycle. ASHP Midyear Clinical Meeting 2007
Electronic Health Record
Medical record built through capture of order entry, results
data capture and clinical documentation designed to support
users through complete and accurate data. (C Armstrong 2001)
Core
Functionalities*
Other
Functionalities
Health Information and
Data
Electronic Communication
and Connectivity
Results Management
Patient Support
Order Entry and Support
(CPOE)
Administrative Support
Decision Support (CDS)
Reporting and Population
Health Management
D Blumenthal, NEJM 2007
CPOE and CDS
Computerized Provider Order Entry (CPOE)
Direct entry of medical orders by a provider into a system that transmits
these electronically to the appropriate department. (D Brailer 2003)
Clinical Decision Support (CDS)
Provides clinicians with clinical knowledge and/or patient related
information, intelligently filtered or presented at appropriate times, to
enhance patient care. (J Osheroff 2004)
CPOE
CDS
Pharmacy
EHR
State of Implementation in the US
50
Comprehensive EHR includes
MD and RN documentation
Percent of US Hospitals
40
Full CPOE = >50% medication
orders entered by providers
30
20
10
0
2.9
Comprehensive
EHR
7.9
Basic EHR
9.6
6
'Full' CPOE
Some CPOE
KLAS Presentation April 24, 2008
KJ Ashish, NEJM 2009
Ordering and Administration
100%
80%
60%
40%
20%
0%
19%
20%
CPOE
Tube
Delivery
70%
Fax Delivery
49%
5%
Paper MAR
eMAR
Source: American Society of Health Systems
Pharmacists, Section of Information Technology, Survey
conducted 2007
Impact of HIT leads to push
to computerize healthcare
Impact of HIT on Quality, Efficiency and Costs of
Medical Care
257 studies examined
 63% CDS Systems
 37% Electronic Medical Records
 13% CPOE
25% of studies came from 4 benchmark organizations with
homegrown systems
Conclusion: Whether and how other institutions can
achieve the quality and safety benefits demonstrated by
the benchmark organizations is unclear.
Chaudhry B et al. Ann Intern Med. 2006;144:E12-E-22.
HIT Benefits and Inpatient Outcomes
Urban hospitals in Texas assessed for level of clinical IT
automation; 167,000 patients over 50 between 12/05
and 5/06 (41/72 hospitals)
 Fewer complications: 16% decrease in odds with more decision
support
 Lower mortality: “10 point” increase in notes automation was
associated with 15% decrease in adj. odds of fatal hospitalization
 Lower costs: Higher scores on test results, CPOE and CDS were
associated with lower costs for all admissions
Archives of Internal Medicine, January 26, 2009 169(2):108–14
Healthcare IT Trends
HITECH Act – Meaningful Use
The Joint Commission focus on patient safety
through technology
ASHP 2015 goals
Leapfrog
Institute of Medicine
Top strategic goal at many health systems
Three Stages of Meaningful Use
Stage 1
Stage 2
Stage 3
2011 - 2012
2013 - 2014
2015 and beyond
Electronically capture
health information in a
coded format; begin to
track key clinical
conditions and
electronically
communicate for care
coordination purposes
Build upon Stage 1 to
encourage the use of
health IT for continuous
quality improvement at
the point of care and
the exchange of
information in the most
structured format
possible
Promote improvements
in quality, safety and
efficiency using
decision support for
national high priority
conditions and patient
access to self
management tools
14
What are the opportunities for
pharmacists?
HIT Workforce
Approximately 108,000 HIT professionals in US
HIT staff varies by level of EHR adoption
0.082 FTE/bed at EHR Adoption Model (HIMSS
Stage 0)
0.201 FTE/bed at EHR Adoption Model (HIMSS
Stage 4)
40,000 HIT professionals needed to move the entire
country to higher levels of adoption (Stage 4)
HIMSS Analytics™ 2008.
Pharmacy Workforce
Push for automation and integration with other
systems
Leadership positions to manage clinical informatics
teams
Opportunity for exposure at academic level
Medication Safety Officer/Pharmacist
Project Management
Informatics beyond just pharmacy
Resources in short supply
Prevalence of Pharmacy Informatics Positions
Source: American Society of Health Systems Pharmacists,
Section of Information Technology
Survey conducted 2007
ASHP and Educational Opportunities
Eight accredited PGY2 Informatics residencies
across the US
Section of Informatics and Technology created in
2007 (one of five)
Currently four advisory groups working on national
informatics initiatives
Partnerships with HIMSS and AMIA
Convergence
Automation
and
Technology
Pharmacy
Informatics
Pharmacy
Practice
Clinical
Decision
Support