PHARMACY INFORMATICS

PHR 119 | 2ND SEMESTER 2023-2024

eg: Bar Code Medication Administration

PHARMACY INFORMATICS - A properly trained pharmacist informaticist can apply
• A subset of health informatics, leverages both clinical knowledge of medications during the planning and
expertise and knowledge about information technology implementation of electronic bar code medication
to improve medication management processes and drug administration. Bar code medication administration,
administration safety. also known by the acronym BCMA, is the hardware
• The scientific field that focuses on medication-related and software used to provide electronic verification
data and knowledge within the continuum of healthcare that the “five rights” (right patient, right drug, right
systems—including its acquisition, storage, analysis, use dose, right route, and right time) are achieved for the
and dissemination—in the delivery of optimal medication- administration of medications.
related patient care and health outcomes.” o BCMA can protect the patient through the use of clinical
• Pharmacy informaticists are pharmacists with a solid decision support. The pharmacist informaticist designs
background in clinical pharmacy practice, knowledge of and implements safeguards that check the barcode of
pharmacotherapy, and extensive working knowledge of the patient to ensure any medication ordered is
clinical information systems and drug distribution systems. appropriate for the condition being treated, that the dose
is appropriate for the patient and that the new drug does
not interact negatively with any medications the patient is
EVOLUTION OF PHARMACY INFORMATICS already taking.
▪ Hospital pharmacies are well known to embrace
technology and automation to support drug distribution. eg: Computerized Provider Order Entry
Between the 1980s and the 1990s, information systems - Pharmacy informatics professionals may be involved
were primarily used to manage pharmacy inventory and with the design and implementation of computerized
produce financial reports; then, in the early 2000s, provider order entry, or CPOE, in a hospital. CPOE is
hospitals adopted computerized practitioner order entry an application that enables providers to enter medical
(CPOE) and other computerized systems with clinical orders into a computer system, rather than placing
decision support* (CDS) software. orders using paper and impacts many areas
▪ Clinicians were required to oversee and tailor these including nursing, pharmacy, laboratory, admissions
systems to actualize their utility, yet the early experience and radiology—to name a few. One way that a
and research of these investigators described only pharmacist informaticist may be involved in the
general benefits, and they could not report or measure the implementation of CPOE is ensuring that clinical
systems’ effectiveness or value decision support is in place to help guide the provider
▪ During this period of rapid technological growth, hospital to evidence-based treatment options at the time of
pharmacy departments were challenged to manage and ordering.
maintain new hardware and software, employing technical
analysts to support the devices and applications, while eg: Interoperability
pharmacy staff optimized system use to meet clinical and - For a patient’s health records to follow them
dispensing needs. regardless of the healthcare setting, the languages of
▪ By the late 2000s, the health informatics field was each institutions’ EHR must share a set of common
emerging, with specialization in pharmacy practice languages or vocabularies. Pharmacy informatics
ultimately defining the pharmacy informatics role. professionals contribute significantly to these efforts
Pharmacy informaticists became a natural fit to engage by applying clinically accurate verification checks in
health technology advancements, evaluate system the data flowing from system to system, ensuring that
limitations and risk, educate pharmacy end-users, and the dosing information, medication strength,
investigate system issues related to medication safety, frequency of administration and duration of therapy
while supporting pharmacy practice.The American remain consistent for the millions of medication
Society of Health-System Pharmacists (ASHP) first orders occurring daily in the healthcare environment.
described the pharmacist’s role, responsibilities, and
competencies in informatics in 2006, with a recent 2) Knowledge delivery
statement update in 2016. o In a health IT environment, pharmacy informaticists drive
the delivery of medication-related information and
knowledge throughout the clinical knowledge lifecycle.
ROLES OF PHARMACISTS IN INFORMATICS
1) Information management eg: Clinical Decision Support
2) Knowledge delivery - Clinical decision support provides clinicians and
3) Data analytics patients with knowledge and personspecific
4) Clinical informatics information—intelligently filtered or presented at
5) Change management appropriate times—to enhance health and
healthcare. Clinical decision support makes use of
1) Information Management many tools to assist with the delivery of evidence-
o In their key role of overseeing medication-related based care. Some include computerized alerts and
information available within health IT tools, pharmacy reminders, clinical guidelines available during CPOE,
informaticists must generate and share this information condition-specific order sets, and patient data reports
with various healthcare professionals to ensure patient and summaries. Pharmacist informaticists may
safety while also measuring the usage and participate in, lead or help coordinate these efforts.
effectiveness of this information throughout the clinical
process
PHARMACY INFORMATICS
PHR 119 | 2ND SEMESTER 2023-2024

eg: EHR Optimization be involved in the successful implementation of

- EHR optimization is another project that may include computerized med rec is in creating computerized
a pharmacy informatics professional during planning, processes to suggest acceptable inpatient medications on
design and/or implementation. A best practice of formulary that would substitute for the patient’s home
EHR users, EHR optimization is the concept of using medications that are non-formulary in that institution.
the EHR to its fullest capacity in the most efficient o Smart Pump Optimization
way possible. For a pharmacy informaticist, this may - Infusion pumps are commonly used in healthcare
include settings to deliver medications, fluids and nutrients to
patients at precisely controlled rates. “Smart" infusion
o Adding mandatory indications with medication orders pumps have become increasingly sophisticated and
o Creating a computerized antibiotic stewardship include such features as dose error reduction
program software, commonly referred to as drug libraries.
o Developing computerized antibiotic orders with These drug libraries are often implemented and
appropriate treatment plans for that medication maintained by pharmacy informaticists. The drug
o Identifying clinically appropriate medication library technology allows infusion pumps to perform
adjustments functions that assist healthcare providers with
o Preventing therapeutic duplication in patients’ active programming and calculating dose and delivery
medications rates. When used properly, these features help
prevent intravenous medication errors and reduce
3) Data Analytics patient harm.
o In order to improve healthcare, data must be reviewed
and the insights gained from this data must be applied 5) Change management
o Healthcare Analytics o When dealing with knowledge to guide healthcare
- Healthcare analytics is the application of statistical, delivery, the only constant is change. Treatments come
reporting and presentation tools and techniques and go, diagnostic tools evolve, clinical practice changes;
to healthcare-related data in order to study past healthcare regulations, best practices and laws shift—all
situations to improve the quality and efficiency of these things change and all impact your clinical decision
clinical and business processes and performance. support initiatives
Analytics may be applied to a week’s worth of data o Because successful clinical decision support requires
from a unit in a hospital or a health system’s attention to the five rights mentioned earlier, clinical
performance measures over many years. The decision support interventions must be actively managed.
pharmacist informaticist’s expertise in drug To effectively manage the process of selecting, applying
information is crucial to accurate querying and and maintaining these clinical decision support assets, a
reporting of health data governance structure and process must be assembled. A
team of clinical informaticists, including the pharmacy
informaticist, can help accelerate the change
4) Clinical Informatics
management process.
o Clinical Informatics, also called health Informatics, o Before pursuing pharmacy and informatics as a
promotes the understanding, integration and profession, I was a programmer for a large insurance
application of information technology in healthcare company. As a programmer, you are taught that without
settings. documentation your product cannot be maintained and is
o eg: An example I often use to help illustrate applied clinical therefore not acceptable in a production environment.
informatics (which is the title I carry on my white lab coat) Desired components of a successful change management
is a project I worked on with my teammate we’ll call Bob. process include the following.
- Bob is a database expert. He literally wrote a best seller o Governance: Grants decision-making authority, may
on the topic. But while Bob knows how the database works assist with selection and maintenance of clinical decision
from the inside out, he is not able to accurately isolate support interventions Structure: People involved include
ACE inhibitors (a class of drug used to treat hypertension) analysts, clinical Informaticists and management to
from a list of thousands of medications used in a hospital oversee and execute knowledge management processes
during the last 12 months. The clinical informaticist is able Clinical decision support change management process:
to navigate the data in the database and help Bob query Get it, vet it, implement it, watch it, fix it, replace it and
clinical data accurately retire it
o eg: Computerized Medication Reconciliation
- Computerized medication reconciliation, also known as
med rec, is the process of comparing a patient’s
IMPORTANCE OF PHARMACY INFORMATICS
medication orders to all medications the patient takes via
the EHR. Research has shown that almost half of ▪ Prevention of medication errors
medication errors occur in the handoff phase with many of ▪ Make the job easier
these errors being avoidable through proper medication ▪ Develop more technology that can provide easier access
reconciliation. on drugs
- Computerized handling of med rec standardizes the
process and ensures that the handoff occurs at each
transition of care in an efficient manner. The pharmacist
informaticist’s knowledge of medications, the med rec
process and the computer system being employed at the
facility are important to the success of projects involving
med rec. One way that the pharmacist informaticist may