Using technology to advance pharmacy practice through education

funny_tech_cartoonI found an interesting article in the October issue of the American Journal of Health-System Pharmacy. The article, titled Informatics in clinical instruction (Am J Health Syst Pharm. 2009 Oct 1;66(19):1694, 1699), gives a description of a software system designed by the authors that “allows students at one site to receive online and teleconference instruction from preceptors at multiple sites through remote, interactive discussion. It also allows “blogging” based on assigned videotapes, simulation modules, live patient cases, discussion questions, and primary literature review. In addition, the system facilitates clinical encounter documentation, including interviewing patients, taking physical assessments (e.g., blood pressure), taking medication histories, assessing for adverse effects (e.g., abnormal involuntary movements), and addressing potential or actual medication-related problems(MRPs).”

The system presented in the article is, by itself, very interesting, but it’s the underlying message from the article that’s more important. In the article the authors elude to the fact that pharmacy schools need to embrace technology and utilize it to enhance the student experience as well as advance the practice of pharmacy. This isn’t a new thought as technology has not only revolutionized healthcare practice, but the delivery of education as well. In an article in The International Journal of Pharmacy Education in 2004 the authors call for the integration of technology “into pharmacy education and the curricula of schools and colleges of pharmacy that students would never think of practicing their profession without the support of technology.” The statement is perhaps a bit extreme, but accurate nonetheless. As far back as 2001, nearly a decade ago, the American Association of Colleges of Pharmacy (AACP) recognized the need for the use of technology in a pharmacist’s education (PDF); a view that continues today.

Unfortunately, schools of pharmacy are not holding up their end of the deal. In an article by Fox, et al. (Am J Pharm Educ. 2008 August 15; 72(4): 89)  89 pharmacy programs with recognized informatics courses were surveyed to determine the state of informatics education in the pharmacy curriculum. Of the 89 programs surveyed, only 32 responded, and of those 32 only 25 programs included syllabi information. In a nutshell the article concluded that “many professional programs are not providing instruction in pharmacy informatics. There may be confusion within the academy/profession between pharmacy informatics and drug information practice. Much work is required for programs to become compliant with the ACPE 2007 pharmacy informatics competencies.” Ouch.

The increased push for inclusion of informatics education in pharmacy schools has not generated additional interest in technology, per se. I’ve attempted to offer an informatics rotation for pharmacy students at our facility, but have yet to receive any interest. Similar stories of disinterest can be found in other Valley hospitals where pharmacy school rotations are available. I don’t blame the student. Even with my deep rooted interest in all things related to technology, my focus during pharmacy school was therapeutics. Everything else was secondary.

Regardless of the level of technology being taught in pharmacy schools, the practice of pharmacy has become one of the most technologically advanced disciplines in healthcare. Pharmacists now utilize a host of technologies to perform even the simplest tasks. Some of these technologies include:

– word processing, spreadsheet, and database software
– mobile computing technologies (mobile phones, PDAs, and tablet computers)
carousel technologies
automated packaging
bar code labeling systems
– bar code medication administration (BCMA)
– pharmacy information systems (PhIS)
– automated dispensing cabinets (ADC)
automated iv compounding systems
– clinical decision-support systems (CDSS)
– robotic technologies (examples: McKesson and ScriptPro)
– electronic medication administration records (eMAR)
– computerized provider order entry (CPOE) systems
– electronic document management (EDM) systems
– data mining
– telemedicine

In addition, advancing technologies that need to be addressed through education include:

auto-verification of medication orders
– biometric scanning (fingerprint recognition, facial recognition, voice recognition)
– “touch” technologies (multi-touch, Surface, holographic projection)
– radio frequency identification (RFID)
– and so on

It will be interesting to see where pharmacy informatics goes from here. We’re at a point in the profession where technology is playing an unprecedented role in day to day operations as well as clinical activities. While the “typical” PharmD curriculum includes many courses to advance pharmacology and therapeutics, the future education of young pharmacists must include informatics and technology. This is the only path that makes sense if we want pharmacists designing systems for pharmacists. Do you want a “non-clinician” designing your clinical workflow and technology? I know I don’t.

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