Pharmacy goals, a reality check and insanity – what the heck are we doing?

I’ve been conversing with several pharmacists about the future of pharmacy practice, specifically about the PPMI developed earlier this year by ASHP. This is a sharp group of people, but what I continually hear is the same thing I’ve heard for a number of years. While I’m not as experienced as many of my esteemed colleagues due to a late start to my career, I have worked in several acute care facilities. I’m not sure who said it, but Einstein gets credit for defining insanity as doing the same thing over and over again and expecting different results.

The literature presented in support of a new practice model is, in reality, based on current practice. It’s all looking at how best to apply the pharmacist’s current knowledge and resources to the current practice model. Economic outcomes improved by a pharmacist; great, but not new. Improved patient outcomes with a pharmacist in a team approach; awesome, but not new. Use a pharmacist as a prescriber; cool idea, but not new. These models are easily ten years old and we’re still talking about them as if they were new ideas. See a trend here? I think this is exactly what Einstein had in mind when he defined insanity.
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“What’d I miss?” – The week of December 5

It’s been a busy week, and pretty much all my attention was focused on the ASHP Midyear event in Anaheim, California. Of course as a pharmacist that’s where my focus should have been, but that doesn’t mean that the rest of the world stopped moving. Here are some of the things I found interesting this week:
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#ASHPMidyear, the end

Here I sit in the airport on my way home as another great ASHP Midyear has come to a close. This feels strangely familiar.  Anyway, the end of the Midyear meeting is always bittersweet. I’ve taken in about all the information my brain can possibly handle, but each day at Midyear brings something new and exciting, which I will miss. Many attendees departed prior to the final sessions today so it was a virtual ghost town compared to the previous days of the event. The exhibit hall was closed, the small stands for food and drink were gone, the line for coffee was non-existent and session attendance was clearly affected. With all that said, it was still worth hanging around for the final session. Huh, I had to, I was presenting at it; more on that later.
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#ASHPMidyear 2010 part deux

Today was a great day to be at ASHP Midyear 2010. Things really got going as the sessions were kicked into high gear and the exhibit hall officially opened.

I spent the day tracking down pharmacy automation and technology. Did you really expect me to do anything else? I don’t ever recall being as excited as a clinician as I am being an informatics pharmacist. Anyway, here are some things I found interesting:
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#ASHPMidyear day one comes to an end

Each day at ASHP Midyear offers some great experiences, and today was no exception.

I spent a good part of my first morning at the Talyst User Group Meeting. It’s encouraging to speak with other pharmacists that use pharmacy automation and technology in interesting ways. User Groups are a great way to get focused information from end users. I always take something away from groups like this. I wish there was a way to apply the format to other areas of pharmacy informatics.

Following the user group meeting I spent some time roaming around the exhibits. Yes, before they’re open “to the public”; vendor badge. While the exhibits weren’t complete, they certainly offered a glimpse of what I can expect for the rest of the week. It also gave a me a good idea of who I’d like to visit and spend some time talking too. It’s always interesting to talk with the vendors in person. Sometimes you can get information that you simply can’t find anywhere else.

I did manage to attend a single session today titled A Hitchhiker’s Guide to Telepharmacy. I haven’t spent much time learning about telepharmacy so I thought this would be a good opportunity to gain some knowledge. To my surprise it turns out that telepharmacy isn’t at all what I thought it was. One of the first slides in the presentation defined telepharmacy as “a central pharmacy, either retail or associated with a hospital, is connected via computer, audio, and video link to one or more remote sites. A licensed pharmacist at the central site conducts remote order entry and then supervises the dispensing of medication at the remote site through the use of video conferencing technology.” (Darryl Rich, The Joint Commission, 2007). Huh? I thought telepharmacy would represent a more clinical approach to patient care through the use of audio and video.

The U.S. Department of Health & Human Services defines telemedicine as “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s health. Electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site.” I assumed telepharmacy would basically be the same thing. Guess not. The Joint Commission definition of telepharmacy stated above is simply remote checking. I’m not sure I like that.

At least my day ended on a positive note. I had dinner with a friend at a great little Mexican restaurant called Tortilla Jo’s in Downtown Disney. We spent a couple of hours talking about all kinds of stuff including pharmacy, informatics/automation and life. Good stuff.

Here’s looking forward to tomorrow.

Oh yeah, on my way to #ASHPMidyear 2010

Here I sit in the airport waiting for my flight to take me to ASHP Midyear 2010 in Anaheim, CA.  ASHP Midyear is the premiere conference/meeting for pharmacists each year. Sure there are larger healthcare conferences/meetings every year, but none are dedicated entirely to the pharmacy profession.

As this is only my second ASHP Midyear in my career I’m excited to see if the experience matches that of last year. I’m sure it will as I continue to be impressed by the number and variety of sessions crammed into such a short period of time. Of course I’m particularly interested in the informatics sessions, but it’s ok if you find yourself sitting in on one of the talks updating you on what’s happening in the clinical world. I won’t hold it against you.

The week for me will kick off on Sunday morning with the Talyst Users Group meeting followed by a session on RFP’s and contracts put on by the ASHP Section of Pharmacy Informatics and Technology’s Advisory Group on Pharmacy Operations Automation. I’ll round out Sunday’s activities by attending the McKesson Safe Compounding Reception. And it will only get better from there as the week will be filled with sessions on clinical decision support, barcoding, telepharmacy, the application of social media to pharmacy, and so on and so forth.  My week will conclude with the session titled mHealth: There’s an App for That where I will be presenting information on the integration of the iPad into pharmacy services.

The information I’m presenting was pretty cutting edge at the time I submitted the slides, but is now clearly dated. That’s the downside of having to submit presentation slides so far in advance. Anyway, it should still be worth the time and effort. I’ve always found it educational for myself to present information to people as someone always has something interesting to add or a good question to stimulate the thought process.

I’m looking forward to the next five days. I’ll be Tweeting (@jfahrni) as much of the event as possible in addition to posting about the day’s activities whenever feasible. I hope to see you there. If you’d like to get together and talk a little pharmacy informatics/automation don’t hesitate to give me a Buzz, Tweet or email.

Thoughts on the #PPMI Twitterchat

ASHP and the ASHP Foundation have undertaken an initiative to change the way pharmacists practice pharmacy. And that initiative is called The Pharmacy Practice Model Initiative (PPMI); go figure. It’s quite an aggressive goal and one that I hope results in some great ideas on how to get pharmacists to the bedside where they have been shown to improve patient care and save hospitals money. Of course I’m banking on judicious use of technology to help lead the way, but that’s just my bias speaking.
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What defines a good pharmacy practice model?

I received an email today from the ASHP PPMI group asking me to take their pre-summit survey. I did, and you should too if you care about the future of pharmacy practice. In addition to the request for survey participation the email included a link to the PPMI practice spotlight, which just so happened to feature Children’s Hospital Central California (CHCC) where I spent a few years working in their pediatric ICU.

The spotlight article talks about CHCC’s use of decentralized pharmacists as well as judicious use of automation and technology. While working for CHCC I never stopped to considered whether the practice model we were using was advanced or not. It was simply the model we were using at the time. It occurred to me that most people probably don’t see their practice sites as advanced because everything in front of them appears “normal”.
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Participating in the ASHP Summer Meeting from afar #ashpsm10

The inability to physically be in Tampa, FL shouldn’t stop someone from participating in the ASHP Summer Meeting. Technology doesn’t care that I’m 2700 miles away or that I’m sitting in my home in my bunny slippers with Diet Pepsi in hand. With a webcam and speaker phone I was able to join a user group discussion held by Talyst.
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