What to do, the case of the unhappy pharmacist

I read an article today at the CEO Blog of the American Pharmacists Association (APhA) that talks about the predicament of the retail/community pharmacist.

According to the post “Pharmacists feel it when they’re asked to fill hundreds of prescriptions per shift, provide immunizations on demand, make outbound calls to promote adherence with patients and to do so with less technician help because management just saw another big contract pricing level get cut. And pharmacists are feeling less respected as the supply of pharmacists has increased and employers find positions are easier to fill.”
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Don’t dismiss the value of an operationally sound pharmacist

As pharmacists begin to move out of the physical pharmacy to the patient bedside I think it will become important not to forget the value of a pharmacist that is well versed in how to handle the operational side of pharmacy. Don’t get me wrong, I think pharmacists should be used more for therapeutics than for the role of physically dispensing medications. However, consider a practice model for pharmacy where technicians are more involved with the day to day operations and automation plays a bigger role in the dispensing process. In this instance a pharmacist will be needed for technician oversight as well as to control the workflow of the pharmacy. In addition that pharmacist will need to have intimate working knowledge of the automation and technology used in the pharmacy space. I don’t believe that a pharmacist needs to see every single item dispensed from the pharmacy, but I do think global oversight is necessary. There are opportunities for positive interventions in all aspects of acute care pharmacy practice.

I began my career as a “operational specialist”. The hospital where I was employed used a hybrid model of satellites and centralized dispensing. They needed stability in the dispensing area secondary to the pharmacist shortage. The pharmacy manager came to me and offered me a unique opportunity to handle the workflow in the main pharmacy from an operational standpoint. The hours were’t great, working Monday through Friday from 1:30pm until midnight, but it gave me a chance to try something new. I spent about a year in this role and found great value in the lessons learned through trying variations on the age old themes of cart fills, ADC replenishment, IV batches, etc. It was worth it.

Do I see the need for an operational specialist in acute care pharmacy? Perhaps, but not in the traditional sense. I see the need for a pharmacist trained in automation and technology with additional skills to manage people and workflow. After all, it is still important that patients receive their medications as safely and efficiently as possible. I envision a role similar to the one I’m in now, with the only difference being less focus on the clinical application of technology for a more mechanical one. Most informatics pharmacists handle both areas of technology now, but as clinical decision support, rules engines, computerized provider order entry, and so on become more prevalent it may become necessary to split the jobs into separate specialties; clinical pharmacy software and pharmacy automation and technology. There’s plenty going on in pharmacy informatics to justify such a design. Similar to pharmacists that have chosen to specialize in Cardiology or Infectious Disease, I think we’re headed for a time when informatics pharmacists will begin to tease out specialized roles in healthcare information technology.

Just a thought.

Time to nominate someone for the ASHP PPMI Summit

I briefly touched on the Pharmacy Practice Model Initiative (PPMI) last week. As part of the initiative ASHP will be holding a PPMI Summit in Dallas, Texas, November 7-9, 2010 where a lot of brilliant minds will come together to work towards advancing pharmacy practice.
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Requirements for a pharmacy informatics professional

In a post from ASHP Midyear I mention that “pharmacists are highly educated clinicians that deserve to practice informatics at that same level. [They] should be the individual involved in making sure that systems are designed to include pharmacy workflow, that the reports being written provide the necessary information to be clinically relevant, that current clinical standards are adhered to during implementation of new systems, be the representative at the table during discussions of integration and interoperability of hospital systems, etc”

A couple of things caught my eye since writing those words and I would like to share them with you here.
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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).”
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Mac tablet coming soon?

9to5mac.com: “The translations are a little sketchy but the ChinaTimes is basically saying that in October, Apple will launch a $800, 10-inch tablet.   Most of this information has been published before so it isn’t certain whether or not this is a rehash of that information or from new sources.  The biggest question at this point is which OSX will it run?  Will it be the Mac OS, the iPhone OS or some hybrid?  The iPod launches are usually in September so a iPod platform device would indicate some deviation.  Also, Apple’s tablet patents seem to indicate that they are working on a full MacOS tablet.” – I really hope this is accurate, especially if the Mac tablet runs on the iPhone OS. Unfortunately the Mac tablet rumor has been floating around for years and has yet to materialize into something tangible. Those of you that know me understand my infatuation with tablet computers. The tablet platform is the perfect combination of desktop power and mobile utility. Pharmacy has yet to unlock the power of tablet computers in the clinical setting, but I believe that will change in the near future. I push my tablet agenda every chance I get.