RxInformatics: “The following was a list serv question from Monica Puebla, PharmD, MBA, BCPS for a HIS course. Here is my response to the Question. I would add State Boards of Pharmacy to the list of those to present this as well.
“If you were given the opportunity to present to your DOP, VP and CFO a project that you deem would have the greatest impact on the pharmacy department as well as the health-system in general from any point of view, clinical, financial, operational, without regards to costs, what would it be?””
John’s response was to “Study under what circumstances pharmacist order review (perfection) could be taken over by automated clinical decision support while increasing quality and safety” in addition to including a nice list of references related to ‘perfection’ (listed at the bottom of this post). I highly recommend looking at the references John provides because they’re informative and enlightening. You can also read more about the ‘perfection’ idea at one of John’s older posts here. It’s amazing that this discussion has been going on for well over a year and to the best of my knowledge has yet to make much headway.
Anyway, there hasn’t been much activity on the question from the listserv, but it was only posted eight hours ago. I’m not really sure the question can be answered in the way the author wants. I always have some things in the back of my mind that I think would have a significant impact on pharmacy practice, and healthcare in general. Unfortunately, In my opinion I don’t think there’s a single item out there that’s worth implementing in a vacuum. Rarely is a single piece of automation or technology going to make a drastic, wide-sweeping change in how pharmacists do their job. Most of the time we see incremental improvements that slowly evolve over time to drive us in a new direction.
As John mention’s at RxInformatics, automated order processing could have a big impact on the way we practice by significantly reducing the amount of time pharmacists spend entering trivial orders. Pharmacy automation in the form or robotics, automated IV preparation, automated packaging, etc also creates an environment where pharmacists have more freedom with their time. Clinical surveillance software can free up pharmacists by pinpointing patients that need pharmacists intervention without the necessity of having to rummage through hundreds of “normal” patients and worthless documentation to find them.
Another idea on the listserv proposed the use of RFID technology to provide real-time medication tracking with integrated CDS. Anyone that knows me understands that I’d love to see that one come to fruition as I’m a big fan of RFID technology. However, based on what I’ve learned in recent months RFID technology isn’t quite ready for prime time application in pharmacy. Not yet, anyway.
So, what project would I deem having the greatest impact on the pharmacy department as well as the health-system in general from any point of view? I can’t think of a single solution, but rather a complete overhaul with implementation of many complex pieces of automation, technology and strategic workflows.
There’s nothing on the market today – software, hardware, practice model – that’s advanced enough to “fix it all”. Just sayin’
References listed by John Poikonen at RxInformatics.com
- A new term for transcribing Am. J. Health Syst. Pharm., Oct 2008; 65: 1801 – 1802. http://www.ajhp.org/cgi/content/full/65/19/1801
- Flynn AJ. Opportunity cost of pharmacists’ nearly universal prospective order review. Am J Health-Syst Pharm. 2009; 66:668–70.
- Poikonen J. An informatics perspective on nearly universal prospective order review. Am J Health-Syst Pharm. 2009; 66:704–5.
- D. A. Tribble Automating order review is delegation, not abdication Am. J. Health Syst. Pharm., June 15, 2009; 66(12): 1078 – 1079.
- P. G. Pierpaoli Creatively using our intellectual capital Am. J. Health Syst. Pharm., June 15, 2009; 66(12): 1087 – 1087
- IBMs’ Watson 1; Human Jeopardy contestants 0 http://www.pcmag.com/article2/0,2817,2375791,00.asp
Nice article. Completely agree that the solution is a complete overhaul! Also, think you might be interested in what we’re doing. We’re big into using IR/RFID to automate workflows and other processes in healthcare. We’re even doing some automated lab and pharmacy orders. Interested to learn more about your ideas. Take care!
Hi Miranda, I am certainly interested in what you’re doing and am thankful that you let me know.