Pharmacy informatics

Without question there is a lack of advanced automation and technology in the acute care pharmacy setting. Spend some time in several acute care pharmacies if you don’t believe me. There’s clearly a need for it, but it’s just not being used.

I am a fan of automation and technology in any setting, but especially in the acute care pharmacy. I believe that the continued use, development and advancement of pharmacy technology should be a key component of any plan to change the current pharmacy practice model. Unfortunately, the situation is problematic because current pharmacy technology is either poorly designed for the needs of the pharmacy or the pharmacy in which it is used has a poorly designed workflow that doesn’t take advantage of it. Why is that? Who’s to blame; someone, anyone, no one? Valid questions.

Unless you’ve been comatose for a while, you’ve certainly heard about the Apple iPad. The device has already been crowned the de facto device for everything from e-reading to creating a new wave in healthcare unlike anything we’ve ever seen. Of course this is all speculation as the device hasn’t been officially released yet.

Many people have speculated that the iPad will be a great device for healthcare. Whether or not that will be the case remains to be seen. One thing is for certain: everyone is banking on the iPad being a big hit in healthcare. Based on the success of the iPhone as a favorite among physicians and nurses, this certainly isn’t a wild prediction. Will this success translate to the pharmacy? Good question.

Over the weekend I spent a little time looking at trends in pharmacy and technology. As expected the healthcare technology market is expanding rapidly and this expansion is creating a need for pharmacists with technology know-how. To prove my point I created a job trends graph from indeed.com using the following search criteria: "pharmacy informatics", "clinical pharmacist" and "director of pharmacy". As expected the search trends for "clinical pharmacist" and "director of pharmacy" are relatively flat, but the trend line for "pharmacy informatics" is striking. It looks like a new pharmacy career path is born.

Our facility is running a trial of DynaMed, “an evidence based medicine point-of-care” database. It reminds me of UpToDate.

From the DynaMed site:

• According to the National Academy Press (2001) 44-98,000 American deaths per year occur due to preventable medical errors; medical errors are estimated to cost the U.S. $17 to $29 billion annually
• Using the "best available evidence" for clinical decision-making improves health outcomes and reduces health care costs
• Busy clinicians use "fast and easy" resources expected to answer most of their questions instead of resources designed to provide the best current evidence
• Clinicians sometimes turn to textbooks and online resources with substantial breadth, but these resources do not use the best available evidence
• Physicians and other health care professionals need a resource where they can reliably answer most questions quickly and accurately (i.e., with the best available evidence)

The application is web-based and easy to use. I only played around with it for about 30 minutes, but was satisfied with what I saw. DynaMed has a nice list of clinical calculators and supports the use of handhelds, including the iPhone, iPod Touch and Android based devices.

I'll spend some more time evaluating DynaMed next week, but at this time I prefer UpToDate over DynaMed for the following reasons:

1) UpToDate appears to, on the surface at least, contain more in-depth information on any given condition

1) UpToDate use Lexi-Comp for their drug information

2) UpToDate has a nicer user interface

The National Library of Medicine has a website know as Pillbox beta that allows anyone to use various identifiers on a tablet or capsule, i.e. imprint, shape, color, size and/or scoring, to quickly identify a medication. I've used systems like this many times for the emergency department when a patient would roll in the door with ten different medications all thrown together in a plastic baggie. The nurse would bring them to the pharmacy and say “I need you to tell me what these are”. I tried holding the baggie to my head like the Great Carnac on Carson, but most of the time I had to use other references to help me out.