How do you see pharmacists transitioning into pharmacy informatics and can you provide some career tips to follow along the way?
Answers from Michael T Van Ornum:
Pharmacy informatics is a dynamically growing and changing field that falls into two very general and overlapping categories: clinical and operational. The pharmacist wishing to transition into an informatics career should first understand which opportunities are available in their present position and then decide if that will provide a good foundation for the role they see themselves taking as a pharmacy Informaticist.
Operational duties revolve around the design, build, and maintenance of the technical systems used in the primary delivery of health care — a pharmacy dispensing system or subsystem, a prescriber order-entry system or subsystem, electronic prescribing system or subsystem, bar code administration, automated dispensing systems, dispensing robots, packagers, etc. This role revolves around managing the interfaces between complex pieces of equipment and the complex relationships between drug nomenclature and real products.
The clinical focus of informatics, typically in greatest demand in hospitals, revolves around the design, build, and interpretation of clinical reports, serving as a clinical resource for IT initiatives, and translating clinical initiatives into terms programmers can understand. This could be to satisfy meaningful use criteria, justify a staffing initiative, or provide a quality check on an existing process to name a few. A deep understanding of the software infrastructure, the data elements available, and the clinical workflow that generates those elements is essential to extracting meaning from the vast machinery of healthcare systems.
Step by Step
Pharmacists interested in transitioning into this kind of work should begin by volunteering or serving on committees involved with decision-making for end-user features and enhancements. This is a great first exposure to the considerations and thought processes that go into design decisions. From there, stay alert for opportunities to work at the next level of detail such as configuring or building the software changes needed. If the organization is undergoing a major change to CPOE, e-Prescribing, or a new software system, the potential for this kind of opportunity is much greater.
People to begin speaking with about opportunities that may arise are: the IT department supervisors, project managers, and directors, the CMIO, the pharmacy director or operations manager, and the medical safety officer. Pharmacy informatics plays a role directly or indirectly in the work of all these individuals to a varying degree depending on the company.
The unique perspective and training a pharmacist brings to the application of technical tools adds value that is qualitatively different than that of a technician or clinician. Bridging the gap between technical tool and quality patient care is a satisfying and worthy goal to strive for.
Answers from George Robinson:
Pharmacists have a unique perspective on the healthcare world as we participate within multidisciplinary teams, provide cognitive clinical services and direct operational tasks associated with the acquisition, order fulfillment and administration or dispensing of medications. Thrown into an environment of escalating workload, increased data reporting requirements and an increased focus on improving overall patient outcomes within inpatient and ambulatory environments, pharmacists increasingly have opportunities to participate within the implementation, maintenance and improvement of supportive information systems.
Knowledge Authoring Activities
Michael provides a great perspective for those transitioning into informatics roles within the boundaries of their enterprise work environment. Perhaps a little less intimidating than leading efforts toward the implementation of systems and system interfaces is the ability to participate in knowledge authoring activities. These activities fall into two categories: 1) applying invoking or suppressing filters to off the shelf decision support content and 2) participation within custom clinical decision support rules authoring and implementation.
Applying filters to off the shelf decision support content
Increasingly, there is an awareness that implementation of off the shelf medication decision support content is fraught with over alerting potential. Working within multidisciplinary teams that evaluate reports of frequently firing, frequently overridden alerts, as the means to assess alert modification “candidates” via the application of filters is a great way to begin to look at the world from an “informatics” point of view. The implementation of alerting filters via EHR or pharmacy management system administrator tools are essential components to the overall management of medication decision support management within an enterprise.
Participating in root cause analysis forums
Similarly, participating in root cause analysis forums that assess frequently occurring adverse drug reactions or drug administration errors is a great way to understand the flow of information and decision points within the continuum in which check and balance types of interventions can be made. Many EHR systems support the implementation of custom alerts. Being able to express desired alerting behavior in a logical manner, using terms that the development support staff can understand, is a skill that is very much appreciated within technical implementation teams.
Similar to Michael’s comments, simply becoming involved at a local level in the day-to-day management of systems and the implementation of quality improvement interventions via supportive systems are great ways to begin looking at the world from an informatics state of mind!