News & Information for the MEDITECH Community
Volume 1 - Issue 5 - October 2006

The MEDITECH Community Bulletin is a periodic newsletter covering a broad range of topics that are relevant to the MEDITECH community.  In addition, this newsletter provides a forum for guest contributors including consultants and, of course, MEDITECH customers. The MEDITECH Community Bulletin is published and distributed free of charge to you by Systems Personnel, a professional search firm specializing in the Healthcare IT and Management market.  Visit us online at www.CarrollSearch.com.

If this is the first time you're reading the The MEDITECH Community Bulletin, consider it a warm hello and a handshake as we introduce our newsletter to your company.  If you're a long-time recipient, we hope that you'll find this issue of the The MEDITECH Community Bulletin just as useful as always.

Thanks for your continued ideas, contributions, and feedback!

Regards,
Donna Carroll

QUICK LINKS:   Industry Spotlight  |  Tricks of the Trade  |  Recent News  |  Worth a Read  |  Contact Info

Industry Spotlight:  National Hospital & Health-System Pharmacy Week is October 22nd -28th, 2006

The American Society of Health-System Pharmacists (ASHP) sponsors this week-long celebration during American Pharmacists Month.  The week focuses on the important contributions made by pharmacists and technicians to promote the safety and well-being of patients in our nation's health care institutions.

The MEDITECH Community Bulletin will use the occasion of National Hospital & Health-System Pharmacy Week, October 22-28, 2006, to underscore the importance of the role which pharmacists and pharmacy technicians play as members of multidisciplinary patient-care teams.  Not only do they play a critical role in preventing medication errors and advising providers on the best drug choices, but hospital and health-system pharmacists have been able to take on enhanced patient-care roles because of the deployment of new technologies like dispensing robots, medication label bar coding, and advanced clinical information systems which provide instant access to both drug and patient data.

Pharmacists are experts on the thousands of medications available today, how each one works in the body, and the ways to use each one safely and effectively.  Pharmacists who graduate today receive six years of education focused on medication therapy, and many pharmacists practicing in hospitals and health systems also complete post-graduate residency programs.  They advise doctors and nurses on the best medications and monitor every patient’s medication therapy and provide quality checks to detect and prevent harmful drug interactions, reactions, or mistakes.

Pharmacists in The Information Age

Like any knowledge-intensive field these days, pharmacy professionals are greatly impacted by the explosive growth of computers.  Pharmacy Informatics is a field that combines drug information, patient data and computer expertise.  But, how do you define Pharmacy Informatics?  Well, it depends upon who you ask ... below are some different, but very similar definitions.

• Pharmacy informatics (PIX), also referred to as pharmacoinformatics, is the application of computers to the storage, retrieval and analysis of drug information.  PIX systems help the pharmacist manage information including but not limited to medical insurance records of patients, drug interaction data, as well as prescription data.  (http://en.wikipedia.org/wiki/Pharmacy_informatics)



• Informatics can be defined as that discipline that assists in the translation of raw data into actionable knowledge, i.e., something that could be used, and the dissemination of that knowledge to other individuals including health care professionals and consumers.  Therefore, pharmacy informatics can be defined as that subspecialty of informatics which is applied directly to pharmaceutical care.  (http://www.pharmacyinformatics.org)



• Pharmacy Informatics is an emerging field of study that combines the uses of information technology with the practice of pharmacy.  (http://www.pharmacyinformatics.com)

Why is Informatics Important to Pharmacy?
* The following information is excerpted from the PharmacyInformatics.com web site. *

“Informatics is rapidly becoming an important field in our society. When is the last time you typed in 'informatics' into a search engine?  Today, you would receive between 40,000 and 50,000 hits depending on the search engine you use.  And while the aspects of informatics are endless, a relatively small number of people truly understand its meaning.  Informatics is still in its beginning stages.  It is a result of our 'age of information' and the shear volumes of endless stacks of data that have seemed to appear in the past decade.  New companies have risen from this growing paper-trail quagmire in an effort to curb the data explosion.  New data storage processes and storage units have been created in response.  But, the problem still remains. How do you effectively manage this data?”

“Pharmacists are not immune to the problem either.  Growing numbers of new prescription and OTC medications, patient records, and newer FDA approved indications have made the daunting task of medication familiarity even more difficult.  A pharmacist can't be expected to know every medication, its therapeutic usage, side effects, drug interactions, and dosage forms.  Therefore, we must rely on these new computer systems and algorithms to manage our knowledge base and extend our capabilities.  However, because the programs that are created to manage this information aren't created by Pharmacists, more problems continue to surface.  How many disgruntled pharmacists have complained about the lack of usefulness of a particular program?  How many times have you sat at a system and wondered why you couldn't complete a task the way you wanted to?”

“Some Pharmacists complain that the implementation of some new computer system causes more work.  But, how can this be?  The very nature of the system should be to reduce paperwork and streamline the flow of information to and from the Pharmacist.  The answer, while not simple or singular in nature, lies in the original study and design of the system.  Had the system been designed, ground up, with the Pharmacist in mind, and created by a Pharmacist, then would the system work more efficiently?  There is a particular dearth of data that would support the answer to this question, but logic would tell us that water mixes with water much better than oil.  Yet, we do not see Pharmacist racing out to get a second degree in computers.  Why?  Most likely because 5-6 years of study are needed to become a Pharmacist and another 4-5 years to become a computer engineer.”

Are you a Pharmacy Informatics Specialist?

As a Pharmacy Informatics Specialist, you perform a very important role.  The demand for such professionals is ever-increasing as healthcare providers recognize the need for a clinical background in the development, use, and management of information systems.  Having first-hand experience in the dispensing of pharmaceuticals is becoming even more important as providers are starting to implement some of the more advanced clinical applications available in the market today.

There are several career options available to Pharmacy Informatics Specialists today.  Sometimes the positions reside in the Pharmacy; other times they report into the Information Systems/Technology department.  The position titles may vary from one organization to the next, but the roles generally fall into the following categories:

• Systems / Applications Analyst:  Works for a healthcare provider (hospital, medical practice, or clinic); performs analysis, implementation, development, user training, and support of a specific (or multiple) vendor application software products.



• Implementation Specialist:  Works for a healthcare software/technology vendor or a consulting firm; performs analysis, implementation, development, and user training of a specific (or multiple) products for their customers.  Such positions generally involve extensive travel to customer sites, nationally or regionally.



• Project Manager:  Works for a healthcare provider, vendor, or consulting firm; performs project planning, management, delivery, and oversight of healthcare software/technology initiatives.



• Product Manager:  Works for a healthcare software/technology vendor; provides input to the full product life cycle including the design, development, sales, marketing, and delivery of product(s).  Works closely with both internal teams and customers.

Regardless of the path you choose, we’ll be there with you.

Systems Personnel is a professional search firm specializing in Healthcare Management and Information Technology.  All of our clients need Pharmacy Informatics professionals at one time or another.  If you’d like to keep your career options open, then please let us know.  Even if we don’t have an immediate opportunity for you, we’d be happy to discuss your background, interests, and career options in order to consider you for future opportunities.  Please feel free to call us at 413-258-4511 or email us at any time.  Your personal privacy is guaranteed!

We’d like to thank you for all that you do and wish you a happy National Pharmacy Week!

Back to top

Tricks of the Trade:  Pharmacy Rules

Contributed by:  Dan Hawrot, RPh, Assistant Director of Pharmacy, Trinity West.

Here are a couple of processes we have implemented:

1. We have a Pharmacy rule in place that prohibits the pharmacist from entering outpatient orders with an incorrect service date, thus eliminating one reason for billing problems.



2. We changed our cart fill method.  The refill lists were changed so that only one patient's meds printed per page (if there is more than 1 page for a patient, the 2 pages are stapled together).  We divided the cart fill area into 4 alphabetical sections.  The first tech is responsible for filling the meds that are in one alphabetical section.  The patient drawer with the refill list is then passed on to the next tech in the next section, until the drawer is completed in the 4th section.  This method has decreased the time it takes to fill the carts and has improved the attitude of the techs filling the carts.

Dan Hawrot, RPh, is the Assistant Director of Pharmacy at Trinity West.  Dan has a B.S. in Pharmacy and over 22 years of hospital experience.  He is responsible for MEDITECH-related issues in the Pharmacy.  Trinity West is a member of Trinity Health System, a hospital system in eastern Ohio with a combined capacity of over 471 beds and 1800 employees.

Contributed by:  Anita Bonds, RPh, Pharmacist / Systems Analyst, Greater South East Community Hospital.

Here are some rules that I have created at my facility:

1. Rule to Check Pregnancy, Breast Feeding and Age in Tetracycline Use.  This rule is attached to all active tetracycline drugs in the dictionary.  This rule uses queries attached to the PHA Pat Cus Def Screen in the Customer Defined Parameters.

       [q OEPREG2]="Y"^A,
       [q OELAC]="Y"^B,
        "IF PREGNANT OR BREAST FEEDING, ADMINISTER ALTERNATIVE ANTIBIOTIC!"^C,
         "NOT RECOMMENDED IN CHILDREN < 8 Y.O. ADMINISTER ALTERNATIVE ANTIBIOTIC!"^D,
         IF{(A="Y")!(B="Y") [f rx msg](C);
         IF{([f pt cur age]<8) [f rx msg](D);
          [f rx ok]}};

2. This is a general rule to check pregnancy and breast feeding status.  This rule uses queries attached to the PHA Pat Cus Def Screen in the Customer Defined Parameters.  This rule is attached on page of the CDPs.

	"PLEASE VERIFY DRUG USE IN PREGNANCY & BREAST FEEDING."^A,
	 IF{([q OEPREG2]![q OELAC]="Y") [f rx msg](A);[f rx ok]};

3. This rule was written to check a patient’s location during order entry.  If continuous orders are entered on an outpatient emergency room location, Pharmacy orders will not be sent to Robot Rx to fill.  Only inpatient locations will send orders to Robot Rx.

	[f pt location]="ERG"^A,
	[f pt location]="EFG"^B,
	[f pt status]="REG ER"^C,
	"Pt status is OUTPATIENT. Only enter a 1 time order."^M,
	 IF{([f pt location]=A!B) [f rx msg](M);
	  [f rx ok]};

Anita Bonds, RPh, has over 15 years of clinical experience.  She holds a Masters degree in Information Technology, and B.S. degrees in Pharmacy and Biology.  Anita is a Pharmacist / Systems Analyst with Greater South East Community Hospital in Washington, D.C.

Back to top

Recent News:  Two New Federal Exceptions to Fraud and Abuse Regulations

Two important new federal exceptions to existing fraud and abuse regulations will be going into effect on October 10, 2006.  These will provide MEDITECH customers with more options for supplying e-prescribing technology to physicians, and further open the door to EHR adoption.

http://www.meditech.com/MIXMAGStrategic/MMSfeatures/pages/0906ehrcorner.htm

Back to top

Worth a Read:  Articles of Interest to the Healthcare IT Field

Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually; Report Offers Comprehensive Strategies for Reducing Drug-Related Mistakes
By:  Office of News and Public Information
The National Academies, July 20, 2006

A new report from the Institute of Medicine of the National Academies reports the most common medical error is a medication error, injuring 1.5 million people a year and costing hospitals well over $3.5 billion dollars a year.
http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11623

POINT OF CARE SERIES:  PART 1 - Patient safety moves forward in some hospitals but, seven years after the “Quality Chasm” report, progress is still spotty.
By:  Mark Hagland
Healthcare Informatics, August, 2006

Because of JCAHO Patient Safety Goals, more and more hospitals are utilizing technology to enhance patient safety.  Are methods being used effective?  This article takes a look at some of the broad trends in improving patient safety and the relationship between culture, processes and information technology.
http://healthcare-informatics.com/issues/2006/08/030/

POINT OF CARE SERIES:  PART 2 - Medication management is getting an IT makeover at safety-conscious healthcare organizations.
By:  Mark Hagland
Healthcare Informatics, September, 2006

Using CPOE, eMAR’s and the electronic health record to improve patient safety during medication management.
http://healthcare-informatics.com/issues/2006/09/052/

Back to top