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Is there a Pharmacist in the House?

November 28, 2010
by Mark Hagland
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When it Comes to Clinical IT Implementations, Healthcare IT Leaders are Turning to the ‘Third Discipline’ for Leadership and Involvement in Clinical Informatics

EXECUTIVE SUMMARY

Johnanne Ross, PharmD
Johnanne Ross, PharmD

Nationwide, healthcare IT leaders are beginning to recognize the need to bring pharmacists to the clinical informatics table along with physicians and nurses. In fact, say CIOs and clinical informaticists, the need for these professionals will only intensify in the next few years, particularly given pressures to achieve meaningful use organization-wide.

After working for 10 years now as a pharmacist informaticist, Johnanne Ross, PharmD, director of pharmacy IT automation at the University of Pittsburgh Medical Center (UPMC) health system, says she can see one obvious change that has taken place: she no longer has to expend as much energy explaining what she does every day. For one thing, in contrast to when she first arrived at UPMC as one of the first wave of full-time informaticists with clinical pharmacy backgrounds, there are more of her colleagues with similar backgrounds now. In fact, Ross heads up a team of seven such informaticists, who have been working on all the electronic health record (EHR) rollouts and implementation of other clinical information systems across the 20-hospital system based in Pittsburgh.

“It's changed a lot,” Ross says of the need to explain exactly what pharmacist informaticists do. “Initially,” she says, “some people didn't recognize the importance of having a pharmacist present at a meds integration meeting. It was actually sometimes the vendors who didn't get it. So I've seen that change over the years, that people do recognize the value of a pharmacist in this role.”

INITIALLY SOME PEOPLE DIDN'T RECOGNIZE THE IMPORTANCE OF HAVING A PHARMACIST PRESENT AT A MEDS INTEGRATION MEETING. IT WAS ACTUALLY SOMETIMES THE VENDORS WHO DIDN'T GET IT. SO I'VE SEEN THAT CHANGE OVER THE YEARS, THAT PEOPLE DO RECOGNIZE THE VALUE OF A PHARMACIST IN THIS ROLE.-JOHNANNE ROSS, PharmD

Indeed, nationwide, more and more healthcare IT leaders are beginning to do just that-to recognize clearly the need for clinical pharmacists to join the clinical informaticist teams in hospital-based organizations-teams that already include physician and nurse informaticists-as patient care organizations push forward with electronic health record (EHR), computerized physician order entry (CPOE), electronic medication administration record (eMAR), advanced pharmacy, and other clinical IS implementations. For when it comes to patient safety, clinical decision support, medication formulary, clinician workflow, and a host of other issues, leaving pharmacists out of the discussion-it's becoming clearer and clearer over time-is a recipe for implementation failure.

As an example of the kinds of involvement that pharmacist informaticists are engaged in, Ross cites a recent go-live with CPOE at one of UPMC's facilities. “We gave the people in the neonatal ICU things like dose-range checking for several medications; deployed a rounding report for them; were able to add head circumference and gestational age as data elements in the order entry system, in order to keep up with the babies' gestational ages; and developed new label codes for the babies,” among other things. “They were extremely happy with what they got, absolutely happy.”

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