ComputerTalk Director of Editorial Content Will Lockwood talks with American Society of Consultant Pharmacists (ASCP) CEO Chad Worz, Pharm.D., BCGP, about where he and ASCP see technology playing the biggest role in pharmacy this coming year.

Read More On The Outlook for 2021 > Nov/Dec 2020 Cover Story

ComputerTalk: Let’s talk about the next big thing in pharmacy from your perspective and from ASCP’s perspective. What technology do you see being critical for pharmacies in 2021?

American Society of Consultant Pharmacists CEO Chad Worz Pharm.D.
ASCP CEO Chad Worz, Pharm.D.

Chad Worz: We are really engaged on a number of levels, and what I think is important — and it may seem very intuitive and obvious — is the adaptation of data to clinical decision support. We’re getting to the point where healthcare systems are talking to each other and where we’re able to aggregate data that we might start applying in clinical protocols and algorithms to impact patient care. An example would be the anticholinergic burden score, which is a score that gives us insight into how problematic somebody’s medication regimen may be. These kinds of tools are starting to become embedded in pharmacy software, whether that’s a consultant pharmacist’s software, a pharmacy management system, or an EHR (electronic health record) system. And I think access to that kind of artificial intelligence is the next big thing.

ComputerTalk: When we talk about this sort of sophisticated decision support driven by artificial intelligence, or AI, the groundwork for this is all being laid by the massive advances in computing power and the massive amounts of data on which AI needs to be trained. What are your thoughts on data ownership and privacy?

Worz: I think there’s always going to be that concern about patient data and privacy. The questions we have to ask are: What’s the use case? Why are you using the data? How interoperable are the different systems so that we’re making sure that sharing the data back and forth is for patient care? Do we have those clinical agreements that cover data use for the patient care processes? I think when we talk about big data from ASCP’s perspective, we’re talking about how we take the health record data that we have access to because we’re performing a clinical service or function for a patient and use that data — whether that’s in that internal system or combining it with an external system that we’re using. How do we use it to try to understand better what’s going on with that patient? I think there’s a difference between aggregating big data and doing research and saying, hey, we noticed these trends or areas of concern in a population of 5 million de-identified patient records. That’s a very different use case.

And there are certainly privacy aspects to this that I think all of us need to consider. If I am taking the perspective of a patient, I might be saying to my doctor, “You know, you’re taking all kinds of information from me. You’re putting that data into your EHR system. I want you to use that data to make me better, or to better care for me. But if you take my data, remove my name and sell it to a company to use in a research project, then that’s a little different use of my data. And I probably want to be aware of that and authorize that.”

ComputerTalk: Do you think that organizations like ASCP will drive the use of data to create decision-making rules? Or will that be the domain of technology vendors?

Worz: I think that’s a good question. It’s always a partnership and a collaboration between different sectors within an industry. If ASCP is doing its job well, it’s representing its pharmacy and pharmacist members by hearing from them and learning that these are the kinds of tools that they need. We’re listening to them when they are saying what kind of applications of data they need at an individual practice level. And then we are considering how we can bring in the right stakeholders to move the software or the systems along toward common goals. ASCP is not going to produce that data or write the code for that artificial intelligence, but we can be a mediator to the different companies about what’s important to pharmacists who practice in senior care settings, from a global perspective. We can communicate what kinds of things our members want and why these needs will be helpful for pharmacy practice and patient care. When we’re convening those stakeholders and creating that dialogue, then we’re helping the industry down the road of better AI and better application of AI.

ComputerTalk: There’s a real need to make sure that you’re asking the data the right questions.

Worz: Absolutely.

ComputerTalk: Is there a big initiative that ASCP is focusing on for 2021?

Worz: Yes. We’re working very hard on the use of psychoactive medications. Some of that is driven by the regulatory environment of skilled nursing facilities, but certainly how psychoactive medications impact older adults is something that applies to a nursing home, an assisted-living facility, and people who live in the community.

So to the extent that we can build dialogue around how to best look at those medications, look at their risks, look at their benefits, and then be able to help build procedures and systems and, to some degree, technology to help us better manage that, this is a key priority for ASCP in 2021. To this end, we’re working on an initiative called Project PAUSE (Psychoactive Appropriate Use for Safety and Effectiveness) with the Alliance for Aging Research. The goal of the project is to better measure nursing facilities’ use of antipsychotics from a regulatory perspective, but the real basis of it is how do we use that information for decision support so that we can make better interventions and decisions? So that we can not only better measure how we’re using those medications, but also ensure that they’re being used appropriately, and that patients are gaining the benefits that improve their care?

We are also embarking on a project looking at anticholinergic burden, something I mentioned earlier, and how can we take some of the scoring systems that exist out there and give insight into the risk of someone’s entire medication profile, to put that information into the hands of the pharmacists who can then take action. This does involve some form of artificial intelligence to score patients and to deliver that information to the clinicians making decisions.

ComputerTalk: What’s your perception of the reaction by pharmacists to these goals and to the topic of artificial intelligence?

Worz: There’s still some trepidation with all clinicians when they hear the words “artificial intelligence.” And I think one of the things that I’ve learned throughout my career using technology, even attempting to innovate on some platforms, is that technology is always part of your tool belt. It’s part of your arsenal that you use to deliver better patient care. It certainly is never going to replace that human-to-human interaction that needs to happen on an individual basis when we’re dealing with healthcare and healthcare decisions. Advances in AI and decision support amplify the opportunities for pharmacists to practice at the top of their license. These aren’t tools designed to replace pharmacists or serve as a surrogate for a pharmacist. These are tools that make the pharmacist better at delivering their services. I always think we have to keep that perspective. CT