Little Data: Health Information Technology Helping Weather the Storm ––>
Many of your patients (and probably you, as well) are “cost conscious.” Your patients certainly have loyalties to those pharmacists and pharmacy staff who provide exceptional, personal service. At the same time, many do pay attention to cost, and their behaviors can be influenced by the cost of goods and services. We think of ourselves as “coast conscious.” You ask, what does that mean? While Auburn, Ala., is our home, we are both originally from the Gulf Coast. As we write this column, we are closely monitoring Hurricane Irma’s path, while we continue to be deeply concerned about those impacted by Hurricane Harvey. As those in Florida and Georgia are preparing for the worst, we are hoping for the best.
Today, we are still impressed by the collective effort — enabled by health information technology (HIT) — that provided critically important information to support the continuation of care.
During this time of year — especially in late August/early September — we think about Hurricane Katrina. While it has been 12 years, our personal connections to the region keep the memories of that storm fresh in our minds. Many of ComputerTalk’s readers also have memories from August 2005. Maybe your pharmacy was directly impacted by the storm’s fury. Or maybe your pharmacy provided valuable healthcare services to patients impacted by the storm. Maybe you entered practice after 2005. If that is the case, find colleagues who were in practice then and talk with them about the ways pharmacists helped those in need
Americans have a history of coming together in times of great need. KatrinaHealth.org was created shortly after the storm hit to provide a central point of access to evacuees’ prescription histories by authorized healthcare professionals. In less than a month, 150 organizations pulled together to create the site (including businesses in competition with each other). Today, we are still impressed by the collective effort — enabled by health information technology (HIT) — that provided critically important information to support the continuation of care
Now, almost 12 years to the day since KatrinaHealth.org was launched, we read that Surescripts and Allscripts are providing free access to 12-month medication histories for pharmacists in Texas and Louisiana through Allscripts’ cloud-based application. In 2005, cloud-based computing platforms were much less common than today. And today’s pharmacists and patients alike are arguably more comfortable with cloud-based services. This serves as a great example of the role of HIT — to support pharmacists and other providers in their efforts to ensure optimal patient outcomes.
The Role of HIT
Turning to Hurricane Irma, we have been discussing how information technology can help those in the path of the storm. Yes, we anticipate that this storm is going to result in pharmacists in Florida (and likely surrounding states) being granted access to medication histories, much like that seen in Texas and Louisiana. But what about the residents, whether they are “riding it out” or they choose to evacuate? As the evacuation orders have been progressively given, beginning in southern-most Florida, we have noticed that the GasBuddy app (and website) is being promoted as a go-to source to get the latest in gas availability. It happens with virtually every major storm. We are reminded that five core needs always rise to the top — food, water, shelter, transportation, and healthcare.
So, where might information technology help patients with healthcare needs during natural disasters? The pharmacy app that your patients currently use will include a pharmacy locator. This is a common feature across a variety of apps. But what happens when a patient gets to a pharmacy and it no longer has the item(s) they need? Based on our experiences, this could reasonably be expected to happen for both front-store items like water, to prescription and OTC medications, especially during natural disasters. Existing pharmacy smartphone apps for pharmacy staff can currently provide inventory levels for a variety of items.
Americans have a history of coming together in times of great need. KatrinaHealth.org was created shortly after the storm hit to provide a central point of access to evacuees’ prescription histories by authorized healthcare professionals.
Should this information be available to patients in times of unique need, like natural disasters? We believe this is worth consideration. We can envision patients from south Florida who are planning to stop in Gainesville (Florida) for essential items as they evacuate before Hurricane Irma arrives. They use a pharmacy locator to identify pharmacies along their route and pick one. But they get to the pharmacy, and the essential item is sold out. During times like this, pharmacy shopping for essential items is not a viable option. Readers who have been involved with a mass evacuation will appreciate this reality.
Where do prescription medications fit in this scenario? We acknowledge that there are medications that pharmacists may not necessarily want to list as “available” in their pharmacy. This becomes even more relevant when we consider that looting can occur during natural disasters. We are not suggesting using information technology to hang a virtual sign on your pharmacy that reads, “We have opioids!” However, we believe patients can benefit by knowing where they can get medications to treat chronic conditions, especially when they may be displaced from home for a lengthy period of time. Prescription transfers, of course, will need to occur
A final note: In this scenario the information that becomes available in a pharmacy’s app during an emergency is incorporated into a pharmacy’s disaster plan. The information is maintained by the pharmacy’s inventory and POS systems longitudinally, and it becomes available in the app when the disaster plan is activated. We can see pros and cons to including this information in an app all of the time, but believe individual pharmacies should have the final decision in what information is available and when it is available.
This scenario assumes that a patient has the pharmacy’s app. This may not be the case for independent pharmacies or small chains that are not located near the patient’s home. However, a simple Google search for “pharmacies in Gainesville FL” will bring up the websites for pharmacies on the patient’s route. They then find the app download link from the pharmacy’s website. There are certainly other challenges in this scenario, but as we watch Hurricane Irma bear down on Florida, we are reminded that novel ideas are needed in unique situations. We welcome your comments. CT
Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, and Joshua C. Hollingsworth, Pharm.D, Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn Campus, Harrison School of Pharmacy, Auburn University. The authors can be reached at email@example.com and firstname.lastname@example.org.