Brent I. Fox, Pharm.D., Ph.D and Joshua C. Hollingsworth, Pharm.D., Ph.D.

We both have young children. In the months leading up to their arrival, well-intentioned family and friends generously shared their advice and the experiences they’d had with their own children. They wanted to help prepare us for the change that we were about to experience. Those of you with children know very well that nothing can prepare you for their arrival: It is the most exciting and frightening event in your life.

We are also both pharmacists and educators of tomorrow’s healthcare professionals. Neither of us entered pharmacy school with the plan of (or even the remotest interest in) becoming educators. But, as Bill Felkey once said in reference to an old Yiddish adage, “People plan and God smiles.”  We had plans for our futures, but other opportunities presented themselves. And here we are today doing our part to help prepare future healthcare providers for their careers.

Maybe it is a result of our role as educators, but we find ourselves seizing on countless teaching opportunities with our children each day. Certainly, we want to help mold them into individuals who provide valuable contributions to society. We believe parents have a responsibility to guide their children in how to value others (and themselves) and to treat others how they would like to be treated. These are common norms in our society. But are we going too far when we delve into the intricacies of the Saffir-Simpson Hurricane Wind Scale with a 3-year-old? Or, when an episode of Vampirina (a children’s cartoon) leads to a discussion of the Electoral College? Maybe it is simply the educators in us.

The Opportunity

Did you know that you have an opportunity to provide a pivotal role as an educator of tomorrow’s pharmacists? Every pharmacist and pharmacy technician who reads ComputerTalk has an opportunity to help prepare today’s pharmacy students for the careers they will soon enter. Exactly what are we referring to? A little more than a decade ago, two papers that examined the current state of pharmacy informatics education in U.S. schools of pharmacy were published. A ten-year follow-up to one of those papers was published this year. The papers found that approximately one-third of pharmacy schools provide informatics education, both a decade ago and currently. While a dissection of the exact informatics topics that are taught will likely reveal substantial differences across schools of pharmacy, the take-home message of some 60% of schools not providing informatics education is important.

The American Journal of Pharmaceutical Education found in a 10-year follow-up study that little progress has been made to increase the importance of informatics in pharmacy schools. Read the entire study here.

It is important for three critical reasons. First, our accreditation standards dictate that we teach the materials. Second, the Institute of Medicine has indicated that informatics should be a core pillar of health professions education due to its role in practice. Third, can you envision a pharmacy setting that is NOT supported by some form of information technology? Some will argue that informatics and information technology are distinctly different fields. However, in the world of pharmacy practice (regardless of the setting), these terms are intricately related. Informatics is the optimal use of information for decision-making. Information technology is the platform that enables how we use information.

So, where do you come in? This is where our seemingly irrelevant discussion of taking advantage of teaching opportunities comes into focus. Does your pharmacy provide rotation experiences for pharmacy students, or shadowing experiences for high school students? If not, we encourage you to provide these opportunities. One of the most challenging aspects of teaching informatics-related topics in an academic setting is having access to the systems that students will encounter in practice. This is where your position in a pharmacy provides a distinct advantage: You have access to the systems, providing real-world teaching opportunities.

Real-Life Experience

We have found that we are most successful teaching these topics when we contextualize them in the medication use process. This allows students to consider the systems that are used as a medication travels from the pharmacy shelf to the patient, initiated by the creation of a prescription. We will begin with prescribing. Teaching opportunities related to prescribing can focus on the role of the clinical decision support system (CDSS) for prescribers and pharmacists. Which CDSS modules are active in your pharmacy system? Do prescribers optimally use their CDSS? Data vendors have more than 20 different CDSS modules. How did your pharmacy decide which modules to activate? Also, what was the decision process for deciding the thresholds that must be met before an alert fires? A teaching opportunity related to prescribing would be incomplete if e-prescribing was not discussed. Depending on your comfort level, a discussion of standards would be appropriate here (e.g., NCPDP SCRIPT). What challenges do you face with e-prescribing? It is likely that some prescriptions do not come into your pharmacy management system perfectly. How do you normally address these situations? An additional, timely topic is the role of e-prescribing in preventing drug diversion.

Once perfected by pharmacy staff, prescriptions are dispensed. There is a vast array of technology involved in dispensing medications in the community setting. These technologies primarily focus on solid oral dosage forms because they represent the majority of prescriptions that leave the pharmacy. Students benefit by seeing these technologies in action, ranging from countertop counting systems to robots that count, pour, label, and cap complete prescriptions. What benefits do these systems offer the pharmacy? What challenges are associated with these systems? A critical discussion can occur around the ways these systems help minimize errors and adverse events. These systems are not perfect, so it would also be important to talk about how they may inadvertently automate errors.

The patient and medication then leave the pharmacy. The dedicated infrastructure for monitoring patients’ response to medications is quite different in hospitals from that in the community. This does not mean that patients in the community cannot be monitored. This is actually an exciting area of development as patients are adopting consumer electronic devices that monitor clinical measures that can indicate response to medications (e.g., blood pressure, blood glucose, asthma control, etc.). As you know, the challenge with patients collecting this data in their daily lives is integrating the data into existing clinical systems, like those in the pharmacy. This reality provides a great opportunity to discuss the challenges (access, validity, timeliness, etc.) of using patient-generated data. Additionally, the larger challenge that pharmacy faces in terms of bidirectional, real-time data sharing with other providers’ systems should be discussed.

We have found that the ComputerTalk Buyers Guide is a useful resource in our teaching efforts related to informatics and health information technology in the pharmacy. A quick glance at the lists in the Buyers Guide will reveal that there are many more topics that can be discussed with students. Here, we focused on the topics to which students most easily relate. We are interested in hearing about your experiences teaching students about these topics. CT

Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, and Joshua C. Hollingsworth, Pharm.D., Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn Campus, Auburn University. The authors can be reached at foxbren@auburn.edu and jhollingsworth@auburn.com.edu.

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