It’s been said that music moves people, defines generations, and connects us with our past. As a fan of many genres of music, I could not agree more. In fact, I commonly interject music lyrics into everyday conversations, and I also relate life events to song lyrics. In thinking about this column, a song written by the late artist Prince came to mind. Titled, “Nothing compares 2 U,” the song is better known as Sinead O’Connor’s breakout hit on the Ensign/Chrysalis record label in 1990. How does this song relate to health information technology (HIT)? Read on.
The song begins with the following lyrics, “It’s been seven hours and fifteen days…” and goes on to describe a broken relationship. As regular readers of ComputerTalk know, Bill Felkey and I traditionally author this column. This month, I am the solo author. Bill has decided to step aside and give others the opportunity to work with the gracious folks at ComputerTalk and to connect with the thousands of readers across the country. A new coauthor will join me next issue.
It’s been 17 years and 95 articles. Yes, our collaboration in ComputerTalk began in 2000 with an article that examined pharmacy’s adoption and use of various health information technologies to support efficiency, safety, and patient care. Of course, 17 years ago the term “health information technology” was not in vogue. Since then, we have shared authorship on 94 additional articles and have had the pleasure of meeting many who read our column at various meetings across the country.
In that first article from 2000, we pointed out that most providers believe patients own the medical record, but that patients had very little, if any, true control over their record. This is finally changing.
The intent of our column has always been to inform readers about emerging technologies that can support their practice immediately — or in the near term — while not venturing into bleeding-edge technologies that are not ready for widespread implementation or are too risky for you to devote scarce resources to. While we do not see ourselves as futurists, the rapid change that is characteristic of HIT makes it challenging to not sometimes transition into the role of futurist, so our columns have, at times, been forward looking. Looking back, it can be interesting and enlightening to explore where we got it right and where we swung and missed (or shanked it).
In our second column, we explored how the internet (in all instances) would soon become a resource for purchasing technology. This column was partially correct in that the internet certainly has become a resource for purchasing technology. But where has the internet not become a resource for purchasing? Even major purchases like automobiles, homes, and a location for your next pharmacy often begin with an internet search. Are you considering a new pharmacy management system or automation technology? Where should you turn? How about the Buyers Guide on computertalk.com?
Thinking more about your pharmacy, are your patients able to purchase products and services through your website? Certainly they can — at a minimum — connect to your pharmacy via the internet for refill requests and to access trusted information. If patients cannot view and print their current medication profile, manage refills and their family members’ medications, or purchase front-of-store merchandise from your website, they may look elsewhere, as they have come to expect these conveniences.
In 2002, we wrote about two conveniences that have become common parts of everyday life: broadband and wireless connectivity. Can you imagine not having a broadband connection to support the range of data and information sharing that supports your pharmacy on a daily basis? Fifteen years ago there were a variety of broadband options, but virtually none of them included fiber optic to the curb. And do your patients now expect complimentary Wi-Fi? Of course they do.
It’s been 17 years and 95 articles. Yes, our collaboration in ComputerTalk began in 2000 with an article that examined pharmacy’s adoption and use of various health information technologies to support efficiency, safety, and patient care.
We introduced the digital pen in 2003. Using special paper with an embedded grid, this pen allowed you to transfer your handwritten notes into electronic format. This technology did not gain traction like we anticipated. In fact, many of us now get a cramp in our hand if we have to write more than our signature. Portable devices like tablets and smartphones are largely to blame. The need for special paper also didn’t help the digital pen’s chances. Use of mind-mapping software, Health 2.0 tools, and speech recognition software have not matched what we anticipated.
Along the way, this column has focused on regulations, trends, and changes in practice that would ultimately impact your daily work life. Electronic prescribing, including controlled substances, has been a recurring topic. Beginning in 2005, regular topics include the movement toward electronic health records, including the challenges for community pharmacists to access records that exist outside of their pharmacy management systems. More recently, mobile health (mHealth) and web-based patient engagement are recurring topics that have received continued attention.
Where should ComputerTalk readers turn their attention going forward? In that first article from 2000, we pointed out that most providers believe patients own the medical record, but that patients had very little, if any, true control over their record. This is finally changing. Patient engagement is now an important philosophy that has spread throughout healthcare. Pharmacy must embrace this change and provide the tools and opportunities to connect with its patients — in the way their patients prefer.
One way patients will want to connect is by sharing data they capture through their daily routines. These data will often relate to medication-taking behaviors and to the outcomes of medication use. Other data may document physical activity and wellness behaviors. Certainly access to these data will provide a more complete picture of the patient’s overall health, as pharmacists evaluate the impact of medication therapy. Pharmacy management systems will need to support these activities.
While much progress has been made toward electronic health record (EHR) adoption in hospitals and physician clinics, community pharmacy largely remains on the outside looking in when it comes to EHR access. This must change. This will not change quickly. Groups like the Pharmacy Health Information Technology Collaborative are advocating on your behalf. A parallel effort that may help speed things up is the drive for pharmacist provider status. Optimistically, the outcome of both efforts is that pharmacists will have read/write access to their patients’ longitudinal medical record.
Seventeen years passed quickly. While much has changed in HIT during that time, very little has changed in areas like patients’ access and control of their medical records. Sharing the ah-ha moments, as well as the uh-oh moments, with Bill and ComputerTalk’s readers has been a great experience. I wonder what the next 17 years will bring. If you want to send Bill a note or a question, his email address is firstname.lastname@example.org. 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, Auburn University. He can be reached at email@example.com.