Defining Biomedical Informatics

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What is pharmacy informatics?

UTHealth School of Biomedical Informatics master's student Preston Aycox, PharmD, shares his story and his take on the field.

Preston Aycox, PharmD, had a tough decision to make back in 1997—one that most people confront at least once in their lifetime.  It’s the age-old question: What am I going to do for a living?

“In my mind I had two options when I started college: pharmacy or biology,” Aycox said. “I knew that I eventually wanted to end up in health care, and I wanted an educational background to support that. I always thought of pharmacy as the foundation of health care because it spans all health disciplines, so I decided that was the best choice for me.”

In 2003, Aycox graduated with a Doctor of Pharmacy degree from Texas Southern University. After graduating, he worked at several hospitals across the state of Texas. Today, Aycox has over ten years of experience in pharmacy, working in roles such as clinical pharmacist, operations manager, consultant, auditor and pharmacy director. During those ten years, Aycox has experienced firsthand the advancements in pharmacy, including technology’s growing impact in the field.

“For the past 10 years, I have witnessed the pharmacy profession develop through several stages,” said Aycox. “With technology quickly repositioning to the forefront of health care delivery, we are embarking on another evolution within the field of pharmacy. The combination of informatics and health care has been on the horizon for some time now.”

Defining pharmacy informatics

The American Society of Health-System Pharmacists defines pharmacy informatics as “the use and integration of data, information, knowledge, technology and automation in the medication-use process for the purpose of improving health outcomes.”   

But what does that really mean?

“We’re utilizing technology in order to provide our patients with better health care,” said Aycox.

The average person has certain images that come to mind when thinking about pharmacy, like prescription pads and retail drug stores. Aycox remembers when the hospitals used triplicate forms for medication orders—a system that was rife with human error. There could be a miscommunication between the clinician, the technician and the pharmacist or perhaps the handwriting was illegible and the wrong drug was prescribed. These images and memories that we link to pharmacy may soon be a thing of the past.

A few improvements from the triplicate order method were made but nothing significantly improved the process until e-prescribing was introduced. Now, e-prescribing through electronic health records has become the predominant method of medication ordering. The goal of e-prescribing is to achieve neutrality, transparency, interoperability, efficiency, collaboration and quality. This new method has many advantages, but as a new technology, it doesn’t come without issues.

“With the advent of the EHR systems, errors from illegible handwriting are no longer a problem, but there’s much more to these systems,” said Aycox. “Now physicians can flag the priority of an order, which signals to the pharmacist that it’s a stat medication and needs be moved up in the list. We can also more easily monitor drug to drug interactions, drug abuse and adverse side effects.

“One of the major goals [with EHRs] is to achieve interoperability,” said Aycox. “This will allow hospitals and clinics to share patient information and provide patients access to their personal health record. When a patient is prescribed a new drug, the information is shared and drug to drug interactions, among other patient safety issues, can be more easily monitored.”

As applied to pharmacy, e-prescribing and EHR system use are just a few examples of advancements being made in the field. Telemedicine is another productive arena, which uses telecommunications devices and applications to provide health care at a distance. Telemedicine mobile applications have wide-ranging capabilities to monitor and improve health, including SMS medication and appointment reminders for HIV patients, an app that alerts clinicians and emergency workers of a patient’s genetically predisposed drug responses and cardiac monitoring devices that monitor ECGs and alert the nearest medical center.

The impact of the technology revolution on human health is immense and growing with every passing year.

The need for trained professionals

With all of the new systems, tools and technologies employed by the pharmacy field, the need exists for professionals not only trained to use the technologies but who understand the proper utilization of information, the foundation of the biomedical and health informatics field and the vision for the future.

“Most of us have been introduced to informatics out of the necessity to have a pharmacist developing workflows and configuring a new EHR system or automation within a department,” said Kevin Marvin, ASHP pharmacy informatics and technology chair. “This involves training from the system vendor, connections with users at other facilities and a lot of hands-on experience.

“What is missing for many pharmacists in informatics roles is a foundational education on the principles of informatics with a structured experiential educational component. Without this education, an informatics pharmacist is dependent on others to identify what technology or operational changes are possible or necessary.”

Through his years of experience, Aycox began to see the need for trained professionals who focus on pharmacy informatics. He knew even as an undergraduate that he wanted to go beyond pharmacy and merge his pharmacy background with another focus area.

“When I gained experience in the field (of pharmacy), I saw an opportunity to leverage my knowledge through another field,” said Aycox. “I knew that I wanted to be a ‘hybrid’ professional. I considered medicine, law, education, and finally, I came across informatics. I already saw the trends toward technology in pharmacy while working, and I knew it was what I wanted to do.”

Aycox said he researched several programs and finally decided that the master’s degree in applied health informatics at UTHealth School of Biomedical Informatics was the right fit for him.

“Merging my love for the field of pharmacy and my passion for technology development led me to pursue a degree in health informatics, but it took some time to find the right school with the optimal program to fit my goals,” said Aycox. “The University of Texas School of Biomedical Informatics at Houston has knowledgeable faculty involved in national organizations and a prime location in the world’s largest medical center. The school has just what I was looking for.”

A promising future

Pharmacy informatics and biomedical informatics share a common goal—patient safety and quality of care. Biomedical and health informatics seeks to reduce medical errors and increase efficiency through the use of data, information and technology so that patients will have improved health outcomes. Pharmacy informaticians seek to improve systems and workflow and assist in the development of new methods to achieve safer, more effective medication usage.

“Health informatics has grown dramatically over the past few years, and as the field develops, so will pharmacy informatics,” said Aycox. “In the endless pursuit to become a master of my profession, it is necessary to master the technologies in pharmacy in order to provide optimal, efficient and safe health care to the patient populations I serve.”

Resources:

http://www.ashp.org/informatics

http://studentdoctor.net/2010/12/career-spotlight-pharmacy-informatics/

http://www.slideshare.net/kclauson/how-informatics-will-change-the-future-of-pharmacy

https://www.magnetmail.net/actions/email_web_version.cfm?recipient_id=157722854&message_id=2646096&user_id=ASHPAdv&group_id=925663&jobid=14045797

http://www.himss.org/library/pharmacy-informatics?navItemNumber=16533

http://www.uspharmacist.com/content/d/techrx/c/29579/