The Impact of Electronic Health Records on Pharmacy Practice
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CREDIT: 2.0 Continuing Education EARN CE CREDIT FOR THIS ACTIVITY AT WWW.DRUGTOPICS.COM AN ONGOING CE PROGRAM OF THE UNIVERSITY OF CONNECTICUT EDUCATIONAL OBJECTIVES SCHOOL OF PHARMACY AND DRUG TOPICS Goal: To assist pharmacists and pharmacy technicians in understanding the impact of electronic health record (EHR) systems on pharmacy practice, as the use of EHR systems continues to increase. After participating in this activity, pharmacists will be able to: ● Summarize the impact on pharmacy practice of the new HHS rules governing the use of electronic health record (EHR) systems. ● Identify the ways in which EHR systems will increase the effi ciency of pharmacy practice with respect to continuity of care, formulary checks, drug-to-drug and drug-to-allergy interactions, and medication reconciliation. ● Summarize the challenges pharmacists face as EHR systems come into increasingly wider use. ● Apply the process of pharmacists using EHRs to case scenarios After participating in this activity, pharmacy technicians will be able to: ● Recognize the impact on pharmacy practice of the new HHS rules governing the use of EHR systems. The impact of electronic ● Identify the ways in which EHR systems will increase the effi ciency of pharmacy practice with respect to continuity of care, formulary health records on checks, drug-to-drug and drug-to-allergy interactions, and medication reconciliation. pharmacy practice ● Recognize the challenges pharmacists face as EHR systems come into increasingly wider use. Rachelle Spiro, RPh, FASCP The University of Connecticut School of DIRECTOR, PHARMACY E-HEALTH INFORMATION TECHNOLOGY COLLABORATIVE, ALEXANDRIA, VA; CEO Pharmacy is accredited by the Accreditation AND PRESIDENT, SPIRO CONSULTING, INC., LAS VEGAS, NV Council for Pharmacy Education as a provider of continuing pharmacy education. Pharmacists are eligible to participate in both the ith the American Recovery At the bill’s enactment in 2009, only knowledge-based and application-based activities, and Reinvestment Act (ARRA), 11.9% of hospitals made any use of EHRs, and will receive up to 0.2 CEUs (2 contact hours) for which was signed into law in with only 2% meeting what would be stage W 4 completing the activity/activities, passing the quiz/ 2009, Congress set ambitious goals for 1 meaningful use criteria. Only 21.8% of quizzes with a grade of 70% or better, and completing an online evaluation. Statements of credit are available the nation to integrate information technol- offi ce-based physicians had basic electronic via the online system. ogy into healthcare delivery.1,2 A segment systems and only 6.9% had fully functional Pharmacy technicians are eligible to participate in of ARRA, the Health Information Technol- electronic systems.5 The U.S. Department the knowledge-based activity and will receive 0.1 ogy for Economic and Clinical Health Act of Health & Human Services (HHS) fi nal- CEU (1 contact hour) for completing the activity, passing the quiz with a grade of 70% or better, and (HITECH), authorized incentive payments ized the meaningful use criteria for the fi rst completing the online evaluation. Statements of through Medicare and Medicaid to provid- 2 years of the 3-stage incentive program credit are available via the online system. ers that use certified electronic health in mid 2010.5 The bill’s health information ACPE #0009-9999-12-007-H04-P/T (Part 1) records (EHRs) to achieve specifi ed im- technology (HIT) component followed the ACPE #0009-9999-12-008-HO4-P (Part 2) provements in healthcare delivery and earlier Offi ce of the National Coordinator Grant Funding: Funding for this activity was provided by: implement a nationwide EHR system by (ONC) for Health Information Technology Cephalon; Endo Pharmaceuticals, Inc.; Purdue Pharma L.P. 2014.3 created by presidential executive order in Activity Fee: There is no fee for these activities. Initial release date: 4/10/2012 Faculty: Rachelle Spiro, RPh, FASCP Expiration date: 4/10/2014 Ms. Spiro is Director, Pharmacy e-Health Information Technology Collaborative, Alexandria, VA, and CEO and President, Spiro Consulting, Inc., Las Vegas, NV. Editorial assistance was provided by Deborah To obtain immediate CPE credit, take the test online Kaplan. Ms. Kaplan’s revisions were reviewed and approved by Ms. Spiro. at www.drugtopics.com/cpe. Just click on the link you Faculty Disclosure: Ms. Spiro has no actual or potential confl ict of interest associated with this article. find under Free CPE Activities, which will take you to the CPE site. For first-time users, please complete the Disclosure of Discussions of Off-Label and Investigational Uses of Drugs: This activity may contain discussion registration page. For those already registered, log of unlabeled/unapproved use of drugs. The content and views presented in this educational program are in, find, and click on this lesson. Test results will be those of the faculty and do not necessarily represent those of Drug Topics or University of Connecticut displayed immediately. Complete the evaluation form School of Pharmacy. Please refer to the offi cial prescribing information for each product for discussion and you will receive a printable statement of credit by of approved indications, contraindications, and warnings. GETTY IMAGES/PHOTODISC/MACIEJ FROLOW e-mail, showing your earned CPE credit. For questions concerning the online CPE activities, e-mail: [email protected]. 46 DRUG TOPICS April 2012 DrugTopics.com CONTINUING EDUCATION Glossary of Terms Abstract ACO Accountable care The American Recovery and Reinvestment Act of 2009 set ambitious goals for organization the nation to integrate information technology into healthcare delivery. The ADEs Adverse drug events Health Information Technology for Economic and Clinical Health Act segment of ARRA American Recovery and the bill provides incentives for Medicare and Medicaid providers to use certi ed Reinvestment Act electronic health records (EHRs) to achieve speci ed improvements in healthcare CAH Critical access hospital and implement a nationwide EHR system by 2014. Meaningful use criteria CCD Continuity-of-care document are being promulgated in 3 stages. Medicare and Medicaid incentive payments CDS Clinical decision support will total $27 billion over a 10-year period with $17 billion designated for EHR development. Pharmacists will not receive direct funding or incentives but CMR Comprehensive medication pharmacy schools may receive grants for incorporating electronic personal health review technology into clinical education. The nation’s goal for EHRs is to reduce costs CMS Center for Medicare and through less paperwork, improved safety, and reduced duplication of testing, and Medicaid Services improve health by gathering a patient’s entire health information in a single CPOE Computerized provider order location. Electronic connectivity through e-prescribing—the paperless, real-time entry transmission of standardized prescription data among prescribers, pharmacies, CPT Current procedural and payers—places pharmacists squarely within the healthcare technology team. terminology The Pharmacy e-Health Information Technology (HIT) Collaborative, a group of DEA Drug Enforcement Agency 9 national pharmacy organizations and associate members, advocates integrating EHR Electronic health record the pharmacist’s role of providing patient care services into the national HIT EMR Electronic medical record interoperable framework. The greatest challenge that pharmacists face in the new EPCS Electronic prescribing for era of electronic health information is to be recognized by Medicare and Medicaid controlled substances as eligible providers of medication-related patient care services and as meaningful ePHR Electronic personal health use contributors to electronic health information. record HHS U.S. Department of Health & The primary goals of improving the na- physician offi ces by 2019.8 The Congres- Human Services tion’s HIT infrastructure are to: sional Budget Office has projected that HIPAA Health Insurance Portability • Ensure protection and privacy of HITECH will reduce federal and private sec- and Accountability Act healthcare information; tor spending on health services during the HITECH Health Information • Improve patient care by reducing next decade by tens of billions of dollars 9 Technology for Economic medical errors; by increasing effi ciency. By October 2011, Clinical Health • Reduce costs by removing administra- $1.2 billion incentives had been paid.7 Pre- HIE Health information exchange tive barriers that result in duplicative claims liminary data for 2011 show the use of and services; and EHRs growing, but the goals for 2019 are HIT Health information 10 technology • Improve coordination of care among considered ambitious. healthcare providers. Pharmacists will not receive direct fund- HL7 Health Level Seven To achieve these goals, as much as $27 ing or incentives for adopting electronic LTC Long-term care billion over 10 years was designated in Medi- medical record technology. Pharmacy MTM Medical therapy management care and Medicaid incentive payments for schools, however, are included among the ONC Offi ce of the National eligible providers who use EHRs and demon- list of approved graduate schools that may Coordinator strate “meaningful use” of HIT.3 In addition, receive grants for incorporating electronic PCP Primary care physician (or HIT systems have to be certifi ed as meet- personal health technology into clinical edu- provider) ing certain technologic standards.