ASHP Statement on the Pharmacist's Role in Clinical Informatics
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Automation and Information Technology–Statements 13 ASHP Statement on the Pharmacist’s Role in Clinical Informatics Position ogy professionals to promote the safe, efficient, effective, timely, and optimal use of medications. They contribute to ASHP believes that pharmacists have the training, knowl- the transformation of healthcare by analyzing, designing, edge, background, and responsibility to assume a significant implementing, maintaining, and evaluating information and role in clinical informatics. communication systems that improve medication-related outcomes and strengthen the pharmacist–patient relation- Background ship. The role of pharmacy informaticists revolves around their knowledge of pharmacy practice, safe medication use, Healthcare organizations continue to invest a significant clinical decision-making, and the improvement of medica- amount of financial and human resources in health informa- tion therapy outcomes, combined with their understanding tion technology (HIT) initiatives, including advanced clini- of the discipline of informatics and HIT systems.10 Their pri- cal systems, electronic health records, business intelligence mary roles and responsibilities must encompass five broadly and analytics tools, and applications that deliver the highest defined categories: levels of patient safety and value. This growth has not only led to a considerable demand for HIT workers but, more • Data, information, and knowledge management: man- importantly, has identified the need for a work force with aging medication-related information while promot- training and skills to create a successful and safe interface ing integration, interoperability, and information ex- between HIT and the healthcare delivery system. This work change. force must understand healthcare, information and commu- • Information and knowledge delivery: delivering med- nication technology, and the people, processes, and culture ication-related information and knowledge throughout of an organization. The intersection of these skills has com- the clinical knowledge life cycle, from the point of monly been described as the discipline of biomedical and knowledge generation through cataloging, embedding health informatics, more recently termed clinical informat- 1 knowledge into the workflow, and measuring the us- ics. Evidence continues to emerge regarding the value that a age and effectiveness of that knowledge. well-trained individual in clinical informatics can bring to an • Practice analytics: developing point-of-business ana- organization faced with implementing highly complex and 2,3 lytic solutions for improving decision-making. transformative HIT systems. Applied clinical informatics: applying user experi- Pharmacy informatics has grown to be an integral • ences, research, and theoretical informatics principles discipline within the clinical informatics domain, centered to improve clinical practice and usability. on the effective management and delivery of medication- Leadership and management of change: leading and related data, information, and knowledge across systems • participating in the procurement, development, imple- that support the medication-use process. Pharmacists’ pro- mentation, customization, management, evaluation, fessional identity, education, training, and experience with medication management make them ideal candidates to and continuous improvement of clinical information play a significant role and fill a critical need in pharmacy systems. informatics. Their firm understanding of core pharmacy operations, clinical practice, the medication-use process, Data, Information, and Knowledge Management. standards, and regulations and their long history of utiliz- Pharmacy informaticists play a key role in maintaining the ing technology to support medication management provide data, information, and knowledge assets across all systems the essential components for effectively transitioning into that support medication management. They are instrumental this role. Despite the growing number of formally trained in ensuring data quality and safety, minimizing data-quality pharmacy informaticists, the path and skills required for a risks, and affirming medication-related data, information, 10,11 career in informatics have varied considerably, emphasizing and knowledge management best practices. Data quality the need to build core competencies and grow the number and information management best practices encompass of available programs.4-6 The American Board of Medical Specialties (ABMS) recognition of clinical informatics as a • Providing the appropriate level of data governance and physician subspecialty will likely play an important role in stewardship. evolving pharmacy informatics beyond its current state to • Adopting standard human- and machine-interpretable one with a clinical edge, centered on analytics and delivering formats. information and knowledge at the point of care. This ABMS • Utilizing controlled terminology for integration and decision may also impact the development of a standardized, interoperability. interprofessional educational road map for individuals seek- Ensuring that data are accurate, accessible, complete, 7-9 • ing a career in pharmacy informatics. consistent, current, timely, precise, at the appropriate level of granularity, reliable, relevant, conforming, and Roles and Responsibilities understandable across all data-quality management domains. Pharmacists who practice clinical informatics must col- • Ensuring the consistent use of maps to internal and ex- laborate with other healthcare and information technol- ternal standards and reference data. 14 Automation and Information Technology–Statements • Ensuring that system architecture supports data inter- porting, predicting, and harvesting new information to cre- change. ate new knowledge for improving outcomes. • Ensuring that data, information, and knowledge are audited, measured, and evaluated for effectiveness. Knowledge Application and Delivery. Pharmacy informat- • Ensuring that data, information, and knowledge assets ics is responsible for leveraging knowledge at the right time are validated, integrated, normalized, consolidated, and place within a provider’s workflow to improve caregiver and routinely optimized. effectiveness, work satisfaction, patient satisfaction, and • Developing infrastructure for knowledge, metadata, the quality of care. Pharmacy informatics must continue to and terminology management. evolve to optimize the use of clinical decision support and • Ensuring that information is readily and rapidly under- develop tools that reduce information overload and provider stood and accessed within the workflow. burden. Pharmacy informatics is responsible for looking be- • Ensuring that information and knowledge are centrally yond the traditional means of delivering knowledge by ana- managed, collaboratively developed, and easily dis- lyzing process and outcomes data from existing applications seminated and maintained. to develop and implement new solutions for embedding • Ensuring that information and knowledge are platform knowledge into the workflow.13 independent. • Developing tools to effectively maintain and manage Knowledge Asset Management. Pharmacy informatics must data, information, and knowledge. play a significant role in managing and supporting a health- care system’s technology-enabled medication information Maintenance roles and responsibilities include and knowledge assets. This role would include assisting with authoring, encoding, cataloging, versioning, updating, • Corrective maintenance: taking the corrective and ed- disseminating, and maintaining an inventory of medication- ucative steps required to correct problems with the uti- related information and knowledge. Despite the emergence lization of a clinical information system or technology. of commercial content-management systems and groupware, • Customized maintenance: modifying features already pharmacy informatics must provide the appropriate level of in production systems that require updating or modifi- oversight and governance for these activities and play a role cation for user needs; customized maintenance is es- in the development of future knowledge asset–management sential in clinical information systems, as healthcare systems that support end-to-end knowledge engineering. is constantly changing (e.g., new drugs, new treatment guidance, new procedures). Practice Analytics. The healthcare industry has histori- Enhancement maintenance: improving the perfor- • cally generated large amounts of data driven by financial, mance of applications and people associated with the regulatory, compliance, and patient care–related activities. use of tools. These data have primarily been stored in hard copy form, Preventive maintenance: taking steps in advance to re- • making them difficult to process through traditional data- duce the risk of a problem, including testing before a 12 base management tools. Paper records have also limited op- new release or system upgrade. portunities for the effective exchange of information with Information and Knowledge Delivery. Healthcare delivery other healthcare systems and for providing actionable in- is inherently complex and knowledge dependent, and it is sight on reducing costs, improving performance, and mak- becoming ever more challenging for providers to absorb and ing decisions. The recent infusion of financial incentives and regulation involving HIT from the American Recovery assimilate the growing volume and granularity