Editor ials
ar Layar
Safety perspectives on informatics
T
he 2013 ASHP national survey on informatics highlights the implementation and use of health information technology (HIT) in healthcare systems.1 While the adoption of new technologies has increased since 2007 in U.S. hospitals, determining how to maximize the use of new technologies remains a challenge. In 1962, the U.S. automobile industry introduced a vital piece of technology for the front seats of cars: the seat belt. In 1966, the Highway Safety Act and National Traffic/Motor Vehicle Safety Act were passed, requiring the installation of seat belts in American-made cars to reduce the risk of death or serious injury in automobile accidents. While this safety technology is widely available today, only 87% of Americans reported using seat belts in 2013.2 The early debate, and subsequent imperfect adoption, of seat belts can be likened to the implementation of healthcare technologies. Healthcare technologies such as electronic health records, barcode-assisted medication administration, computerized prescriber order entry, and smart pumps, among others, have been proven to decrease the likelihood of harm to patients yet are still not widely adopted in all settings. In 1999, reports issued by the Institute of Medicine highlighted the patient harm crisis. This awareness, coupled with ever-growing research validating the importance of integrated health informatics for safety, led to the inception of national programs, including meaningful use and health information exchanges (HIEs). Armed with specialized knowledge of the medication-use process pharmacists are uniquely positioned to serve as liaisons between clinicians and information technology specialists.3 A strategic road map to help guide this involvement was developed by the Pharmacy Health Information Technology Collaborative.4 As part of this guidance, three strategic goals were developed: (1) access—ensure HIT supports pharmacists in health care service delivery, (2) connectivity—achieve integration of pharmacies and pharmacists into HIEs, and (3) quality—support national quality initiatives enabled by HIT. Measuring the success of technology implementation will be critical as quality and safety measures are developed and used to distribute incentives (and penalties) in an expanding number of reimbursement models. Professional initiatives such as the ASHP Pharmacy Practice Model Initiative (PPMI) provide pharmacists with recommendations for benchmarking and measuring individual health-system performance on various
Copyright © 2015, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/15/0402-0616. 616
Am J Health-Syst Pharm—Vol 72 Apr 15, 2015
informatics measures. Given the alignment of PPMI, meaningful use, HIEs, and other national programs, pharmacists have many opportunities to drive the adoption, interoperability, and successful use of HIT to advance the safety and quality of care. While notable improvement has been made since ASHP’s 2007 survey on informatics, much work is left to do.5 This is evident in the 2013 informatics survey in which nearly half of respondents (46.2%) remain unsure of their hospital’s HIE status. Medication safety technology and expertise are needed in all care settings, including ambulatory care. Emerging technologies, including patient portals and mobile devices, will continue to expand access to patient health information and should be strongly considered as transitions of care are managed. According to survey respondents, the majority of medication reconciliation processes still include a manual component (87%), with nearly half (48%) relying solely on paper records. This reflects no change from the 2007 ASHP informatics survey. Ultimately, practicing medication safety is minimizing harm during every step in the medication-use process. Only when implemented correctly can health informatics and technology hope to fulfill this aim. As the medication-use experts, pharmacists must take a leadership role in the adoption and optimized use of HIT. Patient safety depends on it. 1. Fox BI, Pedersen CA, Gumpper KF. ASHP national survey on informatics: assessment of the adoption and use of pharmacy informatics in U.S. hospitals–2013. Am J Health-Syst Pharm. 2015; 72:636-55. 2. National Highway Traffic Safety Administration. Seat belt use in 2013—overall results (January 2014). www-nrd.nhtsa.dot.gov/ Pubs/811875.pdf (accessed 2015 Mar 12). 3. American Society of Health-System Pharmacists. ASHP statement on the pharmacist’s role in informatics. Am J Health-Syst Pharm. 2007; 64:200-3. 4. Pharmacy Health Information Technology Collaborative. The roadmap for pharmacy health information technology integration in U.S. health care: 2014–2017 update. www.pharmacyhit. org/RoadmapUpdate_2015.pdf (accessed 2015 Mar 12). 5. Pedersen CA, Gumpper KF. ASHP national survey on informatics: assessment of the adoption and use of pharmacy informatics in U.S. hospitals—2007. Am J Health-Syst Pharm. 2008; 65:224464.
John B. Hertig, Pharm.D., M.S., CPPS, Associate Director and Clinical Assistant Professor of Pharmacy Practice [email protected] Dan Degnan, Pharm.D., M.S., CPPS, CPHQ, Senior Project Manager and Clinical Assistant Professor of Pharmacy Practice Center for Medication Safety Advancement College of Pharmacy Purdue University Indianapolis, IN The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp150155
Copyright of American Journal of Health-System Pharmacy is the property of American Society of Health System Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
ar Layar
Safety perspectives on informatics
T
he 2013 ASHP national survey on informatics highlights the implementation and use of health information technology (HIT) in healthcare systems.1 While the adoption of new technologies has increased since 2007 in U.S. hospitals, determining how to maximize the use of new technologies remains a challenge. In 1962, the U.S. automobile industry introduced a vital piece of technology for the front seats of cars: the seat belt. In 1966, the Highway Safety Act and National Traffic/Motor Vehicle Safety Act were passed, requiring the installation of seat belts in American-made cars to reduce the risk of death or serious injury in automobile accidents. While this safety technology is widely available today, only 87% of Americans reported using seat belts in 2013.2 The early debate, and subsequent imperfect adoption, of seat belts can be likened to the implementation of healthcare technologies. Healthcare technologies such as electronic health records, barcode-assisted medication administration, computerized prescriber order entry, and smart pumps, among others, have been proven to decrease the likelihood of harm to patients yet are still not widely adopted in all settings. In 1999, reports issued by the Institute of Medicine highlighted the patient harm crisis. This awareness, coupled with ever-growing research validating the importance of integrated health informatics for safety, led to the inception of national programs, including meaningful use and health information exchanges (HIEs). Armed with specialized knowledge of the medication-use process pharmacists are uniquely positioned to serve as liaisons between clinicians and information technology specialists.3 A strategic road map to help guide this involvement was developed by the Pharmacy Health Information Technology Collaborative.4 As part of this guidance, three strategic goals were developed: (1) access—ensure HIT supports pharmacists in health care service delivery, (2) connectivity—achieve integration of pharmacies and pharmacists into HIEs, and (3) quality—support national quality initiatives enabled by HIT. Measuring the success of technology implementation will be critical as quality and safety measures are developed and used to distribute incentives (and penalties) in an expanding number of reimbursement models. Professional initiatives such as the ASHP Pharmacy Practice Model Initiative (PPMI) provide pharmacists with recommendations for benchmarking and measuring individual health-system performance on various
Copyright © 2015, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/15/0402-0616. 616
Am J Health-Syst Pharm—Vol 72 Apr 15, 2015
informatics measures. Given the alignment of PPMI, meaningful use, HIEs, and other national programs, pharmacists have many opportunities to drive the adoption, interoperability, and successful use of HIT to advance the safety and quality of care. While notable improvement has been made since ASHP’s 2007 survey on informatics, much work is left to do.5 This is evident in the 2013 informatics survey in which nearly half of respondents (46.2%) remain unsure of their hospital’s HIE status. Medication safety technology and expertise are needed in all care settings, including ambulatory care. Emerging technologies, including patient portals and mobile devices, will continue to expand access to patient health information and should be strongly considered as transitions of care are managed. According to survey respondents, the majority of medication reconciliation processes still include a manual component (87%), with nearly half (48%) relying solely on paper records. This reflects no change from the 2007 ASHP informatics survey. Ultimately, practicing medication safety is minimizing harm during every step in the medication-use process. Only when implemented correctly can health informatics and technology hope to fulfill this aim. As the medication-use experts, pharmacists must take a leadership role in the adoption and optimized use of HIT. Patient safety depends on it. 1. Fox BI, Pedersen CA, Gumpper KF. ASHP national survey on informatics: assessment of the adoption and use of pharmacy informatics in U.S. hospitals–2013. Am J Health-Syst Pharm. 2015; 72:636-55. 2. National Highway Traffic Safety Administration. Seat belt use in 2013—overall results (January 2014). www-nrd.nhtsa.dot.gov/ Pubs/811875.pdf (accessed 2015 Mar 12). 3. American Society of Health-System Pharmacists. ASHP statement on the pharmacist’s role in informatics. Am J Health-Syst Pharm. 2007; 64:200-3. 4. Pharmacy Health Information Technology Collaborative. The roadmap for pharmacy health information technology integration in U.S. health care: 2014–2017 update. www.pharmacyhit. org/RoadmapUpdate_2015.pdf (accessed 2015 Mar 12). 5. Pedersen CA, Gumpper KF. ASHP national survey on informatics: assessment of the adoption and use of pharmacy informatics in U.S. hospitals—2007. Am J Health-Syst Pharm. 2008; 65:224464.
John B. Hertig, Pharm.D., M.S., CPPS, Associate Director and Clinical Assistant Professor of Pharmacy Practice [email protected] Dan Degnan, Pharm.D., M.S., CPPS, CPHQ, Senior Project Manager and Clinical Assistant Professor of Pharmacy Practice Center for Medication Safety Advancement College of Pharmacy Purdue University Indianapolis, IN The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp150155
Copyright of American Journal of Health-System Pharmacy is the property of American Society of Health System Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
