Principles of specialty practice in pharmacy informatics are delineated in a statement published by ASHP.1 These principles can be woven into a list of measurable standards,
duties, and responsibilities to create the pharmacy informatics specialist job description. In general, the specialist will be directly or indirectly responsible for evaluation, selection, training, configuration, testing, implementation, maintenance, enhancement, and support of all pharmacy information technology. Depending on the scope of the position, institu- tional structures, and organizational needs and goals, the pharmacy informatics specialist job description might contain some or all of the components listed in Appendix 9.1.
After attaining a position as pharmacy informatics specialist, think about the medica- tion use process and work flow in the practice setting. The specialist should identify all current systems and potential opportunities for the optimal use of information and tech- nologies to promote efficiency and better patient care. He or she should keep in mind the needs of colleagues in medicine, nursing, and other disciplines to make sure that the spe- cialist’s ideas and recommendations are in line with the organization’s goals. Experience and creativity should be used to develop new programs beyond the informatics applica- tions listed here:
supply chain •
electronic ordering and invoicing of wholesaler drug orders •
just-in-time replenishment system for automated dispensing cabinets •
medication ordering •
electronic health record (EHR) •
computerized provider order entry (CPOE) •
facsimile and digital image transmission of written orders •
electronic drug information sources •
decision support deployment, including rules and alerts •
drug dispensing •
robotic initial dose preparation and cart fill system •
robotic intravenous solution preparation •
automated dispensing cabinets (ADCs) •
parenteral nutrition admixture compounding pumps •
drug administration •
electronic medication administration record (e-MAR) •
bar code medication administration (BCMA) •
computer-based infusion devices (smart pumps) •
drug monitoring •
pharmacokinetic dosing tools •
electronic documentation of clinical interventions •
electronic documentation of adverse drug events and •
automated reports that trigger follow-up •
9.4.1 Project Management
Project management is a large part of the informatics specialist’s responsibilities. Selection and implementation of projects are done in collaboration with a number of individuals. Many useful tools are available to document and track these projects. Simple lists and grids can be built using word processing or spreadsheet software. Project management software suites, such as Microsoft Project (Microsoft Corporation, Redmond, WA), provide more sophisticated features for managing projects and both human and financial resources. Project tasks can be documented, time lines formu- lated, milestones set, and responsibilities and resources allocated. It is important to use the documentation procedures specified by the organization, particularly with respect to the organization’s information technology governance and change-manage- ment processes.
128 ◾ Armen I. Simonian
The specialist should look for opportunities to standardize applications across the orga- nization and develop implementation standards for each application. For all applications that are implemented, he or she should develop and adhere to policies and procedures for the safe and effective use of the software and technologies. Beyond proper use, numerous other aspects of computer applications are necessary:
maintaining and monitoring the applications •
addressing standard software settings •
assessing employee education and competence •
addressing employee access and login security •
backing up and archiving data and •
developing planned and unanticipated downtime procedures •
For consistency across applications and organizational entities, drug database mne- monic and nomenclature standards should be created and adhered to. Designations for every product, such as an intravenous drug solution, should be consistent across all sys- tems from ordering to administration to the patient. Collaboration with nursing and other disciplines is necessary to define standard products available for ordering and agree on standard dose-administration times. These types of standardization efforts add to the safety of clinical systems.
9.4.2 Personnel Management
Once the informatics specialist has established his or her position, a pharmacy services informatics team should be built. Each entity (hospital or retail pharmacy) of a multisite institution should have a representative on the team. In the pharmacy, this staff member is usually a pharmacist who has responsibility for submitting change management requests and providing local informatics support. These individuals might be called “superusers” or “database managers,” and they may participate in projects as time allows. Organizations might also have pharmacy technicians who specialize in automated dispensing, and they also should be part of the informatics team. Team meetings help with information sharing, resolution of issues, and project planning.
On a more global basis, regular meetings should be held to address organizational phar- macy informatics topics. The goals of the pharmacy informatics group meetings are to make decisions on system functionality, implementation, work flow, quality, safety, and standardization. The appropriate membership of internal and external representatives who can address interrelationships between pharmacy applications and other systems should be included. Regular attendees should include the pharmacy information specialist, phar- macy database managers, pharmacy directors, information systems pharmacy lead and analysts, and nursing and physician informatics specialists. Content experts, such as clinical pharmacy and medication safety specialists, and experts from other disciplines
may be invited as needed to address specific issues. The group sets priorities for changes and enhancements. Items that have a direct impact on other systems and disciplines are referred to the appropriate groups representing those disciplines.
To build vendor relationships and provide more effective support for specific tech- nologies, separate meetings should be held for teams that address a particular technol- ogy. For example, one team might focus on automated dispensing cabinets, and the core membership for this group might include the pharmacy informatics specialist, techni- cian superusers, information systems pharmacy analysts, and vendor representatives. Ad hoc membership could include pharmacy directors and information systems leads.
9.5 SuMMARy
Specific roles and responsibilities of the pharmacy informatics specialist are still being defined, and the job description will probably change over time. A creative individual with knowledge of pharmacy and computer science has tremendous opportunities to improve the efficiency, safety, and effectiveness of medication use processes through the appropriate application of information technology.
REFEREnCES
1. ASHP statement on the pharmacist’s role in informatics. American Journal of Health-System
Pharmacists 2007. 64:200–203.