One of the things I like about attending ASHP meetings is that I get the chance to talk with people who really stretch my thinking. One such conversation occurred with Kevin Marvin; another with Nate Peaty. None of what follows (which could qualify as a rant) should be laid at their doorsteps, but I suspect we are not misaligned on this.
First let me say that I think there was some terrific educational material presented in the Informatics Institute. For the second year, the section got some very thought-provoking and pretty technical material out in front of those of us who really need it.
There was also some reasonably good material that I would describe as basic, and it was surprisingly well-attended (even at 8 AM Wednesday morning!).
Having said that, I find myself more and more alarmed at the lack of fundamental understanding of informatics matters within the profession at large. This concern started when Mark Siska and I collaborated on the technology briefing paper for the November 2010 PPMI summit and drew such comments as "great paper, I didn't understand a word of it" and garnered no discussion at all in any public forum. Now PPMI eventually adopted the notion of the need for technology support of practice in order to achieve its goals, but to this day, there seems to be little effort to ensure that those entrusted with pursuit of that vision have the minimal understanding of technology necessary to ensure that technology is designed to be the toolset that we need to achieve those goals.
Further, while there are now requirements for informatics in Pharmacy School curricula, there seems to be little consenus on what that education should entail, or how we would know that it was successful. Indeed, it is not clear to me that most schools of pharmacy have the faculty expertise to provide such education.
My perception is that we will begin to be able to deliver this kind of training when we perceive informatics as a subject as worthy of research as we consider clinical practice. If we rightly understand that informatics represents a toolset by which we enable our practice, then we should be researching what does and doesn't work, and should be actively involved in describing and defining the tools we need to conduct our practice. Note that this likely requires that we actually study and understand our current processes (and their limits and problems) far better than we do today. I have long asserted that pharmacy workflows are not designed, they are evolved, and, as a result, are poorly and incompletely understood. How can we effectively design or evaluate tools when we don't clearly understand how we currently do our work?
Until there is a core of competence within the profession that is actively involved in improving our automation toolset, we are at a competitive disadvantage compare to those healthcare profesions such as medicine and nursing, who have active informatics communities at HIMSS (ours seems to have fallen apart) and are actively researching what would make their toolsets better.
To do that, we also need to understand that there is not a monolithic informatics practice, but that there are a variety of roles each of which has its own expertise and training requirements, ranging from truly technical roles involved with machine design, development and deployment to strategic roles involved with envisioning and planning the technology that will take us into our desired future. We need to understand those roles, ensure they are properly trained, and ensure that they are properly filled. At this point, a pharmacist can only do this by leaving practice and going into industry.
Until we somehow get this done, we are a profession sitting and waiting for the industry to bring us the next wonderful thing which we then decide whether or not to use. That isn't fair to us, and it isn't fair to industry.
Dennis A. Tribble, Pharm.D. FASHP
Ormond Beach, FL
DATdoc@aol.com
(386) 481-8166
The opinions expressed herein are my own, and are not necessarily the opinions of my employer nor of ASHP.