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I read an interesting article in Beckers this morning about a Harvard Business Review questionnaire in which 43% of the respondents (characterized as 757 members of the Harvard Business Review audience who work in healthcare) said that “disconnected or incompatible systems” are the biggest hurdles to becoming more data driven. While this is inarguably true, at least in our pharmacy world, that statement implies that resolving the connectivity problems would just fix things. My experience has been that this is not true; that there is still a lot of data cleanup and governance work ahead once the “data pipeline” has been opened. A number of these disconnected ...
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I had a chance to view an article by Bastow and Greszler in the American Journal of Pharmaceutical Education about the value of including exposure to Industrial Medical Affairs in pharmacy education and residencies. It is gratifying to see discussion of industrial practice as something other than "going to the dark side". I am grateful both to Samantha and Craig for their excellent article, and to the American Journal of Pharmaceutical Education for publishing it. It is important to understand that Medical Affairs practice exists because regulatory bodies need a group of professionals and scientists within the pharmaceutical and medical device industries ...
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Tiffany Dinh is a fourth-year pharmacy student from The University of Texas at Austin College of Pharmacy. She is currently completing an APPE rotation with ASHP, focusing on national association management and working on projects related to the Innovation Center. As a student who began pharmacy school at the height of the pandemic, she is intrigued by the pivotal role of technology in shaping modern healthcare practices. Recognizing the importance of staying on top of emerging advancements in the field, she aims to share her research findings with fellow peers and colleagues from a student’s perspective : The ...
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Today (7/21/2023) I read an article in Beckers regarding research that indicates charging patients for sending email to physicians has not decreased the physician email burden. According to this article, the burden of emails from patients on physicians through their practice portals has increased 50% after the pandemic. The article further states that those physicians who receive a lot of emails feel burned out and are thinking about leaving their profession. This got me to wondering what that burden tells us and makes me wonder what (other than charging the patient) might help alleviate this burden. I find myself wondering: · Does this ...
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I don’t write about clinical topics very often, but I ran across an article in the ASHP Daily Briefing I got this morning that made me stop and think. It was an article in JAMA Network Open entitled Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide . What originally piqued my interest was that this article was about finding the prevalence of potentially inappropriate medications (PIM) in senior citizens (of which I am a member) who were treated in hospital outpatient departments (of which I am not a member). They concluded that the use of potentially inappropriate medications was increasing among the elderly population ...
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I was reading my daily digest of things from Becker's this morning when I came across an article entitled " 75 hospital and health system chief pharmacy officers to know | 2024 ". I read through this list with great interest. There were a number that I know; there were a number that I do not know. There were a few surprises. There were some old friends. Congratulations to each and every pharmacy executive on this list. There were names I was surprised not to see. One wonders how this list was chosen. The list explicitly claims to not be exhaustive but I can think of some that were surprising omissions. Perhaps ASHP would consider producing a more inclusive ...
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Many ASHP members will be interested in a novel and engaging podcast that shows how selections from the humanities (e.g., literature, films, works of art) can be applied in health professional education and practice. Launched in 2022, “The Clinic & The Person” is narrated by the podcast’s creators, J. Russell Teagarden and Daniel Albrant. Teagarden came to his interest in applying insights from the humanities to biomedicine after decades in clinical pharmacy practice and research. Albrant had a long career in clinical pharmacy practice before preparing for the ministry and becoming a pastor. The podcast’s intended audience includes healthcare practitioners, ...
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Retirement

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I am writing this blog mid-December. I am scheduled to retire in early January. I have scheduled this blog to post the day after I retire. If one thinks of life as an ocean voyage, at 74 I can now see the oncoming shore that is the end of that voyage. It won't be tomorrow, but it becomes more certain with each passing day, and has spurred me to seriously consider how I will spend my remaining time on this earth. Retirement seems to be the correct choice. Next year will mark 50 years since I graduated from Pharmacy School, and 50 years since I joined ASHP. I must confess that I approach retirement with some anxiety. I am one of those people who succumbed ...
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I recently reviewed a summary article entitled How are other systems breaking down data silos? 35 leaders share . What I found most interesting were the expressed notions of why data silos exist and what these leaders are doing about them. A lot (but not all) of the responses focused on infrastructure issues to get data to be consistent and shared more broadly. Several spoke of cultural changes being necessary to overcome those silos. This caused me to think about our practice in health-system pharmacy, how we wind up with our own data silos, and how we get past them (or do not). Pharmacy is, perhaps, unique in the acute care world in that we tend to operate ...
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Hello Everyone, I am posting notes our outstanding facilitators Jill Robke, Melissa Ruble, and Jared Sheley took at the Roundtable Session on IPE at the Midyear Clinical Meeting. Please pardon the formatting. Our outline is not pasting nicely into Connect. I am happy to e-mail notes to anyone interested. Interprofessional Education (IPE) Resources and Best Practices 1. Models of IPE education in experiential and didactic curricula a. What are you doing for IPE in the experiential setting? i. Pre-specified days for IPE experiential day (P4s are excused from rotation for ...
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When the AI is wrong

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Today (6/15/2023) I read an article in Beckers regarding a case in which a nurse felt compelled to draw blood on a leukemic patient because the AI came to the conclusion that the patient might be septic even though they disagreed. The nurse felt that the AI did not understand the impact leukemia might have on a patient’s presentation or on the risk of drawing blood. The blood was drawn, that patient was not septic, and, thankfully, the patient did not acquire an infection. The article goes on to note a couple of other things: Although the organization indicated that the ultimate decision belongs to the physician and the nurse, caregivers may feel ...
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I read two interesting articles today: one about why healthcare information exchanges (HIE’s) are failing (it blames fax machine use) and another on ubiquity of pagers within the healthcare system. As I read through them, I was reminded of a presentation that I once saw (I think it was at a HIMSS meeting but am uncertain) about a project to replace a white board in an ED with a shiny new large-screen display. It failed to a large degree for the same reasons faxes and pagers persist, which appears to be because the infrastructure (both physical and operational) that supports these newer technologies is not sufficiently organized or robust to completely ...
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Pharmaceutical Acuity

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I recently received an email from the European Association of Hospital Pharmacists (EAHP) describing a project supported by EAHP to define a definition of pharmaceutical acuity which has apparently been published. Sadly, I seem to be unable to obtain a copy; I hope to yet get one. This made me think about some of the early efforts along this path that have occurred historically. These efforts resulted in models that attempted to look at acuity in terms of the cost of pharmacy services (including the costs of drugs involved) that arose because current general patient acuity models treat disease states with very different use of pharmaceutical services as ...
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As a fourth year pharmacy student on an APPE rotation with ASHP, I had the distinct pleasure of attending ASHP Policy Week. For those who may not know, policy week is an annual event where appointed members of ASHP Councils and Commissions gather in Bethesda, Maryland to discuss key issues and important topics that are impacting the profession of pharmacy. The appointed members in attendance serve on the Commission on Affiliate Relations or one of five councils which include Education and Workforce Development, Pharmacy Practice, Pharmacy Management, Public Policy, and Therapeutics. The councils use this week to collaborate and develop recommendations to guide ...
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Authors Rigo Segovia, PharmD, Annie Vo, PharmD, BCPS, Emily Gamroth, PharmD, Priyan Lad, PharmD, Chad Compagner, PharmD Introduction The metaverse is a broad term that describes an integrated and shared virtual space. A singular metaverse that is fully networked and immersive has yet to be developed, but platforms using virtual reality ( VR ), augmented reality ( AR ), or mixed reality ( MR ) are numerous. Applications focused on taking users to a different space tend to favor VR, where the environment is entirely virtual. Conversely, usage focused on providing additional information or multitasking favor AR or mixed reality, where virtual elements ...
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I read an interesting article in Beckers today regarding a hospital that suffered a data breach because an unauthorized person stole patient records from an old, unused facility in which they were being stored in bins awaiting shredding. The building was apparently scheduled for demolition but still contained bins of records awaiting destruction. One wonders how long they had been there. I won’t pretend to know why they had put those records there or what their plans were for the ultimate destruction of those records. But it made me think about old reports, returned medication containers, and other detritus that sometimes accumulates in our pharmacies because ...
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While reading a recent ISMP publication, I learned today of the death of someone I came to know as a friend and colleague, Larry Trissel . I first met Larry at M D Anderson during my first tour of duty at Baxa when I met with him to ask about an idea for a new product (I really don’t remember now what it was). What I remember was the speed and acuity with which he dove to the fundamental weaknesses in the concept without making me feel like the village idiot. We subsequently continued what was mostly a correspondence relationship, with occasional meetings at national conferences. I came to be more and more ...
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I had a chance to read a compelling discussion regarding the need for a significant change in the way that electronic medical records (EMR) products interact with physicians. While a lot of this discussion centered around removing regulatory and administrative tasks from the clinician interaction with the patient, it also talked about changes in design, configuration, and implementation of these EMR products. This reminded me of a concern I have had for some time that our healthcare products in general seem to heavily rely on user interface technologies that were designed for use in business applications which are both less information intense and less time-sensitive ...
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Limits to Telehealth

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Today (7/13/2023) I read an article in Beckers regarding some research that telehealth only reduces cost for certain types of diseases. Specifically, the researchers noted that telehealth did not reduce costs or the probability of future office visits for patients with circulatory, respiratory, or infectious diseases. They found telehealth to be effective at reducing costs for behavioral health conditions, metabolic disorders, dermatologic disorders, and musculoskeletal disorders, though they did not quantify those benefits individually. When I finally got to the actual abstract , there were some numbers that were interesting: · On average, ...
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Babies Training Babies

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As the profession of pharmacy has progressed, the roles of technicians are changing, the emergence of a worldwide pandemic, and now with the extreme shortage of technicians, it seems like the training of technicians has fallen by the wayside. Now, we see new technicians who have only worked for a few weeks training the new hires themselves. When did we lose our focus on the training of our technicians and how do we correct it? As the pandemic swept the world, healthcare workers took the brunt of the workload. If you were not infected with the virus, you likely were filling in for those that were, as well as working your shifts. As the pandemic slowed, healthcare ...
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