Pellegrin Karen, Chan Francis, Pagoria Natalie, Jolson-Oakes Sheena, Uyeno Reece, Levin Andrew
Appl Clin Inform. 2018 Jan;9(1):1-10. doi: 10.1055/s-0037-1620262. Epub 2018 Jan 3.
While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthcare system, have not yet been reported.
Our objective is to describe the design, implementation, and use of health information technology to support the hospital and community pharmacists' management of medications for high-risk patients statewide in the "Pharm2Pharm" model of care. Our aims were to make it easier for the pharmacists to access information needed to identify and resolve drug therapy problems using best practices for medication management and communicate with other members of the care team.
The pharmacist's roles and the medication management processes guided the design of the supporting technology, which was implemented after the Pharm2Pharm model was launched and the pharmacists' technology needs were assessed. Priorities for technology included sending care transition documents from hospital to community pharmacist securely and efficiently, access to medical records, including medications and laboratory results, documentation, and patient tracking. Implementation and use of the technology were documented.
Communications, medication management, and population management solutions were implemented to support the Pharm2Pharm model. The pharmacists delivering services through this model adopted and meaningfully used this technology to support their work.
Implementing technology with value outside of the Pharm2Pharm model was a strategic approach to investment. This work emphasizes the importance of shifting the focus of technology from supporting a specific piece of the medication management process to supporting the goal of optimizing medication regimens. Health information exchange systems can provide important technology needed to integrate pharmacists into care teams as they are deployed to improve patient outcomes.
虽然证据总体上支持使用药物管理技术,但系统通常是零碎地实施和评估,而不是作为药物管理综合模型的一部分。尚未有支持药物治疗优化的系统的相关报道,而药物治疗优化日益成为药剂师在我们医疗保健系统中的关键作用。
我们的目标是描述健康信息技术的设计、实施和使用,以支持在“Pharm2Pharm”护理模式下全州范围内高危患者的医院和社区药剂师进行药物管理。我们的目的是让药剂师更容易获取信息,以便使用最佳药物管理实践来识别和解决药物治疗问题,并与护理团队的其他成员进行沟通。
药剂师的角色和药物管理流程指导了支持技术的设计,该技术在“Pharm2Pharm”模式启动并评估了药剂师的技术需求后实施。技术的优先事项包括安全、高效地将护理转接文件从医院发送给社区药剂师,获取病历(包括用药情况和实验室结果)、记录和患者跟踪。记录了该技术的实施和使用情况。
实施了通信、药物管理和人群管理解决方案以支持“Pharm2Pharm”模式。通过该模式提供服务的药剂师采用并切实使用了这项技术来支持他们的工作。
在“Pharm2Pharm”模式之外实施具有价值的技术是一种战略性投资方法。这项工作强调了将技术重点从支持药物管理过程的特定部分转移到支持优化药物治疗方案目标的重要性。健康信息交换系统可以提供重要的技术,以便在部署药剂师以改善患者结局时将他们整合到护理团队中。