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Clinical Informatics                   Education                      Experience                          Expectations    ...
ObjectivesEducation Graduate Certificate in Clinical InformaticsExperience PracticumExpectations Healthcare Pharmacy
Education
Carolina Health Informatics ProgramGraduate Certificate in Clinical Informatics  Required (2)     • Introduction to Databa...
Introduction to Database
Systems Analysis
Evidence Based Medicine
Electronic Health RecordElectronic Health Records Overview. Nat Institute of Health, Nat Cent for Res Resources. April 200...
Practicum
Experience
PracticumUNC HCS Practice and Quality Initiative is implementing new patient care modules in WebCIS to demonstrate meaning...
Practicum GoalsExpert walk through and “black box” testingAre modules being used by nursesAnalyze usabilityExplore modules...
Personal GoalsHow will this experience relate to my certificate education?How will this education and practicum experience...
Practicum ConclusionsExperience gained with the modulesWorkflow analyzed, and weaknesses identifiedMeaningful use versus m...
Revisit Personal GoalsHow will this experience relate to my certificate education?How will this education and practicum ex...
Practicum Conclusions– EHR: The environment studied, WebCIS– Database: EHR systems are essentially complex  databases– Sys...
Personal GoalsHow will this experience relate to my certificate education?How will this education and practicum experience...
Philosophical Questions     (aka, why I am speaking to you today)• Is this certificate useful in pharmacy?  Or, more impor...
Expectations
U.S. Bureau of Labor Statistics• Pharmacy  – Employment of pharmacists is expected to increase by    25 percent from 2010 ...
Proposed Timeline of            “New” InformaticsInfrastructure, builds, system conversions System optimization, quality o...
How will it affect Pharmacy
How will it affect Pharmacy/*MUE_BAR*/Select patientID, ptlname, MRN, FIN, ptattendfrom UNCH_dbwhere service = “Sxx”and IN...
How will it affect Pharmacy
“Big Data”I am certain that the battle of the next   generation (of Internet businesses) will be   made up of who has more...
How will it affect Pharmacy       http://www.health.ny.gov/technology/projects/vision.htm
How will it affect Pharmacy                http://www.simile-widgets.org/timeline/
How does the field of pharmacy (education, training, and practice) position itself for these possible changes?
Clinical Informatics “Cohorts”• American Board of Medical Specialties  – Recognized clinical informatics as a subspecialty...
A lot of information, but• Clinical Decision Support• Storage and data warehouse  – Secondary use of data  – Data analytic...
Clinical Informatics                   Education                      Experience                          Expectations    ...
Is this meaningful use?Or, is this meaningful capture?
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
Clinical Informatics: Education, Experience, Expectations
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Clinical Informatics: Education, Experience, Expectations

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  • Pharmacy Informatics - robots, dispensing devices (Pyxis,Omnicell), TPN compounder, etc..But this is more “clinical,” maybe how clinical pharmacy is different from pharmacy of retail, dispensing, etc.
  • How is a 5__ class an introduction?What is your favorite database? Learn modeling, MS Access, SQL
  • Find and define problemBuild models to help define and create solutionsHow to find best solutionSoftware development life cycleChange managementContextual Design – interviews of end users
  • Vocabulary, architecture, data language, EBM and QI, MU, security, etc.
  • Hands on ExperienceOften with area IT industryEngage the practical and theoreticalPresentation and physical Deliverable
  • Robert Berger, MDRobb Malone, PharmDNew modules in WebCIS for meaningful use needed usability testing and analysisSmoking cessationObesity
  • Marcy DelMonte
  • Expert walkthrough and “black box” testingDetermine if modules are being usedAnalysis of usabilityInterviews, site visits, questionnairesExplore context of workflowsDetermine the applicability of modules to patient care and outcomes
  • Captured, structured data better than free textWhy is QI information gathered on vital screenDoes a nurse counsel on smoking, obesity, etc?
  • Neighbor
  • Manhattan ProjectNorris Dam
  • Systems changes per Obama $Technical: builds, conversionsSystem modification and optimization to impact quality of care and best practicesEnsure Meaningful useUnderstand systems of care, workflowsUtilization of Big Data to identify best outcomes
  • Documenting interventions
  • 13 of these measures are specifically drug relatedSome colleagues would think a 2-3 lie in the “clinical pharmacist” domain
  • Replace MUE and DUE With Queries
  • Where will you get your (BIG) dataLocalUHCYour system (Seimens, Epic, Microsoft, etc.)
  • Med Reconciliation - doesn’t have to be expansiveGood example of using information “better”Health Information Exchange
  • Transcript of "Clinical Informatics: Education, Experience, Expectations"

    1. 1. Clinical Informatics Education Experience Expectations Britt Ritter, PharmD Clinical Specialist, Department of Pharmacy Clinical Assistant Professor, School of PharmacyStudent, School of Information and Library Sciences
    2. 2. ObjectivesEducation Graduate Certificate in Clinical InformaticsExperience PracticumExpectations Healthcare Pharmacy
    3. 3. Education
    4. 4. Carolina Health Informatics ProgramGraduate Certificate in Clinical Informatics Required (2) • Introduction to Database (INLS 523) • Systems Analysis (INLS 582) Elective (2 out of > 20) • Evidence-Based Medicine (INLS 890) • Electronic Health Records (INLS 890) Practicum
    5. 5. Introduction to Database
    6. 6. Systems Analysis
    7. 7. Evidence Based Medicine
    8. 8. Electronic Health RecordElectronic Health Records Overview. Nat Institute of Health, Nat Cent for Res Resources. April 2006. Pub. The MITRECorp., Center for Enterprise Modernization.
    9. 9. Practicum
    10. 10. Experience
    11. 11. PracticumUNC HCS Practice and Quality Initiative is implementing new patient care modules in WebCIS to demonstrate meaningful use. – Smoking cessation – ObesityTwo UNCHCS outpatient clinics – CAH – UNC Internal Medicine
    12. 12. Practicum GoalsExpert walk through and “black box” testingAre modules being used by nursesAnalyze usabilityExplore modules in context of workflowDetermine aspects where modules affect patient careDefine the relevance of these modules to meaningful use
    13. 13. Personal GoalsHow will this experience relate to my certificate education?How will this education and practicum experience relate to pharmacy?
    14. 14. Practicum ConclusionsExperience gained with the modulesWorkflow analyzed, and weaknesses identifiedMeaningful use versus meaningful captureRecommendations made to UNC HCS
    15. 15. Revisit Personal GoalsHow will this experience relate to my certificate education?How will this education and practicum experience relate to pharmacy?
    16. 16. Practicum Conclusions– EHR: The environment studied, WebCIS– Database: EHR systems are essentially complex databases– Systems analysis: Understanding workflows and usability are essential for applying informatics to systems– EBM: How all of the above can affect patient care.
    17. 17. Personal GoalsHow will this experience relate to my certificate education?How will this education and practicum experience relate to pharmacy?
    18. 18. Philosophical Questions (aka, why I am speaking to you today)• Is this certificate useful in pharmacy? Or, more importantly, will it be?• Should more pharmacy students and trainees be given opportunities in informatics?• How important will the changes in health informatics be to patient care?• How could informatics change pharmacy?• What kind of person am I?
    19. 19. Expectations
    20. 20. U.S. Bureau of Labor Statistics• Pharmacy – Employment of pharmacists is expected to increase by 25 percent from 2010 to 2020, faster than the average for all occupations• Computer and Information Systems Managers• Computer and Information Research Scientists – Employment for computer and information systems managers is projected to grow 18-28 percent from 2010 to 2020
    21. 21. Proposed Timeline of “New” InformaticsInfrastructure, builds, system conversions System optimization, quality of improvement, standards ‘Big Data,’ secondary use of data
    22. 22. How will it affect Pharmacy
    23. 23. How will it affect Pharmacy/*MUE_BAR*/Select patientID, ptlname, MRN, FIN, ptattendfrom UNCH_dbwhere service = “Sxx”and INR > 4.0and med = “warfarin”, “dabigatran”, “rivaroxiban”and ICD-9 = 430, 431, 432, 850, 851,852,853, 854and hair color = “blonde”order by date admin;
    24. 24. How will it affect Pharmacy
    25. 25. “Big Data”I am certain that the battle of the next generation (of Internet businesses) will be made up of who has more data and who knows how to use it better than anyone else. Scott Thompson, former PayPal executive
    26. 26. How will it affect Pharmacy http://www.health.ny.gov/technology/projects/vision.htm
    27. 27. How will it affect Pharmacy http://www.simile-widgets.org/timeline/
    28. 28. How does the field of pharmacy (education, training, and practice) position itself for these possible changes?
    29. 29. Clinical Informatics “Cohorts”• American Board of Medical Specialties – Recognized clinical informatics as a subspecialty, 2011• UNC School of Public Health – CHIP Certificate program 2012• UNC School of Nursing – CHIP Certificate program 2011• UNC School of Pharmacy, UNC Hospitals – Elective – Included in some training programs at different levels
    30. 30. A lot of information, but• Clinical Decision Support• Storage and data warehouse – Secondary use of data – Data analytics• HIPPA and Information Security• Hardware – Mobility• Patient portal• Social media
    31. 31. Clinical Informatics Education Experience Expectations Britt Ritter, PharmD Clinical Specialist, Department of Pharmacy Clinical Assistant Professor, School of PharmacyStudent, School of Information and Library Sciences
    32. 32. Is this meaningful use?Or, is this meaningful capture?

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