Pharmacists Know How to Put Informatics Tools into Practice

Informatics initiatives can support clinical decision-making, streamline communications, improve workflow efficiency, and more for busy pharmacy teams. The challenge lies in choosing the right technology and designing thoughtful tools and processes to meet stakeholders' needs, according to speakers at Informatics Gems 2024: Resident & New Practitioner Bytes of Informatics, held at the Midyear Clinical Meeting & Exhibition in New Orleans.

The Dec. 8 session offered several case studies illustrating how inventive pharmacy informaticists have leveraged clinical data, existing systems, and new technology to improve patient care in their hospitals and health systems.

Standardizing critical drug shortage alerts: As a postgraduate year 2 (PGY2) resident at St. Jude Children’s Research Hospital, Nicholas (Austin) Jantrakul helped devise a new process for alerting physicians to critical drug shortages. Previous workflows required providers to remember all active shortages between weekly notifications, and pharmacy informaticists’ processes were not standardized. The new alert prompts providers at the time of order entry and recommends alternative management strategies to consider. Informaticists also meet routinely to discuss current drug shortages, update the list of relevant medications, and fine-tune the alert’s content and interface. Within 90 days of implementation of the new critical drug shortage alert system, nearly 60% of prescribing physicians either removed their orders or accepted alternative treatments, reducing the effects of drug shortages on patient care.

Using AI to summarize existing institutional knowledge: Internal communications channels like Microsoft Teams contain vast amounts of user-generated information that accumulates with every interaction. The pharmacy informatics team at Aurora Health Care Metro in Milwaukee, Wisconsin, wondered if the new Microsoft Copilot, an artificial intelligence (AI)-powered software released in 2023, could summarize this shared knowledge well enough to become a first line of defense for answering pharmacists’ requests for information technology (IT) assistance.

A Copilot testing plan revealed the software performed best at direct recall — but it struggled to interpret time-related words such as “recent” or “latest,” provided responses that often lacked context, and even sometimes produced hallucinations. For these reasons, practitioners should always validate its answers for accuracy. “I still believe it’s a powerful tool, and I find myself using it often” to summarize basic information, shared PGY2 pharmacy informatics resident Clare Chen. “AI continues to grow and develop, so I hope these problems and limitations can be addressed in the future to help create more efficient workflows … leaving humans more time for critical thinking.”

Boosting reporting efficiency and maintaining accreditation: University of Wisconsin Specialty Pharmacy, which provides care to over 6,000 patients, historically relied on various custom-built electronic health record (EHR) tools to track patient touchpoints and interventions. But pharmacists found it tedious to analyze that data for reporting and fulfilling accreditation and for pharmacy benefit manager and manufacturer requirements, noted PGY2 resident Julie J. Zhang. The group is working to integrate the current specialty pharmacy workflow into a new care coordination software module designed to standardize EHR configurations, increase efficiency, improve reporting capabilities, and fulfill accreditation standards. The solution is scheduled to go live in spring 2025.

Improving pharmacy-IT collaboration: Health systems must continuously update their EHR systems to align with the latest clinical practice and technology paradigms, but implementing changes and upgrades via a traditional IT ticketing software is rarely straightforward or simple in practice. Because pharmacy and IT professionals are unfamiliar with each other’s nuances and processes, and communication between these groups can be spread across multiple channels, EHR tickets can take several weeks to complete.

Recognizing these challenges, pharmacy informaticists at UC Davis Health created a multidisciplinary Pharmacy Informatics Enhancement Review (PIER) Committee to triage EHR changes. Clinicians now submit their requests directly to the PIER Committee, which meets weekly to determine the most clinically and technically optimal paths forward. The result: better oversight from leadership, improved prioritization, enhanced transparency around turnaround times, and increased collaboration and satisfaction, reported Roy Weng.

Activating voice alerts when every minute counts: Informaticists at Houston Methodist piloted voice-activated alerts to help get critical medications, specifically bleed reversal agents, to patients faster. “When everything is STAT, nothing is STAT,” PGY2 resident Akraam Abdel-Kerem said of typical flood of medication approval requests. The team designed actionable voice alerts to quickly draw pharmacists’ attention to the verification queue — importantly, without causing alert fatigue or desensitization. The pilot program reduced the median response time for critical medications from 28 minutes to 18 minutes. The voice alerts have now been deployed to seven hospitals within the health system.

The diverse use cases presented at this Midyear session underscored several key insights for successful informatics initiatives in pharmacy settings:

• Engage all key stakeholders early on to design truly useful technology solutions.
• The best tools are often the simplest and most concise and should fit into existing workflows.
• Collaboration can reduce unnecessary communication, improve solution design and configuration, and increase efficiency.
• Adequately train practitioners on new technology, processes, and expectations to ensure smooth transitions.
• Continue to evaluate and optimize your initiative after launch, as well as keep up with newer technology.
• It’s important to acknowledge the benefits and limitations of emerging tools such as AI.