HIT in community pharmacy practice
If you have ever practiced in a community pharmacy and felt the crush of a Monday workload, then you have probably been thankful for times when your practice has increased the number of technicians, pharmacists, and support staff on duty. You may also be thankful to have an automated order system for medicine through your wholesaler based on inventory levels so you don’t have to take time to reorder medicine manually throughout the day.
Have you ever wondered what goes into making such decisions? How does a practice set their minimum inventory level on Januvia versus hydrochlorothiazide versus OTC loratadine? When does management decide to staff additional technicians versus pharmacists versus pharmacy support staff? Health information technology (HIT) is at the root of finding these answers.
I’m a data miner
Most pharmacy dispensing systems track key information that allows pharmacists to make management decisions to improve practice and enhance efficiency. The challenge is in knowing how to data mine such information and apply it to practice. In my role at Osterhaus Pharmacy in Maquoketa, IA, I perform these and other analytics on a regular basis to identify ways to enhance efficiency and care we deliver to our patients.
I can create a report of our inventory on hand through QS1, our dispensing system, and input the information into Excel to target high cost inventory. From the Excel spreadsheet, I can break down the number of patients using a medicine and funnel them to our synchronized refill program. This allows us to not only fill the medicine before the patient completely runs out and gives us time to order it without having to stock it on our shelf for a month, it also enhances patient satisfaction.
Performance and quality measures are another form of analytics that we use every day to help identify training gaps for our staff and track progress. What percent of prescriptions are assembled or produced by each technician? What percent of electronic prescriptions are processed by each technician? These measures allow us to identify technician training gaps in the order process.
Using our software’s workflow reporting feature, I have the ability to produce a text file with the daily orders and take this to Excel for further analysis. Using a pivot table, which summarizes trends within raw data, I let the software do the work for me to group prescriptions by the same technician in categories. As a result, I can produce a graph showing percentage of prescriptions processed by each technician for a given month. This trend allows me to identify, given all the techs were somewhat equally divided in their daily roles for the month, that Tech I, Tech II, and Tech III probably need additional training for processing compared to Tech V.
Although I would ideally check the quality related event rate for Tech V to assure that accuracy is accounted for here, I would generally allow Tech V to train the others in her usual workflow since she is excelling in this process. This information enables me to staff my most efficient technicians in appropriate roles for the busiest times in the pharmacy.
Further analytics can be applied to staffing roles for technicians and pharmacists, which can assist in scheduling downtime tasks, projects, and days of the week where more or less staffing would be desired. Using this kind of analysis over several years, you can determine the best time for inventory, vacations, meetings, or relief support.
Diverse training required
The training and background needed for a career related to data analysis and HIT is diverse. I believe I am more effective in applying analytics to practice with my pharmacy training. Proficiency in Microsoft Excel, PowerPoint, and perhaps computer programming allows for fast and accurate data analysis to be applied in daily workflow situations. My background includes courses in computer science and engineering at the University of Iowa, but using data analytics with the ever-changing Microsoft platforms involves significant independent study.
A thorough knowledge of the pharmacy dispensing system is also very important. A user must be aware of how to extract real data through the computer system in order to apply practice-based improvements. I regularly watch webinars and meetings through my dispensing system’s website to make sure I am aware of new changes in the system and ways to apply those changes to my practice.
The health care environment is very dynamic and fluid. It is important for individuals who are involved in HIT to educate themselves about the best tools and resources available to improve efficiency and safety within practice.