Technology in Pharmacy Education & Learning SIG
Using an Electronic Health Record to
Simulate Real-World Experiences in
p
and Skills Laboratory
y
Therapeutics
Courses
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Technology in Pharmacy Education & Learning SIG
Using an Electronic Health Record to
Simulate Real-World Experiences in
p
and Skills Laboratory
y
Therapeutics
Courses
Presenters
•
•
•
•
Keith Christensen (Moderator)
Sam Augustine
Kim Begley
Amy Pick
• TIPEL S
SIG
G Chair
C a – Ga
Garyy Thielman
e a
Objectives
• Describe the benefits of the use of an electronic
health record (eHR) in achieving educational
outcomes in students throughout the curriculum
• Demonstrate the application of the eHR for the
delivery of information necessary to prepare a
medication therapy management plan for a
therapeutics case study in lieu of paper-based
documents
Objectives
• Describe the development and implementation of the
Electronic Laboratory Manual approach to simulating
pharmacy practice and skills development
• Describe the use of the laboratory sequence as a
means of demonstrating student achievement of
educational outcomes and applicability to curricular
assessment
Technology in Pharmacy Education & Learning SIG
Development and Use of an
Electronic Health Record
Keith Christensen, Pharm D, BCPS
Associate Professor of Pharmacy Practice & Internal Medicine
Creighton University
School of Pharmacy and Health Professions
School of Medicine
Background
• Case content delivery for a Pharmacotherapeutics
course previously consisted of information contained
within a single document
• Many health-systems are now adopting electronic
health records for storage of health record
information
• Education regarding the navigation of a health record
would
ld b
be b
beneficial
fi i l ffor th
the did
didactic
ti llearning
i
environment
Electronic Health Records (eHR)
• There are many companies developing proprietary
eHR software solutions
– Available for purchase/installation in a health-system setting
• Some require local storage of the data, others are
“cloud-based” solutions where storage is off-site
• Acquiring an eHR for use in the classroom may prove
to be difficult as not many companies have
d
developed
l
d th
thatt solution
l ti
Lowes R. Top 10 Cloud-Based EHRs. Medscape Medical News,
http://www.medscape.com/viewarticle/763894; Accessed June 12, 2012.
Local Development
• Our quest was to develop an eHR system for use in
our classes and classrooms that would introduce the
concept of information retrieval from an electronic
database to the learning process
• Implemented in our Pharmacotherapeutics sequence
and also utilized by our Pharmacy Skills Lab
sequence
• C
Customizable
t i bl ffor other
th courses and
d ffor courses iin
other disciplines
US Patent Pending, SYSTEM AND METHODS FOR EFFICIENTLY DEVELOPING
THERAPY DECISION MAKING SKILLS; September 2, 2009: Number 61/275,771.
Description
• Access database platform with planned conversion to
an SQL database platform
• User level access ((students)) and administrator level
access (faculty)
• Case information entry using de-identified patient
information collected from 4th year pharmacy
students and preceptors
Utilization
• Used in the Pharmacotherapeutics sequence as a
method for students to retrieve needed case
information to assess and optimize drug therapy
• Introduces the concept of using an eHR for
information retrieval
• Allows for a “real-world” experience in searching
through an eHR for relevant information vs. case
i f
information
ti given
i
iin a d
documentt
Demonstration
Technology in Pharmacy Education & Learning SIG
Pharmacy Practice Skills Lab Electronic
Simulation Manual
Kimberley Begley, RPh, Pharm D
Assistant Professor of Pharmacy Practice
Creighton University
School of Pharmacy and Health Professions
Sam Augustine, RPh, Pharm D, FAPhA
Professor, Pharmacy Practice
Creighton University
School of Pharmacy and Health Professions
Laboratory Layout
Lab Content
• Pre-lab review of session
• Rotation sequence
– 9 out of 14 lab sessions were “stations”
– Timed: 8 minutes per station with
distractions
– Graded real time with QuestionMark;
faculty/alumni volunteer feedback; rubric
assessment
• Post-mortem (post-lab review)
Simulation Rotation
• Phone Interaction
– Voice Mail
– Live
• Prescription
Verification
• Sterile Preparation
Verification
• Calculations Case
• OTC Drug Utilization
Review
• Patient Case
– QuestionMark Quiz
• Brown Bag/Drug
Utilization Review
• Prescription Entry
• Patient Assessment
• Patient Counseling
– New Medication
– Medication History
e-Voice Mail
Live Communication
Prescription Verification
Prescription Verification
1.
Joseph Clark -- Ceftazidime
Looking at the physician order and what was entered into the pharmacy
system
y
((typed
yp on the label),
) was the correct information entered?
Yes
No
Did the technician choose the correct IV solution?
Yes
No
Did the technician choose the correct volume of IV solution?
Yes
No
Did the technician choose the correct medication?
Yes
No
Was the dose of ceftazidime drawn up correctly?
Yes
No
e-Prescription Verification
Live Prescription Verification
Live Prescription Verification
Live Sterile Product Prescription
Verification
Drug Utilization Review
Brown Bag Instructional Videos
Students
Faculty
e-Brown Bag
e-Brown Bag
Live Brown Bag
Live Drug Utilization Review
Brown Bag Rubric
Remediation Videos
Medication Therapy Management
Mi i
Mirixa
Pharmacy Management
Systems (Prescription Entry)
• Cerner Etreby
– Prescription Entry
– Patient Profile
– Prescription
Processing
– Self-Care
Recommendations
• QS1
– Prescription Processing
• Hard copy scanned
– Patient Profile
• Prospective/Retrospective
DUR
• Clinical decision to fill or
override
Advantages/Disadvantages
g
g
Cerner Etreby
QS1
ADVANTAGES
– Used at CUMC
Outpatient Pharmacy
– In-house IT support
ADVANTAGES
– Free
– Used byy most
independents
– Prescription scanning
DISADVANTAGES
− Expense
p
− “Training version”
− Not universally used
− License number
limitations
DISADVANTAGES
– Off site support
pp
– Longer response times
Communication
− Phone Verification
– Patient Counseling
– Patient Histories
– Electronic
El t i O
Order
d
Entry Verification
Assessment
EDUCATIONAL OUTCOMES
•
•
•
•
•
•
•
•
•
•
Ignatian Values
Professionalism, Citizenship, and Leadership
Critical Thinking
Communication
Patient Assessment
Medication Therapy Management
Di
Dispensing
i Medications
M di ti
Drug Information
P bli Health
Public
H lh
Health Systems
Introduce, Reinforce and
Demonstrate
Pharmacy Skills Lab has
responsibilities
p
in Reinforcement and
Demonstration
• Application
A li i
to our Pharmacy
Ph
Curriculum
C i l
(Educational Outcomes) Assessment
Plan
Pharmacy Curriculum (Educational Outcomes)
Assessment Plan
EO
7. Dispensing
Medications
-Dispense
drug
products
consistent
with patient
needs and
patient safety
in harmony
with the law.
Measure
When
By whom
Data sent to:
Area 2 scores
from NAPLEX
Post graduation
(Summer)
Dean
MPJE scores
Post graduation
(Summer)
APPE
(Dispensing &
Medication
preparation
scores)
Skills Lab Dispensing
Year 4
Semesters 7-9
Special
Assistant to the
Dean
Office of
Experiential
Education
Program
Assessment
Committee
Program
Assessment
Committee
Program
Assessment
Committee
Years 1-3
13
Semesters 1-6
Instructors of
Record
Program
Assessment
Committee
7. Dispensing Medications
7.1 Identify drug products by their generic, brand, and common names.
7.2 Determine whether a particular drug dosage strength or dosage form is
commercially available and whether it is available as nonprescription.
7 3 Accurately interpret the prescription
7.3
prescription, select the appropriate dosage form
form, route
and method of administration, and appropriately package and label the product.
7.4 Utilize appropriate resources to select drug products and devices.
7.5 Identify and communicate appropriate information regarding drug effects,
packaging, storage, handling, administration, and disposal of medications.
7.6 Identify and describe the use of equipment and apparatus required to dispense
and administer medications.
7 7 Explain the role of technology and apply it in the dispensing process
7.7
process.
7.8 Utilize appropriate resources to determine equivalence among manufactured
drug products and identify products for which documented evidence of
inequivalence exists.
7 9 Interpret
7.9
I t
t and
d comply
l with
ith ffederal
d l and
d state
t t llaw iin th
the practice
ti off pharmacy.
h
7.10 Describe and apply techniques and procedures related to drug preparation,
compounding, and quality assurance.
7.11 Identifyy and use resources,, components,
p
, and equipment
q p
necessary
y to
properly prepare compounded medications and maintain quality assurance.
7.12 Identify and describe devices required to monitor medication therapy and
patient outcomes.
Technology in Pharmacy Education & Learning SIG
Development and Use of Multimedia in
the Instruction of Cases
Amy Pick,
Pick Pharm D,
D BCOP
Associate Professor of Pharmacy Practice
Creighton University
School of Pharmacy and Health Professions
School of Medicine
Pain Management
• Electronic review of conversion
calculations in pain management
• Interactive case studies
Pain Conversion Calculations
• Website
• Videos
– JingPro
– OneNote
• Comments
C
t
Assessment of Pain Management Therapeutic
Outcomes Training
g Using
g a “Multimedia
Interactive” Case
• Rationale:
– Learning varies among students
– Shift in teaching from traditional didactic
lectures
– Role of technology
– Distance education
Development
• Case prepared in PowerPoint
• Recorded videos using Flip Video HD
• Use
U off Wavepad
W
d and
d Ji
Jing
• Options given for all questions/answers
• iSpring Pro
• Winstream
Video
• Pain video
Comments on Interactive Case
• Feedback
• Future
– Explore other topics
– Remediation purpose
– Brown bag review
Questions
Technology in Pharmacy
Education & Learning SIG: Using
an Electronic
El t i H
Health
lth R
Record
d tto
Simulate Real-World
Experiences in Therapeutics and
Skills Laboratory Courses
CODE:
HHP4N6