Last year I joined an unparalleled group of domain experts to help author the HIMSS-produced book Blockchain in Healthcare: Innovations that Empower Patients, Connect Professionals and Improve Care. I was honored to be invited to contribute the chapter on blockchain and pharmacy alongside my colleague Beth Breeden from Lipscomb University College of Pharmacy & Health Sciences in Nashville, TN. The print edition of the book debuted at the HIMSS19 conference in Orlando, FL, and the e-version has since been released on Amazon Kindle and Apple Books.
We divided our chapter into four subsections:
Healthcare Financials (which is where many of the earliest wins are coming in the space using Hyperledger builds)
Pharmaceutical Supply Chain (which we started exploring in 2015, and still holds great promise – as does the broader health supply chain and emerging cannabis market)
Clinical Trials (which was a conversation that we began during a Precision Medicine Workshop at the White House in 2016), and
Social Good (which features some of the projects I am most excited about sharing including Solaster and RemediChain)
This chapter also details a few use cases including an interesting, albeit early, proposed approach by ConsenSys on using distributed ledger technology (DLT) for combating a few elements of the opioid crisis.
If you are interested in the intersection of of healthcare and blockchain/DLT, I can’t think of a better place to start than this text!
Over the last two years I have been fortunate to work with some real leaders in pharmacy informatics education. One of the most accomplished pioneers in this realm is Dr. Beth Breeden, who is the Director of the Master of Health Care Informatics (MHCI) program at the Lipscomb University College of Pharmacy and Health Sciences in Nashville, TN. Pharmacy students at our University have a rare set of opportunities in informatics education, including a dual pharmacy-informatics program that is the second of its kind in the country. Pharmacy students can choose to concurrently complete a dual PharmD+MHCI or PharmD+Certificate in HCI. We also offer both summer internships and a specialty residency in partnership with Vanderbilt University focused on pharmacy informatics as well as related experiential and research opportunities to our students. It doesn’t hurt that Nashville has evolved into the health care capital of the country. But creating these types of health care informatics opportunities for pharmacy students is a challenge nationally for pharmacy and other health care educators, which is why the article described below was written. Hopefully the framework presented and specific examples described help educators working in even the most resource-challenged environs develop informatics opportunities for their students.
Standards requiring education in informatics in pharmacy curricula were introduced in the last 10 years by the Accreditation Council for Pharmacy Education. Mirroring difficulties faced by other health professions educators, implementation of these requirements remains fragmented and somewhat limited across colleges of pharmacy in the US. Clinical practice and workforce metrics underline a pronounced need for clinicians with varying competencies in health informatics. In response to these challenges, a multitiered health informatics curriculum was developed and implemented at a college of pharmacy in the Southeast. The multitiered approach is structured to ensure that graduating pharmacists possess core competencies in health informatics, while providing specialized and advanced training opportunities for pharmacy students, health professions students, and working professionals interested in a career path in informatics. The approach described herein offers institutions, administrators, faculty, residents, and students an adaptable model for selected or comprehensive adoption and integration of a multitiered health informatics curriculum.
The summary and book chapter below represent our contributions to this text. The topic remains an area I have great enthusiasm about and high hopes for, when executed well.
Irrational use of medications is a global challenge, with the World Health Organization (WHO) estimating that “more than half of all medicines are prescribed, dispensed, or sold inappropriately”. This situation is exacerbated by half of all patients not taking their medications as intended, with non-adherence rates in disorders like schizophrenia reaching over 70%. Medication non-adherence and polypharmacy (i.e., use of multiple medications) are massive barriers to optimal medication management and are the source of substantial health and financial costs. Mobile health (mHealth) offers myriad methods to address these challenges, ranging from simple text message reminder systems to ecological momentary interventions (EMIs) to leveraging interface versatility for eHealth literacy solutions. In this chapter, current scientific evidence will be used to explore the role of mHealth in enhancing pharmacy-related outcomes in varying healthcare settings and diverse populations. Current and future developments in mHealth will be explored through the lens of select disease states and patient populations.
The next frontier in healthcare? The next step in patient-centered delivery of health services? Technology’s next overhyped bubble? There are grains of truth in all of these labels that have been given to mHealth. However, what is beyond debate is that there are opportunities with mHealth. In particular, I am optimistic about the opportunities with mHealth for pharmacists. To that end, I asked several colleagues to help outline the potential of this informatics arena. Those efforts were recently published as an article in the American Journal of Health-System Pharmacists (AJHP). My hopes are that this article serves to increase awareness of these opportunities and perhaps spurs some pharmacists to capitalize.
Source: Clauson KA, Elrod S, Fox BI, Hajar Z, Dzenowagis JH. Opportunities for pharmacists in mobile health. Am J Health Syst Pharm. 2013;70(15):1348-1352.
Kevin A. Clauson, Pharm.D., is Associate Professor; and Shara Elrod, Pharm.D., is Assistant Professor, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL. Brent I. Fox, Pharm.D., Ph.D., is Associate Professor, Harrison School of Pharmacy, Auburn University, Auburn, AL. Zaher Hajar, Pharm.D., is Fellow in Consumer Health Informatics, College of Pharmacy, Nova Southeastern University. Joan H. Dzenowagis, Ph.D., is Senior Scientist e-Health World Health Organization, Geneva, Switzerland.
One of my favorite developments within the Florida Society of Health-System Pharmacists (FSHP) has been membership’s growing interest in informatics. Of course, there are FSHP members who have been active in informatics for 20+ years, but the increased focus on it in the last 5 or so has been particularly encouraging.
To that end, I was asked to present this year at FSHP Annual on one of my favorite topics – patients’ use of mobile health (mHealth) apps to enhance their self-management. The expanded slide deck from my FSHP presentation is below.
A new journal, Future Learning, launched this year aims to provide “the current best thinking, research, and innovation for the effective utilization of technology for educators in higher education, professional education, workplace learning, continuing education, and life-long learning”. The inaugural special issue was on Social Media and Learning, and I am happy to have been able to help contribute an article to it. That issue (and hence our article, “Thematic analysis of pharmacy students’ perceptions of Web 2.0 tools and preferences for integration in educational delivery”) can be accessed for free via the journal’s download form here. Alternately, all abstracts from the issue can be read here. The journal arena is a crowded one, but I have high hopes for this effort by editor Dr. Lisa Gulatieri (@LisaGulatieri) and their Board.
When you teach at a University with multiple campuses (in our case, Fort Lauderdale and Palm Beach in Florida and Ponce in Puerto Rico) even with live, interactive videoconferencing – you have to try and figure out ways to connect with your students at different sites. We’ve tried different methods over the years with varying success, but one that worked well early on was the use of an audience response system (aka clickers). This is something I talked about previously in the presentation, “The Science Behind Engaging Students in Class“.
Our recent article in the American Journal of Pharmaceutical Education basically describes our multi-campus implementation and measurement of its impact on student engagement, satisfaction, and opinions about projected use of clickers in other courses. We also touched on related issues, such as clickers’ possible role in helping desensitize communication apprehension in students.
We are very excited that the Nova Southeastern University College of Pharmacy has officially launched our Center for Consumer Health Informatics Research (CCHIR)! Like all undertakings of this magnitude, it has been in the works for some time and has benefited from tremendous support from many corners – in particular the Chair of the Department of Pharmacy Practice and the Dean of the College of Pharmacy. Below is a presentation outlining some basics about the Center. I look forward to working with its faculty and collaborators and steering the CCHIR toward many great developments in the future.