Seth Hartman, PharmD, serves as director of pharmacy informatics at University of Chicago Medicine, an 811-bed academic medical center.
In his role, which he has held since 2017, Dr. Hartman is responsible for overseeing the university's medication-use systems, leading the pharmacy informatics team and coordinating information system projects.
Becker's Hospital Review recently asked him how the pharmacy informatics role is evolving, what technologies will shape the industry and how informatics systems can be improved.
Here's what he had to say.
Editor's Note: Responses were edited for length and clarity.
Question: How is the pharmacy informatics role evolving?
Dr. Seth Hartman: As healthcare has transitioned from individual institutions of care into more organized health systems comprised of working relationships between primary, secondary, tertiary and quaternary care facilities, pharmacy informatics has changed as well. Due to this shift, pharmacy informatics went from focusing on a single site of care to focusing on the patient throughout the care continuum. This required inpatient-focused practitioners to learn outpatient models, incorporating pharmacist workflows into clinics and involving outpatient pharmacy services into the comprehensive health record, and vice versa for informatics pharmacists traditionally focused on outpatient workflows. We are constantly looking at our systems and working through how to improve decision support algorithms or better integrate multiple sources of data to prevent errors of commission or omission by seeking to capture the entirety of the patient's history into the CHR.
Informatics pharmacists are now responsible for a greater breadth of services and medication use workflows than ever before. This has increased the need for their expertise when designing systems, making strategic business decisions and creating new ways to engage patients. They are required to operate at a higher level than just maintaining medication records and are required to understand the implications of designs for the patient across workflows for the entirety of the patient's journey through these systems. Today, more than ever, we rely on the informatics pharmacist's expertise to help grow pharmacy systems within health systems.
Q: What is the next big thing for the pharmacy informatics industry?
SH: At the risk of sounding repetitive with daily reports around the advancements in these fields, it is fairly easy to say that artificial intelligence, blockchain, telepharmacy and digiceuticals are going to shape the future of our industry. Here is a breakdown of my thoughts on these:
- AI: We are already using machine-learning algorithms in practice. It is easy to see that, particularly with the advances in deep learning in radiology, it cannot be too far away that the process of checking the accuracy of the standard medication dispense will be handled this way too. AI stands to make drastic improvements in both how we manage our data with analytics but also in how we run our operations. The more we increase our automation with robotic process automation augmented with machine learning, or other forms of AI, the more we'll be able to extend our resources to the patient instead of just within the walls of the hospital.
- Blockchain: Independent pharmacies have struggled with relevant medication information at the time of dispense, and hospitals have struggled to obtain records from other organizations that can be meaningfully incorporated into our ecosystems to provide relevant data and triggers to our decision-support systems. Moving patient health information into the blockchain, allowing patients to own the keys to provide the transference and access, and having a national standard for the structure of the data might help to solve the privacy, safety and availability concerns in these situations, among others.
- Telepharmacy: In one form or another, the practice of telepharmacy is already approved in many states, but is often limited by access and bandwidth issues. These barriers prevent it from being meaningful, especially to the remote patients that it would truly benefit. With advances in 5G technology and infrastructure improvements, we aren't too far away from having the ability to provide more services outside our four walls than within. I expect to see kiosk pharmacies and telepharmacy solutions pick up in the next few years, to better serve outlying communities that don't have access to these services in-person.
- Digiceuticals: This new term, sometimes referred to as digital therapeutics, is meant to comprise digital health technologies that can be used to treat specific conditions or assist in medication therapies. Several health systems are already recommending digital health apps and have marketplaces where users can select an app from a list of approved apps for specific uses. Going forward, I believe we'll be responsible for not only vetting, but ensuring appropriate use and data incorporation from these structures into our CHRs. In addition, I expect we'll need to incorporate the "prescription" of these apps to patients and allow for tracking their use as we do today with medication therapies.
To choose one next big thing I don't believe is possible, I believe we'll see these technologies, most likely in combination with one another, bringing new models of healthcare delivery to the U.S. As a result, we will need to continue to prepare our informatics pharmacist and teams to be able to ensure accuracy, safety and efficiency with these tools to ensure optimal outcomes for our patients.
Q: How can pharmacy informatics systems be improved?
SH: There are so many pharmacy information systems in use today, most of which operate with the same principal of automating the medication-use cycle. Introduction of the above technologies is certain to have some impact on improving these systems, and is likely to drastically change them for the better. The best areas to improve pharmacy systems with artificial intelligence, blockchain, telepharmacy and digiceuticals would be to do the following:
- Improve the usability of our systems to reduce the cognitive burden on our clinicians
- Drastically improve the accuracy of our decision-support systems, reducing alert fatigue
- Provide more portability of health data and give this control to our patients
- Extend the reach of our systems through telemedicine/telepharmacy/digiceuticals
If we can focus on improving efficiency for our end-users, perhaps we can reduce some of the burnout caused by the tedious nature of documentation. If we give our patients access to a digital app with their medications, maybe we will be able to help reduce visits to our emergency departments by improving medication adherence, and perhaps we could automatically be notified when they are struggling. If patients brought their health data with them to each visit in a way we could readily incorporate it into our system, we would have fewer medication errors due to a lack of information or incorrect information. There are myriad ways where these areas could provide great improvements to our systems today, and I believe we are taking appropriate steps toward them.