Using an Electronic Health Record to Simulate Real-World Experiences in Therapeutics and Skills Laboratory Courses

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2 Technology in Pharmacy Education & Learning SIG Using an Electronic Health Record to Simulate Real-World Experiences in Therapeutics and Skills Laboratory Courses

3 This is a reminder that this session is being recorded and synchronized to speaker materials for future viewing on the AACP Online Learning Center. As an attendee benefit, the AACP Online Learning Centre is available to you FREE. This online resource allows you to catch up on sessions you missed, review key information at your own pace and helps you continue your professional development year-round. St t d f t f il ith i t ti Stay tuned for a post-conference with instructions for accessing your complimentary content. Visit the Registration and Information desk for more details.

4 Technology in Pharmacy Education & Learning SIG Using an Electronic Health Record to Simulate Real-World Experiences in Therapeutics and Skills Laboratory Courses

5 Presenters Keith Christensen (Moderator) Sam Augustine Kim Begley Amy Pick TIPEL SIG SGChair Gary Thielman

6 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

7 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

8 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

9 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 be beneficial i for the didactic learning environment

10 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 developed d that t solution Lowes R. Top 10 Cloud-Based EHRs. Medscape Medical News, Accessed June 12, 2012.

11 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 Customizable for other courses and for courses in other disciplines US Patent Pending, SYSTEM AND METHODS FOR EFFICIENTLY DEVELOPING THERAPY DECISION MAKING SKILLS; September 2, 2009: Number 61/275,771.

12 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 Case information entry using de-identified patient information collected from 4 th year pharmacy students and preceptors

13 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 information given in a document

14 Demonstration

15 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

16 Laboratory Layout

17 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)

18 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

19 e-voice Mail

20 Live Communication

21

22 Prescription Verification

23 Prescription Verification 1. Joseph Clark -- Ceftazidime Looking at the physician order and what was entered into the pharmacy system (typed 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

24 e-prescription Verification

25 Live Prescription Verification

26 Live Prescription Verification

27 Live Sterile Product Prescription Verification

28 Drug Utilization Review

29 Brown Bag Instructional Videos Students Faculty

30 e-brown Bag

31 e-brown Bag

32 Live Brown Bag

33 Live Drug Utilization Review

34 Brown Bag Rubric

35 Remediation Videos

36 Medication Therapy Management Mirixai

37 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

38 Advantages/Disadvantages g Cerner Etreby ADVANTAGES Used at CUMC Outpatient Pharmacy In-house IT support DISADVANTAGES Expense Training version Not universally used License number limitations QS1 ADVANTAGES Free Used by most independents Prescription scanning DISADVANTAGES Off site support Longer response times

39 Communication Phone Verification Patient Counseling Patient Histories Electronic Order Entry Verification

40 Ignatian Values Assessment EDUCATIONAL OUTCOMES Professionalism, Citizenship, and Leadership Critical Thinking Communication Patient Assessment Medication Therapy Management Dispensing i Medications - Drug Information Public Health Health Systems

41 Introduce, Reinforce and Demonstrate Pharmacy Skills Lab has responsibilities in Reinforcement and Demonstration Application i to our Pharmacy Curriculum (Educational Outcomes) Assessment Plan

42 Pharmacy Curriculum (Educational Outcomes) Assessment Plan EO Measure When By whom Data sent to: 7. Dispensing Area 2 scores Post graduation Dean Program Medications from NAPLEX (Summer) Assessment -Dispense Committee drug MPJE scores Post graduation Special Program products (Summer) Assistant to the Assessment consistent Dean Committee with patient APPE Year 4 Office of Program needs and (Dispensing & Semesters 7-9 Experiential Assessment patient safety Medication Education Committee in harmony preparation with the law. scores) Skills Lab - Years 1-3 Instructors of Program Dispensing Semesters 1-6 Record Assessment Committee

43 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. 73Accurately 7.3 interpret the prescription, select the appropriate dosage 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. 77Explain 7.7 the role of technology and apply it in the dispensing process. 7.8 Utilize appropriate resources to determine equivalence among manufactured drug products and identify products for which documented evidence of inequivalence exists. 79I 7.9 Interpret t and comply with federal and state t law in the practice of pharmacy Describe and apply techniques and procedures related to drug preparation, compounding, and quality assurance Identify and use resources, components, and equipment necessary to properly prepare compounded medications and maintain quality assurance Identify and describe devices required to monitor medication therapy and patient outcomes.

44 Technology in Pharmacy Education & Learning SIG Development and Use of Multimedia in the Instruction of Cases Amy Pick, Pharm D, BCOP Associate Professor of Pharmacy Practice Creighton University School of Pharmacy and Health Professions School of Medicine

45 Pain Management Electronic review of conversion calculations in pain management Interactive case studies

46 Pain Conversion Calculations Website Videos JingPro OneNote Comments

47 Assessment of Pain Management Therapeutic Outcomes Training Using a Multimedia Interactive Case Rationale: Learning varies among students Shift in teaching from traditional didactic lectures Role of technology Distance education

48 Development Case prepared in PowerPoint Recorded videos using Flip Video HD Use of Wavepad and djing Options given for all questions/answers ispring Pro Winstream

49 Pain video Video

50 Comments on Interactive Case Feedback Future Explore other topics Remediation purpose Brown bag review

51 Questions

52 Technology in Pharmacy Education & Learning SIG: Using an Electronic Health Record to Simulate Real-World Experiences in Therapeutics and Skills Laboratory Courses CODE: HHP4N6

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