role of computers in clinical pharmacy
TRANSCRIPT
Clinical pharmacy is the branch of Pharmacy where pharmacists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists often collaborate with physicians and other healthcare professionals.Drug information retrieval system and special therapeutic programs are available to further assist in patient care role
CLINICAL PHARMACY
• Prescription monitoring• Prescribing advice to medical and nursing staff• Medication errors and adverse drug reaction
reporting• History Taking• Patient education and counseling• Pharmacokinetics and therapeutic drug level
monitoring• Professional and Clinical Audit
ROLES OF CLINICAL PHARMACIST :
Computers have played a vital role in the development of clinical
pharmacy practice and basic pharmacy research :-• Patient record Management• Entries of Medication Orders• Patient Medication Profile• Drug Therapy Monitoring & Problem Detection• Record Drug-Drug Interactions & ADR’S• Pharmacy Automated drug interaction screening (PADIS) system• Teaching Techniques• Building Data Base • Inventory control • Medical Research• Computerizing Drug Information System • Uses Of Computers In Other Fields Of Pharmacy
ROLE OF COMPUTERS IN CLINICAL PHARMACY
The Clinical computer system must assure the patients record database is continually updated to reflect the current status of all patients. This updating is done by assessing the database of admitting department to determine the information about recent admissions, discharges, patient transfers. Pharmacist should be present to check the details regularly.The computer system should be capable of producing other information such as
• Present diagnosis• Allergies• Weight• Height • Name of Attending physician• And any special note about the patient.
Patient record management
Medication orders should be entered regularly and the Pharmacist must be able to retrieve orders prior to administration to patient. Date must be entered by use of codes for drug names, dose scheduling. All drug orders should contain following :
• Drug Name• Drug Generic Name & Strength• Route of administration• Dosage schedule• Physician Data or Code
Entries of Medication Orders
The computer systems should be capable of producing the labels and reports in the form of
• Patient Medication Profile• “Fill Lists” for preparations of Individual doses• Lists of medications charged• Drug order renewal lists for the prescriber• Medication administration Record (MAR)• The computer system should have the functions to
prepare separate lists of TPN, IV Solutions and admixtures.
Preparations of Lists
Computer systems helps in diagnosing DRUG Interactions & warns potentially dangerous combinations of medications along withDrug-drug, Drug- lab, Drug-Allergy interactions & Wrong Diagnosis automatically.
DRUG INTERACTIONS
RECORD DATA BASE MANAGEMENT
AUOMATED AMBULATORY MEDICAL RECORD SYSTEMS (AAMRS)- • Billing,accounting,patient scheduling
immunization etc. Identifying high risk conditions
• Providing patient with personal records
• MEDICATION ADMINISTRATON RECORD (MAR)-printed list of medication orders for each patient on nursing unit e.g name ,bed number,diagnosis,sex,weight,height ,allergies
• DRUG UTILIZATION REVIEW-monitoring of drug use & also cost.it is designed to investigate suspected problem
• DRUG THERAPY PROBLEM DETECTION-automatic screening of medication order for possible drug interaction for new or changed drug order is enteru into patient profile
• DRUG THERAPY MONITORING-improves individualized dosing decision ,allow multiple storage,precise dosing
• PATIENT BILLING
• MANAGEMENT REPORTS AND STATICS
• RATIONAL DRUG PRESCRIPTION-computer based consultation system assist in rational prescribing.one such system is MYCIN
ADMINISTRATIVE APPLICATIONS• PATIENT BILLING-bills for no. of doses of
each item is supplied
• DRUG UTILIZATION-monitor use of specific drug for cost analysis , budgeting, or quality assurance
• WORK LOAD ANALYSIS-frequency of specific activities, average time for specific function, determining staffing needs, productivity estimates are also possible
• COST AND REVENUE ANALYSIS-department costs, expected revenue,inventory turn over,wastage,lost charges etc. Applicable in budget development,drug control,inventory management
• GROUP WORKING-accessible for multi users
• NETWORKING-making sharing easy < INTRANET-presenting information in a way every 1 can see it <EXTRANET-extending infornation outside work group
IN-HOUSE PREPERATION• Schedualing,calculating quantity of
additives and correct concentration,label,record maitenance,TPN ,sterile solution,radio pharmaceuticals
• STABILITY studies extrapolated stability curves for expiry date calculation,test schedule,shelf life calculation.serves as calender,data analyser,report writer.
SOFTWARE of PHARMACIST’S INTEREST• Drug interaction• Inventory management• Decay calculator• PK calculator-ADME studies,TDM,toxicity
dose• SPSS-for statistical evaluation• Clinical pharmacist-for dose calculation• Stability analyzer• Population pharmacokinetics• Trial managing
• HELP : The Program HELP ( Health Evaluation Through Logical Processing ) is used to allow experts in a medical specialty for defining the criteria of medical decision making. The broad base and flexibility of HELP permits complete drug monitoring. After receiving the Warning from computer the pharmacist contact the nursing staff and the physician. This system makes the pharmacist more efficient and accurate in monitoring patient drug therapy. The system issues warning more quickly than manual methods.
Software's & Programs For Clinical Monitoring
• Messages are presented in the form of pharmacological summary.
• The drug interaction messages are integrated with computerized drug profile systems.
• All drug interactions which may occur in current drug therapy of the patient are reported by this system.
• The information received from the system is to be used by either a physician or pharmacist in the clinical area
• The system is useful in reducing drug interactions.
features of HELP system
Monitoring Evaluation Of Drug Interactions By A Pharmacy Oriented Reporting.
This system issues a warning when potentially interacting drugs are prescribed for a patient
MEDIPHOR
• If a prescription containing many drugs is entered in the computer for billing purpose, immediately the computer scans the drug and issues the warning if there is possibility of drug interaction. Thus the computer helps in avoiding the drug interactions.
• The computer also warns when two or more drugs of same generic are entered. Avoid duplication.
Data Base
• A pharmacy automated drug interaction screening (PADIS) system is described which detects possible drug interactions by screening patient medication profiles. The data base contains approximately 24,000 drug interaction combinations of drugs marketed in the U.S
• The PADIS system operates as a batch run program which screens all patient medication profiles on a daily schedule. A patient drug interaction profile is printed by the computer for use by the pharmacist to suggest alternative therapy to the physician. The computer detects potential drug interactions
Pharmacy Automated Drug Interaction Screening (PADIS)
• Computerized Listing Of Abnormal And Unsual Drug Effects
• Containing 17,500 abnormal effects on laboratory tests of 1500 drugs may be computerized to match the laboratory test effects of drugs with patient because scanning manually for every patient is time consuming
COSTAR • COmputer STored Ambulatory Record (COSTAR) is
an electronic medical record using the MUMPS programming language
CLAUDE
• COSTAR(computer stored ambulatory record)-manages office, clinical functions, patient registration, scheduling billing, revenue analalysis , medical records , chart review
• MUMPS-supports database maintaining complete medical record
• SCAMP-comprehensive ambulatory record-billing, appontments, patient care reports, lab data, health maintenance, general/medical management
• AUTOMED-complete financial,administrative, clinical computer package
• FMIS(family medicine information system)
• MARTINDALE’S Extra Pharmacopoeia is now available online
• MEDLAR’S ( Medical literature Analysis And Retrieval system )
• MEDLINE ( Medlars Online )• NLM ( National library of Medicine )• PNI ( Pharmaceutical News Index ) Contained
news about devices and health industries.
Other Computer Software's
Automated Inventory System
• Computers have two types of applications in Medical research :
I) Computerized testing equipments ( Blood chemistry n gas analysers, Ultra sound scanners and CT scanners
II) Data collection, storage retrieval and research planning & Statistics
Medical Research
• Multimedia refers to the presentation of information in formats other than text alone. Included in these format types are: sounds, images, graphics, animations and videos
• Computers help a great deal in pharmacy training and education
• X.RAYS , Electrocardiograms and other interpretations and values with reference to cases can be shown on multimedia and taught to the students.
• E-Books, Websites and Wikipedia are also a great source of help for the Clinical pharmacists and students to gather information and data.
• Computer simulations are helpful in teaching techniques i.e Demonstration of complete physiological or pharmacological process.
Use Of Computers In Clinical Education
HOSPITAL INFORMATION SYSTEMS• hospital information-intensive istitution where lot of
time and budget involved inacquiring,recording,processing,retrieving and communicating information.
• Computer based information system available icluding AUTOMATED HEALTH INFORMATION SYSTEM,clinical informatin system,medical information system
• COMPONENTS:• 1.patient registration/admission/transfer/discharge• 2.patient clinical data base(history/physical
examination/labortory/progress notes)• 3.dignosis and treatment desion support• 4.order entery/execution/confirmation
• 5.Lab/diagnostic report• 6.Pharmacy support• 7.Food and nutrition services• 8.quality servillience• 9.billing/insurance/collection• 10.administrative report
computer based information system allows multi user accessd,provides ongoing monitoring, programs to detect risk situations,alert patieny senstivity, interactions.inapropriate dosing,medication strength, frequency of administration
However traditional paper based system is disorganized/illegible and can be used by only one person,at one location
• DRUG SUPPLYING & DISPENCING: label printing for individual patient,keep tracks of dosing,correct medication,dug list,charge information
• DRUG INFORMATION: keep up to date with new development,all library contents can be available
• Computer bases resources of information are available to provide rapid,efficient,current,compact inf( electronic journals,CDs,electronic bullitien ,world wide webs)
• Receiving of inquiry• Literature search• Delivering the responce
PUBLISHING• Formulary• Procedural manual• research report• Drug bullitien• ADR report
• REPORT GENERATION-for retrospective data analysis
• PATIENT DRUG PROFILE-prescribed drug , dose , age , allergy , height, weight and dignosis
• PATIENT LOCATION
• MEDICATION ADMINISTRATION
• AUTOMATIC DATA COLLECTION
• Maintenance of perpetual inventory control :Whenever an item is added to stock or removed from stock immediately the position of stock can be updated by the computer. This operation of the computer is intimately linked to other operations such as receipt of good, dispensing of goods, billing of goods, return of goods etc
• Maintaining the inventory records :
For annual auditing of pharmacy department , records of numerous items are required ,They can be easily obtained by the computer database records.
Purchasing and inventory control
1. Reduced book keeping2. Fewer transcription and medication error3. Reduce duplicate medication order4. Lowering cost in preparing bill5. Improves efficiency in order processing6. Improved detection of drug allergies, interactions7. Improved managing reports8. Improved inventory management9. Reduced ordering cost
ADVANTAGES OF COMPUTERS IN CLINICAL PHARMACY
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