mHealth and Tertiary Resources

• mHealth's connectedness and convenience can improve quality of life and ease of care.
• Benefits of mHealth include improved medication adherence, paperless transactions, and aggregated patient data.
• Barriers to mHealth include data breaches, privacy issues, demographics, scarcity of resources, regulatory/payment/security issues, lack of system interoperability and technology coverage/access, limited technology literacy and capacity to invest.

Tertiary Resources

• Condense and summarize data from primary literature.
• Include textbooks, compendia, electronic databases (e.g., Micromedex, Lexicomp), and review articles.
• Best if written by experts and peer-reviewed.
• Useful for answering questions and identifying information.
• Convenient, easy to use, and familiar to pharmacists.
• Lag time for publication is a limitation, along with potential author bias or inaccurate information.

Evaluating Web-Based Drug Information

• Questions to ask include: -Who is responsible for the site? -What is the site's mission? -Does the site want anything in return (personal information, etc.)? -Who funds the site and do they benefit from site access? -Is the information written/reviewed by healthcare experts? -Where does the information come from (expert opinion, studies, etc.)? -What is the editorial policy? -How current is the information?
• Check for site maps, contact information, or mission statements.
• Be wary of unbelievable claims.

Tertiary Databases

Clinical Pharmacology

• Features product comparison tools for allergies or dietary restrictions, linked to PubMed citations.
• Generates information on product dosage forms, clinical attributes, and adverse events.

Facts and Comparisons eAnswers

• Referenced abbreviated drug information.
• Includes comparison charts, daily news updates with FDA recalls.
• Provides information on patient assistance programs, look-alike/sound-alike drugs, and a manufacturer index.

Lexicomp

• Offers comprehensive info with over 1700 drug monographs.
• Includes drug shortages, FDA recalls, dangerous abbreviations, equivalent generic drugs, and extemporaneous preparations.
• Good for quick retrieval of easy-to-understand facts.

Micromedex

• Designed for healthcare professionals with clinical inquiries.
• Covers drug information, poison information, acute care medicine, and patient education.
• DRUGDEX provides evidence-based, detailed information.
• Micromedex offers a drug interaction app.

ClinicalKey

• Provides full-text access to journals, books, and medical videos.
• Supports healthcare professionals with evidence across specialties.

UpToDate

• Evidence-based, peer-reviewed reference available online.
• Covers medical disciplines and topics.
• Geared toward prescribers with summary documents of evidence-based medicine.
• Uses Lexicomp for point-of-service drug information.

Electronic Textbook Databases (eTextbook)

• Online textbooks in electronic format.
• Collections are geared toward specific subjects (pharmacy, medicine, nursing).
• Collections can be cost-effective.
• Content can be updated quickly, but the cost can be a disadvantage.

Impact of Emerging Technologies

CPOE (Computerized Provider Order Entry)

• Transmits prescriptions instantaneously from clinician to pharmacist.
• Allows pharmacy staff to move outside of a centralized location and do validation from remote locations.
• Speeds up medication ordering and reduces time to administration.

Automated Dispensing Machines

• Improve hospital safety and free time for staff.
• Allow pharmacy-validated orders to be immediately available at dispensing machines.
• Works with CPOE systems and helps prevent mistakes.
• Helps prevent drug diversion, increases security, improves inventory management/billing, and increases patient safety and care time.

Barcode Medication Administration

• Medications and patients are identified and matched with unique barcodes.
• Helps with pharmacy inventory and retrieval processes.
• Reduces time spent managing inventory.
• Eliminates some verification when combined with IV robotics, ADCs, and other automated dispensing.

Compounding Area Camera Surveillance

• Addresses contamination concerns in compounding.
• Allows remote monitoring, freeing up pharmacists.
• Captures the compounding area from multiple angles.
• Provides accountability and improves compliance, increasing patient safety.

IV Robotics

• Used to prepare and fill IV bags/syringes.
• Validates stock items, sterilizes items, and transfers to IV bag/syringe based on order information.
• Verifies compounded doses and applies barcode labels.

RxNorm

• Gives standard names to clinical drugs and delivery devices.
• Helps to communicate medication data electronically.
• Helps to avoid mistakes by ensuring consistent naming conventions.
• Increases coordination of patient care and data sharing.

Impact of New Roles for Pharmacists

• Can focus on patient health management.
• Can work directly with patients; interface with clinicians about care options; and assist nurses in medication remediation.
• Can create individualized plans for patients based on evidence and cost effectiveness.
• Staff will have to adapt to a faster paced decentralized environment
• Must be open to innovation.