Slides On Advances in Pharmacy Practice (For Self-Paced Learning)

UNIT VII
ADVANCES IN PHARMACY
PRACTICE
Objectives
q Enumerate the different advances in Pharmacy in terms of
technology, practice, and services
q Identify the advantages and disadvantages of each potential
technology
q Understand how changes to the workflow process can help
reduce potential errors by the Pharmacists.
Potential Technologies Solutions
1. Computerized Physician Order Entry
2. Computerized Prescription Transmission Systems
3. Electronic Prescribing
4. Bar Code Technology
5. Radio Frequency Identification
6. Automated dispensing
7. Other technologies and services
Computerized Physician Order Entry
What is CPOE?
qCOMPUTERIZED PHYSICIAN ORDER ENTRY
qCOMPUTER PHYSICIAN ORDER ENTRY

SYSTEM
qCOMPUTER-BASED PHYSICIAN ORDER

ENTRY
is a process of electronic entry of
medical practitioner instructions
for the treatment of patients
(particularly hospitalized patients)
under his or her care.
These orders are communicated
over a computer network to the
medical staff or to the departments
(pharmacy, laboratory, or radiology)
responsible for fulfilling the order.
CPOE include the following:
q Provides information regarding drug of
choice and appropriate alternatives
q Provides feedback regarding
medication appropriateness and
formulary availability
q Provides information about potential
drug duplication
CPOE include the following:
q Checks patient-specific information
such as allergies, age, and weight
q Screens for drug-drug or drug disease
interactions
q Recommends appropriate dosage
q Provides high/low dose warnings
q Reviews patient medication history
Features
üOrdering – Standardization
üSafety - Real-time identification
üIntuitive - Workflow efficiency
üPortability - Not location specific

Features
üBilling - Diagnose Charge Linking
üManagement - Statistical Reporting
üRegulatory compliance - Electronic Signature
üDecision support - Patient-centered

How does it work?
¨ The physician logs into the web-based and inputs the
patient's identification information, such as a medical
record number.
¨ The physician indicates the test they want to order by
choosing from a predetermined set of menus.
¨ The physician uses a series of check boxes to indicate
the patient's symptoms, the individual's past history
and the probable diagnoses.
How does it work?
¨ Once a test is chosen the system may alert the physician to
previous outcomes for that test in other patients with the same
signs and symptoms.
¨ Scheduling can be done online saving the patient and hospital
valuable time.
¨ Once the appropriate test is performed, physicians caring for the
patient will be notified immediately that images and text reports
are available so that important clinical decisions can be made in a
timely fashion.
Advantages
o Improved quality of care
o Provides timely delivery of patient care
o Supports efficient workflow

Advantages
o Automate ordering process
o Reduces Order Errors

Standardized, legible complete orders
o Data collected on variances in practice

Advantages
qallow error checking that can prevent
problems from occurring before the order is
completed.
qcan track orders and be queried to give
clinicians data regarding their own practice
compared to clinical standards and peers.
qdecreases delay in order completion
Advantages
qreduces errors related to handwriting or
transcription
qfaster transmission to the pharmacy
potential economic saving
qimproves response time and avoids
scheduling problems and conflict with
existing orders.
Advantages
qDrug-specific information that eliminates
confusion among drug names that
sound alike
qImproved communication between
physicians and pharmacists
qReduced healthcare costs due to
improved efficiencies.
Disadvantages
vErrors still possible
vAlerts
vMultiple steps
vAccess
Disadvantages
ØPhysicians' time is consumed in doing order
entries
ØComputer access is required and may not be
easily available when the physician is off
site or when there are too few computer
stations available during peak usage times.
Traditional Prescribing Computerized Prescribing
Prescribing The physician writes the drugs to be The physician encodes the drugs into the
prescribed to the patients (takes computer system (takes 20 seconds or less)
more than 1 min)
Ordering The patient then goes to the The drug and patient infos then goes
pharmacy and presents the through the computer system
prescription written by the physician automatically. (less than 1 second)
to the clerk.
Transcribing The clerk must read the prescription The pharmacist sees the order in her
correctly and communicate it computer system and approves dispensing.
accurately to the pharmacist.
Dispensing Once, the prescription is validated, The clerk prepares the orders.
the clerk can now prepare the order.
Barriers and Challenges to CPOE
ü Financial commitment
ü Physician and staff acceptance
ü Training
ü Interorganizational communication
ü Introduction of “new errors” due to
new technologies
Electronic Prescription
What is an e-prescription?
E-prescriptions are computer-
generated prescriptions created
by your healthcare provider and
sent directly to your pharmacy
Electronic Prescription
How does e-prescribing work?
Instead of writing out your prescription on a
piece of paper, your doctor or other
healthcare provider enters it directly into his
or her computer
E-prescriptions are sent electronically through

a private, secure, and closed network – the
Surescripts network – so your prescription
information is not sent over the open Internet
or as e-mail.
Electronic Prescribing
üFast
üConvenient
üSecure
üLegible
üEconomical
Advantages
ØImproved patient safety and overall
quality of care
ØReduces or eliminates phone calls,
faxes and call-backs to
pharmacies
ØStreamlines the refill's requests and
authorization processes
Advantages
ØImproves Formulary adherence

ØIncreases patient convenience
ØOffers true Provider Mobility
ØIncreases patient compliance
ØImproves reporting ability
Disadvantages
qAccidental data entry errors such as
selecting the wrong patient or clicking on
the wrong choice in a menu of dosages
qInadvertently divulging protected health
information on the internet
qPrescription duplication can also occur
Disadvantages
ØSometimes the dosage or dosage

form listed on the computer is just the
dose that the drug formulary allows or
what the pharmacy stocks and doesn’t
reflect minimum or maximum doses
Disadvantages
ØThere is a transmission fee
associated with receiving
prescriptions electronically or
requesting/receiving a refill
approval electronically
Bar Code Technology
What is a bar code?
A bar code is a graphic representation of
data that is machine-readable
They may be thought of as another way of

writing, because they replace key data entry as a
method of gathering data.
Bar codes are a way of encoding numbers and

letters by using a combination of bars and spaces
of varying widths.
A bar code is a reference number that a computer

uses to look up an associated record that contain
descriptive data and other important information.
Bar Code Technology
Note: The computer does not
read the numbers underneath
the barcode. These Human
Readable (HR) numbers are
printed so a "human" can easily
read the barcode, if necessary.
Bar Code Technology
Anatomy of Bar code
Codes of the Number System Character:
0 - Standard UPC number.
1 - Reserved.
2 - Random weight items like fruits, vegetables, and meats, etc.
3 - Pharmaceuticals
4 - In-store code for retailers.
5 - Coupons
8 - Reserved.
9 - Reserved.
Bar Code Technology
How do computers read barcode?
A device in the
Bar codes are
scanner takes The scanner’s
read by sweeping
1st 2nd 3rd

the reflected
a small spot of laser starts to
light and
light across the
converts it into read the bar
printed bar code code
an electrical
symbol.
signal.
A unit is either black or white. A unit that is black would display as a

"bar". A unit that is white would display as a "space". Another way
of writing a barcode unit is "1" for a single unit "black bar" and "0"
for a single unit "white space".
Bar Code Technology
B
A Bar heights are chosen to make
R it easy to keep the sweep within
the bar code area.
H
E
I
G The longer the information to be
H coded, the longer the bar code
T needed. As the length increases,
so does the height of the bars
S
and spaces to be read.
Bar Code Technology
Bar codes are a fast,
easy, and accurate way
of entering data.
Barcode in
business
Bar codes can reduce

inefficiencies and
improve a company’s
productivity
Bar Code Technology
Sheets of bar codes were placed by
computer terminals on patient units
for staff to swipe
• patient’s bar code label,
Implementing • the bar codes of the tests,
barcode in health
care
procedures,
• medications to be ordered for the
Apatient.
decade later, a handheld device
dubbed the “Steam Iron” was
introduced to the healthcare market.
This device included a keyboard
display, and bar code reader.
Bar Code Technology
Advantages
• Fast-selling items can be identified
quickly and automatically reordered.
• Slow-selling items can be identified,

preventing inventory build-up.
• The effects of merchandising changes

can be monitored, allowing fast-
moving, more profitable items to
occupy the best space,
Bar Code Technology
üProvide unit-of-use coding
üAccurately track clinical trial supplies
üImprove medical device and
pharmaceutical production
üAid compliance with FDA labeling and
product traceability requirements
üImprove quality and reduce costs of
prescription labels
Bar Code Technology
üTrack patient records, drug
dispensing, medical
supplies, and equipment
üStreamline admissions and
patient data entry
üImprove security for people,
facilities, and equipment
Bar Code Technology
Disadvantages of Using Barcode
1. It is costly
Businesses that want to implement bar code
equipment and technology have to
withstand the growing pains of doing so. This
includes training employees, installing the
equipment, expensive printers and the time
spent entering codes for labels.
Bar Code Technology
2. When a labels are damaged or non-existent,
it poses problems.
Damaged labels make it difficult for the cashier

to scan. Even the 12-digit number on the label
may be damaged to the point where it is not
legible. When this occurs, the checkout
process is significantly delayed while the same
product is sought out and brought to the
cashier for scanning.
Bar Code Technology
3. If the cashier sees a number of

items that look or seem the same
and scans one item multiple times
to save time. Each item and type of
item has a unique bar code and
must be scanned separately. As a
result, this could affect inventory.
Bar Code Technology
(Pharmacode)
• Also known as Pharmaceutical Binary Code
• It is a barcode standard used in the
pharmaceutical industry as a packing control
system.
• It is designed to be readable despite printing
errors.
• It can be printed in multiple colors as a check to
ensure that the remainder of the packaging is
correctly printed
Bar Code Technology
ROLE OF BARCODES IN HEALTHCARE
1. Ensured Accuracy-
Barcodes are used throughout the
healthcare industry for error free tracking,
validating, documenting, and billing.
Bar Code Technology
2. Integrity of Data
Integrity of data is very important in
healthcare industry as even a small
mistake can be fatal for the patient.
One of the common mistakes in healthcare
is incorrect infusion. Barcode scanners
eliminate this problem by helping
healthcare professionals to provide right
drug to right patient in the right dose.
Bar Code Technology
3. Fast and Effective Execution
Barcodes are widely applicable in healthcare
industry, as they are fast, easy to use, and
effective to execute.
Relevant data can be extracted quickly and
effectively using barcodes. They provide
timely feedback from data captured in real
time, enabling to take right decisions and
increasing patient's health by reducing risk.
Bar Code Technology
4.Cost Effectiveness
Usage of barcodes reduces the number
of employees who are prone to make
mistakes reducing rectification costs to
control damage further.
Barcodes reduce the operational and
inventory costs by improving the
delivery of medication to the patients,
eliminating treatment errors, and
tracking the shelf life of drugs. Bar Code Verifier
Bar Code Technology
Barcode Printer
Barcode scanner
• One of the most proven and effective methods to prevent
medical errors is to use bar coding to identify medications
at the unit-dose level for dispensing and administration.
• Used in the hospital include a bar code, pharmacists can
set a strong foundation for patient safety initiatives
Bar Code Technology
Bar Code Technology
Bar Code Technology
Bedside
At the patients' bedside, health care professionals can
use fixed and/or portable batch/wireless data collection
devices to scan both the barcode on the patients', as
well as on the patients' chart to verify they are talking
with the right patient, thus increasing bedside security.
Upon verification, you can view and update patients'

medical charts, check vital signs, insert notes, and use
cross-checking tools to expand patient care at the
bedside.
Bar Code Technology
Medication Dispensation
•When it is time for patients' to receive medication,
once again scans both the patients' wrist and chart to
ensure they have the proper patients, and then scans
the medication to check that it is right for the patients.
Automated dispensing
• It involves the use of machines pre- stocked with
drugs that are programmed to automatically
dispense physician’s orders upon request.
Advantages
• Some of the advantages include improved efficiency,
enhanced safety, and improved use of space.
1. Reduces Errors
• This can help with errors for both inpatient
and outpatient medications.
• Improvement in efficiency-using an
automated dispensing system can speed the
process of filling prescriptions while cutting
down on costs.
2. Bedside Use
• It can be used to manage medications for an inpatient who
needs many medications.
3. Helpful at Nursing Stations

• Can access common medications quickly and easily.
• This cuts down on trips to the pharmacy or to a storage closet
elsewhere on the ward, making the nursing staff more
efficient.
4.Efficient for Pharmacies
• These systems can reduce the amount of work for pharmacy
staff members, allowing them to focus on more complicated
tasks that cannot be completed by an automated system.
• ADVANTAGES : [SAMPLE]
• Saves time and greatly reduce the potential for inventory discrepancies
• Automatically rotates inventory on a first-in, first-out basis
• Makes narcotic medications controlled and secured
• Promotes compliance with the prescribed medication therapy and helps
prevent missing doses
• List restocking accurately and facilities medications for transfer patient
• Eliminates time-consuming work
• DISADVANTAGES [TRADERS]
• Time needed to load
• Risk of breakdown [downtime, system failure,
machine defects]
• Additional training and technical help
• Discourages staff from checking stock
accurately
• Errors in order entry
• Risk of insufficient storage capacity
• Space and cost issues
• Machine defects. No machine will run forever without
shorting out. If the pharmacy doesn't have some sort
of back up system installed to manually keep tract of
inventory and the system crashes, all the data will be
lost.
• Too costly
• Product defects
• Less man power; may cause unemployment
• Pharmaceuticals are already present at the point of care and do not
need to be sent or transported from main pharmacy stores, a time
and labor intensive process.
• Controlled substances remain in a secure lockbox.
• Patient charges and inventory control tasks are simplified in an
automated dispensing system and "lost charges" are much reduced
• It can provide clinical decision support to improve
patient safety---providing drug-allergy alerts, drug-
drug interactions, advise on high risk medication and
avoid confusion with "sound alike" medications
RADIO FREQUENCY IDENTIFICATION
What is RFID? ¨a system that transmits the

identity (in the form of a unique
serial number) of an object or
person wirelessly
¨uses radio waves that transfer
data between a reader and an
electronic tag attached to an
object for the purpose of
identification and tracking.
Chip of RFID Tag
RFID
Tag
• Radio Frequency Identification
• Describes any system of identification wherein an electronic device that uses
radio frequency or magnetic field variations to communicate is attached to an
item.
How does it work?
• It is composed of three parts:
• Antenna or coil
• Transceiver with Decoder
• A transponder with RF tag programmed with unique information
How does it work?
¨ The antenna emits radio signals to activate the tag and to
read and write data to it.
¤ emits radio waves in ranges of anywhere from one inch to 100 feet or
more, depending upon its power output and the radio frequency used.
¤ When an RFID tag passes through the electromagnetic zone, it detects
the reader's activation signal.
¨ The reader decodes the data encoded in the tag's integrated
circuit (silicon chip) and the data is passed to the host
computer for processing.
RFID: The Advantages
¨very simple to install/inject inside the body of animals
¤useful in animal husbandry and on poultry farms
¤Gives the general information about the animals, such as the
age, vaccination, and even the health
¨Better security of the product
¤It cannot easily be replicated
¤Prevents the counterfeiting of products
¨Major part of retail business
¤Helps in managing of stocks and logistics of product
RFID: The Advantages
• Can store up to 2kb of data
• tags are placed inside jewelry items and an alarm is installed at the exit doors
• More versatile
• Has the read and write capability
• More productivity
• Group of RFID tags can be read simultaneously
• Critical data such as temperature monitoring can be automatically logged
RFID: Disadvantages
• Tags are unreadable in liquid and metal surfaces
• Presence of mobile phone towers interfere the RFID
• An invasive technology
• customer can be tracked and his personal information can be
collected by the RFID reader
• SOLUTION: RFID are deactivated once product is purchased
• Not proven its reliability in large-scale
• Cannot withstand extreme temperature
HEALTH RISKS
• Only applicable to RFID
implants
• Once implanted they may
experience headache
• Though FDA approved,
• In animal studies from
1996 to 2006, implants
can cause malignant
tumors The yellow is from the iodine disinfection
before inserting the chip
USES OF RADIO FREQUENCY IDENTIFICATION
• Asset Tracking
• Assigned to products especially to those that are
underused for easy tracking if they will be needed
• Tracks lost or stolen products
• Manufacturing
• Track parts and works in a process
• Reduce defects
• Supply Chain Management
• Track shipments
USES OF RADIO FREQUENCY IDENTIFICATION
• Retailing
• Improves supply chain efficiency
• Makes sure that product is in the shelf when
the customer wants to buy it
• Security and Access Control
• electronic key to control who has access to
office buildings or areas within office buildings
• Low frequency RFID
Other Technologies: ROBOTICS
q The ROBOT-Rx® automated
medication dispensing system
prevents medication errors, reduces
pharmacy labor, and lowers drug
inventory. The hospital pharmacy
robot automates medication storage,
selection, return, restock, and
crediting functions for 90 percent or
more of a hospital’s daily medication
volume.
Features
ØDispenses patient-specific medications into cassettes or envelopes,
facilitating cart fill, first dose, stat and now deliveries.
ØSupports cabinet restocking and medication deliveries to multiple
hospital sites.
ØStores more than 25,000 medications—practical storage.
ØAccommodates more than 98 percent of all drug forms, including
tablets, capsules, syringes, pre-packaged liquids, vials,
ampoules, and patches.
Features
üProvides real-time, enterprise-wide picture of medications stored,
dispensed, credited and administered through the system.
üContinuously tracks all online and offline inventory, checks itself for
expired and slow-moving medications and generates
restocking reports.
Advantages
Improve efficiency of dispensing
Improve accuracy, reduce errors
Improve documentation
Authorized access only, enhance security
Reduce job stress and staff turnover
Shorten med pass times for nurses/caregivers
Disadvantages
The main disadvantage of using automated equipment in the
pharmaceutical manner is that whenever problems regarding power and
system failure arise, the health of the corresponding patients are
compromised.
Difficulty in manually retrieving stock.
The machine and maintenance are very expensive.
There is a need for additional training and technical help.
Will encounter a lot of cost and space issues.
Other Technologies: MedROVER
MOBILE DISPENSING CABINET
§ a mobile drug cabinet which dramatically increases
dispensing safety and time at the patient bedside
§ flexible storage options and lightweight, ergonomic design
make it an ideal solution for hospitals looking to reduce or
augment existing stationary cabinets.
§ holds patient-specific medications, floor stock, and supplies
nurses need in a convenient cart that can be brought to the
patient bedside for administration and verification.
Features:
üBedside verification
üSimple touch interface
üTriple lock security
üBiometric authentication
üLocked supply drawer
üLocking wall dock
üPull-out work surface
üUp to 108 storage bins (multiple sizes)
üSpecific bins for patient meds and floor stock
Pharmacists:
ØReduces overall costs by tracking all medications to
prevent loss
ØSemi-automated refilling of medication containers
ØSecure, cabinet-style dispensing of patient medications
ØFlexible computer platform accommodates bedside
verification software
ØAccommodates various replenishment models
Other Technologies: IVR
Interactive Voice Response
q includes automatic validation in host and

automatic doctor communications
q reduces errors by allowing patients to enter
their refill prescriptions via internet or their
phone’s keypad, by passing the verbal
communication to a pharmacy staff member
• What is it used for?
• Patient refill requests
• Patient refill status requests
• Automatic callout notifications upon
prescription completion
• Automatic faxed refill requests to
prescribers
• Alternate language call trees
• Customized messages to the patient
for holiday or pharmacy operations
Advantages
• “Automated Phone Systems”
• Provide 24/7 service to customers/patients
and customer convenience
• Reduces prescription fraud by validating
refill requests with patient-specific
information.
Advantages
• Reduces interruptions and
distractions to the dispensary staff
• Further reducing the risk of
medication incidents
• Disadvantages
• Some menus are too long
• Some people dislike talking to machines
• Older adults might have a hard time following
• Voice prompts are hard to understand
Other Technologies: Vertical Carousels
ØThe MedCarousel® system automates the
medication management process, from order
fulfillment to patient medication dispensing
and restocking.
ØRegardless of the workflow, it is an ideal

component of any hospital pharmacy due to
its versatility.
qAided by rotating shelves, pick-to-light, bar-code
scanning.
q guides to medication storage locations,
q improving picking speed and accuracy.
q the convenient workflow simplifies medication
selection for cabinet restocking, first doses and
cart fill.
qstores many drug forms-bulk bottles,
unit-dose solids, liquids, IVs and odd-
form medications.
qits advanced software accurately

tracks inventory and expiration dates
making medication management
efficient and streamlined.
Other Technologies: Tablet Counters
“Universal” or “Countertop” tablet
counters (where the stock is poured
into the patient’s vial in a weigh-type
machine) now use bar code scanning
to verify the stock bottle retrieved
matches the product requested by
matching it to a bar code on the Rx
label set. Ex. Kirby Lester
Other Technologies: Tablet Counters
“Cassette” or “Canister” tablet counters
(where each high-volume product is
stored in its own unique canister which
is then placed on a counting unit) can
be activated directly from the
pharmacy’s management system,
allowing validation that the correct
canister was placed on the counting
unit
Other Technologies: Rx Image
Scanning
• Storing of patient’s
prescription “history” file
• Pharmacist will be able to
assist the patient better
• Reduces waiting queue
Other Technologies: Medical Vending Machine
• Allows pharmacists to concentrate more on Rx
drugs instead of OTC drugs
• Allows pharmacists to concentrate more on patient
handling
• After filling up the prescription, if patient is not
there for pick up, the pharmacist may store it in the
vending machine and just have the patient scan his
personal identification code for pick up.
• Cuts down prescription mix ups
• Machine connects to a pharmacist 24 hours
Other Technologies: Medication Detection Machine
• check the content of medication pouches
• Advantages
• Medication pouches are checked accurately and at high
speed
• Provides proof for the packing process
• Gives detailed information about the packing process
• Decreases need for manual checking
• Offers extra information about pouches
per patient and other statistics
Other Technologies: Electronic Signature
• Electronically capture, store and retrieve Patient signatures
• Eliminates paper storage
• Saves and tracks signature image for prescription
• Creates a history of prescription pickup activity including date,
time and counseling details
• Enhances patient privacy at point of pick up and minimizes
effort and time involved in accessing information to address
customer inquiries and third-party
Other Technologies: Rx Printer
• Pharmacy labelling is an important part of the
packaging process (Need to put drug specific,
bar code scannable labels on many different
types of packages prior to them being
dispensed)
• Can generate, log and print the majority of
drug specific labelling requirements
• Utilizes an extensive drug database to produce
a wide variety of medication labels
Other Technologies: Doctor Auto-Fax
• Doctor fax monitoring system
• Notes the time, date and completion of the
fax to the doctor
• Improve physician relation
• Can customize fax form to help doctors
respond appropriately:
• Rx renewal request
• Prior authorization
• Step therapy
• Drug substitution
Other Technologies: In-store Display
• Displays prescription ready to be picked up
• Increases customer patience
• Customer will not wonder when their prescription
is ready = will not bother pharmacist
• Merchandising strategy
Other Technologies: Automated Dispensers
q count less. do more.
q automated dispensing and counting
systems work to increase productivity
and patient safety.
q has a lower initial capital investment
and lower lifetime operating costs than
other counting and robotic systems.
Other Technologies: Strip Packaging Machines
q formerly used only for long term
care facilities
ü now being used for patients of all
ages who prefer their medications in
compliance pack strip
Other Technologies: Automated Packaging System
The PACMED™ high-speed packager

automates bar-code packaging of oral
solid medications, improves packaging
accuracy and pharmacy workflow
efficiencies, and facilitates the
transition to scanning bar-coded
medications at the patient's bedside.
Other Technologies: Automated Packaging System
üPharmacy automation uses significantly less labor,

optimizes inventory levels, enables bulk medication
buying, and improves pharmacy management.
üThe intelligent PACMED packager works virtually
unattended to fulfill orders electronically, replenishing
for carts, cabinets, pharmacy stock and multiple sites.
Electronic Enabled Packaging
Pharma DDSi Wireless

q This technology is based on
conductive ink on a carton
board-based blister in lay,
which is connected to a
cellular module embedded
in the package
Electronic Enabled Packaging
q The removal of pills is

tracked and the
information can be sent to
an electronic database
automatically via GSM
cellular network
Packaging Against Counterfeiting
q Latest development are

fluorescent labels, packaging
with laser surface
authentication, which can be
identified through a unique
code, and the near field
communication tags (NFC)
CHILD RESISTANT PACKAGING
q can be opened by applying
pressure at two separate
points on the packaging
The talking Packaging: “SELF TALK”
qThe “Talk Pack” from
Wipak in Germany, a system
which can be invisibly
integrated into any printed
image on any packaging
material, but needs a special
scanning pen.
The talking Packaging: “SELF TALK”
q The tags provided spoken
dosage instructions from
pharmacy staff, to aid a
visually impaired or blind
person.
These are called already the “around the
pill” digital offerings: digital health mobile
apps, devices or services that could be
prescribed by a doctor or bundled with a
drug.
Some packages come with a wearable
monitoring device and an app, through
which patients can receive positive feedback
from their doctors and from the automated,
personalized feedback generated by the app
itself.
ADVANCES IN PHARMACY PRACTICE
CURRENT TRENDS IN CLINICAL PHARMACY PRACTICE
CLINICAL PHARMACY
q CP is a health science discipline in which pharmacists provide patient
care that optimizes medication therapy
q It promotes health, wellness, and disease prevention
q Embraces the philosophy of pharmaceutical care, specialized
therapeutic knowledge, experience, and judgment for the purpose of
ensuring optimal patient outcomes.
CLINICAL SERVICES IN PHARMACY
• Ward rounds participation
• Poison information services
• Pharmacovigilance
• Therapeutic drug monitoring
• Drug information services
• Patient counseling and Education
• Medication Therapy Management
• Drug Utilization Evaluation
• Hospital Formulary Preparation and Management
Drug and Poison Information Services
• Drug Information Center – are the service centers established in
hospitals, community pharmacies and the patient counseling services
who are providing an information sought by a doctor, nurse or
patients on demand about a drug and its actions, dosage and
administration and all other precise information based on which a
clinical decision can be taken by a clinicians.
Drug and Poison Information Services
• Poison Information Center – are usually located in the hospital to
provide quick precise and latest information on demand by a clinician
where emergency treatment poison cases are treated
• to provide latest reliable drug or poison information gathered from
various information resources.
• A drug information Pharmacist is responsible for providing drug
information and this information center is headed by the Clinical
Pharmacist
Patient Counseling
• Means the oral communication by the pharmacist of information to
the patient or caregiver, in order to ensure proper use of drugs and
devices.
It aims to produce following results
• Improved medication adherence
• More effective drug treatment
• Better patient understanding of their illness and the role of
medication in its treatment
• Improved quality of life of the patients
• Better coping strategies for medication-related adverse effects and
unnecessary health costs
• Improved professional rapport between the patient and pharmacist
Medication Therapy Management (MTM)
• Is team effort of healthcare professionals to ensure expected
outcomes in a systems approach.
• Pharmacists make a pharmaceutical care plan and explain to the
patients in detail regarding disease, drugs and life style.
• The MTM involves the pharmacist’s interventions in carrying out the
process of therapy under direct supervision.
MTR Core Elements Service Model
Medication Therapy Review (MTR)
Interview patient tp gather information for the appointment
session
Patient Medication Record (PMR)
Generate a comprehensive report from the computer system
Medication Related Action Plan (MAP)
A patient-centered document containing a list of actions for the
patient to use in tracking progress for self-management
MTR Core Elements Service Model
Intervention and Referral (IAR)
Consultation services and pharmacist intervention to address
medication-related problems and refer to another provider.
Documentation and follow-up
MTM services are documented and communicated to each
prescriber and patient in a consistent manner
Therapeutic Drug Monitoring (TDM)
• TDM is a branch of clinical chemistry and clinical pharmacy that
specializes in the measurement of medication concentrations in
blood. Its main focus is on drugs with a narrow therapeutic window.
• TDM also provides useful information regarding individual variation in
drug utilization patterns and alteration in drug utilization as a
consequence of altered physiological state or disease process

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UNIT VII

qCOMPUTER PHYSICIAN ORDER ENTRY

qCOMPUTER-BASED PHYSICIAN ORDER

üSafety - Real-time identification

üIntuitive - Workflow efficiency

üPortability - Not location specific

üManagement - Statistical Reporting

üRegulatory compliance - Electronic Signature

üDecision support - Patient-centered

o Provides timely delivery of patient care

o Supports efficient workflow

o Reduces Order Errors

o Data collected on variances in practice

E-prescriptions are sent electronically through

ØImproves Formulary adherence

ØSometimes the dosage or dosage

They may be thought of as another way of

Bar codes are a way of encoding numbers and

A bar code is a reference number that a computer

1st 2nd 3rd

A unit is either black or white. A unit that is black would display as a

Bar codes can reduce

• Slow-selling items can be identified,

• The effects of merchandising changes

Damaged labels make it difficult for the cashier

3. If the cashier sees a number of

Upon verification, you can view and update patients'

3. Helpful at Nursing Stations

What is RFID? ¨a system that transmits the

q includes automatic validation in host and

ØRegardless of the workflow, it is an ideal

qits advanced software accurately

The PACMED™ high-speed packager

üPharmacy automation uses significantly less labor,

Pharma DDSi Wireless

q The removal of pills is

q Latest development are

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