The University of Illinois at Chicago presents the next webinar in our series: The Evolution of Pharmacy Informatics. David Kushan, Managing Partner at HealthCare IS, will discuss the evolving field of pharmacy informatics and answer questions including:
• What are the current job opportunities in pharmacy informatics?
• Why is a pharmacist’s experience important for involvement within the health informatics industry?
• How do pharmacists fit in the big picture of health informatics?
• How does an advanced education in health informatics provide a competitive advantage for pharmacists?
File Name: The Evolution of Pharmacy Informatics
START TRANSCRIPTION
0:00 DAVID KUSHAN: …get started. First of all, as an overview, we’ll try to keep this entire phone call to about 30 minutes. I’ll try to present the information in about 20 and leave some time at the end for any questions that people may have. First, I’ll just take a few minutes as we get rolling and describe my background, what we do and our firm does. From there, I’ll go into the information I have been asked to research and provide to the participants today. That primarily entails around the current pharmacy informatics landscape, the job landscape, the future landscape… what things are looking like down the road, why a pharmacist background may be necessary and what involvement it may have overall within the industry moving forward. From there… excuse me one second here… I’ll take a little bit of time to talk about how pharmacists fit into the big picture overall of health care informatics. And also, I’ve been asked to talk a little bit about how retail pharmacists will get their foot in the door and what role they may play overall within the industry.
1:10 DK: So, from there, very briefly, I’ve been in the search and recruitment business for the last eighteen years. Primarily, most of that has been in the healthcare IT aspect of things within the healthcare industry. About the last five or six, we’ve transitioned into that area that’s evolving in informatics. I started healthcare IS in 1998. We had several practices each focusing in different areas of software implementation and during the time we’ve been in existence, we’ve worked with… we’re just coming up on about 170 different organizations on a national basis. Those tend to primarily be with inpatient as well as outpatient organizations and physician practices. We do work with some consulting firms as well as vendors out in the marketplace.
01:58 DK: Day to day, I personally lead our pharmacy IT informatics practice and we placed our first IT pharmacist back in 2005. It was interesting how that occurred. We had an organization that was a university medical center on the West Coast. They were looking to implement a pharmacy application. Having already implemented other applications at the organization, they really began to see the need to bring clinicians into their IT area, so that, and I’ll go into more detail later, but the main reason was credibility in the systems of that project, so we’ll talk a bit about that, but that was our first entrance into placing pharmacists into, at that time the IT area, and today, quite a bit in the informatics area as well.
2:44 DK: The first thing that I want to mention overall is “How did I come up with the information I’ll be talking about today?” Well, first we have many clients as I mentioned throughout the marketplace on a national basis and what I hope to share from you is… are some of the actual things I hear day-to-day from our actual hiring managers and companies that come to us to help them find people for full-time positions, and one thing I may not have noted, we also do place consultants as well…but in our full-time practice, a lot about how the positions are evolving; the information we’re receiving from clients and how that information is evolving into the different types of people they’re looking for and how maybe the same job has evolved from a few years back to today. Also, I’ll share some of the perspectives of what I hear from candidates in the marketplace, those people that we’re actually placing in positions with our clients. People that are doing it today and some of the things that they’re looking at and they’re considering as they’re managing their careers.
03:43 DK: Also, for my preparation for today, I actually took some of the questions that were sent to me, some of the information that I was asked to provide, and sent these questions to informatics pharmacists that I’ve known. Of all the pharmacists I sent them to, I think at a minimum, I’ve known people for three years plus. These are pharmacists that are working in inpatient settings, a couple of them are working for vendors. They’re at community hospitals, they’re working in multi-entity health systems. So, I’m trying to do the best I can today to stay away from my personal opinion but provide information that is actually coming from people that are in the marketplace, doing the work day-to-day.
04:25 DK: Overall, I want to give a little bit of guidance about how to use the information that’s being presented. This is clearly an evolving marketplace. What I have to present today clearly isn’t the end-all, be-all. I know that. People today are a listening and determining how they can use this information to help guide themselves in their career. And you know what? I think that this could be a really good starting point for somebody who is deciding whether or not they want to get into a career in informatics, and just as importantly, if you’re already in informatics, in the informatics function today within an organization, this could be something that you could clearly add to your bucket of knowledge, and help you guide and do research as to where you want to head in your career.
05:10 DK: So, having said that, “What is pharmacy informatics?” I think it’s a very tough phrase to describe and get consensus on. I think if you were to go and talk to ten people in the marketplace today and ask them what pharmacy informatics is, you may not get ten answers, but you’d certainly get four. So what I decided to do, just to use this as a basis of our discussion, I went to the University of Illinois at Chicago Web site and used their definition. And what they have there, the pharmacy informatics is a sub-discipline of health informatics. It deals with the integration of information technology and its application in the pharmaceutical practice. It focuses on leveraging technology, technology systems and medication use to ensure optimal patient safety and help outcomes. So that’s kind of the framework I’m using for the information we’re gathering today. But having said that, I think that there’s still a lot of, I don’t want to necessarily say confusion, but lack of consistency in the marketplace. As you explore careers in this field, there are a lot of different titles in the job market for positions that I’m seeing that do literally the same thing. I think you can look at positions for informatics pharmacists and IT pharmacists. Maybe even a pharmacy IT analyst, and although they all have different titles, you can find that from one organization to another, that IT pharmacists and informatics pharmacists can be doing 80 percent of the same position, and you can also many times find nurses, physicians in pharmacy analyst roles doing very similar tasks to an IT pharmacist.
07:04 DK: So the first thing I was asked to think about was, or is, the current job landscape. And what I would say overall is there’s a lot of stability in the market as it relates to pharmacy informatics job market. And overall, it is, in my opinion, over the eighteen years, it’s about as strong as any niche market that I’ve seen over that period of time. A lot of that today is being driven by ARRA, which is American Recovery and Reinvestment Act, which has a big component of that dedicated to the implementation of technologies in health care settings. Organizations are trying to become meaningful-use compliant. There’s a lot of financial incentive for providers to adopt certain aspects, certain criterias of technology that has been put out there as incentives right now. And although this was an evolving market, and it was getting stronger prior to 2009, things have certainly picked up since meaningful use criteria has been put in place.
08:17 DK: If we look into the future a little bit, and in terms of future, I look at the three to five year standpoint, I still think it’s very strong. I think there was a concern overall in the marketplace that there would be a big, quick two- to four-year rush, two to five year rush, and things would die down quite a bit, but I think as things are moving forward, from a lot of the people that I’m talking to today, what’s being realized is that organizations are working very hard right now to meet government imposed timelines and organizations are doing the best they can to hit those timelines, meeting it at a minimum criteria level. So what we’re seeing right now is that it’s systems, technologies being implemented very fast. People I’m talking to today feel like the demand and the work will be prolonged, due to going back and optimizing everything that’s being put in place today.
09:11 DK: The second thing that I’m seeing quite a bit, and this is not being too publicized, but some of the timelines are very aggressive for certain-sized organizations. If you’re an organization out there that does not have the financial resources or the personnel resources, it can be very difficult for them to hit some of these timelines, so although they may not be publicizing it, there are folks that I’m talking to that said that they’re going to be attempting to eventually meet the criteria that was put in place, but they recognize that they can’t do it at the pace that they’re being asked to do. So you’re going to see continued technology install, technology implementation going beyond the dates of meaningful use.
09:53 DK: Informatics is an area that’s going to continue to grow. As I have written here, informatics is just going to continue to play a larger role in diagnosing and treating patients. With that, there will be new technology out there to maximize and get the most out of information data that’s being accumulated. Therefore, I think that the demand will stay out there beyond as what we see today in the market as a whole. And along in that last point, as the data is captured, there will be new ways to maximize the information that’s being accumulated so…
10:34 DK: From there, one of the things I was asked to talk about a little bit is to discuss why a pharmacist background is necessary. And I think…or … excuse me, “pharmacist” might be too… might be pigeon-holing it just a bit. It could also include nurses. It could include physicians, people that are dealing in the area of medication, but what’s very important, first and foremost is pharmacists talk the language. I think going back to the example that I mentioned on the first or second slide. That first project our firm worked on, the organization had had a lot of difficulty from an IT perspective getting buy-in as to … or increasing the confidence level and the credibility level of the IT department when they didn’t have staff that could go out and talk to people in departments and demonstrate that they knew what their job was, how they were doing the job and maybe how to improve their job before implementing the technology. So talking the language is very important.
11:36 DK: Knowing the workflow of the department, very important. These are some of the answers that I got back from speaking to pharmacists and asking them why they felt their jobs might be easier today because they are pharmacists. And you know they… each of them talked about knowing the department and the workflow. What might be a little bit redundant, what I just said, but having that credibility and dealing with other pharmacists or other people that are dealing with medications and patients on a day to day basis. It’s very important to have.
12:03 DK: Again, this was another tidbit that came back from another pharmacist, understanding the workflow, focus on the specific needs of the pharmacy operation as a whole. Very important. And lastly, a highlight. Go back to that first example, the organization that we worked with at the time, with hindsight was ahead of their time, bringing… we had seen a number of nurses and even some physicians, but that was the first step back in 2005 where we saw a pharmacist being brought in on a very consistent basis.
12:34 DK: So, how do pharmacists fit in to the big picture of things? Well, first of all, again from the questions that I got back from the people that I talked to, they’re the key in managing medication therapy in informatics. That was just something that… the credibility that comes along with that… it’s very difficult to replace. Knowing how to manage the creation and maintenance of all the medication therapies within an information system can be a pretty complex task, as many organizations are finding out. And so pharmacists have their trained knowledge along with having gained some IT expertise, are bringing a lot of value to the marketplace today. And in line with everything that I’ve said, pharmacists are bringing a unique perspective to help drive the decision-making process. That’s one of the keys that’s not always given as much credit to, and the time that’s necessary. But the better you can do on the planning up front in any of these systems, the better it’s going to be. The technology is not just there to implement. The technology is there… this is information that came back a number of times, to focus on the technology being the tool to help implement the ideal process, and so the better decision-making up-front the more happier it seems that end users are with the technology that’s eventually implemented.
13:58 DK: Another interesting point that was brought up in terms of why a pharm… or how does a pharmacist fit into the big picture, is we’re seeing technologies that are going throughout the entire organization today. There used to be a time when an order would eventually end up in pharmacy and that information would be dealt with in pharmacy and something would be… the order would be dispensed and administered. Today what we’re finding with CPOE is that the siloes are really …changing quite a bit. Systems are being set up to enable nurses and physicians to put orders in place and pharmacists have to make sure at the same time that these systems are useable, that the data and information still comes into the pharmacy in a way that it is workable, so having somebody that has the overall organization, operational focus and workflow in mind, as well as understanding pharmacy information, excuse me, how that information best flows in a pharmacy is something that’s critical and still needed, and probably going to be needed as time goes on. As informatics departments are continually expanding, we’re seeing different areas of specialty and so pharmacy is at the center of a lot of this and it’s very important to have someone who’s knowledgeable about as broad a spectrum as they can be.
15:28 DK: And also, one of the pharmacists brought up a very interesting point to me. He said that a lot of individuals are accustomed to analyzing a tremendous amount of data, much more data in the new car they purchase, than they are in the choice of what drug they use. And I think just as, I’ve noticed over time, personally going into outpatient clinics and having a family, the time that is spent with a pharmacist, talking to a patient before something’s handed to them, as there’s more information out there, they’re educating patients in the marketplace, in the patient care arena. There’s clearly lines where patients don’t need to be as in tune with all of the details that one has in becoming a pharmacist, but there is an emphasis on making sure the patients are educated. And you know, the one aspect that I’ll share from my personal experience, it seems to be that the pharmacist is the one that, especially in the outpatient environment, talking to patients before they leave with medications.
16:34 DK: So, in coming to one of the later points here in the overall discussion, how can a retail pharmacist get involved? How can they get involved in informatics? And I heard… I put this into maybe two bullets here because I heard two general comments back from the pharmacists that I talked to. Number one is that getting into pharmacy informatics in a hospital setting really requires the hospital operational pharmacy experience. Got that a number of times. That in order to implement technology, the right questions have to be asked up front about the operation. That has to be done during a planning process, and the technology and automation is used to make that process as efficient and as effective as possible. So it’s very difficult for someone in retail to walk in the door and bring value immediately if they’re not familiar with their operation, but they certainly have a… with some effort there … a foundation is there to be able to become familiar with what’s going on in the hospital. That’s certainly a key. The challenge is in how to get from retail into the hospital, or I should say challenge in doing so is gathering that information so that you’re qualified to walk in and be able to do things necessary to help that hospital pharmacy or the processes within the hospital plan their technology implementation.
18:03 DK: But the second thing that came up a number of times, I know this is a little bit longer, is that … health care systems are breaking down barriers between inpatient-outpatient and community pharmacies, and one of the things that was highlighted a number of times is that a true health care… a true electronic health record really must include all of the aspects of health care for the individual patient, and that doesn’t necessarily stop during the hospitalization. So as information is gathered at the hospital and a patient leaves a hospital with their meds that need to be used after that hospital care, there’s certainly interaction with a patient that somebody outside of the hospital has and as the siloes continue to break down, they look, from the people that I’ve talked to that are in hospitals today, they really talked about ways that that information that’s been gathered today and the results that are happening at the end will be used in overall decision support and educating those retail pharmacists as well to be able to play a bigger role in contributing overall aspect of the process.
19:14 DK: So, in conclusion, I think going back to the beginning of the presentation, I’d highlight again that we’re in a strong, growing job market overall. From some of the things that I’ve been hearing and continue to hear, signs are pointing toward continued growth. Also within the market, you know pharmacy informatics today is somewhat viewed as a niche, but I would say as someone who is in the market and filling positions with employers, you know, a wide range of employers that even within pharmacy informatics, niches are developing. Technologies that are going in, such as CPOE, e-prescribing, process of med reconciliation, bedside barcoding… in the consulting practice that we work in, there are clearly specialists today in each of those areas. So there’s the big picture of pharmacy informatics, and then there’s becoming the specialty processes of certain types of automation and technology within that full gamut.
20:14 DK: I used to hear a saying that “All things being equal, then…” and I realize that there weren’t many times where all things were equal, so I like to use the phrase “All things being close….” And I think if you’re in informatics today and you’re thinking about which way to guide your career or if you’re thinking about getting further education in this area, I would say today that all things being close, advanced education, studying in informatics, an informatics degree is beginning to make a difference right now. I think the reasons why it has not made… in my opinion… as much of a difference in the past is that there were not many programs or curriculums in place in the informatics area. As we’re continually seeing, degrees for informatics being implemented in several different places, several different universities… I don’t have any numbers on how many there are today compared to the past but I am seeing a number of resumes coming my way with an informatics degree, I’m beginning to be asked for that, especially for full-time roles, full-time leadership roles specifically. So if this is something, a career path that you’re in, or looking to get into it would be worth really considering advanced education.
21:44 DK: And one of the other things that I heard just the other day from a CMIO that I was talking to is that he asked me specifically when I was presenting candidates to him that… he wanted to have some sense that the people who were… who he’s considering for his…and this was a pharmacy informatics coordinator role… that they truly had a plan to be in this place, or plan to be into this type of a role at some point in their career, as opposed to somebody who just happened to bounce from position to position. And what that tells me, and I’m sure that there’s several opinions on that, but what that tells me is that the people that are doing the hiring are starting to see how this is really becoming a career path for people. And they’re wanting… in order for them to make their decisions on who they want to hire, they’re wanting to make sure the people they’re hiring aren’t just sticking, you know, their foot in the water and seeing if this is a good path for them. They’re wanting to know that this is what people are going to be. So much of the experience that provides the value is what you’re going to get on the job, and these employers that are making these hires recognize the need to hire qualified people, but there’s a lot of knowledge that individual’s going to gain while they’re in this role, and they want to make sure that it’s a path that they’re happy with and want to be in. So that’s another reason to consider an advanced degree in an informatics aspect.
23:07 DK: So having said that, you know, I’m more … happy to open up the floor for questions. On the screen, of course, is my information, phone number and email address. Feel free to contact me if there’s anything more specific than the general questions that we’re able to get to today. Also just as a sidebar for those of you that are on Linked In, we do have a group. The group’s called Healthcare IS, Pharmacy IT, Pharmacy Informatics CPOE Group. There’s a number of discussions that are on there in relation to career; the types of backgrounds that are important for your career as well as organizations that are dealing with these technologies that are being implemented today and I’d be happy to have you join our group online as well. Thank you for your time. I’d be open to any questions.
23:52 HOST: Thank you David. That was both comprehensive and very interesting. I want to open it up for questions at this time. We have a chat function at the bottom of your Option Bar and within that, if you’d like to type a question, I can then relay that to David, and he can then answer that question, so if you can go ahead and do that right now that would be wonderful. We have a question coming in. It is a long one. This person has a BS in Pharmacy, an MBA in Health Care Systems and Retail, Hospital and a pharma company experience, with management … project management experience. I believe the question is “Is another Master’s enough or do I need to go for a PhD? If the Master’s is enough in informatics, you still need a PhD to teach, right? I think that this might be a little bit… I mean, I don’t know if you’ve… David… have had any experience with putting people into faculty positions at universities but I’m assuming that….well, from my experience, I can answer this question. You don’t necessarily need a PhD to teach, but if you’d like to speak a little bit more about putting someone in a role with that sort of background that would be great. So someone that really does have all of that experience and education. You know, how easy is it to place someone in a position right now?
25:20 DK: The… I don’t have experience in faculty-level, and I very rarely… just to address that…very rarely have a position that comes to our firm where the PhD is required. The advanced degree, I think again shows that the mindset is there, that this is the career field the person wanted to be in, and I think as, what I’m seeing right now, is the … curriculums that are really laying a nice foundation. They’re adjusting to giving someone that foundation that’s going to enable them to walk in the door and have the tools to be able to do this type of position. Nothing’s going to beat that hands-on experience but a lot of people don’t have that educational foundation in specifically informatics, and most people who have gotten into pharmacy informatics are pharmacists that worked in a pharmacy department and that organization was going to be implementing some technology and the pharmacy director would ask “Who has interest?” Somebody would have an interest and they were in the door. And that’s still happening out there but I think moving forward, as the industry gets more populated with people who have been doing informatics and have pharmacy informatics degrees, they’re going to expect a little bit more of a foundation moving forward.
26:37 HOST: Ok, great. I have another question, and that question is “What are the salary ranges for someone that’s in a pharmacy informatics role?”
26:46 DK: What I’ve tended to see in general is that each… each marketplace, each geography has its standard pharmacy compensation, so whether, you know I’m on the West Coast, whether you have San Francisco or LA or Fresno market, they each have standard compensation for inpatient pharmacists. What I tend to see is that the informatics pharmacist makes about the same thing…makes about the same salary as what the hospital would pay plus about five or ten percent. Because it is a salaried role, there will be times during projects where it’s going to be necessary to work more than forty hours a week, and since it’s a salary, rather than getting an overtime pay, they’re already building in about that five, ten percent increase in additional compensation.
27:36 HOST: Ok, wonderful. A question came through and it was “Where can I have a higher degree in informatics online?” Well, you can receive one at the University of Illinois at Chicago. We offer a Master’s in Health Informatics and a post-Master’s in Health Informatics, so that’s a question that I can answer. David, I had a question for you: “Where do you recommend that a pharmacy informatics role be placed within an organization’s structure?” So I would assume within a hospital or healthcare setting. How do you see that position correlate with the other departments in that hospital?
28:17 DK: I don’t know if I have a strong opinion on where that should be. I think that it’s a by-product of the culture of the facility. I do see three main things right now. I see them in… generally speaking… you’ll see the pharmacy informatics person in pharmacy, unless there’s a Clinical Informatics department. And the Clinical Informatics department will have representation from all of the departments within that department as a whole, but going back to what I’ve seen in some of the slides, the bigger question … or another way to look at it is what are the tasks that need to be done? Because I do see informatics pharmacists in pharmacy doing things like building order sets, which has traditionally been done in an IT department. And I’ve seen people within an Informatics department building order sets, which tends to be… which is in the past is done in IT departments. So each organization is completely different. I think it’s up… I think you’ll find that each of those organizations, there’s no two that are alike out there but the key is the role, the specific functions of the position and what you’re doing. Each organization’s going to feel like there’s more value in doing it in different departments, so I hope I wasn’t too long-winded there but that’s… I don’t think we’re going to see commonality anytime soon on where specific tasks, specific positions are found in a hospital.
29:50 HOST: Well, that makes sense. As far as a retail pharmacist is concerned, it seems that there are a lot of questions coming in with people with that background. They want to know what… if they really are interested in getting into pharmacy informatics, what would be their steps? Would someone with this background probably benefit quite a bit from a master’s degree in Health Informatics, wouldn’t you say? Or some of the other steps, what would you consider them to be? Or what would you recommend to others?
30:19 DK: Well, I would say number one, I do speak to a lot of retail peop… pharmacists. A lot of the retail people that want to get into informatics, and the challenge is that the specific knowledge base or skill sets that a hospital may be looking for, most retail pharmacists don’t have. You just mentioned to demonstrate that it’s a path you want to go down, and having that advanced degree, that is a Step One that… will it get you to the position? Well, that’s going to be different from organization to organization but it is something that regardless of the organization will help you stand out compared to someone with a similar background and they don’t have that advanced degree. The second thing is, you just have to find a way to get the experience. Whether txhat’s … I’ve talked to retail pharmacists that, you know, it’s not always a popular thing to say but they’ve worked, if they were able to get their foot in the door to a hospital project, they’ve done it at a compensation rate on a short-term basis. It provides a win-win. They get the experience they’re looking for, so that for that next position they can say they have the experience and the hospital was able to save in terms of their budget costs by getting somebody that has some overall knowledge but not specifically the knowledge they’re looking for so any way you can be creative and get that information… or get the knowledge base that you can then demonstrate on the next full-time role you’re looking for is going to be valuable.
31:47 HOST: Wonderful. Have you seen a role for pharmacy IT in a managed care setting? So for instance, the PPN/HMO etc?
32:00 DK: Managed care’s probably only about ten percent of the positions that we place, or where I interact on an ongoing basis. I have. I certainly see the pharmacists bringing their knowledge base to helping those organizations with the way they’re run but I just at this point, I haven’t seen the pharmacy IT, at least as I think about it, how I described it today. I’m not saying that it’s not out there. I’m not speaking with confidence that it’s not out there, I just haven’t seen it.
32:30 HOST: You haven’t had the experience in it? Wonderful. What type of work experience and length of time in their jobs are the companies you’re working with require?
32:44 DK: I’m not sure. I’m not sure I understand that. Is that meaning “What length of time before someone’s considered to be experienced? I’m…
32:49 HOST: Yes. That would be the question.
32:53 DK: Ok. Answering under that standpoint, I think once … I think once… the way the marketplace is today, there are certainly people out there with fourteen… with ten, twelve years of experience, just headed an organization that took on technology, brought a pharmacist into a role, but I would say on average right now, if somebody’s CV comes my way and they’ve been in an organization and implemented a… gone through a technology project or some sort of implementation, could be automation, could be software, a good project of maybe a year and a half to two years is the type in an informatics or an IT role is good enough to start to stand out in today’s marketplace.
33:43 HOST: Great. I think I’m going to ask one more question because I know we’re about at the allotted time and that question would be “Where will there be growth in the industry? Where will the jobs be in the future?
34:01 DK: Well, as I mentioned in the slide, I think there’s… I would just take a look at, if you have time to look at the aspects of becoming meaningful-use compliant that organizations are trying to achieve and looking at what… how it affects you know, medication therapy process and that’s where you’re going to see the growth. Right now, there’s… CPOE is big. Medication reconciliation is big. E-prescribing is big, but these are all things again that are part of becoming meaningful-use compliant. So right now, it’s hard to look beyond that. There’s a lot in the air with these things but as I also mentioned I think as a [unintelligible] over the industry something else will evolve. It’s just really hard to put a finger on it beyond what organizations are doing right now to hit that compliance factor.
35:01 HOST: Great. Thank you so much for your time today, David. If there are questions that were unanswered, we’ll try to have David answer them offline and they will be emailed out to everyone that had asked that question. With that said, thank you David. Thank you everyone for taking the time out today to hear a little bit more about the evolution of pharmacy informatics. I hope everyone has a wonderful Thursday and enjoy the rest of your work week. Thanks again.
35:30 END TRANSCRIPTION