Ep 1 - What's the difference between an I.T. Pharmacist and an Informatics Pharmacist?

That's a question that can be answered many ways. Find out one Pharmacists answer to this question and many more in our latest interview with Dave Wolfe, Vice President of Professional Services. With over ten years of experience of focus in pharmacy IT he offers a well rounded opinion on the subject. This is the first installment of the Healthcare IS podcast where we will be interviewing a new pharmacist in the IT or informatics field each month. Listen in to hear what these experts have to say and subscribe so you don’t miss out on any episodes.

If you like what you hear or have an opinion of your own, don’t be afraid to leave us a comment below! Who knows, with your great input you might find yourself joining our guests with an interview of your very own.

Listen to the episode here: Healthcare IS Podcast

Episode highlights:

• The difference between an I.T. Pharmacist and an Informatics Pharmacist
• When a pharmacist attempts to transition into Pharmacy IT and does not succeed
• The biggest surprise for most people who get in to this area of Pharmacy..
• Can a retail pharmacist transition to an Informatics Pharmacist Role?
• Does familiarity with a particular software or technologies or devices a facility is using matter?
• What are the advantages and disadvantages for an IT Pharmacist working in either the IT department or the Pharmacy?

You may also like: A Conversation with Steve Sisko

Healthcare IS Podcast Episode 1 Transcribed: Dave Wolfe on Pharmacy IT

One of our goals is to be a resource for people thinking about getting into pharmacy informatics. In each Podcast we will have an interview with a successful pharmacist who has transitioned into the role of pharmacy informaticists. I like to introduce everybody to our first ever podcast guest, Dave Wolfe.

Dave is somebody I’ve known for a few years now, I consider him a friend, and we’ve done work together for clients of Healthcare IS. Dave is the founder and principle consultant of FusionRX LLC. He’s a pharmacist with over ten years of focus in pharmacy IT, CPOE systems implementation and optimization. Dave has worked with a variety of applications in the Industry, specifically Siemens Pharmacy, Soarians Clinicals, Soarian CPOE, Mckesson Pharmacy, Meditech, and Care Fusion.

Q1 – In your opinion, what is the difference between an I.T. Pharmacist and an Informatics Pharmacist?

Dave, that question comes up quite often and in my mind in differentiate in this way. I view an IT Pharmacist is a functional expert who understand the implementation, the maintenance and the workflow of the pharmacy system and how they function and interface in other systems. The informatics pharmacist on the other hand, is more of a specialist who turns that pharmacy data into information. What I mean by that is, he/she will do an analysis of the pharmacy data, the clinical data, the cost data, and that type of functional data to improve clinical outcome, cost control, and ultimately system optimization. One is more of a product specialist and the other takes that data and turns it into useful information.

Q2 – What originally attracted you to this area of pharmacy?

When I started in this space about 10+ years ago, it was really in its infancy. They realized that pharmacy and IT really needed to blend together and created a whole new career path and opportunities for growth. As an entrepreneur I saw it as a great opportunity to create and build a business that’s supporting a lot of needs that vendors like Siemens, Epic and Meditech as well and the hospital pharmacies who were under resourced to support the implementations. So I saw this as a huge growth opportunity and another career path pharmacists could take that traditionally wasn’t there in the past.

Can you give me an example of what your first step was into this market?

I had the opportunity to get in on the ground floor of a hospital build. We were working in a trailer and the hospital wasn’t even built yet. It was a Siemens pharmacy implementation and they didn’t have a director of pharmacy or any pharmacy staff hired yet. I was asked to come in and build the pharmacy system for them in concert with the Siemens vendor as well as the hospital resources that were there at the time. I hadn’t done that type of work before. I had experience with IT departments reporting to me but I had never done that kind of ground level work. I dove in and it was a lot of fun and it created a whole new opportunity for me moving forward. Very unique and a little scary but it turned out better than I ever planned.

Q3 – Was there ever a time when you weren’t sure if this was for you?

I think everybody oscillates back and forth on their comfort zone of where they came from. For me, I looked at the never ending opportunity but when your heads down in a project it’s hard to find the next gig and take the time to do the business development side. I think that was the one thing that got me a little anxious..

“Ok what’s next after this project ends?”

The projects are generally supposed to last for 3 to 6 months but many times can last for 12 to 24 months the key is to continually look out for the next gig while still in the current project.

How have you overcome that issue over the years?

There have been a couple different ways that I did that. One is aligning myself with companies and vendors who provide the next opportunity for me. When I got started I was actually contracted into a pharmacy management company as an independent contractor. I did a good job with a Siemens implementation and it led to more work through that venue. In addition the relationships you build within the client and the vendor as you do a successful job they are always recommending you for the next contract. So I think the key there is networking, aligning yourself with a company be it a management company or a company like Healthcare IS, that looks out for the next opportunity. I think that alignment is really the key to success.

Q4 – When a pharmacist attempts to transition into Pharmacy IT and does not succeed, why do you think that is?

Well there are a couple of things. If you think of a traditional hospital pharmacist on a routine schedule, whether that be day shift and every second or third weekend, evening shift or seven on seven off to working the overnight shift, it tends to be a pretty standard schedule and one that they can predict and be comfortable with. The appeal of going into a pharmacy IT space is it’s pretty much a Monday thru Friday job but what people don’t realize it there are times for example when a system go live is going on or an upgrade is happening, you may have to do over night coverage, weekend coverage and work far beyond the normal 40 hour work week. It really ebbs and flows between the demands of the project. The other thing I have seen with pharmacists who have gone into this space is that some of them really miss the patient interaction or the clinical interaction with the other providers. You still have that but it’s not the day to day patient care focus that you had in the past. One of the biggest challenges I’ve seen folks struggle with who went into pharmacy IT or informatics is many times your working on more than one project there’s times when you may be working on 10 different projects in parallel and all are important initiatives for your institution. Some folks have trouble juggling all of those priorities and then they feel more comfortable going back into the day to day pharmacy order entry. That’s the difference I see with some people go into pharmacy IT and then go back into their comfort zone.

Q5 – What one or two things were not as you expected when you first got into this profession?

Like some of the pharmacists that I mentioned in my last example, some of the overnight coverage was a surprise to me, travel was also an imparter. Many times depending on the project you may have to be onsite more than 4 days a week and away from home. It’s a challenge that I think we need to talk about is when somebody considers a career in this pharmacy IT space, as hospitals get more comfortable with you, eventually you can balance it out so that you can do just as much remote work as you do onsite work. You will come across compromises where the hospital system isn’t comfortable with remote work and you have to be onsite. I think that’s been one part that I’ve struggled with from time to time.

Q6 – If you were talking to a colleague who was thinking about getting into a Pharmacy IT or Informatics role, what piece of advice would you give them that you don’t think they are currently aware of.

I think that as I talk with anyone considering that I think they underestimate the personal as well as professional growth opportunities in this area of the profession it allows you to look at things through a little bit different glasses I think. You can experience what you impact of the pharmacy system is on the whole enterprise not just your little piece of the puzzle. As you understand these different system dependencies, you see some true results in optimizing it and improving patient care ultimately and you have a much deeper and interdependent understanding of how pharmacy impacts not just getting the meds to the floor in a timely manner but the impact in the healthcare system in general from admission all the way to discharge.

The focus keeps coming back to better patient care and in understanding the interworking of the system you end up with better results.

Q7 – What do you think is the biggest surprise for most people who get in to this area of Pharmacy?

Elaborating on what I said about understanding how pharmacy affects the healthcare spectrum, eyes get wide open as to ok if I enter this drug in this manner, here’s what it’s going to look like in discharge. Pharmacy tends to use Latin figs, Latin instructions or Latin abbreviations for how frequently you’re given a drug. We as pharmacist are very comfortable with that language and those abbreviations but for the patient with a prescription they were discharged on, says that they are taking this drug QID..

They would say “What is QID?”

Instead of saying four times a day, they wouldn’t know how to take that drug. Its things like this that make you realize that we may need to retool and rename some of the names and processes we currently have in place that are impacting not only the pharmacy staff but ultimately the patient in the end. So again, it really opens your eyes to your impact on not only your little pharmacy world but how you have a huge impact on the rest of the world.

Q8 – Can a retail pharmacist transition to a hospital and bring any value in an Informatics Pharmacist Role?  What value “could” they bring?

Great question Dave, and we tend to be a bit myositic and say that you can’t get into pharmacy IT unless you’re a hospital pharmacist or have that background and I look at it a little bit differently. I find it a lot easier to teach a pharmacist the technology than to teach the traditional IT specialist the clinical side. So if you take somebody who is a retail pharmacist they get pharmacy, they understand drugs and they get patient care. It may not be in the same setting but I could teach them the hospital setting and the technology and the IT aspect of it. To be clear, it’s easier for me to teach the clinician the IT component than to teach the IT specialist the clinical component.

Q9 – Is an Informatics Pharmacist who is familiar with the software or technologies or devices a facility is using bring more value than an experienced Informatics Pharmacist who is has no specific familiarity with what the facility has in place?

Good question, many times that facility is going to say I want somebody with a specific number of years in experience with a certain application. Depending on the particular project and how detailed it is, and this kind of goes back to your first question, the difference between pharmacy IT and pharmacy informatics, a pharmacy informatics person in my mind are vendor neutral. They can pull data out of any system and get the quality outcome and information they need to make requisite changes in that system or the work flows. It depends on what the project is, if it’s a true deep build or a brand new build of a system, there’s some value in having someone who’s done that before with that particular vendor or application. As you mentioned in my introduction that I have worked with several different systems and I found that, the vendors won’t like me saying this per say, but if you peel the onion back or any of the systems, the core components are the same and it doesn’t take an experienced person long to learn a new application.

Q10 – What are the advantages and disadvantages for an IT Pharmacist working in either the IT department or the Pharmacy?

Like you Dave I’ve seen it both ways and it really depends on the organization but in my personal preference, especially if it’s a larger institution or enterprise hospital system with multiple hospitals within it, it makes a lot of sense to me to have an IT pharmacist who works in IT but has a strong working relationship with the pharmacy department. Generally you need a dotted line in who the IT pharmacist will report to whether is the system director of pharmacy, the director of pharmacy, director of clinical operations, CIO or CMIO within the organization. I’ve found that if a pharmacy it person is housed or work out of the pharmacy department they tend to get pulled out of the day to day operation an awful lot. I see a lot of value in pulling them out of that environment and allow them to focus on the projects at hand. They may working on projects that won’t be implemented for 6 to 24 months out, but its critical they take that time and use that resource and capacity instead of having them dive into staffing on an as needed basis.

When housed in the IT department it’s harder to get them back into the staffing on a day to day basis and I think that makes a lot of sense.

Q11 – Can you think about times or specific situations (particular projects maybe or cultures or circumstances) where it would be better to work in the pharmacy department or the IT department as an IT or Informatics Pharmacist? 

Where I’ve seen more value in having the IT pharmacist housed in the pharmacy department is with smaller hospital systems less than 100 beds where pharmacy resources are very scarce so you end up with a hybrid type position where they spend 25-50% of their time in pharmacy IT and the rest of the time either being a pharmacy manager, director or staff pharmacist. In that type of setting it makes a lot of sense to me because first they are resource strapped, they can’t afford to hire a full time pharmacy IT person nor does the volume of work require it. But what I’ve seen in those situations is when a big implementation is coming up they may outsource or bring in pharmacy it consultants on a temporary basis to fill those resource gaps in order to get the project implemented in a timely manner, simply because they don’t have the staff on hand to do it themselves. So I think that’s where it makes sense in that smaller hospital settings it could be a small community hospital or a critical access hospital with only 1 or 2 or 5 pharmacists on staff to begin with it makes sense to have that hybrid model in place.