2018 APhA Policy Topics
The policy topics to be considered by the 2018 House of Delegates, along with potential issues to be addressed and possible direction of potential policy are as follows:
Immunization information systems (IIS), or registries as they are also termed, have been in operation for decades and serve a key role to house and provide access to a patient’s electronic vaccine record. It is always important for patients to know their vaccine history, and providers to have access to complete vaccination histories. The IIS has served a role in tracking these records, but as the world advances technologically, the registry systems have been lagging behind in interoperability compared to other health database systems. Due to research showing the positive effects of pharmacist administered vaccinations and as the scope of pharmacist provided immunizations expands there is a need within the profession of pharmacy to integrate the records contained within an IIS into daily operations of the pharmacy, regardless of setting. Access to up-to-date IIS information is not always available based on which providers are required to input administered vaccines into the registry and the level of electronic communication between pharmacy management software, health system/hospital records, and the IIS itself. Improvement in communication methods and pharmacist access to an up-to-date IIS record will allow opportunities for immunization assessment upon or even prior to patient arrival. Streamlining the assessment process and information input into an IIS by pharmacists will further advance vaccination rates and improve communication between other healthcare providers regarding a patient’s vaccination status. The revised NVAC Adult Immunization Standards call on all providers (including pharmacists) to assess immunization status at each patient encounter, recommend appropriate vaccines, and either refer/.administer vaccines and report to IIS and a patient’s physician, if known. This reiterates the importance of having Association positions that supports pharmacist adherence to national guidelines.
Use of Pharmacogenomics Data within Pharmacy Practice
Personalized medicine is the next phase of medication therapy and pharmacogenomics is the center piece for designing personalized medication therapies. Providers can design medication regimens to prevent adverse events, enhance benefits from a medication, or even avoid harmful interactions by studying how a patient metabolizes medications based on their genome. As the medication expert, pharmacists should be involved in pharmacogenomics based programs or projects in operation or development across the country. Currently, some Colleges or Schools of Pharmacy do offer programs centered on pharmacogenomics, but overall there may be a lack of education on this quickly evolving topic. Beyond practitioner education, patients and health care providers also need to have the best information to decide the most appropriate treatment options and pharmacists, currently, are not always involved in the counseling process. As the topic of pharmacogenomics continues to evolve in the future, the profession of pharmacy needs to be ready to evolve along with how pharmacogenomics may change medication therapy. There remains concerns among consumers and health professionals regarding appropriate utilization and access to the information collected that pharmacists must be aware of and prepared to handle.
Pharmacist Workplace Environment and Patient Safety
Patient safety is paramount to the pharmacist’s role in any health care setting. Included within this area is consideration of workflow, utilization of technology and technicians, and reduction of distractions to pharmacists’ ability to provide patient care. As a recent Chicago Tribune article discusses, the current pharmacy workplace environment may not lend itself to ensure proper patient safety procedures, are followed, be they based in law or internal company policies. Breaks for meals or the restroom, staffing model variations, and metric requirements are some areas of concern that may potentially impact patient safety. The proposed policy might address scope of technician activities and technician ratios, information technology, etc. This topic will address the issue of patient safety in these areas of concern and fill in gaps within existing APhA policy to support an ideal workplace focused on patient safety.