| THE IMPERATIVESIn recent years, health systems across the United States and around the world have faced persistent challenges including the underutilization of necessary care, the overutilization of inappropriate care, rising costs, disparities in access to care, patient safety concerns, System-level improvement requires a broad and diverse intellectual community. The necessary transdisciplinary community will be composed of scholars with expertise in social, political, technical, and clinical fields, along with many others who bring critical experience from practice. It follows that a third imperative is to form this community and provide it with a gathering place for its evolving scientific ideas and insights.

Objectives. To assess pharmacy informatics education, identify current competencies, and develop a foundational set of recommendations. Methods. Accredited pharmacy programs were contacted. Data were collected using a mixed-mode procedure. Didactic and experiential syllabi were analyzed for compliance with informatics competencies in Accreditation Council for Pharmacy Education (ACPE) Standards 2007. Results. Thirty-two of 89 schools responded; 25 provided syllabi (36% response rate, 28% submission rate). Twenty-seven didactic and 9 experiential syllabi were received. The syllabi contained a diverse mix of educational content, some of which represented pharmacy informatics content as defined by ACPE. Schools are teaching clinical system terminology, applications, and evaluation. Conclusions. Many professional programs are not providing instruction in pharmacy informatics. There may be confusion within the academy/profession between pharmacy informatics and drug information practice. Much work is required for programs to become compliant with the ACPE 2007 pharmacy informatics competencies.

Introduction Health systems are challenged by care underutilization, overutilization, disparities, and related harms. One problem is a multiyear latency between discovery of new best practice knowledge and its widespread adoption. Decreasing this latency requires new capabilities to better manage and more rapidly share biomedical knowledge in computable forms. Knowledge objects package machine‐executable knowledge resources in a way that easily enables knowledge as a service. To help improve knowledge management and accelerate knowledge sharing, the Knowledge Object Reference Ontology (KORO) defines what knowledge objects are in a formal way. Methods Development of KORO began with identification of terms for classes of entities and for properties. Next, we established a taxonomical hierarchy of classes for knowledge objects and their parts. Development continued by relating these parts via formally defined properties. We evaluated the logical consistency of KORO and used it to answer several competency questions about parthood. We also applied it to guide knowledge object implementation. Results As a realist ontology, KORO defines what knowledge objects are and provides details about the parts they have and the roles they play. KORO provides sufficient logic to answer several basic but important questions about knowledge objects competently. KORO directly supports creators of knowledge objects by providing a formal model for these objects. Conclusion KORO provides a formal, logically consistent ontology about knowledge objects and their parts. It exists to help make computable biomedical knowledge findable, accessible, interoperable, and reusable. KORO is currently being used to further develop and improve computable knowledge infrastructure for learning health systems.

Pharmacy has an established history of technology use to support business processes. Pharmacy informatics education within doctor of pharmacy programs, however, is inconsistent, despite its inclusion as a requirement in the 2007 Accreditation Council for Pharmacy Education Standards and Guidelines. This manuscript describes pharmacy informatics knowledge and skills that all graduating pharmacy students should possess, conceptualized within the framework of the medication use process. Additionally, we suggest core source materials and specific learning activities to support pharmacy informatics education. We conclude with a brief discussion of emerging changes in the practice model. These changes are facilitated by pharmacy informatics and will inevitably become commonplace in our graduates' practice environment.

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Objectives. Pharmacy practice is changing in response to several clarion reports published by the Institute of Medicine (IOM) documenting preventable medication errors. This paper seeks to assess the current curricula of US colleges of pharmacy to determine the readiness of new pharmacist graduates to do the pharmacy informatics work necessary to implement a safer, more information-rich medication use system. Methods. Data were collected from course titles and descriptions published on the public Internet web sites of the 89 US colleges of pharmacy recognized as regular institutional members of the American Association of Colleges of Pharmacy (AACP). Results. Of the 88 colleges of pharmacy included, 73 (83%) maintained updated curricula on their web sites. Of the 73 pharmacy curricula studied, only 24 (33%) included courses in pharmacy informatics. Conclusions. In the United States, colleges of pharmacy are formally training only a small portion of their pharmacy students in pharmacy informatics while informatics knowledge is desperately needed to improve medication use practices.

SummaryRecently the crystal structure of creatine kinase from Torpedocalifornica was determined to 2.1 Å . The dimeric structure revealed two different forms in the unit cell: one monomer was bound to a substrate, MgADP, and the other monomer was bound to a transition-state analogue complex composed of MgADP, nitrate and creatine. The most striking difference between the structures is the movement of two loops (comprising residues 60 -70 and residues 323 -333) into the active site in the transition state structure. This loop movement effectively occludes the active site from solvent, and the loops appear to be locked into place by a salt bridge formed between His66 and Asp326. His66 is of particular interest as it is located within a PGHP motif conserved in all creatine kinases but not found in other guanidino kinases. We have carried out alaninescanning mutagenesis of each of the residues in the PGHP motif and determined that only the His66 plays a significant role in the creatine kinase reaction. Although neither residue interacts directly with the substrate, the interaction His66 and Asp326 appears to be important in providing the precise alignment of substrates necessary for phosphoryl group transfer. Finally, it is clear that neither His66 nor Asp326 are responsible for the pKs observed in the pH-rate profile for HMCK. IUBMB Life, 57: 355 -362, 2005

Computerization is transforming health care. All clinicians are users of health information technology (HIT). Understanding fundamental principles of informatics, the field focused on information needs and uses, is essential if HIT is going to support improved patient outcomes. Informatics education for clinicians is a national priority. Additionally, some informatics experts are needed to bring about innovations in HIT. A common approach to pharmacy informatics education has been slow to develop. Meanwhile, accreditation standards for informatics in pharmacy education continue to evolve. A gap remains in the implementation of informatics education for all pharmacy students and it is unclear what expert informatics training should cover. In this article, we propose the first of two complementary approaches to informatics education in pharmacy: to incorporate fundamental informatics education into pharmacy curricula for all students. The second approach, to train those students interested in becoming informatics experts to design, develop, implement, and evaluate HIT, will be presented in a subsequent issue of the Journal.