Clinical Pharmacy Services Enhanced by Electronic Health Record (EHR) Access: An Innovation Narrative

Abstract

Background: Patient care in the community pharmacy setting is often hindered due to limited access to adequate patient health information (PHI). Various studies suggest that lack of access to PHI is a main reason for delay in pharmaceutical care, medication dispensing errors, and lacking interprofessional relationships between prescribers and pharmacists. Literature has shown that interprofessional collaboration and improved access to PHI can improve transitions of care and communication for pharmacists, but literature is sparse on implementation of electronic health record (HER) access within independent community pharmacies. Methods: This observational study follows implementation of HER access into a rural community pharmacy to enhance common clinical services carried out by pharmacy staff. Metrics include number of enhanced consultations by pharmacy staff, type of consultations provided, potential reimbursement, decreased need to follow up with other providers, potential for decreased time to treatment or refills, and aspects of EHR most utilized during search. Results: Two-hundred sixty three patients’ profiles were assessed, with 164 (62.4%) deemed appropriate for EHR access and searching. Most interventions made were related to cardiovascular, endocrinologic, neuropsychiatric, and COVID-19 therapy medications. Conclusion: EHR access in community pharmacy has the potential to improve both the quality and availability of clinical patient interventions through enhanced knowledge of PHI.

Barriers and Opportunities for the Use of Digital Tools in Medicines Optimization Across the Interfaces of Care: Stakeholder Interviews in the United Kingdom

“…Plans also exist to roll out the electronic prescription service to secondary care and other care settings and to develop a patient-centered consolidated medication record that can be used by health care professionals working in different settings [15]. Such records may be associated with a range of benefits including improved safety, greater flexibility, enhanced ability to respond to patient queries, reduced duplication, and lower costs [16][17][18]. However, their use is still at an early stage, and challenges have been identified in some studies, including problems with system reliability, technical issues, and patient concerns regarding inaccuracies and the governance around sharing data [17,19].…”

Usability Evaluation of a Community Pharmacy Health Information Exchange Interface Prototype

“…Findings from previous literature, such as pharmacy teams lack of access to patient data 27 as well as our own preliminary research, such as the need for integration with existing software systems and an intuitive interface, were incorporated into our initial HIE-Pioneer mock-up development. 11 Additionally, we incorporated design input from a multidisciplinary team of pharmacists, information technology specialists, and a usability expert to build an interface that would efficiently provide access to external patient data for pharmacy teams in a way that was consistent with their current workflow.…”

Improving access to prescription-based care through patient-centered smart pharmacy ecosystems

“…Portals and EHR platform applications extend smart capabilities to the home environment, offering patients information on the proper use and quality of their medications. The addition of electronic health record (EHR') access for the patient allows for a closed cycle of the care each patient receives in both inpatient and outpatient medical settings, providing a clear view of the patient's recent vitals, labs, and diagnoses that support the prescribing of a specific medication [25]. Patients with access to their EHRs leads to improved adherence to prescribed medications and better adherence to guidance from pharmacists [26].…”