pharmD

1. Rai Waqas Ali
Pharm D
L.C.P.S Lahore
E.mail:raiwaqas98@gmail.com

2. Clinical pharmacy is the branch of Pharmacy where
pharmacists provide patient care that optimizes the
use of medication and promotes health, wellness, and
disease prevention.
Clinical pharmacists often collaborate with physicians
and other healthcare professionals.
Drug information retrieval system and special
therapeutic programs are available to further assist in
patient care role
CLINICAL PHARMACY

3. • Prescription monitoring
• Prescribing advice to medical and nursing staff
• Medication errors and adverse drug reaction
reporting
• History Taking
• Patient education and counseling
• Pharmacokinetics and therapeutic drug level
monitoring
• Professional and Clinical Audit
ROLES OF CLINICAL PHARMACIST :

4. Computers have played a vital role in the development of
clinical pharmacy practice and basic pharmacy research :-
• Patient record Management
• Entries of Medication Orders
• Patient Medication Profile
• Drug Therapy Monitoring & Problem Detection
• Record Drug-Drug Interactions & ADR’S
• Pharmacy Automated drug interaction screening (PADIS)
system
• Teaching Techniques
• Building Data Base
• Inventory control
• Medical Research
• Computerizing Drug Information System
• Uses Of Computers In Other Fields Of Pharmacy
ROLE OF COMPUTERS IN CLINICAL PHARMACY

5. The Clinical computer system must assure the patients record
database is continually updated to reflect the current status of
all patients. This updating is done by assessing the database of
admitting department to determine the information about
recent admissions, discharges, patient transfers. Pharmacist
should be present to check the details regularly.The computer
system should be capable of producing other information such
as
• Present diagnosis
• Allergies
• Weight
• Height
• Name of Attending physician
• And any special note about the patient.
Patient record management

6. Medication orders should be entered regularly and the
Pharmacist must be able to retrieve orders prior to
administration to patient. Date must be entered by use
of codes for drug names, dose scheduling. All drug
orders should contain following :
• Drug Name
• Drug Generic Name & Strength
• Route of administration
• Dosage schedule
• Physician Data or Code
Entries of Medication Orders

8. The computer systems should be capable of
producing the labels and reports in the form of
• Patient Medication Profile
• “Fill Lists” for preparations of Individual doses
• Lists of medications charged
• Drug order renewal lists for the prescriber
• Medication administration Record (MAR)
• The computer system should have the functions to
prepare separate lists of TPN, IV Solutions and
admixtures.
Preparations of Lists

9. Computer systems helps in diagnosing DRUG
Interactions & warns potentially dangerous
combinations of medications along with
Drug-drug, Drug- lab, Drug-Allergy interactions
& Wrong Diagnosis automatically.
DRUG INTERACTIONS

10. RECORD DATA BASE MANAGEMENT
AUOMATED AMBULATORY MEDICAL RECORD
SYSTEMS (AAMRS)-
• Billing,accounting,patient scheduling immunization
etc. Identifying high risk conditions
• Providing patient with personal records

11. • MEDICATION ADMINISTRATON RECORD (MAR)-printed
list of medication orders for each patient on nursing unit
e.g name ,bed number,diagnosis,sex,weight,height
,allergies
• DRUG UTILIZATION REVIEW-monitoring of drug use &
also cost.it is designed to investigate suspected problem
• DRUG THERAPY PROBLEM DETECTION-automatic
screening of medication order for possible drug
interaction for new or changed drug order is enteru into
patient profile

12. • DRUG THERAPY MONITORING-improves individualized
dosing decision ,allow multiple storage,precise dosing
• PATIENT BILLING
• MANAGEMENT REPORTS AND STATICS
• RATIONAL DRUG PRESCRIPTION-computer based
consultation system assist in rational prescribing.one such
system is MYCIN

13. ADMINISTRATIVE APPLICATIONS
• PATIENT BILLING-bills for no. of doses of each item
is supplied
• DRUG UTILIZATION-monitor use of specific drug for
cost analysis , budgeting, or quality assurance
• WORK LOAD ANALYSIS-frequency of specific
activities, average time for specific function,
determining staffing needs, productivity estimates
are also possible

14. • COST AND REVENUE ANALYSIS-department costs,
expected revenue,inventory turn over,wastage,lost
charges etc. Applicable in budget development,drug
control,inventory management
• GROUP WORKING-accessible for multi users
• NETWORKING-making sharing easy
< INTRANET-presenting information in a way every 1 can
see it
<EXTRANET-extending infornation outside work group

15. IN-HOUSE PREPERATION
• Schedualing,calculating quantity of additives and
correct concentration,label,record maitenance,TPN
,sterile solution,radio pharmaceuticals
• STABILITY studies
extrapolated stability curves for expiry date
calculation,test schedule,shelf life calculation.serves as
calender,data analyser,report writer.

16. SOFTWARE of PHARMACIST’S INTEREST
• Drug interaction
• Inventory management
• Decay calculator
• PK calculator-ADME studies,TDM,toxicity dose
• SPSS-for statistical evaluation
• Clinical pharmacist-for dose calculation
• Stability analyzer
• Population pharmacokinetics
• Trial managing

17. • HELP :
The Program HELP ( Health Evaluation Through
Logical Processing ) is used to allow experts in a
medical specialty for defining the criteria of medical
decision making. The broad base and flexibility of
HELP permits complete drug monitoring. After
receiving the Warning from computer the pharmacist
contact the nursing staff and the physician. This
system makes the pharmacist more efficient and
accurate in monitoring patient drug therapy. The
system issues warning more quickly than manual
methods.
Software's & Programs For Clinical Monitoring

18. • Messages are presented in the form of
pharmacological summary.
• The drug interaction messages are integrated with
computerized drug profile systems.
• All drug interactions which may occur in current
drug therapy of the patient are reported by this
system.
• The information received from the system is to be
used by either a physician or pharmacist in the
clinical area
• The system is useful in reducing drug interactions.
features of HELP system

19. Monitoring Evaluation Of Drug Interactions By A
Pharmacy Oriented Reporting.
This system issues a warning when potentially
interacting drugs are prescribed for a patient
MEDIPHOR

20. • If a prescription containing
many drugs is entered in the
computer for billing purpose,
immediately the computer scans
the drug and issues the warning
if there is possibility of drug
interaction. Thus the computer
helps in avoiding the drug
interactions.
• The computer also warns when
two or more drugs of same
generic are entered. Avoid
duplication.
Data Base

21. • A pharmacy automated drug interaction screening
(PADIS) system is described which detects possible
drug interactions by screening patient medication
profiles. The data base contains approximately
24,000 drug interaction combinations of drugs
marketed in the U.S
• The PADIS system operates as a batch run program
which screens all patient medication profiles on a
daily schedule. A patient drug interaction profile is
printed by the computer for use by the pharmacist
to suggest alternative therapy to the physician. The
computer detects potential drug interactions
Pharmacy Automated Drug Interaction Screening (PADIS)

22. • Computerized Listing Of Abnormal And Unsual
Drug Effects
• Containing 17,500 abnormal effects on laboratory
tests of 1500 drugs may be computerized to match
the laboratory test effects of drugs with patient
because scanning manually for every patient is
time consuming
COSTAR
• COmputer STored Ambulatory Record
(COSTAR) is an electronic medical record using
the MUMPS programming language
CLAUDE

23. • COSTAR(computer stored ambulatory record)-manages
office, clinical functions, patient registration, scheduling
billing, revenue analalysis , medical records , chart review
• MUMPS-supports database maintaining complete medical
record
• SCAMP-comprehensive ambulatory record-billing,
appontments, patient care reports, lab data, health
maintenance, general/medical management
• AUTOMED-complete financial,administrative, clinical
computer package
• FMIS(family medicine information system)

24. • MARTINDALE’S Extra Pharmacopoeia is now
available online
• MEDLAR’S ( Medical literature Analysis And
Retrieval system )
• MEDLINE ( Medlars Online )
• NLM ( National library of Medicine )
• PNI ( Pharmaceutical News Index ) Contained
news about devices and health industries.
Other Computer Software's

25. Automated Inventory System

26. • Computers have two types of applications in
Medical research :
I) Computerized testing equipments ( Blood
chemistry n gas analysers, Ultra sound scanners
and CT scanners
II) Data collection, storage retrieval and research
planning & Statistics
Medical Research

27. • Multimedia refers to the presentation of information in
formats other than text alone. Included in these format
types are: sounds, images, graphics, animations and
videos
• Computers help a great deal in pharmacy training and
education
• X.RAYS , Electrocardiograms and other interpretations
and values with reference to cases can be shown on
multimedia and taught to the students.
• E-Books, Websites and Wikipedia are also a great source
of help for the Clinical pharmacists and students to
gather information and data.
• Computer simulations are helpful in teaching techniques
i.e Demonstration of complete physiological or
pharmacological process.
Use Of Computers In
Clinical Education

28. HOSPITAL INFORMATION SYSTEMS
• hospital information-intensive istitution where lot of time and
budget involved inacquiring,recording,processing,retrieving and
communicating information.
• Computer based information system available icluding
AUTOMATED HEALTH INFORMATION SYSTEM,clinical
informatin system,medical information system
• COMPONENTS:
• 1.patient registration/admission/transfer/discharge
• 2.patient clinical data base(history/physical
examination/labortory/progress notes)
• 3.dignosis and treatment desion support
• 4.order entery/execution/confirmation

29. • 5.Lab/diagnostic report
• 6.Pharmacy support
• 7.Food and nutrition services
• 8.quality servillience
• 9.billing/insurance/collection
• 10.administrative report
computer based information system allows multi user
accessd,provides ongoing monitoring, programs to detect risk
situations,alert patieny senstivity, interactions.inapropriate
dosing,medication strength, frequency of administration
However traditional paper based system is disorganized/illegible
and can be used by only one person,at one location

30. • DRUG SUPPLYING & DISPENCING: label printing for
individual patient,keep tracks of dosing,correct
medication,dug list,charge information
• DRUG INFORMATION: keep up to date with new
development,all library contents can be available
• Computer bases resources of information are available to
provide rapid,efficient,current,compact inf( electronic
journals,CDs,electronic bullitien ,world wide webs)
• Receiving of inquiry
• Literature search
• Delivering the responce

31. PUBLISHING
• Formulary
• Procedural manual
• research report
• Drug bullitien
• ADR report
• REPORT GENERATION-for retrospective data analysis
• PATIENT DRUG PROFILE-prescribed drug , dose , age ,
allergy , height, weight and dignosis
• PATIENT LOCATION
• MEDICATION ADMINISTRATION
• AUTOMATIC DATA COLLECTION

32. • Maintenance of perpetual inventory control :
Whenever an item is added to stock or removed from
stock immediately the position of stock can be updated
by the computer. This operation of the computer is
intimately linked to other operations such as receipt of
good, dispensing of goods, billing of goods, return of
goods etc
• Maintaining the inventory records :
For annual auditing of pharmacy department , records
of numerous items are required ,
They can be easily obtained by the computer database
records.
Purchasing and
inventory control

33. 1. Reduced book keeping
2. Fewer transcription and medication error
3. Reduce duplicate medication order
4. Lowering cost in preparing bill
5. Improves efficiency in order processing
6. Improved detection of drug allergies, interactions
7. Improved managing reports
8. Improved inventory management
9. Reduced ordering cost
ADVANTAGES OF COMPUTERS IN CLINICAL
PHARMACY

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