Learn why pharmacists are in a great position to join the fastest-growing area in health care: technology
Lukasz Przychodzien is a clinical pharmacy manager of data analytics at New York Presbyterian Hospital. This interview highlights technology in health care.
Matt: Matt Paterini here with The Nontraditional Pharmacist, part of The Pharmacy Podcast Network. Really excited about our episode today, a topic everyone’s talking about: technology, informatics, analytics, artificial intelligence (AI), as well as big data. Really. when you look at the field of technology in the health care space in particular, the number of jobs in the field is growing twice as fast as overall employment, really due to a shortage of qualified employees available. But today, we have no shortage of qualified individuals available. We have the wonderful, the one and only Lukasz. Lukasz, you have a name kind of like Cher, you just have to say 'Lukasz,' and everyone knows who we’re talking about. So excited to have Lukasz on the program today. He is the clinical pharmacy manager of data analytics at New York Presbyterian Hospital. We’ll talk technology, health system informatics, and of course get into how these things are changing and redefining the pharmacy landscape. Lukasz, welcome, and thank you for joining.
Lukasz: Thanks Matt. Very happy to be here.
Matt: Excellent to have you on. We’ll start with the first question we ask all of our guests, which is to give us some insight into your background in pharmacy. Kind of your history and what led you to your role in informatics today.
Lukasz: Sure. My background isn’t really anything unique. I did pharmacy school. I did residency (PGY1 and PGY2), specialization in informatics. I didn’t create some type of crazy new technology, and I got a position through that. It’s a very standardized process now in pharmacy for most specializations. My background when it comes to informatics is I had an interest in high school programming, and I actually never thought of informatics as a career choice. I wanted to do industry for a long time. It was only until I started looking at [Advanced Pharmacy Practice Experiences (APPEs)] where I got more exposure to informatics, and I started asking questions, picking and prodding and asking around for more work during APPEs, that I really learned to fall in love with informatics, and things just kind of snowballed from there.
Matt: Excellent. So, you got into informatics kind of by chance it sounds like. Walk us through what pharmacy informatics is in general. Give us an overview of what the field is like.
Lukasz: Informatics is a very interesting field, because it’s still very young and still very developing. There’s not a lot of very concrete definitions out there. But if you ask someone that’s in informatics, they’re going to probably give your response along the lines of working on building or modifying an electronic health records system like Epic, Cerner, Meditech, Allscripts, etc. What they do is they really try and bring the institutions culture and personality into an electronic health records system. Again, the definition is very variable, because as my PGY2, I’ve worked with informatics pharmacists from all walks of life. And even myself: I’m technically a nontraditional informatics pharmacist in that I’m in data analytics.
Matt: We have a nontraditional role within a nontraditional role. How do you see other areas of informatics stemming from this? You’re in data analytics. What other areas are there?
Lukasz: I’m in data informatics, and again, there is kind of overlap when it comes to pharmacy, because technically if you work on utilizing any type of information technology to improve how the health system works, you can call yourself a little bit of an informatics pharmacists. A good example is my medication safety rotation at my PGY2. Technically, the medication safety officer worked on creating clinical decisions support and alerts in an electronic health records system. And therefore, by definition, he was an informatics pharmacist that way. I work with informatics pharmacists in academia, in health care in terms of government, such as the US Food and Drug Administration and National Institutes of Health. So, they’re all over the place.
Matt: OK, so pharmacy informatics really can touch on each of the other areas in pharmacy we talk about, health system, governmental, regulatory agencies, industry too, no doubt. But what about your role specifically? You’re the clinical pharmacy manager of data analytics in a large health system. Walk us through that role, kind of your day to day and what you do for that health system.
Lukasz: It’s funny. A lot of people I work with ask me about that role, because it’s such a broad definition. I really work on seeing where the gaps are and try to build a data environment where, as a department we’re trying to utilize the data we have in unique and innovative ways to serve our patients. I work on everything from operational to looking at medication use evaluations and working on different type of projects when it comes to financial issues. I also do some 340B, and a lot of auditing of the standards of practice both pharmacists and physicians, even nursing. I would like to say that an informatics pharmacist is good if he doesn’t have to do the same thing probably twice. I try to live by that.
Matt: Fair enough. That’s probably a good rule for everyone to live by. What about logistically. How do the hours of working in a health system in informatics compare to other roles in the health system and how does this work in your personal life, too?
Lukasz: As you mentioned, informatics is such a growing field and has so much involvement, the hospital has no shortage of problems to solve. I’m constantly trying to go out of my way to get involved and put myself out there when it comes to all these problems. If they could, they would have me there for 24 hours a day, 7 days a week. And I’d be very happy, because I’d be really solving problems, which is something I love to do is solve problems. But it’s very difficult to not get involved, especially if you have an “informatics personality,” I’ll call it, where you see problems and you really want to help and try and figure them out. I love my work. I define myself through my work. And so I work anywhere from normal hours to 10 p.m. if needed, depending on project and deadlines.
Matt: What are some of the really cool projects you’re working on now,i f you can share with us this kind of overview at a high level?
Lukasz: Sure. We have what we call F&T, other hospitals it’s called P&T, that are requests for medications for specific indications. For example, I would take a look at the data and actually see if any type of benefit has been shown for the medication or if the medication had previously been approved through F&T and to see if it has been giving the benefit claims and outcomes that we’re looking for in the medication. That’s an example when I work on the clinical aspect. When I look at things from a financial aspect, I look at how the pharmacy is doing in terms of the initiatives that we have in saving us money. Are we billing things correctly? I’m even working on billing medical procedures, 340B for disproportionate share hospitals. I’m trying to assure that we’re getting the appropriate amount of money that way. And when it comes to operations, 1 of the big things I’m working on now is, are we are we following our medications appropriately? Are we able to be accountable for medications throughout the entire medication distribution cycle such as automated dispensing cabinets to ensure we have no expired medications, that the units have the medications that they require, and that patients can be served on a proper and timely basis?
Matt: Sounds like you’re working on a lot of really cool things and spoken like a true data informatics professional, when you have to say, “look at the data." We love to hear that. How does this role that you’re in right now help you achieve your personal and your professional goals?
Lukasz: One of the best things about being in informatics and being at my level is that you get to work on problems that affect the whole institution. I look from the perspective of I’m doing my clinician duties to try and serve as many patients as possible through this role. If I’m improving how an ICU can get its vasopressors to its patients, then I’m going to be improving how every patient that walks into the ICU that needs it gets taken care of. I find a great deal of satisfaction, personally and professionally through my work.
Matt: I like that, and it doesn’t matter what role you’re in necessarily. Every role is important and it’s how can you be most effective in that role to best serve patients, best advance the profession, and all of that, that’s great. I like that. We already talked about this a little bit, but what are some other roles in pharmacy informatics? Where do you see yourself most interested in as you move through your career?
Lukasz: Yes, like I mentioned, informatics really can spread far and wide. You can say like we talked about a little bit with medication safety. You can even talk about drug information. You’re supplying the correct information to the people that need it, which to a certain extent is kind of my goal as someone in data analytics. We have the data, let’s turn that into information and let’s provide it to the people that need it. So, to a certain extent you can you can say the drug Information is and informatics role. But in terms of where I see myself, I really try and focus on having hospitals work as efficiently as possible. There’s a lot of gaps when it comes to finances. So that’s an interesting development. I haven’t had that during pharmacy school. No one ever talked to me about finances and 340B and how things are billed, but I find that to be an interesting piece of health care, because there’s so much change going on when it comes to billing. And there’s just so much out there when it comes to looking at things and assessing if we are getting our money’s worth for these medications and if the pharmacy department is actually showing the benefit and the outcomes with these medications. In the future, I’d love to get into more outcomes data analytics. That’s something that as the industry has yet to prove is outcomes. And so that’s something I’m really interested in.
Matt: Interesting. Do you think that that’s where the industry is headed? Or do you think that’s where it should head? What is your take on where we’re going?
Lukasz: The industry should be going toward improved outcomes, right. At the end of the day, we want to take care of our patients as best as we can with the materials and resources and time we have. So, ideally everything moves toward outcomes. And that’s again where I see a lot of pressure being put on. The problem is that it’s a very, very difficult problem. There’s many multibillion dollar companies [that] have tried to address the problem, and it’s been tough. Time can only tell what kind of problems I’ll get into.
Matt: You mentioned a lot of different aspects of pharmacy informatics, really very wide reaching. Is there any 1 area of informatics in the future that you think is going to be the dominant definition of pharmacy informatics?
Lukasz: I think pharmacy informatics is still going to be switching a little bit in the clinical decision support aspect of things when it comes to the traditional informatics pharmacist. The software that’s being provided by the vendors like Epic, Cerner, Allscripts, Meditech, etc, they’re all starting to become very good at all the different customization features themselves, but it’s the clinical decision support. It’s the alerting, the order set building, the standardizing of treatment, all those pieces where you can actually bring in your clinical and your operational knowledge together as a pharmacist and really learn to apply it. You’re not necessarily programming the system, as many people have a false assumption of informatics. It’s more about building it in a certain way that when some alert triggers, the physician will actually respond to and they will not get alert fatigue through it, because it fires too often. And the alert was able to portray the most important information and have the most important outcome result because of that.
Matt: Right. We’ve already kind of taken care of Step 1, customization, electronic health record, digital recording of information. But now it’s kind of taking a step further, and how can we use that information that we have and make actionable insights on top of that, which is kind of where we are now, and it sounds like we’re heading in the future. What advice would you give to pharmacy students or other pharmacists that are looking to pursue a career in pharmacy informatics?
Lukasz: As I mentioned with my story that as an APPE student, that’s where I really learn about informatics. I literally just Googled through the [American Pharmacists Association's website, ‘what type of career options there are through pharmacy,' and I just started scrolling through it, because I wanted to adapt my APPEs toward whatever future goal I had. So, I found informatics and really solidified my interests through my search and my APPEs. I really cannot stress enough to go to all these different places during rotations and experience everything they are doing and really putting yourself out there. You know, tell people what you’re looking for in terms of your career goals, where you see yourself. Ask to have more work on the side after your responsibilities for that rotation are done. Try and talk to and shadow people in informatics. Really put yourself out there. That’s what I did, and I got a lot of great experiences from it. Even every little experience you get, it may sound mundane, but it’ll expose you a little bit more. You’ll be a little bit more intelligent and it will keep building.
For pharmacists, I have great news! Most of the informatics pharmacists that are out there did not start with the residency in informatics. That’s still actually very much not the traditional way of doing things. I know plenty of people that have done informatics right outside of pharmacy school and right outside PGY1. So, if you’re a hospital pharmacist, really all you have to do is raise your hand. Volunteer, show that you are interested, and you’re willing to work on difficult technology-based problems. If you’re not in [a] hospital and you want to get informatics, I highly recommend picking up a per diem shift in helping identify problems that you can work on during your time when you’re working there and kind of bite the bullet and really understand you’re not going to be doing this for the extra pay. It’s going to be just for the exposure.
Matt: A lot of good advice there. I like how you know you stressed the networking, putting yourself out there. We stress that all the time, so important. Also, did you hear that everyone? It started with a very high-tech way to learn about this new career called Google. Google is great, a great place to learn a lot of stuff, your baseline information. Where would people go to learn more about informatics, maybe some key resources that you could recommend to folks listening?
Lukasz: Sure. If you’re part of American Society of Health-System Pharmacists (ASHP), they have a section for pharmacy informatics that is a great place to meet people and read about things. Healthcare Information and Management Systems Society: that’s a great organization when it comes to technology in health care. American Medical Informatics Association; that’s also a great organization. There’s plenty of publications out there to justify what we’re doing as informatics pharmacists. They have different white papers on the different type of clinical initiatives that pharmacists can take or what roles they can play in different teams or what they can build. Again, clinical decision support: If you look that up, you’ll find a lot of informatics-based publications. Especially as a pharmacist or student, you know if you look at dispensing cabinets, barcoding on administration, etc., all the different terms you’ll come to know and use on a daily basis. You know you can look more into the publications. Just throw them into Pubmed, and see what pops up. You’ll get a lot of exposure that way. You’ll be surprised how much reading you do during residency, so, I know they’re out there.
Matt: Well, that’s great. Lukasz. You have a very unique perspective on the field of pharmacy. We like to end and conclude our episodes with, what do you think the future of the pharmacy profession is in general?
Lukasz: It’s very difficult to predict where pharmacy’s going, especially since we’ve been trying to solve the same problems and going after the same initiatives, like provider status for a long time. I’d love to see pharmacy continue to grow, which I feel like it’s had a little bit of a struggle in terms of growing and adapting, especially when it comes to an industry such as health care which is only now starting to get really influenced by technology. And so, I really hope pharmacy can keep up with it and be on the winning side of technology. But that’s only going to be by us, such as you going out there and working with other pharmacists and you know bringing the community together to try and solve mutually beneficial issues.
Matt: Well, thank you so much, Lukasz. Excellent take on pharmacy informatics the field of pharmacy in general. The 1 and only Lukasz! Thanks for everyone for tuning in today. Please connect with Lukasz via the contact information provided below on The Pharmacy Network, and be sure to subscribe to both The Nontraditional Pharmacist and the wonderful Pharmacy Podcast Network. Until next time, this is Matt Paterini with The Nontraditional Pharmacist.