Dr. Joseph Walton is a faculty member in the College of Graduate and Professional Studies in the Health Informatics program, and has some fascinating projects going on in his professional career.
We spoke with Dr. Walton recently about his work in the field of Health Informatics, and how he creates a sense of community among his online students.
I have been in the Pharmacy Informatics field for about five years now. I graduated from pharmacy school with a dual degree, earning both a Pharm.D. and a Master’s in Science and Technology Management. Throughout my education, I was able to incorporate a lot of technology and informatics-based projects into my coursework.
After graduation, I was hired on at a cancer center as an Informatics Pharmacist and stayed there for about four years. While I was there I mentored college students and medical residents, and I enjoyed that portion of teaching, but I wanted to expand how I was able to impact students and the next generation of informaticists. I began teaching the Introduction to Health Informatics course as an adjunct at UNE Online as a way to reach more students.
Last year around this time I accepted a position with a 14-facility health system in the Tampa Bay area, where I am one of two pharmacy informatics coordinators for the health system. Even though I switched jobs I continued to teach at UNE Online – as I have for the past two years.
Most hospitals and health systems have some form of Informatics Pharmacist on staff. They maintain all of the drug databases that physicians, nurses, pharmacists, and all other healthcare providers use in their daily work within the Electronic Health Record (EHR). All of the default order sentences that you might see for different medications, including the correct dose, frequency, route, and duration are, for the most part, formulated by a pharmacist.
Informatics Pharmacists also work within the system to optimize the drug-drug interactions, any medication safety efforts that may arise, as well as a limited amount of pharmacy automation.
I’m overseeing three big projects right now, the first of which is a new software implementation. The product we are implementing system-wide across our 14 facilities uses barcode scanning, image capture, and gravimetric validation of IV compounds to reduce the risk of pharmacy compounding errors and improve workflow efficiency.
Every step of the way during the IV compounding (the process of adding medication and additives to standard IV fluids), the technician monitors the screen and follows the instructions on what to do to program that particular IV mixture, which in itself adds a measure of safety to the process. At each step, the technician also scans the vials of the IVs they are preparing and scans the IV bags to make sure everything is correct in what they’re doing. They weigh each transfer of drug or diluent on the scale, which automatically captures the picture of the bag, and alerts the technician if they have withdrawn the correct dose for the patient.
Gravimetric validation is simply the validation of the product by weight. We pre-program the density of each drug into the system so the software can quickly run a calculation and determine if the technician has withdrawn 5 ml or 5.5 ml. By calculating the difference between desired weight and actual weight, the system can also tell you exactly how much medication the technician must return to the vial. The withdrawn drug is then weighed again to ensure accuracy.
If the technician were to make a mistake by withdrawing too much medicine, for example, the incident is recorded. When the pharmacist reviews the sequence of events afterward, they can see every step that was taken, and where the tool caught a mistake. They can then check that mistake area more closely to make sure that the technician fixed the mistake correctly.
The second of my three big projects is deploying an oncology module within our Electronic Health Record (EHR) software system. Oncology chemotherapy orders are one of the last things that remain on paper for a lot of facilities because they are so complex and high risk.
For all of our sites that have oncology centers, chemotherapy, and chemotherapy administration, we’re working on developing those electronic orders for them to safely order, validate and administer that to the patients. Right now chemotherapy orders are one of the last pharmacy processes that we have on paper, so we’re working to get that updated. The third project ties into that, as well actually.
The other holdout pharmacy process that we still have on paper is TPN, or Total Parenteral Nutrition. This is essentially feeding a patient through their veins. When patients can’t eat for a prolonged period of time, pharmacists, dietitians, and physicians will work on ordering them all of their nutritional needs to be delivered through an IV. TPNs are very complex orders, and as such can be very high risk as well. It takes a great deal of attention to get them correct and to do the best we can for the patient.
We are implementing a software solution that will function within our existing EHR, and will help to optimize how these TPNs are ordered. It brings the pharmacist – or dietitian or physician – all of the pertinent information regarding the patient’s nutritional status, all of their lab results, all of the existing medication orders that may affect how you would order this patient’s TPN. And it gathers all of this information into just one view, so it allows the caregiver to go through that process of ordering in a very logical way.
After the order is determined, it is verified by the pharmacist. From there, the software interfaces straight to some of the compounding facilities that we contract with. TPNs are complex to order, and they are also complex to compound. Many facilities in the United States use a third party to compound their TPN orders. This new software will allow us to then interface our system to our compounding facility and allow no reentry. This software will increase safety all along the entire ordering process.
I think that for a lot of medicine we’re not there yet, but IBM’s Watson is being used for a lot of AI within healthcare, and there are even some oncology centers using it to assist in determining what the best treatment options are for the patient. These new software solutions are part of Clinical Decision Support (CDS), which might be considered the foundation for AI since we need to have the systems in place so we can begin to learn best practices and build that best practices database. But right now the role of AI is to simply suggest best-practices options to the healthcare provider up front, and in a way that the healthcare provider can be fully informed and make the correct treatment decision.
I hold weekly office hours where my students can come and chat or video chat with me online, and they take advantage of that. I also encourage them to spend a significant amount of time on the discussion boards, because I’ve found that it helps them to get to know each other and bounce ideas off of one another and learn from one another.
There is also an online student discussion board that provides a place for students to talk with one another about the class in general, and also about specific topics. For example, they often share interesting articles that they might have come across and post those for their classmates to read and then they all talk about it. The chat room aspect wasn’t originally a part of the course – it was actually requested by my students because they wanted a non-curriculum-based forum where they could talk to one another.
The Health Informatics program at UNE Online has a diverse faculty and curriculum, and faculty members are encouraged to bring their professional experiences into the classroom. So depending on your instructor, students are exposed to a wide variety of workplace-specific examples. I bring a lot of examples from the pharmacy world into my class, whereas another instructor may be a nurse, and they may bring a lot of nursing examples and a lot of nursing experience to the class.
Each student finishes their courses with the learning objectives being met and the essential knowledge gained from the course curriculum, but students are also getting a lot of those life experience examples from their instructor. And those are learning experiences that you might not get at every university.
I enjoy working with a wide range of students. I have students who have been in healthcare for longer than I have, and I enjoy learning from them. I also have students who have never worked a day healthcare, but they’re interested in getting into that field, so I help them with that transition.
I also enjoy working with each student individually to help them set their goals. It keeps things very interesting!
If you are interested in pursuing a career in Health Informatics, or if you’re simply interested in discussing the program, please reach out to an Enrollment Counselor at (855) 751-4445 or via email at firstname.lastname@example.org.
Or, fill out an online application today at online.une.edu/gateway-portal-page – we look forward to hearing from you!
More Health Informatics program information: go.une.edu/health-informaticsTags: Faculty Spotlight | Graduate Certificate in Health Informatics | Health Informatics | Master of Science in Health Informatics
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