APPLICATION OF COMPUTERS IN HOSPITAL PHARMACY PRACTICE: A TEACHER’S COMPREHENSIVE GUIDE
Welcome, future pharmacy informaticians and healthcare professionals!
Computers have become an indispensable tool in modern pharmacy practice. The informational needs of pharmacists are increasing day by day, and computer systems have revolutionized how pharmacy services are delivered. From patient record maintenance and inventory control to medication monitoring and drug information retrieval, computers have transformed every aspect of hospital pharmacy practice.
As a pharmacy educator with years of experience teaching pharmacy informatics, I have observed that students often underestimate the importance of computer literacy in pharmacy practice. Many insurance and prescription plans require online verification and authorisation before dispensing any medication. Pharmacists utilise the internet to gather information about diseases and related drug therapies for their patients. The use of computer systems aims to reduce paperwork, streamline manual record keeping, and increase the efficiency of transactional processing.
In this comprehensive guide, I will walk you through the various applications of computers in hospital pharmacy practice—from patient record maintenance and inventory control to medication monitoring and drug information systems. I will also cover Electronic Health Records (EHR) and the various software programs used in pharmacy practice. By the end of this article, you will have a thorough understanding of how computers are shaping the future of pharmacy. Let us begin our journey into the digital transformation of pharmacy practice.
Dpharmguru’s exam insights:
The application of computers in hospital pharmacy is a frequently tested topic in pharmacy exams. Remember: Computers are used for maintenance of records, inventory control, medication monitoring, drug information retrieval, and in both hospital and retail pharmacy establishments. Key concepts include: Patient Medication Profiles, Medication Administration Records (MAR), MEDLARS/MEDLINE, and various software programs like Guardian Plus and EHR systems. Pay special attention to the components and advantages of Electronic Health Records (EHR)—this is a very current topic in healthcare!
7.1. APPLICATION OF COMPUTERS IN HOSPITAL PHARMACY PRACTICE
Computers are widely used in pharmacy practice because the informational needs of the pharmacist are increasing day by day. Many insurance and prescription plans require online verification and authorisation before dispensing any medication. Pharmacists utilise the internet to gather information about diseases and related drug therapies for their patients. The use of computer systems aims to reduce paperwork and manual record keeping, and to increase the efficiency of transactional processing. To accomplish these goals, the computer system has been highly structured and rigidly formatted. Computers can also be used for improving management information.
The various applications of computers in hospital pharmacy practice are discussed below:
- Maintenance of records
- Inventory control
- Medication monitoring
- Drug information, data storage and retrieval
- Hospital pharmacy and retail pharmacy establishments
7.1.1. Maintenance of Records
A computer system used in pharmacy practice should assure that the patient record database is being regularly updated as it reflects the current status of all patients. Updating is done by assessing the database of the admitting department. This helps in gathering information about all the new patient admissions, discharges, and transfers.
Entries of Medication Orders
A pharmacist can retrieve orders for review before administering to patients. Data may be entered by using codes for drug name and dosing schedule. The drug orders should comprise of the following:
- Drug name (code)
- Generic name and strength
- Administration route
- Dosage schedule
- Starting date
- Stopping date
- Physician code
- Pharmacist verification code
Features: The system should rapidly collect and display entries by patient’s name or room number. It should be able to schedule, start, and stop dates automatically, and separate the patient orders on active drug therapy from those with no drug therapy.
Patient Medication Profile
Pharmacists keep the prescription records of patients (i.e., the patient medication profile), which provide information on the patient’s current medication and also history, like previous medication, any idiosyncrasies, allergies, and medication effects. This provides sufficient data for consultation.
The following basic information is included in a patient’s medication profile:
- Patient’s name
- Address
- Telephone number
- Age
- Date of birth
- Allergy or sensitivities
- Special diet
- Special medical conditions
- Date of prescription dispensed
- Prescription item
- Dosage instruction
- Quantity
- Repeats (if any) and prescriber
Medication Administration Records (MAR)
Keeping complete medication records proves to be helpful for all the health professionals in hospitals. Using computer systems in hospitals for this purpose has the following benefits:
- It prevents the consumption of more time, personnel, and money.
- It serves as a guide to the physician who refers to the computerised records of patient medication profiles while prescribing drugs.
- It prevents drug-drug interactions and drug adverse effects.
- It helps in assessing, evaluating, and maintaining the economic position of the hospitals.
- It also extends the pharmacist’s professional activities in advising doctors on medicines and counselling patients.
7.1.2. Inventory Control
The major task for hospital authorities is formulating an absolute inventory programme, which can be used to check the quantity of medicament available in the drug store, and to make orders for medicaments when they reach the order point. This is done by feeding the following inventory control techniques into the computer program:
- Using Perpetual Inventory Control: Computer systems in hospitals are linked with operations like receipt, issue, return, and billing of goods. This enables updating the stock position after every receipt, issue, or return.
- Setting of Various Levels: Computer systems in hospitals help to set maximum level, minimum level, re-order quantity level, and danger stock level. On feeding these levels into the computer program, the optimum inventory can be tracked to prevent out-of-stock situations.
- Keeping the Inventory Records: For accounting aspects, audit inspections, and legal requirements, records can be made at any time by using the computer system through the above two inventory techniques.
- Measuring Inventory: On feeding the price of each item into the computer, the value of items can be measured. This also helps in evaluating the total inventory of the hospital.
- Finding of Moving Items: This can be evaluated by analysing its utilisation from the stock record in the computer at any framed frequencies per annum. This also helps in evaluating the demand for any particular item.
Dpharmguru’s exam insights:
Inventory control using computers is a practical and frequently tested topic. Remember: Computers can handle perpetual inventory, set various stock levels, keep records, measure inventory value, and identify fast-moving items. The key advantage is real-time tracking and automated reordering when stock reaches the re-order level. This saves time, reduces manual errors, and prevents stockouts.
7.1.3. Medication Monitoring
Pharmacists, for maximising the therapeutic action of drugs and avoiding any toxic effects, make use of some pharmacokinetic and non-pharmacokinetic parameters. This method of therapeutic drug monitoring is helpful in geriatric and paediatric patients and for drugs which undergo interactions.
Therefore, in medication monitoring, computers are used in the following cases:
- Pharmacokinetic Applications: Statistical calculation and graphical interpretations are the methods used for determining the pharmacokinetic parameters (rate of excretion, volume of distribution, clearance, etc.) in individuals. For estimating these parameters, frequent blood samples are collected. NONLIN is a computer program used for predicting the pharmacokinetic parameters to decide the dosing pattern (drug dose and time of administration) so that the drug level is kept within the therapeutic range.
- Non-Pharmacokinetic Applications: Drug-drug, drug-laboratory, drug-allergy, and drug-disease interactions are detected to remove adverse drug reactions. For screening drug interactions, MEDIPHOR (Monitoring and Evaluation of Drug Interactions by a Pharmacy Oriented Reporting) and PAD (Pharmacy Automated Drug Interaction Screening) are the computer programs used. Computers are also used for graphic printing, storage of multiple patient data for analyses, and exact dosing of drugs following a one-compartment model.
7.1.4. Drug Information, Data Storage and Retrieval
A clinical pharmacist searches for complete drug information to clear queries regarding pharmacology, drug interactions, adverse drug reactions, toxicology, etc. with the help of computers. Retrieving information using computers is preferred over manual search as it is time-saving and more detailed.
The National Library of Medicine created MEDLARS (Medical Literature Analysis and Retrieval System) in 1964. It is a computerised medical information retrieval system. Then in 1971, a faster working system named MEDLINE (MEDLARS ON-LINE) was introduced.
Apart from this, management information systems in hospitals are managed by using computers. The information system has two components:
- Information necessary for drug distributions
- Pharmacy management information
Drug distribution activities involve collecting pharmacy information from one file and comparing with, updating, or displaying the information from records in another file. This is done in no time using computers. For example, for preparing an IV admixture, the pharmacist goes through patient drug profile, drug description, patient history, and medication administration record to check the precision of drug therapy. This complete process is carried out using a computer in a short time.
7.1.5. Hospital Pharmacy and Retail Pharmacy Establishment
Computers are used in almost all commercial organisations and business firms, and even in community pharmacy establishments. Given below are the majority of computerised community pharmacy functions:
Clerical Functions:
- Preparing prescription labels
- Providing a receipt for patients
- Generating hard copy record of transactions
- Calculating total prescription cost
- Maintaining perpetual record of inventory status
- Accumulating suggested orders based on suggested order quantities
- Automatically ordering required inventory via electronic transmission
- Calculating and storing payrolls
- Preparing annual withholding statements
Managerial Functions:
- Preparing daily sales report
- Generating complete sales analysis as required for a day, week, month, year, and till date
- Estimating profit and financial ratio analysis
- Producing usage reports
- Calculating gross margins
- Reporting in all manner of details
- Calculating number of prescriptions handled per unit time to help in staff scheduling
- Printing of billing and payment summaries
Professional Functions – Building a Patient Profile:
- Storing information on drug and other allergies to warn about possible problems
- Retrieving current drug regimen for review
- Monitoring of drug utilisation
- Updating patient information in file
- Printing warnings of drug-drug and drug-food interactions
- Maintaining physicians’ files including speciality, designation, address, phone, office hours, etc.
7.2. ELECTRONIC HEALTH RECORDS
Electronic Health Record (EHR) is an automated form of a patient’s medical history maintained over time by the healthcare provider. It contains all the essential administrative clinical data related to patient care—demographics, progress notes, issues, medications, vital signs, past medical history, immunisations, laboratory information, and radiology reports. The EHR automates information access and has the potential to make the clinician’s functionality more efficient. Through a variety of interfaces, the EHR can also directly or indirectly support other care-related activities, like quality control, outcomes reporting, and evidence-based decision support.
7.2.1. Components of EHR
An EHR often contains the following:
- Patient contact details
- Details of consultation with medical experts
- Allergies
- Insurance information
- Family history
- Vaccination history
- Information regarding any ailments or illnesses
- Medicine list
- Hospitalisation records
- Details regarding any previous surgeries or procedures
7.2.2. Advantages of EHR
- Provides patient’s complete, accurate, and up-to-date information while providing care.
- Makes patient records easily accessible for more coordinated and effective care.
- Shares electronic data with patients and other physicians in a secure manner.
- Assists healthcare providers in safer care delivery, medical error reduction, and efficient patient diagnosis.
- Enhances healthcare convenience as well as interaction and communication between patients and providers.
- Makes prescriptions safer and more authentic.
- Improves the security and privacy of patient data.
- Aids healthcare providers in enhancing efficiency and work-life balance.
- Enables providers to increase productivity and achieve their corporate objectives.
- Lowers costs by reducing paperwork, enhancing health and safety, and eliminating redundant testing.
- Provides better healthcare by enhancing patient care aspects, like equity, safety, efficacy, patient-centeredness, communication, and education.
- Offers better health by promoting healthier regimes in a population.
- Ensures greater efficiency and lower healthcare costs by encouraging preventative medicine and better coordinating healthcare providers.
- Makes better clinical decisions by incorporating patient data from many sources.
7.2.3. Disadvantages of EHR
- Insufficient Data Interchange: Limited data interchange and usage capabilities when numerous systems are involved.
- High Cost: Costly to purchase, implement, and maintain because of expensive equipment, conversion of information into electronic format, and execution of training initiatives.
Dpharmguru’s exam insights:
Electronic Health Records (EHR) are a very current and frequently tested topic. Remember the key components: patient demographics, medical history, allergies, medications, immunisations, laboratory results, and radiology reports. Advantages include improved patient safety, better coordination of care, and reduced costs. Disadvantages include high implementation costs and interoperability issues. This is a very relevant topic in modern healthcare!
7.3. SOFTWARES USED IN PHARMACY
Healthcare software has become an integral part of pharmacy practice now due to the increased informational needs of the pharmacist, huge paperwork required in the practice, need for efficiency, and availability of computer technology and large databases which provide the required support. In the market, various softwares and technologies are present that can be used for supporting pharmaceutical care. These softwares and technologies have been developed by combined efforts of professional pharmacy organisations, pharmacy leaders, software developers, and computer vendors.
Examples of Softwares
- Guardian Plus: A Windows-based system marketed by Care Point. Supports the pharmacist in documentation and disease management initiatives. Now combined with dispensing software to provide more extensive patient care.
- Electronic Health Record Software (EHR Software): A computer programme that aids healthcare providers in managing patient medical records and computerising clinical procedures. Allows providers to produce editable notes, reports, interact with staff and patients, use telemedicine, and synchronise data with billing systems.
- Bayer’s DCA 2000: Used to check HbA1c (haemoglobin A1C) for diabetes monitoring.
- Roche’s CoaguCheck: Used to monitor prothrombin time INR (blood clotting time).
- CardioPharm: Public interactive health promotion software developed for customers visiting community pharmacies. Gives advice on the management of risks of cardiovascular disease.
- Medical Billing Software: Used by physicians and medical offices to computerise the healthcare billing process. Examples: athenaCollector, Practice Fusion, Kareo.
- Hospital Management Software: Enables quick and accurate information collection. Aids in issuing patient invoices, maintaining stock levels, and minimising paper use. Examples: Insta, Attune, MocDoc.
- Electronic Prescribing (e-Prescribing): The process of electronically creating and delivering a prescription order. Allows physicians to send electronic prescriptions directly to pharmacies.
- Medical Equipment Management Software: Designed to automate inventory control and equipment maintenance. Examples: Sortly.
- Medical Research Software: Used for teaching medical professionals, assisting in diagnosis, and disseminating research. Example: PubMed.gov.
- Telemedicine Software: Enables medical professionals to schedule patient appointments online using a web browser or mobile application.
- Therapeutic Drug Monitoring (TDM) Programmes: Used to calculate drug dosage to fit individual patients’ needs. Examples: WinNONLIN and USC*Pack.
Dpharmguru’s exam insights:
Various software programs used in pharmacy practice are frequently tested. Remember the key ones: Guardian Plus (documentation), Bayer’s DCA 2000 (HbA1c monitoring), Roche’s CoaguCheck (INR monitoring), CardioPharm (cardiovascular risk advice), and WinNONLIN/USC*Pack (therapeutic drug monitoring). Also, remember the difference between EHR software, e-prescribing, and medical billing software.
COMPARISON: COMPUTER APPLICATIONS IN PHARMACY
| Application Area | Key Functions | Examples/Software |
|---|---|---|
| Record Maintenance | Patient profiles, MAR, medication orders | EHR systems, Pharmacy Management Software |
| Inventory Control | Perpetual inventory, re-order levels, stock tracking | Hospital Management Software |
| Medication Monitoring | Pharmacokinetics, drug interaction screening | NONLIN, MEDIPHOR, PAD, WinNONLIN |
| Drug Information | Data storage and retrieval | MEDLARS, MEDLINE, PubMed |
| Pharmacy Management | Clerical, managerial, professional functions | Guardian Plus, Medical Billing Software |
| Clinical Monitoring | HbA1c, INR monitoring | Bayer’s DCA 2000, Roche’s CoaguCheck |
| Patient Care | Health promotion, disease management | CardioPharm |
FREQUENTLY ASKED QUESTIONS (FAQs)
1. What is the difference between EHR and EMR?
EMR (Electronic Medical Record) is a digital version of a patient’s paper chart within a single practice. EHR (Electronic Health Record) is a more comprehensive record that includes data from multiple healthcare providers and can be shared across different healthcare settings.
2. What is MEDLARS?
MEDLARS (Medical Literature Analysis and Retrieval System) is a computerised medical information retrieval system created by the National Library of Medicine in 1964. MEDLINE (MEDLARS ON-LINE) is the faster online version introduced in 1971.
3. What is the purpose of Medication Administration Records (MAR)?
MAR is a record that lists all medications prescribed for each individual patient with administration timings. It helps prevent drug-drug interactions, serves as a guide for physicians, and extends the pharmacist’s professional activities in counselling patients.
4. What is e-prescribing?
E-prescribing is the process of electronically creating and delivering a prescription order, allowing physicians and other healthcare providers to send an electronic prescription from the healthcare setting directly to a pharmacy.
5. What software is used for therapeutic drug monitoring?
WinNONLIN and USC*Pack are computer programs used for therapeutic drug monitoring. They are used to calculate drug dosage to fit individual patients’ needs based on pharmacokinetic parameters.
6. What are the advantages of using computers in hospital pharmacy?
Advantages include: reduced paperwork, increased efficiency, better inventory control, improved medication monitoring, enhanced drug information retrieval, better patient record management, reduced medication errors, and improved financial management.
SUMMARY
The application of computers in hospital pharmacy practice has revolutionised how pharmacy services are delivered. From patient record maintenance and inventory control to medication monitoring and drug information retrieval, computers have become indispensable tools in modern pharmacy practice.
Patient Medication Profiles and Medication Administration Records (MAR) enable comprehensive patient care and help prevent medication errors. Electronic Health Records (EHR) provide a complete, up-to-date patient history that can be shared across healthcare settings. Various software programs—from Guardian Plus and EHR software to medical billing and telemedicine platforms—support different aspects of pharmacy practice.
As I always tell my students: “Computer literacy is no longer optional in pharmacy practice—it is essential. The digital transformation of healthcare is here to stay, and pharmacists must embrace technology to provide the best possible patient care.”
The future of pharmacy will see even greater integration of technology—artificial intelligence, machine learning, and predictive analytics will further enhance medication management and patient outcomes. Understanding the current applications of computers in pharmacy is the foundation for embracing these future innovations.
REFERENCES AND FURTHER READING
- Pharmacy Council of India (PCI). (2022). Pharmacy Informatics Guidelines. New Delhi: PCI.
- International Pharmaceutical Federation (FIP). (2022). Digital Health in Pharmacy Practice. Retrieved from https://www.fip.org.
- World Health Organization (WHO). (2022). Electronic Health Records: Guidelines and Standards. Retrieved from https://www.who.int.
- Ministry of Health and Family Welfare. (2022). National Digital Health Mission (NDHM). Government of India.
- American Society of Health-System Pharmacists (ASHP). (2022). Pharmacy Informatics: Practice Standards. Retrieved from https://www.ashp.org.
- National Library of Medicine. (2022). MEDLINE and MEDLARS: History and Development. Retrieved from https://www.nlm.nih.gov.
Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals for medical concerns. Healthcare technology regulations and guidelines may vary by region—always refer to your local regulatory authorities for specific requirements.
written by:
Dr. N. Sujith Kumar
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