By Karen Dahri
Each spring I give a lecture on the use of technology in everyday clinical practice to our first-year entry-to-practice Doctor of Pharmacy students at the University of British Columbia. I start off the session by speaking about how technology has impacted our practices by allowing us greater access to information when we are providing care to our patients. In the last twenty years, we have moved from carrying a “peripheral brain,” which was just a small black binder with drug facts, to having a smartphone in our pocket filled with healthcare-related apps that allow for quick access to information at the point of care. In March 2020, that became one of the last in-person lectures that I gave for a long time as the Covid pandemic came to the forefront of everyone’s lives.
For hospital pharmacists, engaging with and educating patients about their medications is a key part of our day-to-day activities. Covid forced us to reassess how we carried out all of our regular clinical interactions. For example, interviewing a patient on their medications prior to admission became fraught with concerns around the risk associated with the interaction. Utilizing basic technology such as the telephones in patients’ rooms became a simple way of maintaining communication while minimizing risk and preserving the limited supplies of protective gear. Technology also helped patients connect with friends and family members who no longer could come to the hospital for visits. Patients FaceTimed their loved ones on smartphones and iPads, and hospital pharmacists could also speak remotely to caregivers as they needed to ensure that caregivers understood the patient’s medications upon discharge. Zoomã, a program that most of us were unaware of pre-Covid, became commonplace, allowing us to continue to support our clinic patients, many of whom take complex medication regimens that require close monitoring by pharmacists.
Better use of technology has been prioritized these past years, offering solutions to issues that existed in pharmacy long before Covid. Many of our patients do not speak English, which can be challenging as we often have limited access to translator services. Ensuring that patients understand and feel confident in their medication is a core value of hospital pharmacy, so I was glad to see that my local health authority adopted a virtual translation service during the pandemic. This offered access to numerous different translators immediately when needed and allowed patients to ask us any questions about their medications.
Staffing shortages have been an ongoing issue in pharmacy long before Covid-19, but the pandemic required us to consider scenarios in which even larger numbers of staff may be off sick. As a result, remote order verification procedures were detailed, which would maintain an individual hospital dispensary’s ability to function while utilizing staff at other sites. This represented an effective solution to a long-standing issue. In response to staffing shortages and to minimize risky contact during the pandemic, some countries even began to make use of robots to deliver patient medications and meals (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630467/).
Now, as we begin to move forward from Covid, some of the technology we have used will remain and strengthen hospital pharmacy practice. Other aspects will never be able to fully replace in-person interactions, but we will carry forward the spirit of innovation and willingness to experiment that marked these difficult months.
Dr. Karen Dahri BSc, BSc (Pharm), PharmD, ACPR, FCSHP is a clinical pharmacist in Internal Medicine at Vancouver General Hospital and an Associate Professor (Partner) with the Faculty of Pharmaceutical Sciences at UBC.