Veterans Affairs Collaboration for Medication Safety Introductory Practice Experience Using Remote Access to Health Records

Abstract

Objective. To describe an ambulatory care introductory pharmacy practice experience (IPPE) in medication safety monitoring conducted remotely at the University for first- or second-year pharmacy students in collaboration with a Department of Veterans Affairs (VA) Health Care System.

Methods. A module in medication safety was piloted as part of a required, one-unit IPPE in ambulatory care. Veterans prescribed methotrexate, sulfasalazine or mineralocorticoid receptor antagonists require ongoing laboratory monitoring to screen for adverse drug effects. Working remotely at the school under the direct supervision of VA clinical pharmacists, students accessed electronic health records (EHR), ordered laboratory tests under the prescriber’s name, documented notes in the EHR and sent laboratory reminder letters to patients. Students completed a brief survey at the beginning and end of the course; differences were compared using Wilcoxon signed rank test.

Results. During a 15-week course, following a two-week orientation, three sessions were devoted to the medication safety module. Fifty-eight students reviewed 148 patient records, including non-VA electronic records and ordered laboratory tests for 79 patients. Comparing baseline and course-completion surveys, students reported statistically significant changes in their ability to monitor laboratory tests, use a non-simulated EHR to perform patient care, and explain the role of a clinical dashboard to conduct population health activities.

Conclusion. Conducting an ambulatory care IPPE course remotely enabled 58 pharmacy students to participate in medication safety monitoring for ambulatory patients.