TruePill

Product Manager • December 2021 - Present

Mayo Clinic

Clinical Informatics Pharmacist • July 2015 - December 2021

The Ohio State University Wexner Medical Center

PGY-2 Pharmacy Informatics Resident • July 2014 - June 2015

Indiana University Health

PGY-1 Pharmacy Resident • June 2013 - June 2014

Detection of adverse drug events using an electronic trigger tool

Am J Health Syst Pharm. 2016 Sep 1;73(17 Suppl 4):S112-20 • September 1, 2016

Purpose: Implementation and refinement of an integrated electronic "trigger tool" for detecting adverse drug events (ADEs) is described.
Methods: A three-month prospective study was conducted at a large medical center to test and improve the positive predictive value (PPV) of an electronic health record-based tool for detecting ADEs associated with use of four "trigger drugs": the reversal agents flumazenil, naloxone, phytonadione, and protamine. On administration of a trigger drug to an adult patient, an electronic message was transmitted to two pharmacists, who reviewed cases in near real time (typically, on the same day) to detect actual or potential ADEs. In phase 1 of the study, any use of a trigger drug resulted in an alert message; in subsequent phases, the alerting criteria were narrowed on the basis of clinical criteria and laboratory data with the goal of refining the trigger tool's PPV.
Results: A total of 87 drug administrations were reviewed during the three-month study period, with 27 ADEs detected. PPV values in phases 1, 2, and 3 were 0.33, 0.21, and 0.36, respectively. The relatively low overall PPV of the trigger tool was largely attributable to false-positive trigger messages associated with phytonadione use (such messages were reduced from 35 in phase 1 to 7 in phase 3).
Conclusion: Evaluation and refinement of an electronic trigger tool based on detecting the use of the reversal agents flumazenil, naloxone, phytonadione, and protamine found an overall PPV of 0.31 during a three-month study period.

Harmonization of technology across an integrated delivery network

Am J Health Syst Pharm. 2018 Jul 15;75(14):1073-1078 • July 15, 2018

Summary: Whether to strive for standardization (use of the same vendors and equipment) versus harmonization (use of various technologies to meet patient-specific needs and organizational stability requirements) and how to coordinate activities across IDNs consisting of 3-30 or more hospitals are common questions due to consolidations in the healthcare industry. For most IDNs with legacy systems, harmonization may be the better option. Large-scale harmonization initiatives require significant planning and coordination involving all affected parties. Detailed project plans should include the compiling of all associated harmonization costs that involve human resources, information on ongoing services and equipment, and program schedules for multiple concurrent projects in order to provide a framework for planning and coordination. Part of the planning process for harmonization efforts should include an extensive current-state analysis that includes review of contracts and vendors. Final harmonization decisions should be based on a mix of vendor recommendations, best practices, and accommodation of current practices that result in the lowest complexity of system redesign with regard to existing systems. When harmonizing existing technologies, planning must also consider the impact of the change to both the organization and individual users.