A Module in Medication Safety Involving Remote Access and Review of Veterans’ Health Records

Objective. To describe and assess the effectiveness of an ambulatory care introductory pharmacy practice experience (IPPE) module in medication safety monitoring that was conducted remotely for first- and second-year pharmacy students in collaboration with a Department of Veterans Affairs (VA) health care system. Methods. A module in medication safety was developed and piloted as part of a required, one-unit IPPE in ambulatory care. The module encompassed three sessions of the 15-week course. Working remotely at the school under the direct supervision of VA clinical pharmacists, students accessed the electronic health records (EHRs) of veterans for whom methotrexate, sulfasalazine, or mineralocorticoid receptor antagonists had been prescribed as such patients require ongoing laboratory monitoring to screen for adverse drug effects. After reviewing the record, students ordered laboratory tests under the prescriber’s name, documented notes in the patient’s EHR, and sent laboratory reminder letters to patients. Students completed a brief survey at the beginning and end of the course. Differences in survey responses were compared using the Wilcoxon signed rank test. Results. Fifty-eight students reviewed 148 patient records, including non-VA electronic records, and ordered laboratory tests for 79 patients. On the follow-up survey at course completion, students reported significant changes in their ability to monitor laboratory tests, use an actual (non-simulated) EHR to perform patient care, and explain the role of a clinical dashboard to conduct population health activities. Conclusion. Remotely conducting an ambulatory care IPPE course in which pharmacy students used an actual EHR to participate in medication safety monitoring for ambulatory patients expanded the pharmacy school’s ability to provide crucial practice experience. Other pharmacy schools struggling with logistical challenges and limited resources should explore this approach to fulfilling the experiential education requirements for pharmacy students.