Anyone here ever have an APPE elective rotation in informatics?

[pharmdit]

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I'm an informatics pharmacist in the post-acute care field. We have a couple pharmacy schools located near my office and I've considered opening a rotation site. For those that had an informatics rotation, would you consider it beneficial?

My main concern is that 240 hours is not a long time to get exposure to the field. On the other hand, I could see a motivated student learning a lot of things they may not encounter in other rotation sites. Any input would be appreciated. Thanks!


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[lord999]

I've done it twice, but only when a student specifically approaches me and we agree ahead of time on the work effort. I would suggest if you do though, you reserve the right to interview ahead of the assignment due to the usual policies regarding system access in informatics.

I usually have them do a bunch of background training (send them to the Pioneer Data Systems Greg Kreis class for M and the Intersystems training for Cache for Cache.dat and Cache class instantiation) before the rotation and then when they arrive, send them with a longitudinal "fix the clinical reminders or order sets" or "here's some Forum (alpha and beta) IOC code that needs regression testing" or "I have this data that I need to get into HL7 format, can you write and test the JSON or XML to format the message from VistA".

This has both the intention of warning off anyone who doesn't want to work hard in the rotation, but providing an invitation to those who want the hardcore introduction training for system maintenance and development. If they are not federal bound, I have them get the Intersystems background and train them more on the protocol transmission systems to develop messages to go to CMS or the other regulatory matters. If they are federal bound, they have the choice of learning VA DHCP (RPMS and BEMR side training included if that's where they are going), CHCS II/CHDR if they are going DoD, or CMSNet if they are going to Beltway HHS.

And those of you who are VA, this is @ access in VistA both on the test Canandaigua and the Clin1 IOC side or complete National access to AITC's systems for that training. No better way than to jump into actual testing and debugging work. Much more intensive than the ADPAC standard day, but I find most ADPACs to not care enough about data corruption from bad practices such that I always aim for the low-level training to get mine to understand the implications.

 

[gwarm01]

It's something I would have appreciated as a student, but wasn't offered in my city. Now that I'm in the field I have tossed the idea around about opening a rotation site, which I'm sure the university would love, but I'm still several years away from being competent enough to proctor anyone.

 

[CYP-0]

Bless your hearts! Please do it!!

I fought for about 3 months with our PEP director for a chance to complete an APPE rotation in informatics. He eventually approved my proposal, but I was met with the another big huddle - no informatics rotation site was available within 50-100 miles of my location.

I contacted some out-of-state sites (at my home state), and they were willing to accommodate me as a rotation student. Yet again, a third huddle struck: the site needed to be set up or officially linked to my school as an approved rotation site.

As I prepared a formal presentation about an out-of-state site in a bid to get it approved, I also submitted an appeal for the COP administration to make an exception to their ban on students completing any rotations out of state. I finally gave up when they denied the appeal weeks later. The reason had a politics stench.

But yes, I wanted it that bad. I have no background in anything informatics-related, but it would have been the prime opportunity to know with absolute certainty whether my attraction in the area was merely in theory alone, or in practice as well.

As a consequence of this experience, part of my long term career goal now includes becoming an informatics preceptor, if all necessary circumstances permit.

 

[ABCPharmD]

I didn't realize how uncommon informatics rotations were. There were several informatics APPE rotations offered where I went to school.

 

[lord999]

Unless you have a comp/sci or electrical engineering as part of the background, most interns simply don't arrive with the background skills to perform at a competent level. (And for those who say coding boot camps work, well, there's a strong counterargument where they're here to sell you something like MFA programs to "writers" today.) Yes, it's possible to teach someone coding without the fundamentals of algorithms and data structures, but there are hard limits to what they can do (order menu management, very light clinical decision support). Either they figure those matters out themselves and probably cause a reportable problem in doing so experimentally, or go back for the baseline training later. I find that about 2/3's of the informatics pharmacists in VA are technologically set in terms of not being able to adapt to the changing technologies as they learned the practice without learning enough theory to interrelate when another technology comes in (and honestly, I think more than a third would be removable for competence causes if they did not live in places where I know they cannot find anyone better to work for them.) So, if you do take an informatics resident and you are honestly intending that they apprentice in what you are doing rather than wasting everyone's time with prestige projects, it's a bigger preparation for the intern to arrive ready to learn.

That's why I'm not a big fan of the Epic or Cerner training as it locks you into their ecosystem, where Intersystems training is far deeper where you could migrate off, but you won't want to (and most of it is no cost for the beginner, they make up for it by charging me quite a bit for very esoteric subjects where the class literally is only 13 and 14 civil service and 65-69 Epic). One other matter, it remains to be seen whether or not grey hair discrimination will occur for informatics pharmacists outside the civil service like programmer layoffs when you're 50. I actually bet that it'll be similar, but it may be lost in the noise where pharmacists jobs become more inherently unstable anyway...

http://www.infoworld.com/article/26...eers-where-do-all-the-old-programmers-go.html

http://www.oregonlive.com/silicon-forest/index.ssf/2016/06/intel_layoffs_skew_older_spotl.html