Academic Pharmacy
The News Magazine of the American Association of Colleges of Pharmacy
NOW
Volume 14 2021 Issue 2
Diving Into Digital Health
Pharmacy schools are starting to integrate digital health education into the curriculum to prepare students for rapid advances in technology. 16
Also in this issue: Vaccines Get a Boost 5 Making Inclusivity a Priority 12
Pharmacists Help People Live Healthier, Better Lives.
who we are @AACPharmacy
Academic Pharmacy The News Magazine of the American Association of Colleges of Pharmacy
Pharmacists Help People Live Healthier, Better Lives.
1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org
Founded in 1900, the American Association of Colleges of Pharmacy is the national organization representing the interests of pharmacy education. AACP comprises all accredited colleges and schools of pharmacy, including more than 6,600 faculty, approximately 63,800 students enrolled in professional programs and 4,800 individuals pursuing graduate study.
NOW
CEO & Publisher
Lucinda L. Maine Editorial Advisor
Lynette R. Bradley-Baker
Editorial Director
Maureen Thielemans Managing Editor
Jane E. Rooney
Letters to the Editor
We welcome your comments. Please submit all letters to the editor to communications@aacp.org.
About Academic Pharmacy Now
Academic Pharmacy Now highlights the work of AACP member pharmacy schools and faculty. The magazine is published as a membership service.
Editorial Assistant
Kyle R. Bagin
Communications Advisor
Stephanie Saunders Fouch
Change of Address
For address changes, contact LaToya Casteel, Member Services Manager, at lcasteel@aacp.org. ©2021 by the American Association of Colleges of Pharmacy. All rights reserved. Content may not be reprinted without prior written permission.
Art Director
Tricia Gordon Digital Designer
Sean Clark
AACP’s Professional Supporter Program
Freelance Writer
Joseph Cantlupe
Promotion Supporter
Freelance Writer
Emily Jacobs
Freelance Writer
Athena Ponushis
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Academic Pharmacy NOW 2021 Issue 2
Volume 14 2021 Issue 2
@AACPharmacy a look inside
community impact
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Voicing Support for Vaccination Pharmacy schools are finding creative ways to advocate for the COVID-19 vaccines and to fight falsehoods circulating online.
campus connection
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VCU Student Pharmacists Highlight Sustainability
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The Sustainable Pharmacy Project at VCU’s School of Pharmacy aims to shine a light on the environmental impact of pharmaceuticals.
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Diving Into Digital Health Pharmacy schools are starting to integrate digital health education into the curriculum to prepare students for rapid advances in technology.
Committed to Change The Equity, Diversity and Inclusion Institute pushed teams to take a hard look at their schools as they strive to make their campuses better for everyone.
@AACPharmacy
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Join Us for Virtual Pharmacy Education 2021!
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Get Involved in AACP Call for Committee Volunteers
Mark Your Calendars: #VirtualPharmEd, July 19–22
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community note publisher’s impact
Dear Colleagues: As this issue of Academic Pharmacy Now goes live, I am pausing to reflect on the last 14 months of pandemic navigation. What has changed? What hasn’t changed? AACP has been fortunate that all our staff were remote work-enabled on March 13 (Friday the 13th for sure!) when the executive order from the Virginia and federal governments restricted normal office operations. Would it be weeks? Perhaps months? Certainly not a year! We feel fortunate that the nature of our work has allowed us to continue to support and serve our members as they quickly pivoted into remote learning and identified innovative ways to achieve their missions and goals. AACP has been in action during these months. We have certainly missed being able to host in-person events and are excited for future plans to do so, but as the stories in this issue reveal, we are creating value with and for members in strategically important ways. Planning for the Equity, Diversity and Inclusion Institute—co-hosted with the University of Mississippi School of Pharmacy—began in March 2019. It was to be an in-person event in Oxford, MS, in January 2021. What became clear six or more months prior to the scheduled program was that restrictions on travel and gathering meant that the institute had to be offered virtually. The silver lining in this change was that most likely double the number of teams and individuals participated in this outstanding learning and planning meeting. Sixty colleges and schools initiated or expanded their plans for doing more to address inclusivity and equity at their institutions. We look forward to this becoming an annual program, whether live, virtual or hybrid. And AACP continues to implement our own plans as an organization to achieve our vision of a world of healthy people—all people. I have never been prouder of our members, your faculty and students, with respect to the many roles and contributions you have made and continue to make in the battle to defeat COVID-19. With three vaccines having received emergency use authorization from the FDA in record time, you all have expanded access to immunizations on campus, in mass vaccination clinics, in pharmacies and in many other places. Our state and national leaders are seeing you in action and have gained significant respect for pharmacists’ contributions to public health. Maintaining our gains is a national pharmacy priority. AACP is also committed to working in the critical space of building vaccine confidence across the country so we can achieve herd immunity as rapidly as possible. We are partnered with the American Pharmacists Association on a CDC-funded vaccine confidence project that will yield important educational programs and tools for pharmacists to use with the public to encourage vaccinations. The next frontier is digital health education and practice. AACP recognizes that this is a rapidly advancing arena that is not well integrated into curricula today. As the faculty featured in this article note, we must work together to equip faculty at all of our member institutions with the knowledge and tools to integrate digital health into existing courses, create electives and clinical learning opportunities so that our graduates and alumni quickly become comfortable enabling our patients to achieve optimal health outcomes using this expanding array of tools. A fall 2021 institute is being planned to quick start this curricular advancement priority. So what has changed? Virtually everything is one answer (and everything virtual as well)! On the other hand, what hasn’t changed is AACP’s commitment to providing programs and services that allow academic pharmacy to remain in the vanguard of our dynamic healthcare system helping to create a world of healthy people. Thanks for all you are doing to make that happen. Sincerely,
Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher
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community impact
Voicing Support for Vaccination Pharmacy schools are finding creative ways to advocate for the COVID-19 vaccines and to fight falsehoods circulating online. By Joseph A. Cantlupe
While millions of vaccines are going into arms across the country to prevent the spread of COVID-19, a flurry of misinformation about vaccine efficacy and the disease itself also is spreading. At colleges and schools of pharmacy, faculty, students and staff are working in clinics, stadiums and arenas, or partnering with pharmacies and physicians to administer vaccines and manage workloads. Some schools are taking it a step further, combating the naysayers touting fictions that are swirling around the virus and the vaccines, using YouTube, Instagram or other social media to amplify the message. While scientists strongly argue that the vaccines approved for distribution by the Food and Drug Administration are highly effective—and cannot cause COVID-19 because they don’t contain active viruses—there are still many doubters, who are against vaccines generally because of their own political or religious beliefs or because they do not trust the science. Some who are hesitant about taking the vaccine are unsure of the impacts but are still open to the idea that the vaccines are effective. At the University of Connecticut School of Pharmacy, students wanted to take charge to educate the vaccine hesitant. Dr. C. Michael White, department head and distinguished professor of pharmacy practice, initiated ideas to spread the word about the importance of vaccines,
and students jumped in, discussing social platforms to use and how to find effective messages to counter the arguments from the anti-vaccine population. Student pharmacists worked to create a video series—each one about two to three minutes long—about different elements of the vaccines, such as their chemistry and impacts, focusing on issues that many people would have questions about, said Dr. Diana M. Sobieraj, associate professor. “This was a great example of real life in front of their eyes, and how to use and search for credible information to counter that. We should use this approach for other vaccinations at opportunities in the future,” she said. Among the students’ concerns: Minority and non-English speaking communities are confronted with an array of misinformation about COVID-19 and the vaccines, prompting many people in those communities to decline the opportunity to get vaccinated. Study after study reveals that Black and Hispanic populations are receiving fewer vaccinations compared to White populations, as well as having higher incidences of COVID-19 cases and deaths. Sobieraj noted that the YouTube and social media presentations emphasize the importance of reaching out to multiracial groups. Students focused their attention on the need for outreach to diverse commu-
nities; their videos were recorded in English, Spanish, Mandarin, Cantonese and Polish. “When we released the videos, the timing was perfect,” Sobieraj said. YouTube and social media were the “main mechanisms for disseminating the information, and that is still evolving.” The students engaged in questions and answers with their audiences. “They received a lot of appreciation from patients. The students also shared that information with family and friends to provide accurate and unbiased information.”
Questions and Answers Will the vaccine give me COVID-19? Can the COVID-19 vaccine cause infertility? In a smooth delivery on YouTube, UConn School of Pharmacy student Ann Varga discussed the issues surrounding the vaccines and COVID-19. “Some people have been wondering if you will test positive for COVID-19 after receiving the Pfizer or Moderna vaccines,” she said. “I’m here to answer your questions today.” Varga was candid about the positive impact of the vaccines against COVID-19. “It will rapidly attack and reduce the chances that you will get the disease,” she said. “It doesn’t contain live viruses; the vaccine will not cause you to test positive for COVID-19. The great news is that within a few weeks of receiving the COVID-19 vaccine, it is more than 90 percent likely that you will not contract COVID-19.”
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community impact
AACP to Collaborate on CDC Vaccine Confidence Campaign The Centers for Disease Control and Prevention (CDC) is funding a Vaccine with Confidence campaign that aims to boost confidence among those who are hesitant about receiving COVID-19 vaccines. In collaboration with the American Pharmacists Association (APhA), AACP will work with its member institutions and partner organizations through the ongoing Pharmacists for Healthier Lives campaign to enhance pharmacists’ knowledge and ability to support the CDC’s efforts to boost vaccine confidence within communities. AACP will extend the reach of messages and materials developed by APhA by communicating with member institutions and engaging student pharmacists, as well as hosting a session on the topic at the AACP Virtual Annual Meeting in July. “AACP was thrilled to learn that APhA had included the Association and our Pharmacists for Healthier Lives campaign partners in its CDC-funded vaccine confidence work. Our work over the past three years on the campaign reflects our ability to reach consumers with strong messages, including previous efforts focusing on the importance of immunizations in general,” said AACP CEO and Executive Vice President Dr. Lucinda Maine. “The work of AACP member institutions, their faculty and students in vaccine advocacy and access has been truly remarkable. This project will provide more resources for consumer education and outreach as we combine our efforts with those of other organizations working toward the common goal of reaching herd immunity to defeat the COVID-19 pandemic.” AACP plans to leverage its relationships and partnerships established through Pharmacists for Healthier Lives, which includes 10 national organizations as well as many state pharmacy associations. This will involve working with NASPA to engage with state associations. AACP will also use its social media channels and other communications vehicles to build vaccine confidence and distribute project messaging. Through the Pharmacy Is Right for Me campaign, AACP will engage current and prospective students. Finally, AACP has identified five target markets with high incidences of vaccine hesitancy as well as proximity to a member institution. These markets are Albuquerque, New Mexico; Baton Rouge, Louisiana; Camden, New Jersey; Columbia, South Carolina; and Portland, Maine. AACP will deploy innovative media strategies in these markets to reach individuals who may not have the same digital media habits as those who are eager to receive the vaccine. Pharmacists and pharmacy educators in these communities will be enlisted in their roles as trusted healthcare messengers to appeal to those who are taking a wait-and-see attitude toward vaccination. The campaign aims to highlight the role of pharmacists in administering and counseling about the vaccine.
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“The vaccines are not optimally effective after the first dose,” she added. “It takes time for the body to create that optimal immune response after receiving the second dose. There is a small chance you can still contract COVID-19.” Varga emphasized that the information presented by student pharmacists was based on the COVID-19 vaccine literature, “to help you make an informed decision.” As for the myth that the vaccines cause infertility, that is indeed just a myth. “It was a team effort in creating the script,” Sobieraj said. “The effort was not only to serve the public but also to be creative in a way to allow students to earn their curriculum requirement.” The Western University of Health Sciences College of Pharmacy also tapped into social media to relay the importance of people getting vaccinated and sorting fact from fiction. “A lot of students are working in vaccine clinics and helping people who want to get vaccinated,” said Dr. David Sanchez, associate professor of pharmaceutical sciences at the college, located 30 miles
community impact
“It’s important to give information to people, that’s the key. There are the anti-vaxxers, the people who are pro vaccine and then there are the people who are hesitant. That is an important distinction; the hesitant people are the ones in the middle that the students can engage with.” —Dr. David Sanchez
outside of Los Angeles. “One group is using social media infographics. There are truths and myths about COVID-19. The younger students are good at social media interactions and with that engagement” about the uncertainties surrounding the vaccines, he said. “It’s important to give information to people, that’s the key,” he continued. “There are the anti-vaxxers, the people who are pro vaccine and then there are the people who are hesitant. That is an important distinction; the hesitant people are the ones in the middle that the students can engage with. The antivaxxers, you are never going to change their feelings. But the ones you have to engage with are those on the fence.” Sanchez also discussed inequities among those who have received the vaccines, noting, “different populations have been given preferential treatment, some people are sneaking around for vaccinations, there is a lack of equitable access for everybody. It’s a real-life situation.” As an immunology instructor, Sanchez reached down into his own experience as someone who participated in a COVID-19 vaccine clinical trial. Sanchez said he will continue to be followed in the trial over two years “to
see how the immune response is going and to monitor antibodies and (issues) like that.” The instruction is significant for students, as are the ramifications of how they respond to the COVID-19 pandemic, Sanchez said, because the lessons learned today may be considerably helpful if another virus outbreak occurs “in the next 10 or 20 years.”
AACP Weighs In
vaccines are available to other frontline healthcare providers and serve as certified immunizers to administer the vaccines to patients,” according to the letter signed by AACP Executive Vice President and CEO Dr. Lucinda Maine. She referred to the significant number of students enrolled in an array of academic programs: 60,000 Doctor of Pharmacy, 1,194 Master of Science and 3,217 Ph.D. students enrolled at colleges and schools of pharmacy across the country.
The vaccine rollout, which has been a major priority for President Biden, is “Pharmacy schools have also modified being supported by a special AACP their continuing education and profespolicy task force formed out of the sional development programs to ensure need for educational initiatives related greater access to the training and certito COVID-19, said Jasey Cárdenas, fication programs needed to administer AACP’s associate director of strategic the COVID-19 vaccines,” the letter said. engagement. In a letter to Biden, the Despite that statement, too many in task force outlined how pharmacy academia and elsewhere are unaware schools are involved in the planning for that student pharmacists are and can vaccinations as well as the distribution be involved in distributing vaccinaand administration of the vaccine. tions, Cárdenas said. “A lot of leaders don’t understand that pharmacists are Cárdenas noted that AACP is collecttrained to immunize, and there is a lot ing information for schools about other of training involved in that,” he pointed institutions that are involved in helping out. “We are working to get informadistribute the vaccines, as well as protion out to governors and state health viding tools to help other colleges and officials through the task force and schools of pharmacy get involved. “Stupharmacy partners to let them know dent pharmacists across the U.S. have about student involvement.” been directly involved in ensuring the
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community impact
“This was a great example of real life in front of their eyes, and how to use and search for credible information to counter that. We should use this approach for other vaccinations at opportunities in the future.” —Dr. Diana M. Sobieraj
The letter highlighted the message that AACP is working to “help with the vaccinations and other issues that may arise during the pandemic,” said Cárdenas, “including a lot of the actual work that students can do.” The AACP Policy Advisory Task Force is comprised of members who are administrators, researchers and faculty leaders repre-
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senting private and public colleges and schools of pharmacy around the country. The pandemic has delivered some obvious changes, such as remote instruction, and also underscored that education must be continually innovative, Sobieraj pointed out. “I’ve been in academia as an instructor for over 10
years,” she said. “The [pandemic] has certainly brought us all and pushed us to be better educators and have to adapt to this environment. We are still bound by the curriculum and [standards] but have had to be creative with the delivery of the content.” P Joseph A. Cantlupe is a freelance writer based in Washington, D.C.
campus connection
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The upward trend of the pharmacy industry Pharmacy retains a moderate future employment outlook despite challenging market conditions. Pharmacist Wages & Employment Trends* Median wages (2019) $61.58 hourly, $128,090 annual Employment (2018) 314,300 employees Projected job openings (2018-2028) 15,300 Top industries (2018) Retail Trade, Health Care and Social Assistance
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*Source: Retrieved from O*Net on October 15, 2020. Original source: Bureau of Labor Statistics 2019 wage data and 2018-2028 employment projections. Copyright © 2020 Pearson Education, Inc. or its affiliates. All rights reserved. Pearson and PCAT are trademarks, in the US and/or other countries, of Pearson plc. CLINA23931 MJL 10/20 Academic Pharmacy NOW 2021 Issue 1
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VCU Student Pharmacists Highlight Sustainability The Sustainable Pharmacy Project at VCU’s School of Pharmacy aims to shine a light on the environmental impact of pharmaceuticals. By Emily Jacobs In the process of improving health and saving lives, healthcare providers generate a large amount of waste. Pharmaceuticals account for much of that waste: the chemicals used in laboratories and drug manufacturing, sharps, plastic pill bottles and unused medications, to name a few. When not disposed of appropriately, these materials can have negative effects on health and the environment. A 2014 study by the U.S. Environmental Protection Agency (EPA) found pharmaceuticals in every sample taken from wastewater. While the study found low potential risks for both humans and aquatic life, the environmental impact of medications in water systems may warrant further study. Healthcare’s environmental impact is the primary issue behind the Sustainable Pharmacy Project, launched in 2019 at the Virginia Commonwealth University (VCU) School of Pharmacy. Co-founded by student pharmacists Ladan Karim-Nejad and Kayla Panglinan, the project’s mission is “to educate future and current healthcare providers on the environmental impact of pharmaceuticals in order to encourage positive change for climate action and improved patient outcomes.” The Sustainable Pharmacy Project is VCU’s first student-led organization that focuses on the connection between healthcare and the environment. To Karim-Nejad and Panglinan, informing their fellow students seemed like an ideal first step in bringing attention to the issue. “There was kind of this missing piece, like a puzzle piece to the conversation, because pharmacists are medication experts,” Karim-Nejad said. “And so we should know what’s happening in the beginning as well as knowing what happens at the end [of pharmaceutical manufacturing and distribution].”
Raising Awareness During the COVID-19 pandemic, many of the project’s events moved online. Besides sharing information through its Instagram account, the Sustainable Pharmacy Project
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also holds virtual events. This has allowed the project to connect interested students with experts from across the country. Their first event featured William R. Godfrey, president of the Environic Foundation International, an organization focused on sustainability across nations and industries. Another event featured “Dr. Plastic Picker,” a Californiabased pediatrician who developed her social media persona to promote environmental advocacy. Besides informing student pharmacists, another mission of the Sustainable Pharmacy Project is spreading awareness among the general public about healthcare waste and proper medication disposal. Recycling empty medication bottles and disposing of pharmaceuticals properly are two ways that consumers can help reduce healthcare waste. However, not all communities have recycling programs that accept medication containers or have established drug disposal programs. By bringing more attention to the issue, the project’s leaders hope that more U.S. locations will enable medication disposal, container recycling and an overall reduction of healthcare waste. Even where recycling and disposal programs already exist, patients may not be aware of them or how to use them. The project’s leaders note that pharmacists, as publicly visible and respected providers, are uniquely positioned to inform patients and influence the way they think about medication disposal and recycling. “People trust you, and they take that really seriously,” said Kelly Pratt, secretary for the Sustainable Pharmacy Project. “And so [we need to say], ‘This is a medication, this is a big deal, you need to dispose of this properly,’ instead of simply throwing it away without giving a second thought to where it will end up.” Despite the limitations of COVID-19, the Sustainable Pharmacy Project has plenty of work ahead of it. The pharmacy school of University College Cork in Ireland has invited three of the project’s leaders to contribute to its newslet-
campus connection
Sustainable Pharmacy Project participants at a Keep Virginia Cozy trash pickup event in February.
ter. The project leaders have also been nominated to speak on the student panel at CleanMed 2021, a national conference for healthcare and sustainability. Student pharmacists involved with the project are also encouraging community action through a litter pickup event. Participants will be able to collect trash over several days and send in pictures for a chance to win prizes. Involvement in the Sustainable Pharmacy Project has equipped the students with experience they will carry into their careers. The research they have done within the project has helped emphasize the connection between environment and health outcomes, such as the impact of air quality on asthma. Their work may lead to future consulting opportunities, such as helping hospitals implement recycling programs. Perhaps most of all, the experience has also driven home the pharmacy school’s message of treating a patient holistically rather than focusing on the disease. “I think we’re all reinforcing the fact that you need to think about the patient as a whole person living in an ecosystem,” said Karim-Nejad. P
“There was kind of this missing piece, like a puzzle piece to the conversation, because pharmacists are medication experts. And so we should know what’s happening in the beginning as well as knowing what happens at the end [of pharmaceutical manufacturing and distribution].” —Ladan Karim-Nejad
Emily Jacobs is a freelance writer based in Toledo, Ohio.
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Committed to Change
The Equity, Diversity and Inclusion Institute pushed teams to take a hard look at their schools as they strive to make their campuses better for everyone. By Athena Ponushis
History is not history in Mississippi. That’s what Dr. Katie McClendon said as she welcomed nearly 400 attendees to the inaugural Equity, Diversity and Inclusion (EDI) Institute hosted by AACP and the University of Mississippi School of Pharmacy. She told the story of James Meredith, the first Black student to enroll at Ole Miss. Two people died in a riot following his arrival on campus. “He was not made to feel welcome. Unfortunately, he was not the last student to feel that way,” said McClendon, clinical associate professor, assistant dean for student services and director of student affairs at UM’s School of Pharmacy. She believes you must reckon with history while looking forward, which is why Ole Miss wanted to co-host this event: to show the school’s commitment to fundamentally changing its culture to make its campus more diverse and inclusive. Inclusiveness is one of AACP’s core values and starting the institute was another way of following through on its aim to support members and provide insights and resources for institutions at any stage of the EDI process. Some schools in attendance were just getting started, some had policies in place but more work to do, while others had been working within their strategic plans for years. What emerged from the institute was a unified voice, pharmacy as a voice for EDI. “Diversity, equity and inclusion is a collective process. You can’t do it on your own, and that was the beauty of the institute, seeing the different schools and their teams all there collaboratively working toward this cause from the different stages of their efforts,” said Rosie Walker, AACP’s director of recruitment and diversity. The virtual meeting drew 365 registrants, 60 teams from different schools of pharmacy, 250 participants connected at any given time over three days in January. EDI work can feel overwhelming, as it’s an ongoing endeavor, but the institute carved out time for teams to engage in implicit bias awareness, assess culture and climate on campus, and develop and tailor EDI plans to put into practice
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at their institutions. Even greater than the time the institute gave participants to do the work was the appreciation for how meaningful the work can be. “Diversity, equity and inclusion is very personal to me,” Walker said. “As schools move forward with implementing their EDI plans, I want to remind them to be bold in their implementation. I want schools to develop a better understanding of how these issues affect the individuals on their campuses, whether it’s their students, faculty or staff, because sometimes it isn’t an agenda item for these individuals, it’s part of their daily work and personal life. That’s the thing I really want to see. I want diversity and inclusion to become ingrained in every aspect of our policies and all the things we do on our campuses, as opposed to a separate initiative.”
Weaving in Inclusion Carla White, associate dean of organizational diversity and inclusion (ODI) and a clinical assistant professor at the University of North Carolina Eshelman School of Pharmacy, built a comprehensive, organizational EDI strategy to direct and align with the school’s educational mission. A pragmatic disruptor in the EDI space, she spoke at the institute about her passion: strategy development. “Whenever you have a centralized strategy, meaning one office that’s responsible for executing everything in the EDI space, it’s just not sustainable and it’s not productive,” White said. “Cultural transformation cannot take place with one office and a few individuals. The school community needs to be engaged to create the shift needed for change.” White’s office guides the strategy development and shared ownership of inclusive initiatives, while sometimes serving as a catalyst. Everyone within the school can collaborate with ODI but are also encouraged and empowered to lead programmatic efforts in alignment with their roles and interests.
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“I have always been an advocate for an organizational strategy aimed at infrastructure,” she said. For example, division chairs will look at their faculty with an equity lens to ensure diverse and inclusive perspectives are represented; student and curricular affairs will cast a wide net to ensure pharmacy and the pharmaceutical sciences is accessible to everyone; search committee chairs will send job announcements to sources where diverse talent goes to find information. Schools must also ask applicants about their commitment to diversity and evaluate faculty on what they have done to advance equity. “This is what I mean by infrastructure,” White said. “Utilizing key processes within the school becomes a part of our fabric and the way we operate. More importantly, it’s meaningful. People say, ‘Oh, I see why this is important. I see how this connects to the work that I do,’ and that empowers individuals to contribute.”
White’s EDI work at UNC started back in 2007 with a desire to attract more diverse talent to the Pharm.D. program. Strategy was built around program initiatives, programs directed at leadership development, mentoring and how to prepare for the admissions process. White and her colleagues found that these programs, while important, did not address the student experience, or the support for faculty on how to facilitate inclusive classroom practices, or the need for staff to feel valued, so they expanded their approach. In 2018 her office evolved into the office of organizational diversity and inclusion. White knew how multifaceted the work would be. It was essential for people to understand how their work would connect to the greater work, so she built out a strategic plan with the help of a small working group made up of faculty, staff and the dean, who met weekly and worked nimbly. The group wrote several drafts which they then shared with key stakeholders—students, faculty, staff, alumni. After socializing the plan, White and her group identified three priorities: recruit and retain diverse talent; prepare culturally intelligent individuals; and build an inclusive community. “Those are our anchors,” she noted. Under those priorities the school has strategic initiatives and metrics to hold them accountable (accessible at pharmacy.unc.edu) for all the world to see.
“How we spend our money shows our values. Allocate funding to scholarships, or time support for faculty, administrators and staff. Demonstrate your commitment to diversity, equity and inclusion.” —Dr. Katie McClendon
“Whenever you have a centralized strategy, meaning one office that’s responsible for executing everything in the EDI space, it’s just not sustainable and it’s not productive. Cultural transformation cannot take place with one office and a few individuals. The school community needs to be engaged to create the shift needed for change.” —Carla White
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The inaugural Equity, Diversity and Inclusion Institute, held virtually in January, featured speakers, team discussions and time for attendees to explore topics such as implicit bias and reflect on past experiences.
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campus connection
Strategy Above Money No matter where a school may be on its EDI path today, it’s critical to develop a plan. White hopes that’s the greatest takeaway from the institute: Develop your plan, because without one, it will be challenging. Focus is needed. There are so many layers to unpack with this work. The University of Mississippi’s School of Pharmacy is in the process of finalizing its strategic plan in alignment with the diversity and inclusion plan at the university level. McClendon is excited to see how their plan will point them forward. “I’ll be honest, I don’t think we are the best practice for other schools to look toward. There’s so much we need to work on. Our team was at the meeting just like everyone else, furiously writing down notes, jotting down ideas. The one thing we do have, this past year we formed our permanent committee on diversity and inclusion, so that will be part of the structure of our school moving forward,” she said. That kind of self-awareness combined with understanding what your challenges are and what you have the capacity to do at your school may be the first step. Then build strategy around that. “A lot of times, I hear people say, ‘Well, we don’t have the money to start.’ And I ask, ‘What are you going to use the funds for?’ And they say, ‘To hire people.’ When I follow up with, ‘Well, what are they going to do?’ then it’s just silence,” White said. “Funding is needed, but you need a plan. We should also consider that recruiting diverse talent relies on building relationships and education does not always have to be linked to a cost. It’s amazing to me the talent, expertise, experience and resources that are within departments and at the university levels.” McClendon would also challenge deans to align their existing resources with this work. “How we spend our money shows our values,” she pointed out. “Allocate funding to scholarships, or time support for faculty, administrators and staff. Demonstrate your commitment to diversity, equity and inclusion.”
Keep the Patient in Mind Another takeaway from the institute that Walker found to be transformative for some dealt with implicit bias. Participants attended a workshop where they were placed in an uncomfortable situation and had to do some self-reflection. They were able to openly and honestly discuss what they were thinking and feeling with individuals who could lend perspective. “That’s the biggest thing with implicit bias, you don’t know how to deal with those situations if you’ve never been consciously mindful of being in those situations. A lot of times it really just involves slowing down your thinking,” Walker said.
“Looking at the situation you are in and slowing down your thinking, identifying what your initial response would be and then looking at it in different ways.” Surrounding yourself with outstanding leadership as well as individuals that bring a range of perspectives that you can learn from is important. White pointed out that the dean at her school, Dr. Angela Kashuba, added a critical piece to the paradigm shift that needed to take place. “We are still in that shift. We are shifting, with the support of our dean,” White said. “Our dean was very clear that EDI is one of her top priorities. That has positioned us for success.” With its mission to lead and partner with its members to advance pharmacy education and practice, as well as societal health, AACP has joined CEO Action for Diversity & Inclusion, a CEO-driven business commitment to advance diversity and inclusion in the workplace. AACP has also formed an internal Diversity, Equity, Inclusion and Anti-Racism Committee and plans to implement implicit bias training at its leadership forum. As for the future of the EDI Institute, “The intent for this is not to be a one-time meeting, but an annual activity, because this work is not a one-time effort. It’s a continual process of improving how we do things at our institutions,” McClendon said. The inaugural meeting made it clear that schools of pharmacy must proceed with the patient in mind, and if schools want all patients to feel the value of their work, they must approach it with equity. “We are developing a pharmacy workforce. There’s tremendous responsibility in that,” White noted. “We have to build a workforce that is prepared to care for anyone, because society is counting on us to do that.” P Athena Ponushis is a freelance writer based in Ft. Lauderdale, Florida.
Planning Underway for Encore EDI Institute The inaugural Equity, Diversity and Inclusion (EDI) Institute featured keynote presentations, chats with experts and panel talks as well as facilitated time for teams to develop EDI action plans for their institutions. As inclusiveness is a core value of AACP, planning has already begun on the second annual EDI Institute. Look for more details soon about this event, scheduled for early 2022.
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DIVI Into
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ING Digital Health
With digital health tools improving patient outcomes and changing the way pharmacists deliver care, pharmacy schools are starting to integrate digital health education into the curriculum to prepare students for rapid advances in technology. By Jane E. Rooney
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As it did with so many facets of our lives, the pandemic altered routines and changed the way patients received medical care in the past year. Many providers were forced to move appointments online and practice telehealth, which comes with its own skillset. In addition to being able to communicate effectively with patients remotely, healthcare professionals need to be well versed in using platforms such as Zoom or mobile apps. Meanwhile, patients must be able to access the technology on their end. As the digital health landscape expands and telehealth and other virtual platforms become more widely used, what can pharmacy schools do to prepare graduates to enter practice settings that are more reliant than ever on emerging technologies? As pharmacy schools consider how to incorporate digital health education into the curriculum, one immediate hurdle is that there is no universal definition for digital health, nor is there standardized material to be included under that umbrella. The International Pharmaceutical Federation (FIP) published a digital health report earlier this year to investigate the readiness and responsiveness of pharmacy education to train the current and future pharmaceutical workforce. Dr. Timothy Aungst, associate professor of pharmacy practice, Massachusetts College of Pharmacy and Health Sciences (MCPHS) University, was an adjunct committee member and helped FIP with survey construction in addition to authoring several chapters of the report focused on the educational landscape and needs for digital health in medical education. His research revealed that efforts to incorporate digital health education into the curriculum are introductory at best across the Academy. “Some schools are moving toward digital health now but there’s a concentration in telehealth and pharmacy services,” he said. “The biggest discord I see is when schools talk about it, they think it’s informatics 2.0, which it isn’t, or that it means digitalization of services. Digital health in terms of capitalizing on remote patient monitoring, mobile health wearable sensors and digital therapeutics is relatively brand new.” He sees this deficit in digital health knowledge as something that must be addressed now that the pandemic has accelerated the “hospital at home” model with devices coming on the market (and companies such as Amazon getting involved) that allow patients to share data with providers. “There is really no pharmacy school that has made digital health a huge part of their program. Some have done odds and ends or an overview,” he explained. “[The FIP survey] illustrated that a lot of schools thought they were offering
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“I see further pushes toward remote care, teleservices, monitoring remotely and doing treatment. Smart medications are coming to market that track adherence. Even with MTM services, a few companies are trying to use AI to make that go faster. With all of this technology, pharmacy schools need to step back and say, what is changing in healthcare? Where is our best value statement that we can put ourselves out there?” —Dr. Timothy Aungst
digital health but had limited expertise. The survey asked, if we were to engage in it, how would you teach it? What kind of technologies should you look at? Should we teach students how to program or how to do remote patient monitoring? I don’t know what the best answer is. There’s an opportunity for pharmacy schools and organizations to come together and say as stakeholders, what do we want to engage with versus what we don’t need to talk about. There are a lot of technology companies out there that don’t know that pharmacists fit into this so we’re being ignored. If there was more emphasis from the profession as a whole, we could see new jobs and opportunities for our students to leverage.” Some pharmacy schools have made strides integrating digital health into the curriculum and recognize that it needs to be a priority. They discuss what is working, what is still missing and what student pharmacists need going forward to thrive in the digital health world.
Tracking Emerging Tools
so they can better consult with patients. New tools will be developing such as biosensors. We need to improve the usability of those tools and recommend things that are appropriate and personalized for those patients.” She favors a team-based learning approach and said that it lends itself to a hybrid model of teaching, which many schools were forced to use during the pandemic. “The philosophy of it is that some of the basic content is expected to be acquired before class. We have prerecorded videos and when students come to class, they have to demonstrate that they’ve mastered that content by taking a quiz individually,” she explained. “With team-based learning, they benefit by testing themselves in a group and getting interactions with the team and answering the same quiz. All of those conversations that happen in the team enrich the learning experience. They can discuss why they chose one answer over another. As a faculty member you can introduce more advanced experiential education and spend less time on something that students can master on their own.”
Dr. Ana Hincapie, assistant professor, University of Hincapie said pharmacists need to become familiar Cincinnati James L. Winkle College of Pharmacy, with the personalized aspect of digital health, which suggests that schools start by identifying areas where is rapidly expanding. “We need to work on more in digital health can be incorporated into an existing exposing our students to the potential benefits of curriculum. For example, student pharmacists are these tools and also talking about their limitations.” already learning about diabetes in terms of therapeuDigital health applications offer benefits beyond tics, so information can be added to courses to include improved patient outcomes. “It expands pharmacists’ discussions about apps for diabetes care management opportunities in terms of career paths,” she continued. and how to advise patients. “One of the biggest bar“For example, you say to a patient, you have to take riers is that some of these new tools were developed your statin and change your diet. How can a pharmawithout patient input,” she noted. “We need to be teaching our students usability in terms of the devices cist help incorporate using those digital health tools
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with pharmacotherapy? If the patient is already in the pharmacy, he or she doesn’t need to go to a different provider—you might as well do both.”
A New Virtual World
Lipscomb University College of Pharmacy & Health Sciences has several health informatics offerings, which include a strong digital health component. A reAs Aungst sees it, one place to start is by addressing quired health informatics course in the P2 year covers the lack of continuing education for faculty. “We need areas such as electronic health records, data analytto empower faculty to have a better knowledge base ics, blockchain technologies and virtual health. IPPEs about this stuff,” he said. “Some ability to help train pharmacists who are going to teach students is needed. and internships offer additional opportunities to learn about digital health tools. “The leadership for LipSchools could come together and talk about how to scomb really identified informatics as key for pharmaintegrate standards. For the time being it will be every cy right from the beginning,” noted Dr. Kevin Clauson, school for themselves. That’s the most realistic sceassociate professor, Department of Pharmacy Practice. nario right now.” “Informatics was going to be a core component for the entire profession. That enabled us to explore a lot of He added that schools have to consider what patient care is going to look like in the future and acknowledge opportunities for our student pharmacists.” He emphasized that students do hands-on work and recommendthe landscape students will be entering. “I see further ed that colleges of pharmacy look beyond teaching and pushes toward remote care, teleservices, monitoring research and try to partner with companies to engage remotely and doing treatment. Smart medications are in digital health within the broader community. coming to market that track adherence,” he pointed out. “Even with MTM services, a few companies are “We provide virtual reality headsets to all of our stutrying to use AI to make that go faster. With all of dents. With blockchain, they are directly interacting this technology, pharmacy schools need to step back with networks. We try to get introductions to things and say, what is changing in healthcare? Where is our like coding,” he continued. “We’re not trying to teach best value statement that we can put ourselves out them to be programmers, but we want them to be there? The recent empowerment of technicians to do exposed to baseline, fundamental knowledge that they things like administer vaccines…I don’t see that being would be working with out in practice. We’re mindful rolled back. I can see them being empowered to do to say, ok, if you have an interest in digital health and more. What clinical services offer value and what can you’ve explored how to use this technology to improve pharmacists do? The digitalization of healthcare and patient outcomes, what sort of career opportunities integration of digital health tools will change how are there for you? We show them specific resources healthcare is conducted.” and career opportunities and other broader areas they can look to in order to extend the role of the pharmaThe pandemic ushered in changes in healthcare delivcist going forward as well.” ery that had to be implemented quickly, some of which are likely here to stay. “We saw the drastic change with Dr. Beth Breeden, associate professor, Department telehealth in 12 months. The technology was already of Pharmacy Practice, said that Lipscomb student there but we had no incentive to use it. Now the incenpharmacists were prepared to use Zoom and other tive is there,” Aungst said. “With the fee-for-service model, with the volume of patients getting seen in per- platforms for telehealth prior to the pandemic but it prompted faculty to broaden the discussion to optison go way down we saw health providers and health mizing these tools to deliver clinical outcomes. “Virtusystems lose a lot of money. Those that had valueal health was available but not utilized as significantly based models did fine in the pandemic because they due to reimbursement restrictions,” Breeden explained. swapped their models out to focus on keeping mem“Due to COVID-19, those visits are reimbursed just bers healthy. They were using services like telehealth as in-office visits would be. The question is if those and they were still doing fine. This has opened up a reimbursements are going to remain. There’s a lot to conversation about pushing value-based services even consider from a regulatory standpoint, so we introfurther to reach patients in the home. You’re going to duce that to students so they understand the business see more people going toward these business models.” model as well. Organizations had to implement virtual
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“Student pharmacists now recognize the roles for these technologies. Before there were a lot of challenges that might have been tougher for them to see beyond, but now they are all seeing it being incorporated in practice. I try to give more specific real-world examples of how digital health is not just improving outcomes but is also financially sustainable.” —Dr. Kevin Clauson
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FIP Report: Building on Digital Health Education The International Pharmaceutical Federation (FIP) recently published its “Digital Health in Pharmacy Education” report, which provides a global picture of the areas of focus for digital health education and skills development of the pharmaceutical workforce. Findings indicate that there is a deficit in digital health education and training and that more guidance on how to implement digital health tools is needed. In a webinar summarizing the report, FIP Education Chair Dr. Ralph Altiere outlined three fundamental aspects to digital health education: educating every student and practitioner on the use of the various facets in digital health; educating students and practitioners to be the developers of digital health modalities; and blending remote (online) education and the digital tools available to improve education. FIP plans to develop a global framework for digital health in pharmacy education, including baseline information about digital health literacy. The full report can be found at http://bit.ly/FIPDigitalHealthReport (chapter two focuses on digital health and education). You can also view the webinar here: http://bit.ly/FIPDigitalHealthVideo.
FIP digital health in pharmacy education FIP Development Goal
Developing a digitally enabled pharmaceutical workforce
2021
health very rapidly and have seen success with it. A key feature is to ensure that providers as well as patients can use the virtual health platform, so training and education remain important on that front.” Clauson, who is one of the experts tapped by the FDA to advise its new digital health center of excellence, added that the college refined its instructional approach to reflect the changing state of healthcare. “Student pharmacists now recognize the roles for these technologies,” he said. “Before there were a lot of challenges that might have been tougher for them to see beyond, but now they are all seeing it being incorporated in practice. I try to give more specific real-world examples of how digital health is not just improving outcomes but is also financially sustainable.” He said that COVID-19 has changed how we seek access to and deliver healthcare, prompting additional career opportunities for pharmacists. Breeden noted that support from administration and an already well-trained faculty were instrumental in the college’s early success in digital health education. “I had worked in the informatics space for several years as had Dr. Clauson, who came from a background of digital health. We also sought to maximize collaborations with healthcare organizations and that offered great opportunities,” she said. Clauson added that focused, dedicated courses and longitudinal integration are key. “That integration is usually the easier first step for schools that don’t have people with focused expertise, but I think it’s really important to engage with faculty who don’t have this as their primary focus because it’s going to be integrated throughout practice, he said. “As an example, Dr. Jessica Wallace is our expert on asthma, and while she isn’t focused on informatics, she does incorporate digital health technologies for managing asthma and COPD so students are as practice-ready as possible when they graduate.” The University of South Florida Taneja College of Pharmacy has also made informatics and digital health a core component of the curriculum. “Informatics is one of the four pillars that underpin
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our current curriculum,” said Dr. Amy Schwartz, associ- faculty had to be trained quickly to use online platforms. ate dean for academic affairs. “The founding dean felt “We really had to break down the different softwares strongly that incorporating technology in the curriculum was important. We are constantly looking for differ- that were available to them and talk about classroom response—how do you get engaged when you’re no longer ent ways to enhance it in any capacity.” While digital health is an all-encompassing term, faculty try to adjust face to face? We covered things like camera etiquette and microphone etiquette,” said Davina Devries, learnwhat they teach as technologies change, said Dr. Aimon ing and development manager. Ensuring that students Miranda, associate professor, pharmacotherapeutics & are able to troubleshoot a platform also became a clinical research. priority over the past year. “We’re giving the students “We’re talking about mobile health and wearables. Early the ability to develop problem solving for technology in on, a lot of it was focused on the medication use process, the clinical setting and a technical setting. At least then and now it’s shifted more toward an exploratory kind of they have the baseline skills to figure out what they will course,” Miranda explained. “Students are evaluating need in the clinic.” mobile apps and mobile devices, looking at what is on The pandemic required some additional training and the market. We consider if we had to counsel patients finessing to prepare students to function in virtual on wearable devices, which patients would benefit from environments. “I think there is a skillset involved with them? We also look at issues in the healthcare syshow to build patient rapport and we should be planning tem—how could we implement a digital solution? Their to implement that,” Miranda noted. “We have to think midpoint project is exploring emerging technologies about the skillset a student needs to interview a patient. and how those could be implemented in the healthcare field or if it’s been used in another industry, how it could Making sure you turn on your camera, thinking about your background and whether it’s distracting…there be applied to the healthcare field.” are some soft skills there. It’s about e-health literacy Schwartz pointed out that we often assume students are in general. Some of the patients we see in the clinic are tech savvy because they have grown up with technolhigh-risk patients. Are they able to get online? Are they ogy, but that is not always the case. “They come up to able to access a Teams conversation? Can they set up speed pretty quickly but you have to teach them the their appointments?” educational technology first so it does not impede learning,” she noted. “We had to do that with faculty as well.” Schwartz concurred that students need to hone those skills. “They need to be prepared to assess their paWhen the pandemic forced the shift to remote learning,
AACP to Offer Digital Health Institute The inaugural Virtual AACP Digital Health Institute (DHI) will take place this fall. Planning is currently underway with a select expert committee, which will play an integral role in designing the institute and identifying session content, speakers as well as determining active learning/engagement activities for teams. Attendees will hear from leading experts and digital health innovators regarding how the digital era is transforming healthcare, pharmacy and pharmacy education. As digital therapeutics, remote patient monitoring and telehealth are fundamentally transforming how healthcare is delivered and consumed, schools of pharmacy will learn about effective ways to educate student pharmacists on these issues so that they are better prepared for the emerging workforce.
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“Our society used to tell a patient what do to and hoped they would do it. Using technology can help you better assess compliance and hold patients more accountable. You can have those crucial conversations—what do you want to accomplish with your health? What are your goals?” —Dr. Amy Schwartz
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tients. Using listening and nonverbal communication skills to be able to assess patients are going to be very important.” She added that flexibility will be crucial since the platforms being used in various healthcare settings are not standardized. “There’s a level of standardization they need to be exposed to so they can understand how to readily adapt because it’s impossible for us to teach about all available systems.” Miranda said that faculty do address interoperability issues so students understand the challenges associated with digital health, such as ethics, privacy and security issues, and legal and regulatory issues. “We introduce them to some of those concepts so they appreciate the environment they are working in.”
Enhanced Patient Engagement Digital health presents an opportunity for shared decision making and for patients to be more proactive about their care. “If the patient is engaged and involved in their care, their outcomes are better,” Miranda emphasized. “If we start having them use devices or transmit information to us, we can use that in real time. We have healthier patients with digital health if we train the patients right.” Schwartz added, “Our society used to tell a patient what do to and hoped they would do it. Using technology can help you better assess compliance and hold patients more accountable. You can have those crucial conversations—what do you want to accomplish with your health? What are your goals?” She conceded that while digital health affords clinicians better efficacy and efficiency, wearable technologies do pose affordability and privacy concerns. “We’re partnering with preceptors to provide access to our students and making sure they provide instruction on the technology that’s available at those institutions. For students, seeing [these tools] used in practice is probably the most impactful mechanism. Not all of our institutions have access to digital resources, so sometimes practice is ahead of education, sometimes it’s behind.” Lipscomb’s Breeden agreed that outcomes will improve as patients are enabled to take greater control of their care by using digital tools. “It is an exciting time in healthcare as innovation continues to lead the way,” she said. “The ability for a patient to receive care in their home via telehealth and have medica-
tions delivered to their front door via drone is almost a reality. Subsequent monitoring of those patients via wearables rounds out that cycle. It is important to prepare students to be practice ready for this emerging environment.” Clauson pointed out that the FIP report helped raise awareness that digital health education needs to be accelerated. “Digital health and informatics is and should be a priority. How do we communicate the value of it?” He said pharmacists can leverage technology to address medication adherence and start to overhaul the country’s episodic healthcare system. “You may visit a pharmacist, your primary care provider, your dentist… it’s very siloed. What digital health has the potential to let us do is move beyond episodic healthcare into a continuum to be able to interact with patients and provide care when needed. Leveraging that technology to move to a continuum is one of the greatest opportunities that digital health offers and allows pharmacists to expand and improve patient outcomes.” MCPHS University’s Aungst echoed Clauson’s assertion that digital health platforms can improve medication management as well as medication safety. He also believes it offers a means to collect real-world data about the effectiveness of pharmacists’ interventions. “Why can’t the pharmacist monitor therapy when a patient gets discharged from the hospital? These are new possibilities for us, we just have to figure out how we train ourselves to handle it. When this is achieved it offers better incentives for pharmacists to be involved in patient care,” he said. He favors opening the door to conversations with digital health companies about how pharmacists can work with them. “I’d like to see the Academy take a serious shot in terms of determining what is the best way to integrate and position our future graduates as members of a digital health team that can function in a way that increases job opportunities,” he continued. “Digital health increases pharmacists’ abilities to work as subject matter experts at tech companies or serve as digital health coaches for new clinical businesses that we’ve never been tied to in the past.” P Jane E. Rooney is managing editor of Academic Pharmacy Now.
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@AACPharmacy
Join Us for Virtual Pharmacy Education 2021! Mark Your Calendars: #VirtualPharmEd, July 19–22 AACP is excited to deliver another high-impact Annual Meeting, July 19–22, with pharmacy educators and practitioners from around the globe. Get ready to make new connections, hear from top healthcare and education experts, and leave with new ideas and strategies to implement in your work. Nearly all programming at this year’s Annual Meeting will be delivered live! Check out some of the new meeting highlights at Virtual Pharmacy Education 2021:
Opening General Session Combatting Anti-Science Thinking Moderator: Mary Woolley, CEO & President, Research!America Panel: Georges C. Benjamin, M.D., Executive Director, American Public Health Association Bruce Gellen, M.D., M.P.H., President of Global Immunization, Sabin Vaccine Institute
An exclusive screening of the new COVID-19 documentary, Vaccination: From the Misinformation Virus.
Visit www.aacp.org/pharmed2021 and watch your Inbox for more information coming soon. 26
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Closing General Session The How of Happiness: Boosting WellBeing Through Kindness, Gratitude, and Connection Dr. Sonja Lyubomirsky, Ph.D., Distinguished Professor and Vice Chair of Psychology at the University of California, Riverside and author of The How of Happiness and The Myths of Happiness.
More than 120 educational sessions delivered live, addressing critical topics such as adapting experiential activities to virtual settings, promoting well-being and resilience in student pharmacists, and the role of pharmacists in addressing COVID-19 vaccine hesitancy. CE will also be available.
Registration opens in early May.
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Pharmacists Help People Live Healthier, Better Lives.
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Get Involved in AACP: Call for Committee Volunteers Dr. Stuart T. Haines, AACP president-elect, is seeking volunteers to serve on AACP standing, awards selection, and other committees. The deadline to submit your request is Monday, May 3. During his term, Dr. Haines plans to focus on the key themes that have emerged in our new strategic plan: Practice Transformation; Optimizing Pharmacy Education Across the Lifespan; Addressing Diversity, Equity, Inclusion, and Anti-racism; Well-being for All; and the Financial Health of AACP and its Members. Learn more about the committees: http://bit.ly/2021AACPCommittees If you are interested in serving on an AACP Committee during the 2021–2022 academic year, please submit your request via the form by Monday, May 3: http://bit.ly/AACPVolunteerRequest Questions about the selection process or duties of each committee may be directed to Candelaria Moralez, Manager of Governance Groups and Programs: cmoralez@aacp.org
