Mignon Adams
Philadelphia College of Pharmacy and Science
The Electronic Pharmacy Library
ABSTRACT
As community based health care professionals, pharmacists have a unique opportunity and the professional responsibility to deliver important information to patients about the proper use of medications and their effects.
The Electronic Pharmacy Library, an NLM funded project, provides to pharmacists access to essential databases, full text, and Internet resources so that they have the information they need to carry out this responsibility.
PAPER
Introduction
Your local pharmacist is no longer only a dispenser of information, but is expected to be an active member of the health care team. Pharmacists are the most able to advise cost-effective drug therapy as well as being the health care professional in the best position to alert patients and physicians to possible adverse drug reactions and interactions. In order to fulfill this important role, pharmacists must be able to access up-to-date clinical information, even though they may be far from any library.
The Philadelphia College of Pharmacy and Science is developing an Electronic Pharmacy Library to meet the changing needs of pharmacists. Funded under a two-year grant from the National Library of Medicine, the project aims to:
Develop on one menu access to MEDLINE, International Pharmaceutical Abstracts, basic medical texts, and Internet resources critical for pharmacists.
Train pharmacists in the use of electronic resources, including databases and networking systems.
Keep pharmacists at the cutting edge of information by providing cost-effective electronic access to major medical information sources, and telefacsimile copies of pertinent medical literature.
Allow pharmacists to network with other pharmacists by developing an electronic bulletin board and by providing access to the Internet.
BACKGROUND
The Philadelphia College of Pharmacy and Science was founded in 1821 by a group of Philadelphia apothecaries who met in Carpenters' Hall to determine how best to improve and elevate the practice of pharmacy in the interest of public health. It is the oldest college of pharmacy in the western hemisphere and one of only three private, independent colleges of pharmacy in the United States.
Counted among PCPS alumni and former staff are some of the most distinguished persons in the history of the pharmaceutical industry--Silas M. Burroughs and Henry S. Wellcome (Burroughs Wellcome Company), C. Mahlon Kline (SmithKline Beckman), Eli Lilly (Eli Lilly and Company), John Wyeth (Wyeth Laboratories), Robert L McNeil, Jr. (McNeil Pharmaceuticals), Gerald F. Rorer (Rhone-Poulenc Rorer), and William Warner (Warner-Lambert).
Later additions to the curriculum reflect the College's commitment to the health and life sciences. Today, in addition to pharmacy, the College offers undergraduate majors in biochemistry, biology, chemistry, medical technology, microbiology, pharmacology/toxicology, and physical therapy. Graduate programs leading to master of science and doctor of philosophy degrees are offered in pharmaceutics, medicinal chemistry/pharmacognosy, and pharmacology/toxicology. In order to meet the demand for clinically-trained pharmacists, the College began an entry-level PharmD program in the fall of 1994.
Since the inception of the school, the J.W. England Library has been viewed as one of the finest pharmaceutical libraries in the country. Many historical pharmacy sources are held only by PCPS and the National Library of Medicine. The library fills interlibrary loan requests both nationally and internationally, lending twice as many items as it borrows. Reference questions, are also received from across the country. While small, the collection is a focused and specialized one, concentrating on drug therapy, pharmacy administration, and pharmaceutical manufacturing.
The Library is a founding member of the Health Sciences Libraries Consortium (HSLC), a Consortium funded by Pew Memorial Trusts to improve health care while containing costs by strengthening cooperation and resource sharing among Pennsylvania health sciences libraries.
Through HSLC the Library is fully automated, sharing a system (DRA) with four other Pennsylvania health science libraries. The system is mounted on HSLC's computers, and available on the menus are MEDLINE (CD-Plus), HEALTH (CD-Plus), and CINAHL (CD-Plus). Through Internet connections, 50 other health science library online catalogs are also available, as well as the FDA clinical alerts and bulletin board, and other relevant Internet resources. PCPS users have full access to the library's system from home or office through a computer and modem.
The Health Sciences Libraries Consortium was incorporated as a 501(C)(3) not-for-profit organization in 1988. Founded by every medical school in the Commonwealth of Pennsylvania, as well as several other major health sciences institutions, the HSLC received major developmental funding from The Pew Charitable Trusts ($9.7 million during the period 1987-1992). Capitalizing on the cooperative agreements which preceded formal organization, and from its inception as a grant funded organization, the Consortium partners have contributed substantial capital and staff resources in order to implement a shared vision of cooperative health sciences information services within the region. From its ten-member beginning, the HSLC has grown to over 450 members, including libraries of all types, while retaining its primary focus in the health sciences areas. Among the accomplishments to date are the installation of a DRA automated library system, a wide area communications network, and a database system providing access to the Medline database and other files of interest to the membership. With the installation of an Internet connection in 1992, the HSLC has become a provider of inexpensive Internet services for its members.
Signifigance
The role of the pharmacist is rapidly changing from one of solely dispensing drugs to one of being an active member of the health care team by counseling patients on medication use and recommending to and advising physicians on drug therapy. Pharmacists in large teaching hospitals, who commonly have MEDLINE access in their pharmacies and the support of a medical library, are already demonstrating that pharmacists do fulfill an important role in preventing adverse drug reactions and improving patient drug compliance.
However, community and consulting pharmacists, or those in small hospitals and managed-care facilities, have little or no access to medical information services. They stay up-to-date through continuing education, but continuing education next week cannot provide an answer for the questions today from physician or patient.
Community pharmacists in many instances constitute a primary contact for patients, and have consistently been rated "number one" in public trust over other professionals. For poor or indigent patients, the pharmacists may be the only health care professional who knows their names and their histories. Outside of an emergency room, the community pharmacist is often the only accessible source for those uncovered by medical insurance. The pharmacist is thus in a unique position to advise the most cost-effective drug choice, to monitor possible drug interactions, and to increase patient compliance in taking medication as directed.
Pharmacy schools are reflecting the change in the pharmacy profession by creating entry-level programs which will culminate in the Pharm.D. degree and which emphasize clinical skills, communication skills, critical thinking and problem solving, and the use and evaluation of information for lifetime learning. PCPS's new entry-level PharmD program is planned to incorporate these skills in its curriculum.
The Electronic Pharmacy Library will provide to pharmacists what they need in order to give quality patient counseling by staying up-to-date with therapeutic advances. By doing their own MEDLINE searching, by having the collection of the PCPS library available to them, and by being able to network with colleagues, pharmacists and their patients can be assured that they have accurate and timely information and the documentation that they need.
Implementation
The granting period will begin on March 1, 1995. At that time, the necessary additional equipment and software will be added to the HSLC system. Additions will include:
International Pharmaceutical Abstracts
Full-text medical texts
Full-text versions of selected medical journals
links to all known Internet resources of interest to pharmacists
a bulletin board, running on a listserver
A librarian will be hired to market the service, first to PCPS alumni and then to other pharmacists. It is hoped that the service will be self-supporting at the end of two years.
For further information on the project, please contact:
