Medical Information Department Research Articles

Historical Perspective of Technologies Used in Medical Communications, Past, Present, and Future

Medical communication in the pharmaceutical industry has evolved over the past quarter century along with advances in information technology. The medical information function within the pharmaceutical industry became a distinct entity in the early 1980s as the demand for systematic and organized information increased and the complexity of questions required more in-depth responses. Early on, literature searching was a manual process, but microfiche storage and retrieval systems improved capabilities. The use of the computer in the 1990s played a major role in transforming medical information departments, allowing for shared information, documentation, and electronic system development. Traditional paper-based methods of retrieving information from physical libraries has given way to digitized medical information from virtual platforms accessed via the World Wide Web and proprietary web portals. Likewise, communication of information to the end user has been transformed and is much less reliant on traditio...

A Pharmaceutical Alliance in Medical Information: Lessons Learned in the Life Cycle

The medical information department within a pharmaceutical company functions to provide concise, consistent, and appropriate information and customer service to external and internal customers, while maintaining effective and quality-controlled processes. These medical information departmental goals become more challenging when two companies form a partnership, because of the complexity of additional staff members with varying goals and objectives involved in joint venture projects. The objective of this article is to review how two medical information groups function within a pharmaceutical alliance, and examine changes in the partnership that occurred in the different stages of the drug product life cycle. This is the first published article on the late-phase maintenance of a pharmaceutical alliance in medical information.

Metrics Implementation in an Industry-Based Medical Information Department and Comparison to Metrics Tracked within Other Industry-Based Medical Information Departments

There was no formal metrics system in place for the medical information (MI) department at Solvay Pharmaceuticals, Inc. Therefore, the MI department of Solvay sought to develop a formal metrics system for accurately capturing and reporting workload statistics.A preimplementation survey was administered to assess the impression of MI core function workload including medical response letters, medical inquiries, and promotional review. Monthly workload statistics were captured for each MI team member, and averages at 3 and 6 months were compared to preimplementation survey averages. Another survey gathered information regarding workload tracking practices in other industry-based MI departments.The majority (60-65%) of metrics captured were inconsistent with presurvey perceived averages. The formal metrics system implemented at Solvay more accurately depicts workload and the accomplishments of MI employees, enables better prediction of staffing requirements, and is consistent with workload monitoring practice...

Mega Mergers: A Systematic Approach to the Integration of Two Medical Information Departments

As mergers have become common in the pharmaceutical industry in the past 15 years, the need to understand the necessary components of a departmental integration is essential. This article outlines the development and execution of an integration plan that provided a systematic approach to successfully merge two Medical Information departments. Key elements to be discussed include alignment of processes, system training, standard operating procedures, product knowledge training, and data migration/cleanup. Details of the experience of the Medical Information groups from two companies will be described, as well as the objectives that were accomplished to function as one single department, in one physical location, within a three-month period. Following a systematic approach, it is possible to successfully merge two Medical Information departments into a high-performing, integrated unit while maintaining quality customer service. This article will serve as a helpful guide and resource of information for industry-based Medical Information departments before an integration.

Infections nosocomiales en maternité au centre hospitalier universitaire de Brest du 01/01/2000 au 31/12/2005

Hospital infections are at stake in terms of public health. They are responsible for increase in morbidity and involve the community in high costs. Epidemiologic surveillance has been initiated in the departments of gynecology, obstetrics and maternity with a view to making out the rate of hospital-acquired infections and the risk factors associated to them. It is an incidence survey over a period from 2000 to 2005. Surveillance slips are filled in for every childbirth. All suspicions of hospital infections are analysed in morbidity reviews every trimester. A request to the Medical Information Department of the hospital has allowed to look for variables which were not mentioned on the initial questionnaire and so carry out a more complete analysis. The number of hospital infections amounts to 118 over 9526 childbirths, corresponding to an incidence rate of 1.24%. After vaginal delivery the encountered risk factors are: episiotomy or perineal trauma, epidural anesthesia, urinary infection and the use of tools. After a caesarean section the risk factors are: general anesthesia and lack of antibioprophylaxy. The rate of hospital infections in the maternity department at Brest's centre hospitalier universitaire (CHU) during the considered period and the observed tendency to a decreasing of hospital infections over the same period apparently denotes the interest of surveillance in matter of hospital infections in maternity.

An Assessment of Preparation Methods and Personnel Requirements in a Medical Information Department during Product Launch

A survey of medical information (MI) departments was conducted to gain an industrywide perspective of the launch process. In addition, a second survey was conducted that quantified activities during product launches at Solvay Pharmaceuticals, Inc. (Marietta, GA). Of the 52 initial companies invited to participate in the study, 26% (N = 14) provided responses. The majority of the surveyed teams consisted of two to three personnel from the MI department, and preparation activities began less than 3 months prior to launch. Overall, product launches at Solvay Pharmaceuticals required an average of 1.62 MI personnel and 52.6 hours of self-training. Activities began an average of 6 months prior to the expected launch date. While working on the launch team, MI personnel were responsible for an average of 2.25 additional products. Based on product launch experience at Solvay Pharmaceuticals, a formula was developed to estimate workload during future product launches at Solvay Pharmaceuticals.

電子カルテシステム利用に向けた看護学臨地実習前の準備教育の実際

Preparatory education has been provided for both nursing students and teachers to understand the electronic patient record (EPR) since 2004 when EPR was introduced to the hospitals where students are allocated to undertake their work experience. First, the training and management board contacted our medical information department for an appointment and sent us a working group. They taught the nursing training staff how to use EPR and how to assign students to the proper patient record in the EPR system. Second, as preparatory education for the students, they explained the procedure for the use of EPR and the protection of personal information. Students practiced with training in the EPR system, focusing on the functions which are used frequently in practical tasks. As a result of this preparatory education, students understood the protection of personal information very well, although their understanding of the operation and management of the equipment was relatively poor and adversely affected their practice. We need to review our education contents more often. We also need to examine the present state of understanding of EPR and the problems of teaching in practical nursing training.

Intérêts et limites de la surveillance des infections nosocomiales à partir du laboratoire de microbiologie : expérience du CHG de Meaux

To estimate the incidence of nosocomial infections (NI) in our hospital and to increase healthcare professionals’ awareness of hygiene, a prospective study was performed between January and December 2002 from the microbiology laboratory data. On 1334 suspicions of NI, corresponding to 1062 patients, sent to the hygiene correspondents in each medical care unit, the infection control team received 853 answers (64% of sendings) with 430 NI validated. The incidence rate of NI validated was 1.7 NI/1000 days of hospitalisation and 1.6 NI/100 inpatients. The NI were predominantly related to urinary tract (47%), bloodstream (14%), and lower respiratory tract (12%). Transmission of these informations to medical information department permitted a valorisation of additional 16,000 ISA points. This prospective study permitted to develop a network of hygiene correspondents in every medical care units. None of the medical care units was unharmed by NI but the exhaustive declaration of NI seems difficult to realise. This study permitted to point out some dysfunctionments in the management of invasive procedures and to improve these practices.

Assessment of the Value of Doctor of Pharmacy Clerkship Rotations to Global Medical Information at Eli Lilly and Company

Sponsoring a student program for Doctor of Pharmacy candidates is hypothetically mutually beneficial for the student and the organization. However, without concrete evidence, justifying the continuation of such programs may be difficult. The Global Medical Information Department at Eli Lilly and Company investigated the influence of the student program on future recruitment of employees, effects on preceptor and overall employee satisfaction, and the overall expense to the department. We found that 93% of current Lilly employees who completed a pharmacy student rotation at Lilly believe their experience positively influenced their career decision. Fifty-four percent of employees in Global Medical Information and 88% of those serving as preceptors reported an increased overall personal satisfaction in their job as a result of the student program. Although the cost estimation we conducted was very simplistic, we found a positive cost-benefit to the department based on the student program.

Completeness of ICU activity reports sent to French healthcare authorities

Hospital units report on their inpatient care activity by writing yearly activity reports, which are used by their Medical Information Department (MID) to develop standardized summaries for communication to healthcare authorities. The data are categorized by uniform patient groups and used to describe inpatient care activity and to guide resource allocation. The objective of this study was to evaluate the completeness of activity reports from intensive care units (ICUs) in France. Activity reports sent in 1998 and 1999 by French ICUs participating in the study were collected using dedicated abstracting software supplied to the relevant MIDs. Completeness of data in the activity reports was evaluated, with special attention to the SAPSII score, Omega rating of ICU procedures according to the Classification of Medical Procedures, and primary and secondary diagnoses. The 106 ICUs that volunteered for the study reported data on 107,652-hospital stays. Mean age and SAPSII were 55 +/- 21 years and 35 +/- 21 years, respectively. Mean ICU and hospital lengths of stay were 6.2 +/- 12.4 and 16.1 +/- 21.6 days, respectively. Mean ICU and hospital mortality rates were 15% and 19%. The SAPSII and Omega procedures were reported for 81% and 80% of stays, respectively. The SAPSII and Omega procedures were calculated or coded in 94% (100/106) and 96% (102/106) of ICUs, respectively. Mean number of Omega procedures was 4.3+/-3.9. However, only 5% (5/106) of ICUs entered the SAPSII for every stay, and 21% (22/106) of ICUs failed to enter the SAPSII for over 20% of stays. Similarly, 53% (56/106) of ICUs rated no more than five Omega procedures on average per stay. The primary diagnosis was reported for all stays, and the mean number of secondary diagnoses was 3.5 +/- 3.8. In 80% (86/106) of ICUs, no more than five secondary diagnoses were coded on average per stay. The analysis of this national database shows that data communicated to the MIDs and therefore to the healthcare authorities, are incomplete regarding SAPSII, ICU procedures, treatment intensity, and diagnoses. This may lead to the underestimation of ICU activity and resource needs, particularly if the SAPSII and selected procedures identified as markers for high-intensity critical care are used in the future.

Antidepressants for treating depression in dementia.

The use of antidepressants for patients with dementia accompanied by depressive symptoms is widespread, but their clinical efficacy is uncertain. Many of the individual trials of antidepressants have been too small to provide precise estimates of the moderate benefits that might realistically be expected. Combining the information from all appropriate trials may provide a better estimate of the likely effects of treatment.Objectives To determine whether antidepressants are clinically effective and acceptable for the treatment of patients with depression and also dementia.Search methods The CDCIG Specialized Register was last searched on 27 April 2005. This register contains records from major health care databases and many ongoing trials databases and is updated regularly.Medical information departments of pharmaceutical companies were asked to search their databases for any relevant clinical trials. Where necessary authors of trials were approached with requests for additional information.Selection criteria All relevant unconfounded, double-blind, randomized trials comparing any antidepressant drug with placebo, for patients diagnosed as having dementia and depression, according to established criteria.Data collection and analysis Two reviewers extracted data independently and settled any differences by agreement.Main results There were seven included studies with a total of 1140 subjects of which 769 met inclusion criteria. Four included studies reported sufficiently detailed results to enter into meta-analyses, with a total of 137 subjects. Two of these studies investigated the properties of drugs not commonly used in this population with only two studies (Petracca 2001 and Lyketsos 2003) using the more common selective serotonin reuptake inhibitors (SSRIs). Lyketsos 2003 produced two significant differences in favour of treatment in the Cornell Scale for Depression in Dementia (CSDD) at 12 weeks and in the psychiatrists' global rating. However, the CSDD was not used in any of the other studies and no statistical differences were found with the other measures used in the meta-analysis. The meta-analysis of the number of patients suffering at least one adverse event, one event of the nervous system, one event of the gastrointestinal system and one event of dry mouth at 6 to 12 weeks showed a significant difference in favour of placebo. There were no other significant results.Authors' conclusions Available evidence offers weak support to the contention that antidepressants are effective for patients with depression and dementia.However, only four studies are included in the meta-analysis relating to efficacy, and sample sizes are small.Moreover, only two included studies investigated the properties of the more commonly used SSRIs and no studies investigated the properties of newer classes of antidepressants (e.g. selective noradrenergic reuptake inhibitors). This review draws attention to the paucity of research and evidence in this area.

Zuclopenthixol acetate in the treatment of acute schizophrenia and similar serious mental illnesses.

People with schizophrenia or other psychotic illnesses may have delusions or hallucinations that may lead them to be aggressive or violent to themselves or others. Medication that is used in this context requires the properties of rapid onset of effect (tranquillisation or at least initial sedation in order to quell aggressive or disorganised behaviour, but also antipsychotic effect), low frequency of administration and low levels of side effects, such as cardiological or neurological side effects, or pain at the injection site. Zuclopenthixol is the cis(Z)-isomer of clopenthixol, a neuroleptic of the thioxanthene group, used for treating people with psychotic symptoms. There is one oral preparation and two depot forms: zuclopenthixol acetate and zuclopenthixol decanoate. The acetate version does not stay in the body for very long (a single dose persists for only 72 hours) and is said to have these properties. To estimate the effectiveness of zuclopenthixol acetate for the acute treatment of serious mental illnesses in comparison to other neuroleptic drugs. Searches of Current Controlled Trials (http://www.controlled-trials.com - accessed 5.10.2000), Cochrane Schizophrenia Group's Register of Trials (January 2001), the Cochrane Library (1997, CD-ROM, issue 2), MEDLINE (1966-1997) were supplemented by appeals for unpublished data to the research community and to the Medical Information Department of Lundbeck Limited. Attempts were made to contact relevant authors. Two reviewers independently assessed citations or papers and selected all randomised trials that included people with serious mental illnesses and compared zuclopenthixol acetate with other drug regimes. Two reviewers extracted data independently. Attempts were made to contact authors for additional or missing information. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for binary data. Where possible, OR were pooled using Peto method and intention-to-treat analysis undertaken. Mean differences were used for continuous variables. Pooled data show no difference for the outcome 'no important improvement' in psychotic symptoms at the end of the follow-up period (OR 0.84 CI 0.34-2.05). Sedation was evaluated using different instruments. Only one study presented data which suggested an earlier and more intense sedation in zuclopenthixol acetate users at four hours (OR 0.18 CI 0.04-0.93). Use of additional antipsychotic medication was not avoided in the zuclopenthixol acetate group (OR 2.18, CI 0.64-7.42) and data on total number of administrations were not obtainable. Side effect data were poorly reported but there is no evidence of a consistent difference between zuclopenthixol acetate and other 'standard drugs' for either the pattern of side effects or the wish to leave the study early. Hospital and service outcomes, number of aggressive incidents, satisfaction with care and economic outcomes were not addressed by any study. Recommendations on the use of zuclopenthixol acetate for the management of psychiatric emergencies in preference to 'standard' treatment have to be viewed with caution. Most trials present important methodological flaws and findings are poorly reported. This review did not find any suggestion that zuclopenthixol acetate is more effective in controlling aggressive/disorganised behaviour, acute psychotic symptoms, or preventing side effects. There were no data directly related to tranquillisation, but it may produce more earlier and intense sedation than oral haloperidol. Well-conducted randomised controlled trials are needed to confirm claims related to the use of zuclopenthixol acetate in emergency psychiatry.

Distribution of Off-Label Information By Pharmaceutical Manufacturers?

The 1999 Washington Legal Foundation (WLF) decision stated that the Food and Drug Administration (FDA) was in violation of the pharmaceutical/ biotechnology industry's right to commercial free speech by unduly limiting its ability to distribute truthful, nonmisleading information about off-label uses of its products. The objective of this survey was to assess pharmaceutical companies' current practices for distributing peer-reviewed journal article reprints relating to off-label uses for their medications in response to the 1999 district court's judgment in favor of the WLF. Respondents were employees in the medical information departments of 27 pharmaceutical/ biotechnology companies, 5 of which were unable to provide information. Seventy-three percent (16/22) of the companies that participated in the survey were either distributing articles at the time of the survey or were planning to distribute articles under the WLF ruling. The sales force carried the responsibility for distribution at 94% (15/16) of the companies surveyed. Seventy-five percent (12/16) of the companies surveyed affixed disclaimers to the articles that highlight the off-label nature of the described disorder and/or disclose the company's interest in the product.

Hosting an Open House for a Medical Information Department: An Effective Educational Method

An open house was held over three days to raise awareness about the expanding functions and value of the Glaxo Wellcome Medical Information Department to internal customers. The objective of the open house was to increase the visibility of the Medical Information Department internally by emphasizing its services.

Merger Mania: Impact on the Medical Information Department

The purpose of this project was to create an efficient, stepwise approach to integrating two medical information departments of merging pharmaceutical companies. This project may serve as a templat...

An Interdepartmental Survey of Medical Information Services: Evaluating the Impact of an Open House

A survey was developed to evaluate how internal stakeholders at Glaxo Wellcome perceived the Medical Information Department before the department hosted an open house. The objective of the open house was to increase the visibility of the Medical Information Department by emphasizing its services. A postopen house survey was conducted to measure the impact of the open house by reassessing those perceptions. Approximately 1300 internal stakeholders were electronically mailed a survey prior to and again after the open house. The survey included a demographics section and questions regarding the services of medical information. A medical information open house was held at three different sites within the Research Triangle Park campus. Overall, the preopen house survey return rate was almost 20% (257) with a postopen house return rate of about 10% (125). Analysis of the surveys suggests that hosting an open house can raise awareness and change perceptions.

Pharmaceutical Industry-Based Medical Information in Canada

The medical information departments within the Canadian pharmaceutical industry have experienced a steady increase in demand over the past five years. Consumers are becoming more sophisticated, resourceful, and demanding of information regarding their health conditions and treatment options. Consumers are being bombarded with information on a variety of conditions and treatments with herbal, over-the-counter, or prescription products. This information is partially driven by the industry and the media. The result is at times confused consumers, but always consumers who demand more information. This creates a ripple effect within the health care continuum, which results in an increase in information requests from physicians, pharmacists, and consumers. Canadian pharmaceutical medical information departments have changed and are continuing to evolve in response to the increasing level of demand for information. Ten years ago, information requests that came in from health care professionals may have been handled by a medical information specialist, a medical director, or a product manager on an ad-hoc basis. Many companies would refuse to respond to consumer inquiries at all. Currently, most pharmaceutical companies have a designated medical information specialist/associate or department to deal with inquiries. In recognizing that the push for information is being driven by consumers, many companies are now responding to consumer inquiries with a basic level of information, but still referring them back to their health care professional to get thorough, unbiased, knowledgeable advice regarding their condition and the appropriateness of the various therapies available.

Drug Information in Industry Versus Academia: A Pharmacy Resident’s Perspective of a Sample Case

The pharmaceutical industry and academia both offer career paths for pharmacists specializing in drug information. Each setting presents its own distinct opportunities and challenges. A recent shortage of a thrombolytic agent serves as a sample case because of its impact on the Drug Information Analysis Service at the University of California, San Francisco, and the Medical Information Department at Genentech, Inc. The practice differences between these two settings are highlighted as they relate to the shortage, and the effects on each institution are described. The relationship between the work generated by the shortage and its utility as a teaching case during a drug information residency is explored.

Establishing a Medical Knowledge Extranet to Enhance Medical Communications

The exchange of knowledge within an organization is critical in order for the organization to operate efficiently and effectively. However, establishing a knowledge management program can be difficult because of the magnitude of the project, the complexity of the organization, and information hoarding. This article describes a knowledge management effort using a Web-based, extranet site to facilitate information sharing between a medical information department and a regionally-based clinical liaison group. The site contains a wide variety of information including medical information summaries, medical presentations, publication plans, medical meeting calendars, and other administrative tools. The article reviews the rationale for pursuing the project, assessment of the need, content considerations, implementation tips, the need for site maintenance, and monitoring site usage.

A Combined Industry and Academia Residency Program

The Drug Information Analysis Service of the Department of Clinical Pharmacy at the University of California School of Pharmacy and the Medical Information Department of Genentech, Inc. developed a combined drug information residency. The Drug Information Analysis Service is an academic drug information service that educates and trains pharmacy students and residents and supports a medical center campus. The Medical Information Department of Genentech is a rapidly expanding department that supports health care professionals and consumers using Genentech products. The second year of the combined residency has been completed and three residents have graduated. While the environments and daily operations are different for each site, the goals and objectives of the combined residency program are the same. The relationship established between the two organizations has proven beneficial in numerous direct and indirect ways.