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SHARE with Rowan Sarty · Pods + PANS

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Welcome to Pods and Pans, a podcast brought to you by the Pharmacy Association of Nova
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Scotia.
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This podcast and content contained therein, including text, images, audio, or other formats,
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were created for general education and informational purposes only.
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The content is not intended to be a substitute for professional medical advice, clinical
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diagnosis, or treatment.
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Reliance on any information provided is solely at your own risk.
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Hi, welcome to Pods and Pans.
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My name is Glenn Rodriguez and I'm the Pharmacy Practice Facilitator at the Pharmacy Association
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of Nova Scotia.
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Today, I'm really excited to have Rowan Sardy here.
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Rowan's the Program Manager from the Drug Information System and Share.
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Welcome Rowan.
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Thanks Glenn.
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It's great to be here with you today.
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So Rowan, before I begin, again, when people think about being a pharmacist, you know,
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your title and your position doesn't often come to mind, how would you describe your
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role and what was your journey to get there?
1:14
Great question.
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I started in my pharmacy career as a community pharmacist for about seven years and then
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the pandemic hit and I had a young child and I was trying to look at different job opportunities
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that might offer a little bit more flexibility with the shift at work being a little difficult.
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So I had applied for this position at the Department of Health and Wellness because
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I had a keen interest in technology also and thought it would be really neat growth and
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learning opportunity and also because I, you know, as a user of the Drug Information System
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and Share, I often came across frustrations and thought maybe this was an opportunity
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that I can help to influence some of those things and hopefully make things better for
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folks.
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So my role at the Department is very interesting.
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I struggle often to really describe my role and what I do, but essentially I work under
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a broader digital health team and that team kind of oversees the business side more so
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of our provincial clinical health information systems and applications.
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So specifically the Drug Information System, Share, there's another team that's tasked
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with the Public Health Information System and it's associated applications like Cannamine
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with, for example, and then there's also another team that's tasked with more of the electronic
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medical records EMR space.
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We work really closely.
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Oh, sorry, go ahead.
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No, that sounds like one of the more robust, biggest and probably complicated with all
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the different systems trying to navigate and do that.
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But you know, as we can see with the Drug Information System and Share, it's nice when
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things start slowly becoming centralized.
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Definitely, and there's a lot of work that happens on the Nova Scotia Health Authority
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side as well.
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So our teams work really closely with them as they tend to do more of the actual IT support.
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So our teams are more so looking at kind of the long-term vision and roadmap and making
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enhancements and changes and integrating different systems together and kind of the more big
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picture view, though we do get a bit involved in the IT support aspects as well.
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But yeah, it's a really interesting place to work for sure.
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And I've been learning a lot over the last few years and I continue to learn new things
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every day about these systems.
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So it's really an interesting place to work in a neat way to apply my pharmacy background.
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Well, we're really happy to have you there.
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And again, it's one of these things that it's funny talking to pharmacists and this the
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difference when they suddenly get access to the labs.
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They can't imagine ever going back.
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So really happy for all the work that you're doing.
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So I'm going to start first with we still have some sites in Nova Scotia that aren't
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on share and it is a bit of a multi-step process.
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And we want to try to provide support and guidance to those teams.
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I know over the years I've helped a lot of sites get on board.
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How would you describe this overall process and are there any tips available or navigational
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supports that we could give to our listeners?
4:30
Great question.
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So yes, as you described, the step is it is a multi-step process.
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It's not as streamlined and straightforward as we would like it to be, but there's some
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reasons for that.
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But anyway, we do try to offer as much support as we can for folks working through the process.
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As a starting point, if you're ever kind of unsure, you can always reach out to our teams
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email address, which is simply share at novaskosia.ca.
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And on our website, we have some documents that we hope will help folks navigate through
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the process.
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Essentially, there's two main parts to it.
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The first is whatever pharmacy you're working at needs to have a legal share access agreement
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put in place with the Department of Health.
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And that agreement lays out responsibilities with respect to accessing the personal health
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information that's contained within our systems.
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So for stores that are under a corporate chain, for example, like Thought & Sense or SOBies,
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that kind of thing, they tend to all be covered under one overarching agreement.
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So in that case, usually straightforward, they already have an agreement in place, and
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it's just a matter of the individual pharmacist sending in their individual user request form.
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For some of the independent pharmacies, for example, they'll usually need to have an agreement
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with the store owner and Department of Health.
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So there's a corporate pharmacy request form for setting up that initial kind of site level
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agreement.
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And then once that's in place, the individual pharmacist can submit a community pharmacist
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request form for their own access.
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And that needs to be signed by whoever is designated as kind of the signatory from that site.
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So it's typically the pharmacy manager, but there is some variations.
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So if you're ever, you know, not quite sure who needs to sign them, as I mentioned, you
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can reach out to our email and we can help you with that.
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No, just for everyone.
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Share at novaskosha.ca has saved me a number of times.
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Yes.
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Yes.
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So once that request form with your details is submitted, then our team has a process
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for submitting that to a user access team.
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And they're the ones who kind of set up the accounts.
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And that can take, depending on how busy they are at the time, it can take typically between
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one to two weeks.
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So just good to know that it's not an immediate process.
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Then once that's set up, you should receive an email from us with your login information.
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And you might often see the term credentials used, which I know a lot of pharmacists might
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not be familiar with, but essentially that just means your username and password.
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Because we're giving access to a system that has personal health information, we can't just
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send that over regular email.
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So we use a secure email platform called Move It, and you'll receive the email through
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that.
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And I know some folks sometimes struggle to be able to open that email.
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So we also have a bit of a guide with some screenshots on our website to walk you through
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that if you need assistance.
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Or as always, you can reach out to our email as well if you need some support with that
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part of it.
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It's funny because sometimes when we're trying to figure out, okay, where are we in the process?
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It turns out some of the pharmacy managers may have an email in their inbox that they
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need to open.
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And it's very much like Mission Impossible.
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After so many days, the message will self-destruct for security reasons, right?
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And just trying to make sure that the people that are authorized to access that know to
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make sure they open up that email as soon as they get it.
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Yeah, exactly.
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It's automatically set to expire and be not viewable after 30 days, as you mentioned,
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for security reasons, so important to kind of access that and share it with whoever needs
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to be shared with right away.
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If the form is filled out clearly, so for example, if you fill it out electronically,
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so it's typed and very clear to us what the user's email is, we will try to send it to
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the user themselves.
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But sometimes when the written form is, it might not be quite legible.
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So we send it to the person's manager.
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Okay.
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Now, one last question in terms of getting onto it, and then we'll get more into the
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details or share.
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So some people will find that their passwords expire or they may forget their passwords,
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but advice would you have for them?
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Great question.
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That is something we run into frequently.
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So my biggest piece of advice for that is the importance of setting up what we call
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challenge and response questions.
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So when you're originally setting up your account, there is a form on our website that
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you can fax into a different number than your request form called the challenge and response
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form.
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So you can send those to the Nova Scotia Health Service Desk team so that if you're
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calling them because you can't remember your password or you're having trouble getting
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logged in, they can confirm that you are who you say you are so that they can either do
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a password reset for you or support you in getting your access fixed.
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You can either submit that form kind of when you're first setting things up.
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And if you're ever unsure, if you signed up for share years ago and you can't remember
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if you ever sent that in or not, when you are logged in through the remote desktop using
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share, there is, you know, on the desktop, you'll see there's that link to get into the
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share portal, but then there's also kind of other links as well.
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And you can go through, there's a assist reset application you can kind of use to electronically
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set your challenge and response questions or update them if you need to.
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So it's a good idea every now and then just to go check, make sure you actually know what
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your questions are and what the answers are so that when you do need help with a password
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reset, you can reach out to the service desk and get the help that you need.
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And again, if you need any help with figuring out, you know, how to do that, reach out to
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our email, we're happy to send links for that.
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And the other piece is that passwords, even if you're logging in regularly, which we also
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recommend because people run into issues if they haven't used it in several months, then
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we actually have to get their account fully reactivated.
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So which can take a bit of time.
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So if you log in regularly, that helps to reduce the chance of that happening.
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However, after three months, even if you're using it regularly, your password will expire
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and you'll have to set a new password.
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If you're logging in frequently enough, usually at around the two weeks before that happens,
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you'll get notifications that your password is going to expire.
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And in that quick reference guide that we have, there is a link to where you can go
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to reset that yourself.
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You don't need to call the help desk to update your password if it's expired.
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It's just if you've forgotten your password that you would need to call help desk for
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that password reset.
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But if it's just a matter of it's been the three months and you need to set a new password,
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you should be able to do that yourself.
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Okay, that's great.
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And actually just a reminder to our listeners that on the PAN's member lounge, we have a
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pharmacy practice support link on the left hand side.
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And it's really for frequently asked questions and we do have a link for share.
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So now let's actually jump into share.
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I want to talk about what's on share and what may not be on share so that people will know
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what's the information that's provided and any potential limitations.
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Sure.
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So within share, it does contain a fair bit of data from different health systems across
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our province.
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But it's definitely not entirely comprehensive and that's important to understand because
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you don't want to waste time looking for a result that's not going to be there anyway.
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So one of the main things people tend to use share for in community pharmacy is for the
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lab results.
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Lab results from across the province are generally available within share.
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However, there are a couple of exceptions to that.
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And so one of the important ones to be aware of is when it comes to what we called kind
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of referred or dropped off lab results.
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So that's typically when a result is collected at a certain site, but then it has to be sent
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to a different site for processing.
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Sometimes because those are registered in a different way in the system, they don't always
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actually feed into share.
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So particularly it tends to be if the specimen is collected outside of central zone typically.
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So in eastern zone or northern zone or western zone.
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And if it has to be sent into central zone for processing, in many cases those don't
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tend to be available within share.
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However, if it's going to the out of UK within central zone, so pediatric specific, those
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do tend to be available in share.
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But for the adult population, that can sometimes be a gap as well as when it comes to microbiology
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and pathology reports, there are some gaps with that as well, particularly outside of
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central zone.
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And that's simply because in each zone they're using different systems.
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So some of those older systems just have not been set up to have that information feed
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into share, unfortunately.
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So that's just something to be aware of with what you're looking at what's in share and
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then as well as, you know, those cases where somebody might have go to, you know, a private
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collection clinic to have their blood work done.
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Sometimes that does not make it into share as well.
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But if they're having it collected at a Nova Scotia health facility, it typically will
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be.
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Okay.
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So I also noticed that it's not just labs, but there's also reports there as well.
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Yes.
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And that's something more recent that I'm very excited about.
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Because originally pharmacists only had access to lab results within share, but this past
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year we were able to make a case to have that expanded to also include diagnostic imaging
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reports as well as clinical reports.
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So you'll probably notice when you're in share, usually you're used to accessing the results
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tab that will now in addition to the lab results also have radiology results.
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And then there's an additional tab called clinical reports where you can see various
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reports that have been entered from throughout the hospital systems.
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So the types of reports that are typically helpful to pharmacists are seeing things like
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a discharge summary, which if you receive a discharge prescription, which I'm sure many
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of you have that it might be unclear as to why medication was changed or if it was an
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intentional change.
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Sometimes you can gain really good insight from the discharge summary around the care
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that happened in hospital and why some meds might have been adjusted.
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So it might save you a call to that unit.
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Yeah.
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It's looking at the hospital discharge reports are really comprehensive so that you can understand
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the patient's journey through the hospital.
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And on being on the receiving end of a discharge prescription and not quite understanding what
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happened, that can really be a useful tool.
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Yeah, for sure.
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And then you also can typically find specialist reports.
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If the patients visit a specialist that's located within the hospital, those reports
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are often available, so which can be helpful to kind of get more details about a particular
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medical condition that you're trying to manage for the patient.
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So on our member land, we have this blog called Five Seconds Easier.
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And one of the things we're trying to do for our members is just to find ways to make doing
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the job easier.
15:17
Do you have any specific advice for our listeners?
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For sure.
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When you're in the share application, there's actually an additional tab near the right
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hand side called Helpful Tips.
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And there's a few documents in there.
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A couple of them are reference things that I was talking about, about kind of what's
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in share, what's not in share.
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But there's also some tips around setting your configurations to make navigating share
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a little bit easier.
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So for example, a couple of the things that I've done to just make things slightly quicker
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for myself is when you're in your patient search, you probably notice that it tends
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to default to a search criteria called MRN.
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And that's a unique identifier that's used within the hospital system, but it's not
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relevant to pharmacy.
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So in that kind of box, the top left hand corner, there's a really tiny button that
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says Edit, where you can actually go and change your configuration so that whenever you open
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the patient search, you'll automatically have health card number clicked off instead of
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MRN.
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You don't have to first toggle switch to health card.
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You can just go right ahead and enter the health card.
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Remember, people that have typed in the health card number hit search and had nothing come
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up only to realize that that'll be helpful.
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Yeah.
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I definitely find it helpful and it just saves you a quick extra second, which is always
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made because we're always busy.
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And then the other, when you're viewing the results, you can also change those default
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settings as well.
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So typically it will default to showing the last 30 days.
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Oftentimes, once you open the results, there might not be anything there or not as much
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there as you need to look at.
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So then you have to go into the box to specify how many days you want to go back.
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So again, there is a little edit button where you can change your configuration to automatically
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when you open the results tab and view the results.
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You can set whatever default number of days you want to.
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I typically set it at around 700.
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So I'm looking at the last couple of years, but you can set it to whatever fits your preferences.
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And as well, when you're viewing results, it's important to know, I think, that because
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the information comes from different hospital systems, sometimes the naming conventions
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of a certain lab test can be different.
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So if you're using the keyword search to search for a certain type of result, like if you're
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looking for electrolytes, for example, if you just kind of search elect or electrolytes,
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you might not actually be getting the results from all across the province if the patients
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had care in different facilities because in some systems, electrolytes are actually just
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called lights.
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So it's important when you're searching.
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Yeah, to know that there can be variations.
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So keep your search really vague if you can.
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Or just, you know, as you use it frequently, you start to learn, okay, this is typically
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how it looks.
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So you kind of know what to search by.
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But there's just kind of some of those little nuances that can make things easier.
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And I also typically find it easy to look at various things at once.
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Sometimes if I'm, you know, renewing a medication and I want to look at electrolytes plus their
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eGFR and things like that at the same time, when you're looking at the list of all the
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available results, there's a checkbox on the far left side where you can click which ones
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are relevant to what you're assessing.
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And then there's a bottom at the button that instead of show all, you can just show select
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it and it will give you kind of a summary of those results all on one screen, which I find
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helpful.
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Yeah, I've had some people that they'd click on one result and go back and then click on
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another result and then go back.
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So that's definitely a useful tip.
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And then there is also, if you're looking at trends over time, there is also another function
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that I don't think a lot of people are aware of.
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You might have noticed there's a little kind of line that will say check five or check 10
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on all selected and that is actually, it's not intuitive, but if you click on that and
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if someone's had multiple results over a period of time, it can give you a bit of a visual
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graph of what the trends are of that result, which can be really helpful.
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So a caveat to that is, as I mentioned, because there's information coming from different systems,
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if that person's had blood work done kind of in central zone and then in other zones,
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it can only trend within whatever system it came from.
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So if they have results from multiple systems, you might not be able to get that full picture
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sometimes, but in a lot of cases, it can be a really helpful tool to kind of visualize
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if something's changing gradually or more drastically, et cetera.
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Yeah, it's funny because I've had some of the teams tell me that, you know, that's really
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one of the most useful pieces of information because having a single number in isolation
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isn't as useful as seeing the trends over time.
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So that's been really helpful.
19:57
And the other thing I like is that within share, particularly from med reviews, sometimes
20:03
the pharmacist may be talking to the patient and they'll want a physical copy of it and
20:10
there's a print icon there.
20:11
Yeah, exactly.
20:12
And that's typically when I use the print function as well is when doing a med review,
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it's nice to have that all printed out and available to attach to your med review and
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scan it and all together.
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So when someone else is looking at it, they can have a look at that all in one, which
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is nice.
20:27
And the print functionality is not always very obvious because similar to that edit
20:32
button, it's a very, very tiny little button with an icon of a printer on it.
20:38
It is available.
20:39
And one important thing too with the print function is there are some cases that you
20:43
might not be able to use, utilize the print function and it depends on how you're accessing
20:49
through the remote desktop.
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So when it comes to accessing sharing community pharmacies, you have to first go in through
20:56
what we call the remote desktop.
20:58
And that essentially is getting you into the Nova Scotia Health Secure Network, which is
21:02
where share is accessible within.
21:04
You can't access share outside of that network.
21:06
So first you have to log in through the remote desktop and then that brings you to that kind
21:10
of like new window, desktop window where there's a link to the share clinical portal.
21:14
For the remote desktop, there's two different ways that you can access it.
21:17
You can, there is a URL that you can just access it through the web.
21:21
And then you can also download the remote desktop application from Microsoft onto your
21:26
computer and access it through the application itself.
21:29
If you want to print, you should access it through the application because that will
21:33
allow the print functionality.
21:34
If you're accessing it through the browser version, sometimes that print functionality
21:39
doesn't work properly.
21:40
Oh, that's good to know.
21:41
I did not know that.
21:43
Just to kind of wrap up, what does the future hold for share in your department?
21:48
For the future, there is currently in the works a new platform that is going to be replacing
21:54
share, which we're really excited about because as some people have probably noticed, share
22:00
is what we call a legacy application.
22:02
So you know, the look and feel is older.
22:04
It was developed many years ago.
22:07
And because of that too, it limits, we don't have the ability to actually make many changes
22:12
to the application itself.
22:13
So having a new modern application to replace it is really exciting.
22:19
And I think it should hopefully also help to address some of those gaps that I mentioned
22:25
about some results not making it into share.
22:29
We're hoping that will be solved with this new application.
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We expect it should be out sometime in the next year.
22:38
Don't know the exact date yet.
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But once we do, definitely be sharing it with folks and providing more information about
22:45
it.
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But we hope it will make the user experience a little easier to have a more modern application
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to work with.
22:52
No, that'll be really great.
22:53
I look forward to seeing what's next.
22:56
So I want to thank you.
22:58
I really appreciate you taking the time.
23:01
I know there's some tips in here that are going to help most of our audience.
23:06
And just to let everyone know some of the resources and supports, we're going to update
23:10
our member lounge so that you can tap into those, some of the guides and some of the
23:16
contact information if you need it.
23:18
All right.
23:19
Well, Rowan, thanks again for coming on.
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It's been a pleasure to have you here.
23:24
And thanks again for all the support you and your team have provided to Pharmacist in Nova
23:27
Scotia.
23:28
The problem, thanks again for having me.
23:30
It's been a pleasure and happy to help support where we can.
23:33
So feel free to reach out, as I mentioned, to that share at Nova Scotia.ca email.
23:38
And we can help guide you to the resources that you need.
23:41
Okay.
23:42
And thank you, everyone, for listening.
23:43
Bye for now.
23:48
Thanks for tuning in to this week's episode of Pods and Pans.
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