CPIA Module 1, Section 3: Core Roles and Competencies of the Informatics Pharmacist
MODULE 1: INTRODUCTION & FOUNDATIONS OF PHARMACY INFORMATICS

Section 1.3: Core Roles and Competencies of the Informatics Pharmacist

An exploration of the diverse career paths and the essential skill sets required to excel, from technical proficiency and project management to communication and leadership.

SECTION 1.3

The Informatics Pharmacist: From Practitioner to Architect

Defining your future role and the skills you’ll need to succeed in the complex world of health IT.

1.3.1 The “Why”: Charting Your Career Path

You have made a decision to explore a new dimension of your profession. But what does the destination look like? The term “informatics pharmacist” is not a monolithic job title; it is a broad umbrella that covers a diverse and rapidly expanding ecosystem of roles. The pharmacist who spends their day building medication records in the EHR has a very different skillset and daily focus than the pharmacist who analyzes controlled substance data, or the one who manages the fleet of automated dispensing cabinets. Understanding this landscape is the critical first step in charting your own career path.

This section is designed to be your professional GPS. We will move from the theoretical foundations of the previous sections to the practical realities of the job market. We will provide a detailed taxonomy of the most common roles an informatics pharmacist can hold within a health system. For each role, we will dissect the day-to-day responsibilities, the required technical and soft skills, and the typical challenges and rewards. More importantly, we will continuously translate these roles and skills back to the experiences you already have. Your time spent verifying prescriptions, counseling patients, and managing pharmacy operations has equipped you with a powerful set of foundational competencies. Our goal here is to show you how those competencies map to this new field and to illuminate the path from where you are now to where you want to be.

Retail Pharmacist Analogy: The Many Hats of a Modern Pharmacy

Think about the different roles within a large, modern retail pharmacy that go beyond simply dispensing. There is the Staff Pharmacist, whose primary focus is the accurate and safe verification of prescriptions—the front-line expert. There is the Immunizing Pharmacist, a specialist with a specific clinical skillset. There is the Pharmacy Manager, who is less focused on individual prescriptions and more on workflows, technician scheduling, inventory management, and meeting business metrics. There may be a Clinical Services Leader who runs the MTM program, focusing on patient outcomes and documentation. At a district level, there is a District Manager who oversees multiple stores, analyzes performance data, and ensures standardization. At corporate, there is a Formulary Specialist, a Trainer, and a Software Liaison who works with the IT vendor.

All of these individuals are pharmacists, but their daily jobs are vastly different. They require different skillsets: clinical acumen, operational expertise, business management, data analysis, and training. A great staff pharmacist might not make a great district manager, and vice versa.

The world of pharmacy informatics is exactly the same. It is a team of specialists, each with a unique focus, all working toward the common goal of a safe and efficient medication-use system. This section will introduce you to your future teammates and help you decide which position on the team is the best fit for your unique talents and interests.

1.3.2 The Core Archetypes: A Taxonomy of Informatics Pharmacy Roles

While job titles vary widely between institutions, most informatics pharmacist roles can be categorized into several core “archetypes.” These archetypes are defined by their primary area of focus within the medication-use and health IT ecosystems. As you read through these, think about which one resonates most with the parts of your current job that you find most engaging.

Archetype 1: The EHR Application Analyst (The Builder)

This is often the foundational, entry-point role in pharmacy informatics and the one most people picture when they think of the job. The EHR Application Analyst is the primary owner and builder of the medication-related components within the Electronic Health Record (e.g., Epic Willow, Cerner PharmNet). They are the craftspeople who translate clinical requirements from pharmacists, physicians, and nurses into the functional reality of the software.

Day-to-Day Realities:
  • Medication Record Management (NDC, GCN, Formulary): The absolute core of the role. This involves building, maintaining, and linking thousands of individual medication records in the EHR. When a new drug comes to market or is added to formulary, this pharmacist is the one who builds it in the system, ensuring its name, dose forms, strengths, billing information, and clinical warnings are all correct.
  • Order Set and Protocol Construction: Working with clinical committees, they build the evidence-based order sets (e.g., for sepsis, chemotherapy, VTE prophylaxis) that guide prescribers. This requires meticulous attention to detail to ensure every dose, route, and frequency is built exactly as specified.
  • Workflow Optimization and Troubleshooting: They are the first line of support for medication-related system issues. When a nurse can’t scan a barcode or a pharmacist gets a cryptic error message, the EHR Analyst investigates the problem, determines the root cause (is it a system bug, a user error, a faulty workflow?), and implements a solution.
  • System Upgrades and Testing: They play a critical role in testing new software versions and functionality before they are released to the live clinical environment, ensuring changes don’t have unintended negative consequences.
Who Succeeds in This Role?

This role is perfect for the pharmacist who loves puzzles and details. The successful EHR Analyst is meticulous, logical, and process-oriented. They have a high tolerance for the sometimes tedious work of database management and a passion for getting every detail exactly right. They are excellent problem-solvers who can systematically work through a complex issue. While they need strong clinical knowledge to inform their build, their primary focus is on the technical configuration of the system. Your experience checking thousands of prescriptions for accuracy has trained you for this level of detail-oriented work.

Archetype 2: The Clinical Decision Support (CDS) Specialist (The Architect)

If the EHR Analyst is the builder of individual components, the CDS Specialist is the architect who designs the system’s overall safety logic. This role is less about building individual medication records and more about designing the intelligent rules and alerts that govern how those records interact. They are the guardians of the “Knowledge” layer of the DIKW pyramid, focusing on creating actionable guidance for clinicians at the point of care.

Day-to-Day Realities:
  • Alert Design and Maintenance: Their primary function. They build, refine, and maintain the vast library of medication-related alerts, including drug-drug interactions, drug-allergy checks, dose range warnings, and therapeutic duplications.
  • Alert Fatigue Management: A critical and challenging part of the job. They analyze data on which alerts are frequently overridden by clinicians and work to make them more specific, actionable, and clinically relevant, “tuning out” the noise so the truly important signals get through.
  • Advanced Rule Logic: They work on complex, multi-factorial rules. For example, building an alert that only fires for a potassium-sparing diuretic if the patient is also on an ACE inhibitor AND their most recent potassium level was > 5.0 mEq/L.
  • Pharmacogenomics (PGx) Integration: In advanced settings, they are responsible for building the logic that alerts a prescriber when a planned medication may be inappropriate based on the patient’s genetic makeup (e.g., clopidogrel in a CYP2C19 poor metabolizer).
Who Succeeds in This Role?

This role requires a pharmacist with exceptionally strong clinical skills and a passion for evidence-based medicine. They must be able to read a clinical guideline and translate it into a series of logical “if-then” statements that a computer can understand. They are excellent critical thinkers who can balance the need for safety with the risk of alert fatigue. They are often seen as a master clinician who has chosen to apply their expertise through technology rather than direct patient care.

Archetype 3: The Automation & Technology Specialist (The Engineer)

This pharmacist’s domain extends beyond the EHR to the physical hardware and integrated technologies that store, prepare, and track medications. They are the bridge between the digital world of the EHR and the physical world of the pharmacy and nursing units. Their focus is on the complex interplay between software, hardware, and the human workflow.

Day-to-Day Realities:
  • Automated Dispensing Cabinet (ADC) Management: They are the primary owners of the hospital’s fleet of ADCs (e.g., Pyxis, Omnicell). This includes managing the drug databases, optimizing inventory levels and locations (PAR levels), troubleshooting hardware and software issues, and analyzing usage data for diversion monitoring.
  • Central Pharmacy Automation: They manage the technology within the central pharmacy, such as high-volume robotic packagers, medication carousels, and IV workflow management systems.
  • Smart Pump and BCMA Hardware Integration: They are responsible for ensuring the “smart” IV pumps and the bedside barcode scanners used by nurses can communicate effectively with the EHR. This includes managing the IV drug library that is wirelessly pushed to the pumps, which contains critical safety limits (soft and hard stops) for infusion rates.
  • Interface Management: They work closely with interface analysts to ensure a reliable flow of information between the EHR and the various automation systems (e.g., ensuring a new order from the EHR correctly profiles to the right ADC).
Who Succeeds in This Role?

This role appeals to the pharmacist with a strong interest in operations, workflow, and electromechanical systems. They are often very process-oriented and enjoy the hands-on nature of working with physical technology. They need to be excellent troubleshooters who can diagnose a problem that might involve a software setting, a network connection, a hardware failure, or a user training issue. Your experience managing pharmacy inventory and workflow has given you a direct preview of this role’s challenges.

Archetype 4: The Data Analytics & Business Intelligence Pharmacist (The Detective)

With the mass adoption of EHRs, health systems are now sitting on mountains of clinical data. The Analytics Pharmacist is the specialist who knows how to mine this data for valuable insights. They are less focused on building the system and more focused on extracting and interpreting the information the system generates. Their work is crucial for quality improvement, regulatory compliance, and demonstrating the value of pharmacy services.

Day-to-Day Realities:
  • Report and Dashboard Creation: Their primary function is to write reports and build dashboards to answer clinical and operational questions. They might use tools like SQL, Crystal Reports, or Tableau to visualize data.
  • Antimicrobial Stewardship: They are key partners for the stewardship team, creating reports on antibiotic usage (Days of Therapy), monitoring adherence to prescribing guidelines, and generating antibiograms.
  • Controlled Substance Monitoring: They design and run sophisticated reports to detect potential drug diversion, looking for patterns of unusual ADC overrides, waste discrepancies, or prescribing habits.
  • Quality & Regulatory Reporting: They are responsible for extracting the data needed to report on key quality measures to organizations like The Joint Commission and the Centers for Medicare & Medicaid Services (CMS).
Who Succeeds in This Role?

This role is for the pharmacist who is highly analytical, inquisitive, and loves finding the story hidden within the numbers. They must be comfortable working with databases and have at least a foundational understanding of data query languages like SQL. They are critical thinkers who not only know how to pull the data, but also how to interpret it correctly and present it in a clear, compelling way to clinical and administrative leaders. If you’ve ever enjoyed analyzing your pharmacy’s dispensing data to spot trends, this field could be a natural fit.

1.3.3 The Universal Toolkit: Core Competencies for All Informatics Roles

While the archetypes above have distinct areas of focus, a set of universal competencies is required for success in any informatics role. These are the foundational skills that cut across all specialties. This program is designed to build your expertise in each of these domains, but it’s important to recognize that your current role as a pharmacist has already given you a significant head start in several of them.

We will use a “Competency Matrix” model to explore these skills in depth. For each competency, we will define it, describe its application in informatics, and show how your existing pharmacy experience has prepared you for it.

Masterclass Table: The Informatics Pharmacist Competency Matrix
How Your Pharmacy Experience Applies
Competency Domain Definition in Informatics
1. Deep Clinical Expertise The ability to apply advanced pharmacotherapeutic knowledge to evaluate the safety, efficacy, and appropriateness of system design and clinical decision support. This is the non-negotiable foundation upon which all other skills are built.
  • Direct Translation: Your daily work of verifying orders, catching errors, and counseling patients is the direct application of this skill.
  • Informatics Application: You won’t be checking a single order; you’ll be asking, “How can I build a system that prevents this type of error for all future orders?” When building a chemotherapy order set, your clinical knowledge is what ensures the doses, schedules, and supportive care meds are correct. You are the ultimate clinical SME (Subject Matter Expert).
2. Analytical & Problem-Solving Skills The ability to systematically investigate a complex problem, identify the root cause, evaluate potential solutions, and implement the most effective one. This involves logical, structured thinking.
  • Direct Translation: A patient presents with a confusing prescription from a chaotic ED discharge summary. You methodically investigate by calling the hospital, checking the state’s prescription monitoring program, and talking to the patient to piece together the true medication history. This is root cause analysis.
  • Informatics Application: A nurse reports a “bug” where a patient’s home medication list appears to be duplicated. You don’t just delete the duplicates; you investigate the entire admission workflow, check the interface messages from the ED system, and analyze the audit trail to find the precise step in the process that is causing the duplication, then design a system-level fix.
3. Communication Skills (The Art of Translation) The ability to effectively communicate complex clinical concepts to technical audiences (e.g., software developers) and complex technical concepts to clinical audiences (e.g., physicians, nurses). This is a role of constant translation.
  • Direct Translation: You explain the complex mechanism of action of a new diabetes medication to a patient using simple, clear language. Ten minutes later, you are on the phone with a cardiologist discussing its potential impact on QT prolongation using precise clinical terminology.
  • Informatics Application: You are in a meeting with a software developer explaining why the dose field for pediatric medications needs to allow for three decimal places—a critical clinical need. The next hour, you are training a group of nurses on a new BCMA workflow, explaining the technical steps in a way that is clear, concise, and focused on patient safety.
4. Project Management Fundamentals Understanding the basic principles of managing a project from conception to completion, including defining scope, identifying stakeholders, creating timelines, managing tasks, and communicating progress.
  • Direct Translation: Implementing a new pharmacy service, like a point-of-care testing program. You had to get supplies, train staff, develop documentation, market the service, and manage the rollout. This was a project.
  • Informatics Application: You are tasked with implementing a new feature in the EHR that allows pharmacists to document their clinical interventions. You will create a formal project plan, assemble a team of stakeholders (pharmacy, IT, nursing), define the exact requirements, build and test the new tool, and manage the training and go-live process.
5. Technical Aptitude & Lifelong Learning A genuine curiosity for how technology works, a willingness to learn new software and systems, and the ability to read technical documentation and apply it. This does not necessarily mean knowing how to code, but it means not being afraid of the “back end” of the system.
  • Direct Translation: Every time your pharmacy’s dispensing software was updated, you had to learn the new features, adapt your workflow, and figure out how to use it effectively. You are already an experienced technology adapter.
  • Informatics Application: You will become a certified builder in a specific EHR module. This involves intense training classes, studying manuals, and constant learning as the software evolves. You will become the go-to expert on the capabilities and limitations of your assigned systems.

1.3.4 Building Your Informatics Career: A Strategic Roadmap

Understanding the roles and competencies is the first step. The next is to build a practical, actionable plan to transition into this field. This is not a journey that happens overnight; it requires a deliberate and strategic investment in your skills and network. The path from clinical practitioner to informatics specialist can be broken down into several key phases.

Phase 1: Cultivating Expertise in Your Current Role (The Superuser)

Your transition begins now, in your current job. The single most important thing you can do is to become the go-to technology expert in your department. Go beyond simply using the systems; strive to understand them at a deeper level.

  • Volunteer for Everything: A new version of the dispensing software is rolling out? Volunteer to be on the testing team. The hospital is updating its smart pump drug library? Ask to be part of the review committee. Your department needs a “superuser” to help train new hires on the EHR? Raise your hand.
  • Become a Problem-Solver: When your colleagues have a system issue, don’t just tell them to “call the help desk.” Try to troubleshoot the problem with them. Take notes on recurring issues. Start to see the patterns of system failures and workflow challenges.
  • Read and Learn: Seek out the “Tip Sheets” and training manuals for your systems. When you get an alert, don’t just click through it; read the text and try to understand the logic behind it.

The Goal: To become recognized within your own department as the person who “gets” the technology. This will not only build your skills but also make your name known to the informatics and IT teams.

Phase 2: Networking and Formal Education (The Apprentice)

Once you have established yourself as a superuser, it’s time to make formal connections and build your foundational knowledge.

  • Connect with the Informatics Team: Find out who the informatics pharmacists are in your organization. Send them an email. Ask for a 15-minute coffee meeting (virtual or in-person). Express your interest and ask for their advice. They are almost always happy to talk to an engaged colleague and are your single best source of information about internal job opportunities.
  • Seek Formal Training: This certification is a major step. Supplement it by attending webinars from organizations like ASHP or HIMSS. Consider pursuing a formal certification from your EHR vendor if your organization offers it (e.g., Epic certification).
  • Join Professional Organizations: Become a member of the ASHP Section of Pharmacy Informatics and Technology or your local HIMSS chapter. This will expand your network beyond your own institution.

The Goal: To move from being an interested observer to a known and credible candidate, and to build the formal knowledge base needed to succeed in an interview.

The Residency vs. Experience Debate

A common question is whether a PGY2 residency in Pharmacy Informatics is necessary. The Answer: It is highly valuable but not always essential. A PGY2 is the most structured and accelerated path into a high-level informatics role. However, many successful informatics pharmacists have transitioned without one, leveraging their “superuser” experience and on-the-job training. If you have the opportunity to pursue a PGY2, it is an excellent investment. If not, the path may be more gradual, often starting in an EHR Analyst role, but it is absolutely achievable through the deliberate steps outlined here.

Phase 3: Making the Transition (The Novice Professional)

This is the stage where you actively seek and apply for your first dedicated informatics role. This may be an internal transfer within your current organization or a position at a new one.

  • Tailor Your Resume: Re-write your resume to highlight your technology-related accomplishments. Instead of saying “Verified prescriptions,” say “Utilized the Cerner PharmNet system to ensure the safe and accurate verification of over 200 prescriptions daily.” Frame your experience in the language of informatics.
  • Prepare for the Interview: Informatics interviews often include problem-solving scenarios. They might describe a system problem and ask you how you would investigate it. Use the DIKW framework and a systematic, logical approach to answer these questions.
  • Be Willing to Start at the Foundation: Your first role will likely be as an EHR Application Analyst. Embrace it. This is your chance to learn the system at the deepest level, which will be an invaluable foundation for any future, more specialized role you may pursue.

The Goal: To successfully land your first informatics pharmacist position and begin your new professional journey.

This section has provided you with a comprehensive map of the professional landscape of pharmacy informatics. You now know the destinations—the various roles you can pursue—and you have a roadmap for the journey. The path requires dedication, but it is a path well-trodden. Your core skills as a pharmacist are the perfect foundation. By deliberately building upon that foundation with the technical, analytical, and communication competencies we have outlined, you can successfully transition from a skilled clinical practitioner to a vital architect of the future of medication management.