Pediatric Pharmacists Are Expanding Their Reach in Hospitals and Beyond: Marry Vuong, PharmD, BCPPS

Once rare on hospital rounds, pediatric pharmacists are now essential to patient care, guiding complex, weight-based dosing and reducing medication errors in children, says Marry Vuong, PharmD, BCPPS, chief of clinical operations, Perfecting Peds. As telehealth gains traction, these experts are stepping beyond hospital walls to bring their knowledge directly to families in even the most remote areas, opening the door to safer, more personalized care.

This transcript was lightly edited; captions were auto-generated.

Transcript

As diabetes care becomes more digital, personalized, and data-driven, how is the role of the pediatric pharmacist evolving in both direct patient care and operational leadership?

I think we are kind of the trailblazers in this. In direct patient care, one of my favorite things in the hospital was multidisciplinary rounds. And I can tell you that maybe 10 or 20 years ago, it wasn't the norm to always have a pediatric pharmacist on rounds, but during my time in the hospital, if I, for whatever reason, was not on rounds, they would call down to the main pharmacy and be like, “Where's Marry? We need her on rounds now.”

And it's a great feeling to know that with whatever dose titrations, with whatever it had to do with medications, the team would look to the pediatric pharmacist, because all these residents were trained to consult the pediatric pharmacist if it came to anything. There's little to no data on pediatric patients, and 1 in 3 medication errors will occur in a pediatric patient, just because everything's so specific.

When it comes to an adult, it's very easy. It's a set dose—you get 1 tablet of this, and you get 1 IV [intravenous] bag of that. When it comes to a pediatric patient, it's mg per kg dosing. It's dosed based on their weight. These kids grow, and when they grow to a certain point, you have to adjust the doses. It becomes very complicated, and then everything has to be customized.

What I always tell the residents is, we have a lot of room for error here, and we have to be really careful. For an adult, it's like, "This is your IV bag—you get the full bag." With a pediatric patient, this is the concentration; the child weighs this much, so we have to draw up a smaller syringe of the same concentration for the patient, and then we also have to program the pump. There are so many more layers of complexity.

I think on the patient care forefront, there's so much room for pediatric pharmacists to be integrated. We're totally integrated in the inpatient model right now. I can tell you that most pediatric pharmacists and most children's hospitals have so many pediatric pharmacists on staff, which is great. But in the outpatient space, it's a little bit lacking.

That's where Perfect Peds comes in, and we bring the pediatric pharmacist to the outpatient space virtually via telehealth. It adds a whole other level. We're able to be in the most rural places. A lot of our patients are in the middle of nowhere—Minnesota or Pennsylvania—but they still have the luxury of having a pediatric pharmacist at their fingertips.

Operationally, I think it's also really exciting, because everyone is trained to think that when you're in school, you have 3 paths: you either do clinical in the hospital, retail at Walgreens or CVS, or you can go to pharma. But now, operationally, so many great pharmacists are paving the way by starting their own businesses.

I think that's opened up a whole new can of worms. You can be a pharmacist, and you can be an entrepreneur. There are people doing medical communications jobs, pharmacogenomics. There's also a sports pharmacist who specializes in just sports medicine and things like that.

Operationally, the sky is the limit. I think it's a really exciting time to be a pharmacist.