Using data to build proactive drug error prevention models

Data is variously described as the oxygen of the digital economy or the new raw material of the 21st century.“-Nigel Shadbolt

There are more than a few issues with today’s medication order entry systems. However, in this post I want to focus on only two.

First, alert fatigue. As a pharmacist that has entered his fair share of orders I can tell you that alert fatigue is real. Order entry systems, including CPOE, are designed to indiscriminately alert users of every possible problem associated with the patient’s profile and the order being entered. When entering orders for a patient with complex medical conditions, this can become a bit frustrating because a majority of these alerts are of little to no value. After a while you begin to blow through alerts because so many are simply a waste of your time. Unfortunately, when this happens you will occasionally miss something important. It happens.

Second, the “perfect medication error”.(1) This occurs when a physician inadvertently utilizes CPOE to order the wrong medication for a patient – or the right drug for the wrong patient – but the order meets all the necessary checks and balances to end up on the medication profile, i.e. no allergies, meets all appropriate dosing parameters, there are no drug-drug interactions, labs are fine, and so on. This is an issue that appeared on my radar while performing an FMEA for a CPOE implementation when I was still working as an IT pharmacist.
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Cool pharmacy technology – SMART-IV

Not exactly pharmacy technology. However, SMART-IV involves integration of iv infusions with bar code scanning at the patient bedside. That’s kind of pharmacy related, in a sort of roundabout way.

Check the video below for a look at how the system works. The commentary is in Dutch, so if you don’t speak Dutch you might be in trouble. Regardless, you’ll get the basic idea anyway.

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Saturday morning coffee [August 22 2015]

Don’t accept that others know you better than yourself. Work joyfully and peacefully, knowing that right thoughts and right efforts will inevitably bring about right results.” – James Allen

The mug below comes from the University of Arizona in Tucson. I was there earlier in the week doing some research on a project. In fact, I’m sitting in a hotel in downtown Phoenix this morning as I write this. I’ll be heading home later today. I saw this mug in a display case in the U of A bookstore. It’s an awesome looking mug. I wanted one, but couldn’t bring myself to purchase it because, well, you know, my daughter is a UCLA cheerleader. Having a U of A mug in the house would be akin to blasphemy. It really is a beautiful mug though.

MUG_UofA
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It’s time for pharmacy to find ways to collect and share information

Regardless of what everyone thinks, the healthcare industry is in the infancy of “big data”. The concept isn’t new, but we still have a long way to go, especially in pharmacy. I recall sitting at conferences years ago listening to sessions describing data collection and manipulation. The problem has been that data, especially that found in pharmacies is scattered across disparate systems without an effective method for connecting the dots. The adoption of electronic health records (EHRs) has made things better, but much of the data collected in an average acute care pharmacy is outside the EHR’s reach.  And to say that most pharmacies have their collective heads buried in the sand, would be putting it kindly.

Those on the outside often find it difficult to understand the sheer volume of data that’s produced in a pharmacy. Unfortunately, the data sources are mostly stored in disparate systems creating silos, which makes each system blind to the others. Is is possible to connect the systems and exchange data? Sure, but few if any are doing it.

Data sources in pharmacies come from places like clinical interventions, inventory management, cost containment strategies, regulatory compliance, internal communications, and so on.
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The Garage | Episode 5: Windows 10

Robert and Jerry get back at it after taking nearly two years off. Crazy how time flies. The brothers talk briefly about Roberts big move to a small town before getting into Windows 10 and OneDrive.

Show notes:
Hosts: Robert and Jerry Fahrni

Questions, tips or recommendations for upcoming Garage topics? Find Jerry on Google+ or Twitter (@JFahrni). Find Robert on Twitter (@Fahrni).

Saturday morning coffee [August 8 2015]

Power is like being a lady… if you have to tell people you are, you aren’t.” – Margaret Thatcher

The mug below comes from Six Flags Magic Mountain down in Valencia, California. If you like roller coasters, then this is the place for you. They have some of the best in the business, and my kids love to ride them. We used to go down there a few times a year, but haven’t had the opportunity in a while. It was nice to have a little reckless fun for a change. One of the longtime landmark rides at Magic Mountain was the Colossus, billed as the tallest and fastest wooden roller coaster in the world. Something happened in 2014 and Six Flags did some major work on the coaster. It’s no longer the wooden beast it was, but rather a hybrid wood and steel roller coaster called Twisted Colossus. The new ride features barrel roll inversions, and a near-vertical drop. And when I say near-vertical drop, I mean near vertical. It got my heat racing. Should have brought the GoPro.

Twisted Colossus MUG
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FDA approves first 3D printed drug

This was all over the web yesterday, so I’m not telling you anything you don’t already know, but this is huge. 3D printing is one of those technologies that has the potential to disrupt just about every industry it touches. It’s not often that you can say that. The most recent technologies that I can think of that had that kind of impact was the explosion of smartphones and tablets, which are now ubiquitous across every industry you can imagine.

SPRITAM

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JerryFahrni.com Podcast #3: Semi-automated IV Workflow Management Systems

Show Notes:
Host: Jerry Fahnri

New Equipment:
Blue Microphones Yeti USB Microphone – Blackout Edition
Dragonpad Pop Filter

IVWFM systems discussed:
APOTECAps1
BD Cato
DoseEdge
EPIC Dispense Prep2
i.v.SOFT
IVTrac1
Meditech1,2
PharmQ-ITH – No longer available. IP sold to BD
Phocus Rx
PyxisPrep – No longer available. Killed following acquisition by BD
RxADMIX1
ScriptPro
Verification

  1. I have not reviewed these systems in a live environment, i.e. non-beta customer site. I have had a live demo of IVTrac.
  2. These systems are part of an already existing EHR platform, i.e. they are not standalone