Cool Pharmacy Technology – Intelliguard RFID Solutions from MEPS Real-Time

Last week I spent some time down south in San Diego visiting a couple of hospitals and speaking with the good folks at MEPS Real-Time. My objective for the visit was twofold: 1) see MEPS RFID Solutions in a live environment, and 2) speak with the people at MEPS and get an inside look at their technology. I was able to accomplish both goals.

MEPS Real-Time is a company that specializes in providing RFID solutions for healthcare specifically targeted at acute care pharmacies. Their Intelliguard® RFID Solutions product line currently includes a Kit and Tray Management System, Controlled Temperature Cabinets, and a Vendor Management Inventory (VMI) System.

MEPS_RFID_TAG
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Saturday morning coffee [February 21 2015]

“An error doesn’t become a mistake until you refuse to correct it.” – Orlando A. Battista

So much happens each and every week, and it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The mug below was sitting next to my laptop filled with chocolate covered espresso beans last Saturday morning, Valentine’s Day. A gift from my lovely wife. Apparently she’s aware of my addiction. It made me smile.

MUG_Valentines
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A missed opportunity for safety – why scanning a limited formulary in the i.v. room is a mistake

Although some hospitals have chosen to limit use of these systems [IV workflow technology] for focused areas like admixture of chemotherapy or high-alert drugs, there’s no telling when someone might accidentally introduce a high-alert drug when preparing other drug classes that wouldn’t ordinarily be scanned. Therefore, to be maximally effective, the system must be utilized for all compounded admixtures”. (ISMP)

A couple of weeks ago I wrote about the need to use bar-code scanning technology during compounded sterile product (CSPs) preparation. In my mind it’s a no-brainer. The i.v. room is a dangerous place, and no amount of “double checking” is going to change that.
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Saturday morning coffee [January 24 2015]

“There is a fundamental question we all have to face. How are we to live our lives; by what principles and moral values will we be guided and inspired?” - H. Jackson Brown, Jr.

So much happens each and every week, and it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

MUG_SMC
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Cool Pharmacy Technology – Intelliport Medication System

I briefly mentioned the Intelliport Medication System from BD in a previous post. The technology and potential use cases are impressive.

The BD Intelliport System offers:

  • Drug and concentration information is presented to the user via audio and visual feedback. The system pulls information from the bar code on the syringe as it’s inserted into the Intelliport injection port.
  • Drug identification, dose measurement and drug allergy alerts in real-time. The allergy information is pulled directly from the patient’s EHR record.
  • Automated documentation of medication delivery. The system wirelessly captures drug, dose, time, and route of administration. The information is fed directly back into the EHR

Check the video below, it’s really cool.

Are we seeing the final days of standalone systems in pharmacy?

I’ve used many standalone systems in the pharmacy throughout my career. There was a time when it was considered the norm, but things are starting to change.

I’ve seen a significant shift in thinking over the past couple of years. Hospital pharmacies are tired of dealing with multiple databases, the inability of one system to easily shuttle information to another, and broken interfaces, i.e. “interface is down”. I’ve talked to several pharmacists over the past few weeks that are no longer looking at functionality, but instead are seeking integrated ecosystems to run pharmacy operations. And they’re willing to give up functionality to get it.
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First time using Epic – initial thoughts and impressions

Epic is an Electronic Health Record (EHR) used in hospitals all over the country. If you work in healthcare you know who they are. Epic is the top EHR system in the U.S. and they continue to gobble up market share.

According to the Epic website, the pharmacy information system (PhIS) inside Epic is officially known as the “Willow Inpatient Pharmacy System”. However, I commonly hear it referred to as simply Willow.

Over the span of my 19 year career I’ve used several pharmacy information systems, but never Willow. For whatever reason the hospitals I’ve worked in have used other EHR and/or pharmacy system vendors; GE, Siemens, MEDITECH, IDX, etc. Recently I had the opportunity to spend a couple days learning how to use Willow. I was pretty excited. I’ve heard a lot of good things about Willow, and some bad. I’ve been wanting to get firsthand knowledge for quite some time.

Disclaimer: These are my initial impressions. Two days of training isn’t nearly enough time to learn all the ins and outs of a pharmacy system. I’ve recently accepted a position where I will be using Epic, albeit not in a full-time capacity, so I’m sure that my thoughts and opinions will evolve over time.
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Making the case for bar code medication preparation (BCMP) in sterile compounding

The tragic death of a hospitalized patient in Oregon [1] has once again put a spotlight on pharmacy i.v. rooms. Unfortunately this isn’t the first i.v. error to harm, or kill a patient and I’m sad to say that it probably won’t be the last. We know that IVs present higher risks than most other medications and the literature presents abundant evidence of the prevalence of pharmacy compounding errors which result in patient harm or death.2-11

According to a 1997 article by Flynn, Pearson, and Baker: A five-hospital observational study on the accuracy of preparing small and large volume injectables, chemotherapy solutions, and parenteral nutrition showed a mean error rate of 9%, meaning almost 1 in 10 products was prepared incorrectly prior to dispensing.6

The inherent problem with compounded sterile products (CSPs) is that the efficacy of IV medication administration hinges on the integrity of dose preparation and labeling in the pharmacy. If an item is compounded incorrectly in the pharmacy, no amount of verification at the bedside will alter that. Other than looking at an IV bag or syringe to ensure that no gross particulate matter is present, without chemical analysis it is impossible to verify the contents. Occasionally a color change will acknowledge the addition of the correct additive – yellow multivitamins, red doxorubicin, and so on – but even then, the correct amount (volume/dosage) cannot be verified.
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Should you purchase a robot to help compound sterile preparations in the i.v. room?

The promise of a future where robots handle pharmacy distribution has been around for quite some time. It seems to always be “just a few years away”. I’ve seen my share of robotic distribution systems implemented in pharmacy operations, and the expectation has always been better than the reality.

But what about using robotic systems in the i.v. room to help make sterile preparations? It seems like the perfect place for this type of tool. Activities in i.v. rooms are dangerous and expensive. If one could utilize a robot to increase safety and decrease cost, then it would seem like a no brainer. Unfortunately it’s not as simple as that.

Over the past 16 months I’ve observed several different robots – INTELLIFILL I.V. by Baxter, APOTECAchemo by APOTECA, i.v.STATION by Aesynt, and RIVA by IHS – in several different pharmacy environments – inpatient batch processing for multiple hospitals, inpatient patient specific production for single hospital, inpatient chemotherapy, and outpatient chemotherapy. During that time I’ve formed several opinions about the current crop of i.v. room robots; some good, some not so good.
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