I just finished my last session of the day here in Philadelphia, and overall I would have to say it was a productive one.
My first session today was an update on various future enhancements to both the Siemens Pharmacy System and their barcode medication administration system (BCMA), fondly referred to as MAK. The future enhancements bring much needed functionality to a system that, in my opinion, wasn’t ready for prime time.
Enhancements presented include:
Barcode scan checking via Siemens Pharmacy – This function will allow users to scan newly received orders from the wholesaler to quickly identify barcodes that are not currently in the pharmacy system. Hospital pharmacies will often utilize several different manufacturers of the same drug, like generic Tylenol. Each manufacturer must be scanned into the system and linked to the specific drug. This becomes extremely important for BCMA. Our facility doesn’t have to worry about this issue because all our products are scanned and identified via our AutoPharm system from Talyst, but the feature is still a great addition to the Siemens Pharmacy System.
Pregnancy and lactation checking – The pharmacy system currently has indicators for pregnancy and lactation displayed as “Y” in the patient demographics. Unfortunately these indicators offer only a visual queue to the pharmacists as they do not offer real time checking against possible contraindications for pregnant and lactating women. In other words, you can give a pregnant woman any drug you want without the computer warning you when there is potential danger to the fetus. The upcoming release of Siemens Pharmacy, scheduled for release sometime in 2010, will perform drug interaction checking against both the pregnancy and lactation indicators. This is a great safety feature; one I’ve been hoping for.
Drug-Drug clinical checking will be adjustable at the severity level – Most pharmacists will tell you that too many drug-drug interaction screens can lead to “alert fatigue”. Current systems typically warn you about any potential interaction, no matter how inconsequential. Pharmacists get in a habit of blowing through these types of warning screens, and before you know it inadvertently bypass a serious warning. Siemens newest release will allow pharmacy departments to elect what level of interaction they wish to see and block those they do not. This may sound dangerous, but if used properly can actually increase safety. My pharmacists will be very happy.
Option to leave Navigator open when launching the order summary screen – This is a big problem with the current system. In fact, it was the number one complaint logged by my pharmacists when we upgraded to the current version of the pharmacy system. This change will bring tears of joy.
Manufacturer name, lot number, and expiration – Users will be given the option to require nursing to document the manufacturer’s name, lot number, and expiration date of the medication upon administration at the bedside via BCMA. This will be important for immunizations/vaccines because that information is required.
Reminders in MAK – Siemens will give users the option to attach various “reminders” to specific medications. For example, when entering an order for a topical medication in patch form (i.e. fentanyl, nitroglycerin, nicotine, clonidine, etc) the pharmacists currently have to enter a second order informing the nurse to “remove patch”. This, in theory, prevents nursing from inadvertently leaving the old patch in place while adding the new patch. In the new update this reminder will be attached directly to the drug, thus giving the nurse a visual reminder in the form of a pop-up when applying the new patch via BCMA. No more dual entry.
Order specific barcode – Currently Siemens only produces medication specific barcodes on orders entered via the IV medication screen, i.e. IVPB, LVP, TPN, chemotherapy, etc. The upgrade will allow users to add barcodes to the medication label at the drug level. This is important for items that are compounded, like Stanford Mouthwash, Diaper Mix, etc. as well as pediatric oral syringes. This hasn’t been an issue for us as we use the AutoLabel system from Talyst to barcode items not commercially available. However, it is still a nice feature to have.
ASP services version of Siemens Pharmacy – This is one of the most exciting things I heard today. Siemens is currently beta testing a web-based version of their pharmacy system that would reside on their servers. I believe this falls under the software as a service (SaaS) category. This is just a hop, skip and a jump away from a “cloud” model. Using the pharmacy system in this manner would lead to increased uptime, high availability, built in disaster recovery, decreased capital investment (hardware), and always being on the latest version of the pharmacy software. I spent some time talking with one of the Siemens engineers after the presentation and was very interested in what he had to say. This is good news.
The rest of my day was spent listening to presentations on BCMA. While the information was good, there wasn’t anything that I hadn’t heard before.
Best quotes of the day:
“It’s a great system, but you can’t get away from the human factor.” I believe this down to my core, but I also believe you can limit the human factor by making the system so easy and intuitive that the user would have to go out of their way not to use it. In other words, make it easy to do the right thing and hard to do the wrong thing.
“People still have accountability and responsibility.” If you hold people accountable for their actions, they’re more likely to think before they leap.