Well, I asked for it. Comments and suggestions from previous posts.

If you float something out over the internet, someone is going to see it and keep you honest. Remember what I said, “There is always someone smarter, harder working, more motivated and better informed than me, and those are the people I want to hear from.” Well, those people have responded with some great information pertaining to barcoding and pharmacy automation. 
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Taking advantage of your carousel space.

gapinshelvesI have posted many times on our system for barcoding medications in the pharmacy. The posts have included reference to our efforts to increase storage space.  Our goals have always been to store as many medications as possible within the carousel to take advantage of the software’s many safety features and inventory functionality. 

Like all pharmacy departments we have several medication items that do not require significant storage space. I am talking about items like ophthalmic drops, otic preparations, small ointments and creams and some injectable items that are stocked in small quantities secondary to expense and lack of use. 

Small bins for storing opthalmic preparations.

During installation of our carousels we noticed small gaps in the shelving units. We approached one of the White Systems engineers on site and inquired about the small gaps. I don’t recall exactly why they were there, but the small size made the space virtually useless. Fortunately for us, the Talyst consultant that was on site to help us with the installation process sat down with us to come up with a solution. It was a simple idea really, but quite ingenious.  We purchased small bins that fit perfectly into the empty spaces. The size of the bin limited their utility for storage, but worked nicely for the smaller items mentioned above. The addition of the smaller bins created several empty spaces in the larger bins, giving us significantly more storage. 




Cool Technology for Pharmacy

Pyxis PARx: “The Pyxis PARx® system automates the pick-check-delivery process to provide increased security during medication replenishment throughout the hospital. The system utilizes bar code scanning technology for real-time tracking and monitoring of medication handling, pharmacist review and delivery of medications. By providing a complete chain-of-custody on medications during distribution to the nursing unit and helping to ensure the right medication is getting to the right station and the right pocket in the station, the Pyxis PARx® system is a valuable technology that provides improved patient safety and supports compliance with Joint Commission requirements.
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Problems with barcodes.

ISMP Medication Safety Alert! May 21, 2009 Vol. 14, Issue 10: “Please let us know if you identify problems bar_barcodewith  a company’s unit dose package barcode. An example of an ARICEPT (donepezil) unit-dose package with a barcode  problem appears in Figure 1 (shown in the PDF version of the newsletter). Note that the labeling material has been applied to the unit-dose package in such a way that tearing the doses apart destroys the barcode! Problems like this are due to inadequate quality control and are by no means isolated to one company. When issues like this occur, staff are forced to take extra steps to maintain the quality of the barcode, or they have to relabel products so they can be scanned at the bedside. This, of course, takes time and also increases the risk of a labeling error. If you send barcode problems to us along with a publishable photo, it will help us remind companies about the need for adequate quality control.”  Fortunately for us we haven’t seen anything like this, yet.

Barcode symbologies….what’s in your pharmacy.

I had a brief exchange with a colleague a few days back and the subject of where manufacturers were headed with barcoding came up. It’s an interesting discussion. As mentioned in a previous post the number of available barcode ready, unit-dosed medications has been slowly shrinking. As manufacturers work with government agencies and pharmacy organizations to come up with a standardized barcode format, it appears that they have put their unit-dosed, barcode ready medications on the back burner.

Manufacturers have a lot of barcode options to choose from, which may be contributing to the difficulty in developing a standard. However, it is important for the pharmaceutical industry to realize that the need for a barcode standard is ultimately driven by a goal for patient safety.
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Even the best things can be improved.

I had the opportunity to speak with a nice young lady from Talyst this morning about extending our barcoding system to our pharmacy satellites. She had great insight into what we wanted to do and offered some very helpful tips. The conversation took an interesting turn when she asked me how I liked the system and where I thought improvements could be made. After the initial shock of a vendor asking me my opinion, we spent a few minutes discussing the system and how our workflow has changed for the better.

Overall, we have been very pleased with our barcoding system. I wish all platforms ran as smoothly as our Talyst products. However, there is always room for improvement. I understand that Talyst is currently working on a “big” new release of their AutoPharm software that is focused on patient safety. I don’t have specifics, but it is possible that some of the items listed here are already in the works.
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Extending the reach of AutoPharm/AutoCarousel with “the wall”

In March of 2008 our hospital implemented a system to meet a district wide initiative for 100% barcoded medications in the pharmacy. The barcoding project for the pharmacy was immense, involving a pharmacy remodel, hundreds of thousands of dollars and hundreds (if not thousands) of man hours.

The project included the implementation of an automated bulk packager capable of creating unit-dosed, barcode ready medications (AutoPack), a barcode labeling system (AutoLabel) and an automated medication storage and retrieval system (AutoCarousel with AutoPharm software). All products were purchased from Talyst, who is headquartered in Bellevue, WA.

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Cool Pharmacy Technology


Thin clients are computers that depend on a centralized server for processing power. They are simple devices that typically contain only the most basic hardware, and frequently do not contain a hard drive. Thin clients essentially serve as the interface to the server.

Thin clients are mostly inexpensive compared to traditional desktop PCs, and offer easier management and security secondary to their connection based on a singular source.

Our facility has plans to utilize the Dell thin client as a major component of our bedside barcode scanning system. Thin clients will be attached to monitor, keyboard, mouse and scanner creating a complete scanning solution in each patient room. The result is a simple, low maintenance platform.

I wouldn’t want to use a thin client computer as my primary work machine. I like to customize my work environment and they lack the flexibility. They are, however perfect when a secure, inexpensive solution is needed for use in high trafic areas like hospital wards.

Fewer unit-dosed, barcode ready drugs from the manufacturer?

I’ve noticed a trend over the past few months. Several medications that we typically purchase are no longer available in unit-dosed, barcode ready packaging. The result has been the purchase of more and more medications in bulk, which require repackaging and barcoding prior to dispensing. The reason for the trend is unclear, but appears to be a difference in opinion on what information should be contained in the barcode and what barcode standard to use. Even with organizations like ASHP encouraging manufacturers to develop standards and the FDA requiring barcodes on prescription medications, there appears to be a gap.
Continue reading Fewer unit-dosed, barcode ready drugs from the manufacturer?