ASHP Midyear 2018: Initial Thoughts

I recently returned from the 2018 ASHP Midyear Clinical Meeting, i.e. “Midyear” in Anaheim, CA. This year was a bit different for me as it was the first time in many years that I attended the meeting as a regular pharmacist, i.e. not tied to a pharmacy automation company as an employee or as a consultant. As such, I had no constraints on what I could see, do, or say. It was invigorating, to say the least.

I attended several educational sessions, mostly on USP <797> and <800>. However, most of my time was spent in the exhibit hall wandering from booth to booth checking out all the cool products. It was great.

As much as it pains me to say, not a lot has changed since the last ASHP Midyear Meeting I attended in December 2016.* Many of the products and vendors were exactly as I remember them. With that said, here are a few things that caught my attention:

  • The “Big 3”: Omnicell, BD, and Swisslog all had a big presence on the exhibit hall floor. All three companies appear to be vying for pharmacy supremacy as they continue to grow and gobble up small companies. The Omnicell booth was giant and seemed to always be full. Oddly, it was the only booth I walked into where someone from the company didn’t engage me in conversation.
  • IV workflow management (IVWFM): No longer a hot topic. It appears that the market is slowing as pharmacy leaders turn their attention to other things. Quite a dichotomy from what ISMP and ASHP continue to recommend, i.e. the use of technology during sterile compounding. Apparently patient safety is important, unless it’s inconvenient. Pharmacy is weird.
  • Drug Diversion: Unlike IV workflow management, drug diversion was a hot topic. It seems as though everyone has a software solution to help root out those pesky diverters.
  • Kiro Oncology by Grifols: I wrote about Kiro Oncology back in 2015. At that time, I didn’t think much of the product. It had some serious shortcomings, at least in my opinion.  The robot lacked speed and a drug dictionary that would make it useful. Now, not so much. I was impressed with how far Grifols has come with Kiro Oncology. The speed has significantly improved and they’ve worked with their partners to build an impressive oncology drug dictionary from which sterile compounds can be made. I spent quite a bit of time speaking with a Director of Pharmacy at a facility that is using Kiro. He mirrored my thoughts, i.e. not great to start but significantly better now. Given the new focus on hazardous drug compounding, my thoughts on Kiro have changed. There is great potential here. I may write more about this later.
  • PharmID: PharmID is a product that uses Raman Spectroscopy to identify drug waste. If you’ve been following my blog over the years then you know that I like Raman Spectroscopy. It makes a lot of sense when you want to know what’s in a clear fluid. Before PharmID, the company was trying to fit the technology into the sterile compounding space. That didn’t make sense to me, but this does. Given the focus on drug diversion and the inherent problems tracking waste in the OR, something like PharmID has great potential. Now all they need is something like the now defunct  BD Intelliport to automatically record the volume. If you can do that — identify the drug, measure the concentration and volume — you’re all set.
  • IntelliGuard: In the Summer of 2017, IntelliGuard got a new CEO and then abruptly went dark. The company disappeared from view. After visiting the IntelliGuard booth at Midyear, it was apparent why. They’ve completely revamped their image, created an entirely new marketing strategy, built some new products, improved on old products, and created an integrated platform message. I’ve always liked RFID technology for certain niches within healthcare, and IntelliGuard makes some great RFID products.
  • Swisslog: Some people feel that I’ve been a little hard on Swisslog over the past couple of years. I for one, am not one of the people. I call it like I see it. And my opinion is exactly that, my opinion. When Swisslog acquired Talyst, I was skeptical. Nothing has changed, I remain skeptical. However, Swisslog has two products that I really like. The first is their analytics software. I don’t know the name of the product and can’t seem to find it on their website. Regardless, I’m impressed by the vision that the company has with the product and the number of disparate systems they’ve managed to tie into it. I would love to see it in the wild. The second product is the Relay Robot. Love that little bot. I can see so much potential.
  • DrugCam: DrugCam is an IV workflow management system. I first saw the product at the ASHP Summer Meeting in Minnesota way back in 2013. DrugCam uses computer vision technology that automatically detects items and fluid volumes during the compounding process. As the user passes components in front of the cameras, the system automatically identifies them. If the system doesn’t recognize the item, the user is notified via visual cues on the screen. I’m not entirely sure how it works, but it is pretty interesting. The company had a presence in the exhibit hall but there was no hardware to look at, only a video set on a continuous loop in the background. I was really high on this technology when I first saw it. It would be good to see it in action. There’s an article from April 2016 in the International Journal of Pharmaceutics should you be interested in reading more about it.

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*I skipped the 2017 meeting due to scheduling conflicts with my new job

More thoughts on the ASHP national survey results for informatics and pharmacy practice

On Monday I spoke briefly about two articles in AJHP that summarize two recent ASHP surveys. The first covers Pharmaccy Informatics in U.S. Hospitals(1), while the second focuses on pharmacy practice in acute care hospitals(2).

Both surveys contain a wealth of information, and provide a snapshot of what pharmacies in the U.S. are doing. While conducted at different times by different groups, I think it’s more interesting to look at the two surveys together. As I mentioned in my podcast, the adoption of automation and technology goes hand in hand with pharmacy operations. You can no longer have one without the other.
Continue reading More thoughts on the ASHP national survey results for informatics and pharmacy practice

Drug shortages, whose to blame?

Medscape: “One cause of these shortages, pharmaceutical companies charge, is the amount of time it takes the DEA to approve controlled substance quotas. The DEA has created these quotas for each class of controlled substances and for each manufacturer of drugs containing these agents to prevent their diversion to illegal uses.”

The drug shortage problem is nothing new. It has become an everyday reality of pharmacy practice. ASHP has established a dedicated website for the problem, and the FDA has gone as far as to create a mobile app to help people track shortage information.

For most people the idea of a drug shortage seems silly, i.e. just make more. The problem is more complicated than that, however. The causes of drug shortages are multifaceted.
Continue reading Drug shortages, whose to blame?

Saturday morning coffee [July 27 2013]

So much happens each and every week that 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….

It’s been a while. I feel a bit rusty.

The coffee mug below is from the ASHP Summer Meeting Twitter contest in Minneapolis, MN in June. I took third place, which is a bit of a disappointing as I was the reigning champ for a couple of years back in the day. I’ve had the mug for a few weeks, but haven’t felt like posting so it’s just been sitting in my cupboard. Thanks to ASHP, I’m certainly happy to add it to my ever growing collection.

ASHP SM 2013 Twitter Contest Mug
Continue reading Saturday morning coffee [July 27 2013]

Upon further review – thoughts on ASHP Midyear 2012

I’ve just returned from a week in Las Vegas, NV at ASHP Midyear 2012. The ASHP Midyear conference is the pinnacle of clinical meetings each year for most acute care pharmacists. For me it’s not that interesting anymore as I don’t attend as a pharmacist. It just more work days for me; long work days. I didn’t attend a single “session”, but did manage to find some time to walk through the exhibit hall once and catch up with some old friends.

Enough of that, on with the thoughts:
Continue reading Upon further review – thoughts on ASHP Midyear 2012

Sadly #ASHP misses the mark

I’ve been an ASHP member off and on for much of my career. I’m not much for membership in organizations, but I thought ASHP would be worthy. Heck, they’re the biggest professional pharmacy organization in the country (world?), why wouldn’t I be a member.

I try to give them the benefit of the doubt, but sometimes I wonder who’s driving the bus. I believe ASHP’s goals should be to: 1) promote the profession, 2) improve the profession, 3) defend the profession from nefarious sorts, , and 4) offer guidance to help move the profession into the future. That’s it. Read into it what you will, but pharmacists and technicians pay to be members of ASHP. Why? Because they believe ASHP will make pharmacy better. Otherwise there’s no point.

I’ve dabbled in some of the small groups within AHSP, specifically the Section of Pharmacy Informatics and Technology (SOPIT). These small groups focus on specific issues within the profession. Their purpose is to come up with solutions and recommendations. And in the case of the SOPIT the goal is to help solve problems associated with pharmacy informatics, automation and technology within the practice of pharmacy. It’s actually a good group that has done some great things over the years.

One of these groups in particular had great promise as it brought together several companies in the industry to look at the problem associated with informational standards; particularly drug information updates to pharmacy formularies. One of the problems with information within formularies (drug dictionaries, drug masters, <insert other name here>) is that standards simply don’t exist. Everyone has their own way of doing it, which causes problems.

While serving as the IT pharmacist at my last facility I had to manually maintain several formularies: pharmacy information system, ADC’s, pharmacy inventory management system, barcode labeling system, online hospital formulary, etc. It was time consuming and fraught with error. And before you ask, yes I made mistakes in those systems that caused problems; problems that were a bear to fix.

The group mentioned above was brought together to look at this problem and propose a method for companies to collaborate with the sole purpose of bringing a single standard to the practice that could be utilized to populate hospital formularies in a “downhill” fashion, i.e. one formulary update delivered to a centralized location that could be pushed out to other formularies. One standard. One location to update. One  formulary to monitor. One formulary to maintain. Simple. Fewer errors. Less work. Better for the profession.

Unfortunately AHSP decided to kill the project. I’m greatly disappointed in ASHP for doing this.
Continue reading Sadly #ASHP misses the mark

The ASHP Summer Meeting 2011 continues … (#ashpsm)

ASHP 2011 Summer Meeting and Exhibition

I had planned on blogging daily during the Summer Meeting, but obviously that didn’t happen. Perhaps it was the big dinner I had yesterday evening followed by the insanely good gelato that put me into a food comma, or then again maybe it was just laziness. Regardless, I skipped a day.

The Summer Meeting continues to roll on with some great sessions and lots of interesting conversation. All-in-all between yesterday and today I’ve attended the following:

Continue reading The ASHP Summer Meeting 2011 continues … (#ashpsm)

And so it begins, the ASHP Summer Meeting 2011 (#ashpsm)

As you read this the ASHP Summer Meeting is taking place in Denver, Colorado. While the ceremonial start isn’t until after the Opening Session and Keynote tomorrow (Monday, June 13) things have been in full swing since Saturday.

Continue reading And so it begins, the ASHP Summer Meeting 2011 (#ashpsm)

Why not a computerized pharmacist?

So IBW’s Watson recently competed and won ‘Jeopardy!”. Well, ‘Jeopardy!’ is a lot harder than verifying many medication orders routinely seen by pharmacists in the acute care setting.

According to a recent article at Network World: “Watson’s ability to analyze the meaning and context of human language, and quickly process information to find precise answers, can assist decision makers such as physicians and nurses, unlock important knowledge and facts buried within huge volumes of information, and offer answers they may not have considered to help validate their own ideas or hypotheses, IBM stated.

From IBM: “… a doctor considering a patient’s diagnosis could use Watson’s analytics technology, in conjunction with Nuance’s voice and clinical language understanding solutions, to rapidly consider all the related texts, reference materials, prior cases, and latest knowledge in journals and medical literature to gain evidence from many more potential sources than previously possible. This could help medical professionals confidently determine the most likely diagnosis and treatment options.””
Continue reading Why not a computerized pharmacist?

Death of intellectual curiosity, due diligence and our profession

Over the weekend I read a tweet from a friend and colleague @kevinclauson. The tweet shared a link to an article titled “Young Adults’ Credibility Assessment of Wikipedia”. I don’t have a problem with the article. On the contrary, it just reinforces my dislike of Wikipedia as a healthcare reference source.

From the abstract: “This paper found that a few students demonstrated in-depth knowledge of the Wikipedia editing process, while most had some understanding of how the site functions and a few lacked even such basic knowledge as the fact that anyone can edit the site. Although many study participants had been advised by their instructors not to cite Wikipedia articles in their schoolwork, students nonetheless often use it in their everyday lives.” Kevin also links to the pre-print version of the article here (PDF).
Continue reading Death of intellectual curiosity, due diligence and our profession