First off let me start by saying that I think BCMA is a worthwhile endeavor. It can have a positive impact on a healthcare system, not only in terms of safety, but with inventory management and billing . The other nice benefit is the ability to see the medication administration in “real-time”. Pharmacists can look at vancomycin and aminoglycoside administration times online now instead of going to the paper chart, for example. And isn’t that the whole idea behind electronic documentation? I think so.
Our facility went live with out first BCMA unit last week. It’s still early, but my initial take is that things went fairly well. We had a few minor issues, but nothing that couldn’t be handled easily and quickly. No matter how well you plan for something there will always be some bumps in the road, and that is important to note.
Below are some things that I picked up along the road to implementation. Some of these things we did well and some we didn’t do at all. This list is my opinion and not the gospel on BCMA implementation by any stretch of the imagination. Please remember that as you read through it.
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Talyst has been beta-testing a new customer portal for several months now. The idea was introduced to Talyst customers at their user group meeting during the ASHP Summer Meeting in Chicago last June. Beta-testing took place between the summer meeting and December 2009 when Talyst unveiled the portal to a larger user group meeting in Las Vegas at the ASHP Midyear. Attendees were given a demonstration of the portal and offered an opportunity to provide feedback on possible issues or features they’d like to see. Well, it appears that the portal is out of the beta phase and ready for use.
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As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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The DoseEdge Pharmacy Workflow Manager, formerly IntelliFlowRx Workload Management Software by Baxa, is a system designed to track and manage intravenous (IV) medication dosages prepared by pharmacy personnel in a clean room environment. The system is touted as “The world’s first and only fully integrated workflow manager for the IV room.”
The system is designed to flow something like this:
- IV medication orders entered by the pharmacist, or other healthcare professional, are sent to the DoseEdge system where they appear on the DoseEdge touchscreen.
- When the technician, or pharmacist in some cases, accesses the order via the touchscreen instructions for preparation of the product are displayed.
- The product label is generated.
- The barcode on each injectable ingredient used for the preparation of the IV product is scanned to ensure the correct medications have been selected. Items identified as incorrect result in an audible message of “product not allowed for this dose.”
- The barcode on the IV product label generated by the pharmacy is scanned to ensure that ingredients are appropriately matched.
- Each ingredient is drawn into a syringe.
- An image of the syringe with appropriately drawn medication is taken for review by the pharmacist, or technician, whichever the case may be. This is a nice feature as it allows one to see the actual amount of drug drawn into the syringe prior to shooting it into the fluid bag.
- Ingredients are injected into the fluid bag and an image of the final product is taken.
- A final scan of the product barcode is done to complete the fill.
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As I’ve mentioned before our AutoCarousel system from Talyst utilizes barcode scanners from Code Corp, specifically the Code Reader 3.0 (CR3). As you my or not be aware, I’ve been working with Code Corp and Talyst over the past several months in an attempt to replace our aging CR3 with Code Corps newest version of the scanner, the Code Reader 3500.
The Code Reader 3500 uses newer technology over the CR3 and performs much better with our carousel. The reader is easier to use due to its wider target area and “reflection and glare reducing illumination”. It’s also quite a bit faster. The technicians love it.
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I read Warner Crocker’s musings at GottaBeMobile as well as his Tweets via the @LPH/tablet-pc-enthusiasts list on Twitter. Warner also has a second blog called Life On the Wicked Stage: Act 2, which I do not read with any regularity. I was, however, driven toward his personal blog secondary to a Twitter post. The post, titled Rush and My Mom: Two Different Care Experiences, talks a little about his experiences with his mothers medical care. She is apparently very ill with lung cancer. I sympathize with Warner as my mother-in-law, Mary Lou, succumbed to lung cancer in December of 2008. I also understand much of what he is talking about as my wife and I experienced similar problems during Mary Lou’s chemotherapy, pain management and surgeries.
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Samwell has introduced a tablet PC designed specifically for the medical industry. The tablet is dubbed the MCA9 and offers a 1.6GHz Atom processor, a two megapixel camera, a RFID reader and optional bar code scanner, and an 8.9-inch TFT-LCD touch screen that is readable in sunlight.
According to Samwell: “designed for medical application, the ability for data capture, record and transmission is highly valued. The built-in 2-megapixel camera is centrally mounted on the backside. The 1D/2D Barcode Scanner and 13.56 RFID reader support electronic medication administration records, reliable patient identification, and medical tracking.”
I’m skeptical of tablets with built in bar code scanners designed for “medical application”. The Motion Computing C5 tablet has a similar design. Our facility trialed a C5 tablet earlier this year and nurses found it difficult to use and too heavy to carry for extended periods. The two megapixel camera and small screen may also present a problem for documentation and viewing patient data.
Our facility is in the process of implementing bar code medication administration (BCMA) at the bedside. A large part of the process involves selecting hardware for the nurses to use on the floor. In addition to bar code scanners, the nurses will need access to computers for documenting not only medication administration, but other patient specific information as well.
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As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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Our facility is gearing up to implement bar code medication administration (BCMA) in February 2010. Part of getting ready is making sure that all the medications dispensed from the pharmacy are bar code ready. If the medication isn’t bar coded or won’t scan, then it won’t do the nurse much good at the bedside. We’re in pretty good shape secondary to our carousel install in February of 2008. Everything that gets stored in the carousel is already bar coded. I had hoped that the file stored in our AutoPharm, i.e. carousel, cross reference file could simply be dropped into our Siemens Pharmacy cross reference file, but that would have been too easy. Siemens refused to play nicely with the data.
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