Update: Siemens Innovations 2010 – Day 1

Today was the first real working day at Innovations. Yesterday was taken up by all the registration stuff that you have to do when you arrive at a conference, and the welcome reception. Most of the morning was fairly benign as a good chunk of it was taken up by the opening session. I’m not a big fan of opening sessions as they tend to all sound the same. However, I did manage to squeeze in a couple of good sessions in addition to spending some time at the expo. I general love roaming the expo, but this year’s vendor selection is quite small and not really that interesting. It only took me about an hour to run through all the booths and collect a little reading material for later.

One unplanned event that I have to mention was the pleasure of eating breakfast next to Johnathan Paul, a senior engineer in enterprise R & D at Siemens. He casually sat down next to me this morning and asked me what sessions I was planning on attending. I promptly gave him my spiel about attending the various pharmacy sessions, but in addition I lamented the fact that I was going to miss the presentation on “Virtualization, Cloud Computing, SOA, Elasticity, De-Duplication…What Do These Technical Terms Really Mean and How Do We Apply Them?” because it was at the same time as the pharmacy update. I didn’t know at the time, but he was the presenter for that session. After I got past my initial embarrassment we had a great conversation about many of the topics he planned to cover. I came away with some great information and knowledge that Siemens is doing things behind the scenes that makes me downright giddy.
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Quick Hit – CPOE, a pharmacist’s time and laughter

We’ve finally stepped off the curb and are moving full speed ahead with our CPOE implementation. As a result I spent quite a bit of time last week with our Siemens assigned CPOE consultant. He’s a pharmacist which makes things nice because we understand each other and speak the same language.

The goal of one of the meetings I attended last week was to discuss the resources necessary to implement a CPOE system. Needless to say the project is going to be resource heavy. When it came time to tease out the IT pharmacist part of the project I was a little surprised at what I heard. The time requirements weren’t surprising – several hundred hours – but where the pharmacist fits into the entire scheme was.
Continue reading Quick Hit – CPOE, a pharmacist’s time and laughter

Is the 30-minute rule for medication administration good or bad?

The June 17, 2010 issue of ISMP Medication Safety Alert I received has an interesting article on the unintended negative consequences of the Centers for Medicare & Medicaid Services (CMS) regulation requiring medications to be administered within 30 minutes of their scheduled dosing time. I’m sure that the CMS 30-minute rule was created with good intentions in mind, but in reality it creates a lot of anxiety and bad habits. According to the ISMP article, the CMS 30-minute rule “may be causing unintended consequences that adversely affect medication safety. While following the 30-minute rule may be important to hospitals, many nurses find it difficult to administer medications to all their assigned patients within the 30-minute timeframe. This sometimes causes nurses to drift into … unsafe work habits.” Those unsafe work habits include removing meds from automated dispensing cabinets (ADC) for multiple patients at once, removing meds ahead of time, falsifying documentation to meet the 30-minute rule and preparing doses ahead of time; all dangerous practices.
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“What’d I miss?” – Week of June 27

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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Top blog posts and searches from last week

I always find it interesting to see what brings someone to my website and what they decided to read once they get here. Most of the time it isn’t pharmacy related at all. Funny how that works.

Most read posts over last week:

  1. Medscape Mobile for the BlackBerry – This has appeared at or near the top for the past couple of weeks. It’s a testament to how many healthcare professionals are still carrying BlackBerry devices.
  2. iPad + ClamCase = awesomeness? – This is funny. All I have to do is put the word “iPad” anywhere in a post and people flock to it.
  3. CPOE – Giving it some thought – CPOE is gaining some traction for sure.
  4. Cool Technology for Pharmacy – LXE Bluetooth Ring Scanner – I sat on this one for quite a while. Couldn’t decide if I wanted to blog about it or not.
  5. RxCalc 1.1 now available for the iPhone and iPod Touch – Similar to “iPad”. Put the word “iPhone” somewhere in the post and people will find it.
  6. “What’d I miss?” – Week of May 23, 2010
  7. Cool Technology for Pharmacy – This was before I started putting the name of the cool technology in the blog title. This particular post was from Jun 18, 2009 and covered Alaris Smartpumps.
  8. Best iPhone / iPod Touch Applications for Pharmacists – Ibid, iPhone & iPad. It’s been a while. I should really update this information.
  9. Curriculum Vitae – I see this show up high up on the list occasionally. I believe young pharmacists are looking for an example of how to compose a CV. I spent a lot of time trying to figure out how to write one; still don’t know if I have it right. I can never figure out how much information to include or what should be excluded.
  10. “What’d I miss?” – Week of May 17,2010

Top searchterm phrases for last week

  1. “medscape.com/blackberry”
  2. “autopharm”
  3. “alaris”
  4. “jerry fahrni”
  5. “black cloud”
  6. “cloud computing”
  7. +”magnetic resonance imaging” + “cool image”
  8. “alaris infusion pump”
  9. “dell xt”
  10. “carousel for meds” tied with “medscape mobile”

CPOE – Giving it some thought

Computerized Provider – or Physician if you like – Order Entry (CPOE) is an older technology that has been in the spotlight for the better part of the past year thanks to the American Recovery and Reinvestment Act (ARRA) and key components of meaningful use. Because of the “stimulus” offered by ARRA many hospitals across the United States will be gearing up to implement CPOE, ready or not. Currently less than 20% of the hospitals in the United States are using CPOE, and only a small fraction of those are using it for all orders throughout their facility (AJHP. 2008; 65:2244-64).
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Pharmacy practice model spotlight in ASHP PPMI eNewsletter

ASHP and the ASHP Research and Education Foundation have partnered to take a long hard look at what pharmacy practice looks like now and what it needs to look like in the future. The venture is called the Pharmacy Practice Model Initiative, or PPMI. According to the ASHP PPMI website “there is an urgent need to create a forward thinking hospital and health-system pharmacy practice model.“ I couldn’t agree more.

The current pharmacy practice model is more than 3 decades old and is sorely in need of an overhaul. Of course the changes will represent not only the services pharmacists provide and how pharmacists participate in patient care and safety, but also how to best utilize technology to accomplish the ultimate goal; a better pharmacy practice model.

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“What’d I miss?” – Week of December 13th

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.

Continue reading “What’d I miss?” – Week of December 13th

BCMA vs. CPOE, Which Comes First? Webinar Results

argumentPharmacy OneSource hosted a webinar “debate” today that had two excellent speakers presenting their cases for which technology should implement first; Computerized Physician Order Entry (CPOE) or Bar Code Medication Administration (BCMA). The webinar was well worth the time.

The case for CPOE was presented by John Poikonen, Pharm.D. John is the Clinical Informatics Director at UMass Memorial Health Care, an Academic Medical Center and health system in central Massachusetts. John is an interesting informaticist as he has repeatedly spoken out against the lack of evidence supporting BCMA. It was a good fit for him to argue for CPOE implementation ahead of BCMA. He brought up some great points and presented a fair amount of literature to back them up. You can read more of John’s musings at RxInformatics.com.

The case for BCMA was presented by Steve Rough, the Director of Pharmacy at the University of Wisconsin Hospital and Clinics, and Clinical Assistant Professor at the UW-Madison School of Pharmacy. Steve has done quite a bit of work with bar code medication scanning technology and presented an excellent case for BCMA.

Both presenters had valid reasons and good arguments for their positions. I for one am in favor of both CPOE and BCMA, but would personally push for BCMA ahead of CPOE for several reasons. CPOE requires a much larger investment in resources, both human and financial, when compared to BCMA. There is also a reasonable expectation that BCMA will stop errors at their most vulnerable point, the administration phase. I’ve mentioned this before and Steve brought up some of the very same points in his presentation. Finally, CPOE requires buy-in from physicians in order to be completely successful. And if there is one thing you can count on it’s that physicians will fight you tooth and nail when it comes to technology and change.

You can grab a copy of the presentation slides here.