Jerry Fahrni

Pharmacy Informatics and Technology

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Reviewing an #archetype

Posted on March 31, 2012 by Jerry Fahrni
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I’ve been meaning to write this for a while, but you know how things go.

While at HIMSS12 in Las Vegas last month I was asked to do a little review work. That’s not all that uncommon. People ask me to do things on occasion; review a blog post, review an app, give my opinion on something and so on. But this was completely different as Dr. Heather Leslie (@omowizzrd), Director of Clinical Modeling for Ocean Informatics and Editor for the openEHR Clinical Knowledge Manager asked me to review an archetype. A what? Yeah, that was my response when Heather and I first spoke about the topic nearly two years ago.

According to good ol’ Merriam-Webster an archetype is “the original pattern or model of which all things of the same type are representations or copies: also : a perfect example“. Simple enough, but still too vague for my brain so I went in search of a better explanation which I found at Heather’s blog – Archetypical.
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Categories: Pharmacy Informatics | Tags: ADR, Pharmacy Informatics

#HIMSS12 Day 3

Posted on February 23, 2012 by Jerry Fahrni
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Actually Day 3 was yesterday, but I’m just now getting around to putting some thoughts on paper.

Best session I attended was Care Coordination in Practice: Managing Data Volume and Data
Reconciliation
. The presentation was all about big data and how we’re failing to use it appropriately in healthcare. The slide deck was great. It’s available here if you’re interested.

A couple of things I found interesting in the presentation:

  1. There are approximately 1-2 billion clinical documents produced in the United States each year. That’s mind boggling if you stop and think about for a minute.
  2. More than 60% of key clinical data are not found in coded lists.The remainder of the information is found in free text, scanned documents, etc. That’s a problem because a lot of clinical decision support is based on information in coded lists. So what are we missing? A lot.

The takeaway from the presentation: “Get massive amounts of data flowing, then build structure slowly and incrementally. Don’t wait.” The presenter referred to this as “the Google approach to data”. I’m a fan of all things Google so that works for me.

I had coffee with Pauline Sweetman yesterday (@psweetman). Pauline is a pharmacist from the UK that I’ve been tweeting back and forth with for a couple of years. We had a pretty interesting conversation around the differences and similarities between hospital pharmacy practice in the U.S. and UK. Good stuff.

I also had a great conversation with Dr. Heather Leslie (@omowizard), a physician out of Melbourne, Austrialia that’s doing a lot of work with the openEHR project. During our short visit she persuaded me to participate in their Adverse Reaction archetype review; as a pharmacist of course.She’s always looking for additional help if anyone is interested. It’s a worthwhile project so at least have a look.

I spent more time roaming around the exhibitor area, specifically looking at RFID technology. I’m a fan of RFID, but it doesn’t seem to be catching on in healthcare. There are several reasons why, but we should still be looking hard at it’s application. I’m not sure whether RFID will become important or it it’s a bridge technology to something else. But the only way to find out is start using it and see where it goes.

One product that uses RFID technology that I found particularly interesting comes from a company called MEPS Real Time, Inc. Their product features a dispensing cabinet with real-time RFID driven inventory management to go along with a RFID med tray tracking system. Of course you wouldn’t use RFID for everything because it would be labor intensive and expensive, but for high dollar drugs it might make sense. It was pretty impressive.

MEPS_HIMSS12

Categories: Pharmacy Informatics | Tags: HIMSS, Pharmacy Informatics, RFID

Digital edition of U.S. Pharmacist off to a bad start

Posted on January 26, 2012 by Jerry Fahrni
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I received the announcement below in my email just a short time ago. So being the good little pharmacist that I am, I headed on over to the U.S. Pharmacist website to check it out. Imagine my surprise when I clicked on the digital issue link and was greeted with a “Service Unavailable” message (bottom image). Bummer. Hopefully they’ll get it up and running shortly.

Update: Looks like they got it working within 5 minutes of me posting this. It’s a nice format. Check it out for yourself here.

Read more …

Categories: Pharmacy Informatics | Tags: Bad, Pharmacy Informatics

Model for scheduling complex medication regimens

Posted on November 19, 2011 by Jerry Fahrni
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The abstract below caught my attention. I can’t read the entire article because I don’t have a subscription to the journal (a pet peeve of mine – just sayin’). Nonetheless I found the abstract quite interesting. I think the conclusion is a bit overly optimistic, but the use of computers to calculate an optimized medication schedule for individual patients is a promising idea. (Comput Methods Programs Biomed. 2011 Dec;104(3):514-9. Epub 2011 Oct 5.)

 

Abstract
Medication adherence tends to affect the recovery of patients. Patients having poor medication adherence show a worsening of their condition and/or increased complications. Unfortunately, between 20% and 50% of chronic patients are unable to manage their medications. This study proposes a model to improve the patients’ medication compliance by reducing medication frequency.

Published studies have shown that, based on the patients’ lifestyle, simplification of the medication frequency and remodeling of the medication schedule is able to help improve medication adherence. Therefore, this study tried to simplify medication frequency by combining therapies. Moreover, by adjusting according to lifestyle, the study also tries to remodel medication timing in relation to mealtimes to create personal medication schedules.

In this study, we used 19,393,452 outpatient prescriptions from the National Health Insurance Research Database to verify our system (algorithm optimized). At the same time, we examined the differences between the frequency summarized by general public and experts’ advice medication behavior. Compared with the experts’ advice method, this system has reduced the medication frequency in about 49% of prescriptions.

Using combined medication to simplify medication frequency is able to reduce the medication frequency significantly and improve medication adherence. Furthermore, this should also improve patient recovery, reduce drug hazards and result in less drug wastage.

Categories: Pharmacy Informatics | Tags: Pharmacy Informatics, Pharmacy Practice, Pharmacy Technology, Therapeutics

Witnessless waste, a novel concept

Posted on October 1, 2011 by Jerry Fahrni
1 Comment

While at the Pediatric Safety Summit in Bellevue, WA this week I had the opportunity to speak with several pharmacists about things ranging from the state of pharmacy practice to how best to use technology to improve patient care and so on. There really is no better way to spur idea generation than to sit down with a colleague and talk face to face.

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Categories: Pharmacy Informatics, Technology | Tags: Cool Stuff, Ideas, Patient Safety, Pharmacy Informatics, Waste

The ASHP Summer Meeting 2011 continues … (#ashpsm)

Posted on June 14, 2011 by Jerry Fahrni
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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:

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Categories: Pharmacy Informatics | Tags: ASHP, ASHP Summer Meeting, Meeting, Pharmacy Future, Pharmacy Informatics, Social Media

The next big thing in pharmacy informatics? Hint: IDK

Posted on January 25, 2011 by Jerry Fahrni
2 Comments

RxInformatics: “The following was a list serv question from Monica Puebla, PharmD, MBA, BCPS for a HIS course. Here is my response to the Question. I would add State Boards of Pharmacy to the list of those to present this as well.

“If you were given the opportunity to present to your DOP, VP and CFO a project that you deem would have the greatest impact on the pharmacy department as well as the health-system in general from any point of view, clinical, financial, operational, without regards to costs, what would it be?”"

John’s response was to “Study under what circumstances pharmacist order review (perfection) could be taken over by automated clinical decision support while increasing quality and safety” in addition to including a nice list of references related to ‘perfection’ (listed at the bottom of this post). I highly recommend looking at the references John provides because they’re informative and enlightening. You can also read more about the ‘perfection’ idea at one of John’s older posts here. It’s amazing that this discussion has been going on for well over a year and to the best of my knowledge has yet to make much headway.
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Categories: Pharmacy Informatics | Tags: Pharmacy Future, Pharmacy Informatics, PPMI

#ASHPMidyear 2010 part deux

Posted on December 6, 2010 by Jerry Fahrni
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Today was a great day to be at ASHP Midyear 2010. Things really got going as the sessions were kicked into high gear and the exhibit hall officially opened.

I spent the day tracking down pharmacy automation and technology. Did you really expect me to do anything else? I don’t ever recall being as excited as a clinician as I am being an informatics pharmacist. Anyway, here are some things I found interesting:
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Categories: Pharmacy Informatics | Tags: ASHP, ASHP Midyear, Pharmacy Automation, Pharmacy Informatics

Oh yeah, on my way to #ASHPMidyear 2010

Posted on December 4, 2010 by Jerry Fahrni
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Here I sit in the airport waiting for my flight to take me to ASHP Midyear 2010 in Anaheim, CA.  ASHP Midyear is the premiere conference/meeting for pharmacists each year. Sure there are larger healthcare conferences/meetings every year, but none are dedicated entirely to the pharmacy profession.

As this is only my second ASHP Midyear in my career I’m excited to see if the experience matches that of last year. I’m sure it will as I continue to be impressed by the number and variety of sessions crammed into such a short period of time. Of course I’m particularly interested in the informatics sessions, but it’s ok if you find yourself sitting in on one of the talks updating you on what’s happening in the clinical world. I won’t hold it against you.

The week for me will kick off on Sunday morning with the Talyst Users Group meeting followed by a session on RFP’s and contracts put on by the ASHP Section of Pharmacy Informatics and Technology’s Advisory Group on Pharmacy Operations Automation. I’ll round out Sunday’s activities by attending the McKesson Safe Compounding Reception. And it will only get better from there as the week will be filled with sessions on clinical decision support, barcoding, telepharmacy, the application of social media to pharmacy, and so on and so forth.  My week will conclude with the session titled mHealth: There’s an App for That where I will be presenting information on the integration of the iPad into pharmacy services.

The information I’m presenting was pretty cutting edge at the time I submitted the slides, but is now clearly dated. That’s the downside of having to submit presentation slides so far in advance. Anyway, it should still be worth the time and effort. I’ve always found it educational for myself to present information to people as someone always has something interesting to add or a good question to stimulate the thought process.

I’m looking forward to the next five days. I’ll be Tweeting (@jfahrni) as much of the event as possible in addition to posting about the day’s activities whenever feasible. I hope to see you there. If you’d like to get together and talk a little pharmacy informatics/automation don’t hesitate to give me a Buzz, Tweet or email.

Categories: Pharmacy Informatics | Tags: ASHP, ASHP Midyear, Meeting, Pharmacy Informatics

Who’s to blame for the lack of advancement in pharmacy automation and technology?

Posted on November 14, 2010 by Jerry Fahrni
4 Comments

Without question there is a lack of advanced automation and technology in the acute care pharmacy setting. Spend some time in several acute care pharmacies if you don’t believe me. There’s clearly a need for it, but it’s just not being used.

I am a fan of automation and technology in any setting, but especially in the acute care pharmacy. I believe that the continued use, development and advancement of pharmacy technology should be a key component of any plan to change the current pharmacy practice model. Unfortunately, the situation is problematic because current pharmacy technology is either poorly designed for the needs of the pharmacy or the pharmacy in which it is used has a poorly designed workflow that doesn’t take advantage of it. Why is that? Who’s to blame; someone, anyone, no one? Valid questions.
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Categories: Automation, Technology | Tags: ASHP Midyear, Pharmacy Informatics, Pharmacy Technology, PPMI
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