Tag Archives: Pharmacy Practice

On the job, six months as an independent

Through an interesting series of events over the past several months I’ve slowly transformed myself from an employee to an independent contractor, so to speak. I suppose I’ve officially become a consultant of sorts, but I’m not thrilled with the term “consultant”. My dislike for the term comes from my experience with consultants over the years. I’ve worked with many, but found few that were actually helpful. It’s obviously not fair to lump them all into the same basket, but those are the breaks.

Immediately after losing my job in July 2013 I tried to jump back into pharmacy, quickly realizing that it wasn’t going to happen. Fortunately I was able to piece together “full-time work” by combining some per diem hours at a local hospital and some ad hoc product management work for a small company working on a new pharmacy application. The hospital work was good, but limited to 10-20 hours per week for about three months. As luck would have it as the hospital job was coming to an end another small company building pharmacy software reached out and just like that I had a second job as an ad hoc product manager. Then a few hours helping a group with strategic planning, then a few hours on a marketing campaign, then some time analyzing state specific pharmacy laws, and so on.

I’ve had a fair number of inquiries from various companies covering a host of projects. Some turned into work, while others were nothing more than discussions. I’ve had to turn down two jobs due to a draconian non-compete from my previous employer. That will be gone in July, which means I’ll be able to open myself up to another group of potential opportunities.

Truth be told I’ve entered the world of consulting completely by accident, and it turns out that I like it. I like it a lot. My schedule is flexible and within my control, and the variety of work prevents me from getting bored. I’ve also discovered that the companies that engage me have a desire to do good work. They’re looking for a fresh perspective and aren’t afraid to hear a different opinion. They’re motivated to build some really great products. I’ve been impressed with all the groups I’ve had the privilege to work with. They make rapid, decisive choices and move swiftly to make things happen. I respect that.

It’s not all rainbows and unicorns. There are new things to worry about like paying my own taxes and getting health insurance for me and my family, but the positives clearly outweigh the negatives. Overall I’m enjoying the ride.

Cool Pharmacy Technology – Verification by MedKeeper

I had an opportunity to spend some time at MedKeeper headquarters in Westminster, CO last week. I’ve worked with MedKeeper before, but this was the first time I had the opportunity to visit the facility and meet their team.

MedKeeper is a company that makes several products for acute care pharmacy, specifically they develop software targeted at pharmacy operations. Some of you may know them for their medication tracking system, MedBoard.
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RFID vs barcode technologies

MedKeeper: “Based on similar use cases, the comparison between bar code and RFID technologies is inevitable. Several papers have reviewed the use of these technologies in hopes of defining best practice. Young concluded that a coordinated use of these technologies might provide the best compromise between implementation costs and potential benefits.   RFID technology, with its high cost, may be most appropriate for patient identification, while the lower cost of bar code systems may be more appropriate for material inventory.[3]

Sun et al.[4] arrived at a similar conclusion. In this case, the authors evaluated medication error reduction. Due to the high cost of RFID tags and readers the authors proposed a system utilizing less costly bar codes for unit-dose medications while using an RFID-embedded wristband worn by patients for identification.”
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Things get interesting as #Aesynt acquires Health Robotics

Business Wire: “Aesynt™ announced it has completed the acquisition of Health Robotics, the leading global supplier of automated technology for intravenous (IV) medication preparation, compounding and dispensing.”

For those of you that have short memories, Aesynt is basically a spin-off of the acute care pharmacy side of McKesson. It’s a big group that specializes in things like automated carousels, inventory management software, packaging and bar-coding technology, controlled substance management hardware and software, and a robotic distribution system, i.e. “the McKesson robot”.

Health Robotics is a company that specializes in IV room automation and technology. They have two robots: i.v.STATION for non-hazardous compounding and i.vSTATION ONCO for hazardous compounding, i.e. chemotherapy. Their robots compete with both Intelligent Hospital Systems – the RIVA robot – and APOTECAchemo. They also have i.v.SOFT, a workflow management system that competes against the likes of DoseEdge by Baxter, among others.

Someone at Aesynt has been paying attention. Interest in IV room technology has been steadily growing for the past few years, basically telegraphing the demand that we’re seeing today. This definitely puts Aesynt in a unique position in the acute care pharmacy space, especially when you consider that they also offer a point of care distribution system and something for anesthesia.

The acquisition of Health Robotics by Aesynt is sure to send some ripples through the world of pharmacy automation and technology. Grab some popcorn and settle back in your chair. As interest in the IV room continues to grow, and as companies begin to fight for market share, things are surely going to get interesting. Exciting stuff.

Using Google Glass in the pharmacy [youtube video from Drug Topics]

“Barry Bryant is owner of Barney’s Pharmacy in Augusta, Ga. He and his clinical pharmacy educator, Jake Galdo, discuss some of the ways this new technology can be used in the pharmacy.”

It was bound to happen eventually. Someone in pharmacy finally decided to play with Google Glass. Nothing too specific, apparently just tossing around some ideas, but nice to see. I hope these guys continue to post their experience with glass.

The HIPAA comment cracks me up. The comments about Glass being a HIPAA issue are nonsensical because the same concerns apply to any photo taken with any camera, whether it’s from Glass, a phone, a security camera, and so on. People fretting over the concept of taking a photo of someone is crazy. With that said I’ve come to expect comments like this.

UCSF and Walgreens “reimagining pharmacy care”. Yeah, not so much…

baby_cryingUCSF: “A new initiative by UC San Francisco and Walgreens seeks to turn those numbers around, starting at the neighborhood pharmacy….“Walgreens at UCSF” is a pilot store that offers the most advanced level of community pharmacy care available in the United States today. It starts with the store’s unusual layout: Walk inside and the first thing you see isn’t racks of cosmetics or greeting cards; instead there’s a concierge desk where you can arrange a private consultation with a pharmacist or find out whether your prescription is ready. Pharmacists work with every customer to make sure they understand the medication they’re picking up, while also offering services such as the medication management that brought Helen to UCSF… For UCSF, it will serve as a teaching ground for student pharmacists completing their doctoral degree program, a clinical training site for pharmacy residents, and a research facility that explores new pharmacy patient-care models and programs.”

I found myself at UCSF Medical Center earlier this week and decided to visit the new Walgreens. I had previously read about the setup on Twitter and a couple of articles I found online.

Here are my thoughts and experiences regarding the “Wallgreens at UCSF”.
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PillPack: a new way of thinking about an old problem

I read a Wall Street Journal article this morning about an online pharmacy called PillPack that’s doing something a little different. “PillPack mails its customers their medications every two weeks, but rather than putting them into several big bottles, the company pre-sorts them into sealed, single-dose packs, based on when a patient needs to take their medications throughout the day. The pills arrive in a long chain of dose packs, linked together on a recyclable dispenser roll.

It’s not a new concept at all. In fact, the idea has been tossed around in certain pharmacy circles for years. Many companies are capable of providing such a service, but most lack the vision to bring the concept to life. Perhaps PillPack can provide enough value to its customers to make it viable. I really hope it works out for the company. At least they’re thinking outside the box, er, inside the box.

PillPack should really think about partnering with local hospitals and deliver discharge meds to the patient bedside in this handy format. Counsel the patient, make sure they have their meds, automatically enroll them in the mail order service, and so on. Just sayin’.

Pharmacy system integration appears to be on everyone’s mind

I’ve noticed an interesting trend recently. Healthcare systems, and more specifically pharmacies, have started to understand the importance of having integrated systems. I realize that the concept of having various systems talk to one another isn’t new, but you’d be surprised at how poorly disparate systems within the pharmacy communicate. Automated packager from company “A”, medication tracking system from company “B”, inventory management from company “C”, and so on. These systems rarely utilize a single master database of information, instead relying on frequent manual updates to multiple databases. The result of such a system is often inaccurate information if you’re lucky, or outright errors if you’re not.

integration
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Automated Medication Preparation for Chemotherapy [PP&P December 2013]

The December 2013 issue Pharmacy Purchasing & Products features a Q&A session with Anne McDonnell, PharmD, BCOP; Caryn Belisle, RPh; and Josephine Leung, PharmD, MBA from Brigham and Women’s Hospital, Department of Pharmacy

I had the opportunity to visit Brigham and Women’s Hospital earlier this year while doing some research for a project I’m working on. It’s a very interesting facility that makes use of a lot of pharmacy automation and technology. Based on what you read below you’d think that everything was perfect. What I saw was interesting, but far from perfection.

Worth noting in the Q&A session is that the products being used are never defined, i.e. what technology is being used. There’s mention of a robot, but which robot? They speak of gravimetic analysis, but don’t say what system they’re referring to. I know because I’ve been there, but other people might like to know as well don’t you think?

Here are some of the questions and responses I found particularly interesting in the PP&P article.
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California State Board master formula and sterile compounding logs

I’ve been looking through a lot of the California State Board of Pharmacy requirements for sterile compounding logs and accompanying master formula records. The information can be found in the California Lawbook for Pharmacy 2013 [PDF], specifically California Code of Regulation (CCR), Article 4.5 Compounding.
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