The ZiuZ Inspector – or is it the Foresee Inspector – is an interesting system designed to inspect the contents of unit dose packages produced by high-speed unit dose packagers. I don’t think there’s much need for this in most acute care pharmacy operations here in the U.S. because we don’t unit dose enough tablets and/or capsules to make it worth while, but I do think it may have potential in some long-term care pharmacies using a central dispensing model. Who knows, that’s not really my area of expertise.
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- Scan the bottle
- Pour the tablets onto the Eyecon Pill Counter counting platter. The Eyecon Pill Counter uses “Machine vision technology” to count the tablets.
- Package the tablets
That’s pretty simple. Sure beats the heck out of counting the tablets by hand. 5…10…15…20….
More information on the Eyecon Pill Counter can be found here.
The cleanroom environment, a.k.a. the IV room, is one of my favorite areas inside an acute care pharmacy. It is often alive with activity, and can often be the busiest area of the pharmacy. It is also a unique place since the use of intravenous (IV) medications is vital to the successful outcomes of patients, but at the same time can result in some of the most egregious errors in healthcare. While the IV compounding process is under tight control as demanded by USP guidelines, the method of preparation and distribution is decidedly more conventional, i.e. IV rooms often rely heavily on humans. It’s an interesting dichotomy found nowhere else in the pharmacy. It is for these reasons that I find it interesting that pharmacy IV rooms have lagged behind other areas of pharmacy operations in automation and technology. However, that’s beginning to change.
I came across the HealthOneMed Dispense-A-Pill (DAP) Personal Medication Manager while surfing the ‘net one afternoon earlier this week. It’s basically a miniature ADU with pie-shaped wedge slots for personal medications. I thought it was pretty slick.
MedVantx, Inc., has announced the deployment of its patent pending Patient Profile™ patient medication and adherence reporting engine across its network of 3,600 high prescribing primary care providers participating in the Company’s integrated program of initial free medication therapy, adherence management and home delivery program. This new program utilizes the Company’s proprietary automated ATM like sample management system (“MedStart™“) and an integrated secure web reporting portal to provide physicians visibility to their patients’ adherence to chronic medication therapy…
The MedStart™ system automates the traditional sampling process for the physician; captures physician sampling data for inclusion in the patients’ claims history medical record and provides consumers access to highly relevant drug and disease state educational materials. Since patients don’t always get prescriptions filled, physicians can enhance adherence by providing their patients with initial therapy and better informational tools to manage their conditions right from the office…
Now with the availability of the MedVantx Patient Profile™, physicians are able to view data about how patients, on an individual basis, are complying with their prescribed medication treatments. By showing exactly when a patient fills prescriptions, physicians can detect late refills, gaps in medication fulfillment, discontinued treatments and more to accurately access and improve patient compliance.
Interesting concept. I often wonder if simply getting rid of chain and grocery store pharmacies, and going back to neighborhood community practices would be the best way to improve patient medication compliance. I’ve worked in chain, grocery store and community pharmacies and have always felt that the small community practice knows their patients best and provides the best patient care when it comes to medication management. Something to think about anyway.
More on the system mentioned above can be found at the MedVantx website.
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.
ThomasNet News: “PharmASSIST OPTIx enables remote prescription verification by taking a high-resolution image of each prescription’s vial contents and vial label, and automatically displaying them on a designated pharmacist’s workstation. The pharmacist compares these images to the appropriate drug image from a standardized drug database, along with specific prescription details to complete the verification. The verifying pharmacist can be stationed anywhere – in the front of the pharmacy counseling patients or offsite at another pharmacy, a central processing center, or working from a home office. PharmASSIST OPTIx stores each prescription’s images as part of the patient history record, enabling pharmacies to quickly retrieve them for pharmacy benefit manager (PBM) audits and to confirm the quantity dispensed.
Pharmacies can use PharmASSIST OPTIx in stand-alone mode or integrated with Innovation’s PharmASSIST Symphony® workflow systems, which enables end-to-end prescription tracking, problem management, and reporting. In addition to processing a pharmacy’s countable medications, PharmASSIST OPTIx handles all non-countable products (e.g., ointments/creams, liquids, syringes, inhalers, etc.) for prescription filling and remote verification. The system can also assist pharmacies with physical inventory control.”
It reminds me of a non-cleanroom version of DoseEdge.
Additional automation is needed for it to be a real game changer, but it’s still pretty cool technology. It would be slick if the person filling the prescription never had to touch the product and the end result could be remotely verified.
Product website here.
OPTIx brochure (PDF).
mobihealthnews: “According to a recent study by Express Scripts, Americans might be wasting as much as $258 billion annually by not taking their prescribed medications. Missed doses can lead to emergency room visits and doctors’ visits, which could be prevented if medication adherence was improved. The Express Scripts study found that more than half of people who believe they take their medications properly are not, according to a report in USA Today.
A similar study conducted by NEHI found that poor medication adherence results in illnesses and ensuing treatments that cost some $290 billion in unnecessary spending each year, $100 billion of that in avoidable hospitalizations alone.
Two members of Congress recently introduced bills to allow Medicare reimbursement for more patients to sit down with therapists one-on-one and equip patients with pill boxes or text message services that help patients become more adherent, the USA Today report said.
The Toronto University College of Pharmacy conducted a study that found medication therapy saved about $93.78 per patient annually in a study of 23,798 people, USA Today reports.”
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I’ve worked in several hospitals over the course of my career, ranging in size from 25 acute care beds to nearly 600 (584 beds to be exact). While 600 beds isn’t a large hospital, it certainly isn’t small. Regardless of the size of the hospital I’ve worked in, the operations inside the walls of the pharmacy are strikingly similar, including from the way pharmacists process orders to the way technicians handle distribution. There are differences to be sure, but the basics are the same. Differences to note include clinical services and use of automation and technology.
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