Jerry Fahrni

Pharmacy Informatics and Technology

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Tag Archives: Pharmacy Technology

The weakest link in building a safer medication use model

Posted on June 20, 2011 by Jerry Fahrni
2 Comments

I’ve just spent four days at the ASHP Summer Meeting in Denver, CO. The meeting offered a nice variety of topics, but seemed to focus on medication safety and informatics more this year than in the past. In fact, this is the first year that ASHP has offered a medication safety tract at one of their meetings.

I avoided the more traditional sessions on therapeutics, choosing instead to focus on the informatics and medication safety sessions. Based on the information presented it was obvious to me that these two disciplines are intimately linked. After all, the idea behind much of the technology we use in healthcare today is to improve patient safety.
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Categories: Medication Safety | Tags: Barcoding, BCMA, Patient Safety, Pharmacy Practice, Pharmacy Technology

Technology and pharmacist impact on medication adherence

Posted on June 2, 2011 by Jerry Fahrni
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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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Categories: Therapeutics | Tags: Medication Adherence, Medication Safety, Pharmacy Practice, Pharmacy Technology, PPMI

Do larger hospitals have an edge? Maybe

Posted on April 21, 2011 by Jerry Fahrni
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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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Categories: Pharmacy Informatics | Tags: Pharmacy Practice, Pharmacy Technology, PPMI

The ever expanding role of pharmacists

Posted on April 5, 2011 by Jerry Fahrni
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Lately I’ve found myself thinking about how pharmacists are involved in healthcare. Despite popular belief pharmacists do more than simply work in the pharmacy.

Throughout my career I’ve become accustomed to people viewing pharmacists as the stereotypically person behind the counter at the drug store “counting pills”. While that’s not all pharmacists do, I’ve learned to live with the general publics simplistic view. I don’t think most people realize that pharmacists are involved in every aspect of a patient’s care. If you’ve ever been in a hospital, received a prescription medication, had a loved one in a long term care facility, received intravenous medications at home like total parenteral nutrition (TPN) or antibiotics, received an albumin or intravenous immunoglobulin (IVIG) infusion in an outpatient infusion center or met with a pharmacist in a clinic setting for a medication therapy management (MTM) session, then you’ve been touched by a pharmacist.
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Categories: Pharmacy Informatics | Tags: Pharmacy Future, Pharmacy Practice, Pharmacy Technology, PPMI

Where will automation and technology make the biggest impact in pharmacy?

Posted on March 26, 2011 by Jerry Fahrni
3 Comments

I was planning on writing a rant this morning about lack of motivation, leadership and dumbasses – hey, I was in a fould mood when I got up – but then I opened an email from a friend. He asked me “How can retail pharmacists get involved in this [pharmacy informatics] industry?”. My first thought was to say that retail pharmacy would be the death of our profession and that they have no business getting involved in pharmacy informatics. Harsh I know, but I told you I was in a foul mood.

Then I did something I rarely do, I thought about the question a bit more before answering. After some time I came to the conclusion that retail, or more generally outpatient, pharmacy is exactly where more automation and technology is needed. I follow a few retail pharmacists on Twitter and one generalization I can make from reading their Tweets is that they all pretty much hate their jobs. Why? Because they spend precious little time working as pharmacists, instead spending most of their time physically filling prescriptions, chasing insurance claims, etc.

What retail pharmacy needs is a super-sized dose of pharmacy automation, technology and greater pharmacy technician involvement. Nowhere in pharmacy is there a greater need for automation and technology than outpatient services. Much of what’s done in the outpatient pharmacy setting does not require a pharmacist. This echoes the words by Chad Hardy last week on the RxInformatics website. Chad states “The longer we rely on pharmacists to run the entire supply chain, the higher our risk of obsolescence.” He’s absolutely right, although the article he references insinuates that pharmacists will become obsolete secondary to technology. Nay, I say. Technology in the outpatient arena can offer pharmacists the opportunity to break away from the mundane and do a little more hands on patient care. In addition, the drive to implement automation and technology in the retail setting creates the perfect job opportunity for pharmacists interested in informatics.

Of course we’ll have to prove to the retail boys upstairs that they can save money by using pharmacists in a more clinical role, but that’s what business cases are for. Unfortunately I couldn’t write a business case to save my life. In fact, a colleague of mine told me that pharmacists are terrible at creating business cases. I suppose that’s true as most of us didn’t become pharmacists to practice business. Instead we became pharmacists to provide patient care. Go figure.

Categories: Automation, Technology | Tags: Pharmacy Automation, Pharmacy Practice, Pharmacy Technology, PPMI

How not to design an application for pharmacy

Posted on March 16, 2011 by Jerry Fahrni
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I’ve used Pyxis PARx before, but only in combination with a carousel storage system. I recently had the opportunity to play with the standalone version of PARx and all I have to say is yikes!

The system utilizes an older version of Windows Mobile on a clunky Motorola handheld. To get from log-in to a useful place in the application required me to go through no less than four screens. The touch screen was unresponsive and difficult to use, the device was painfully slow and the connectivity was lacking.

So, to sum up my experience with PARx – used with carousel technology it’s great, but try to use the standalone product and you might find yourself spewing profanity.

 

Categories: Automation | Tags: BCMA, PARx, Pharmacy Technology, Pyxis

Cool pharmacy technology – UCSF Robotics

Posted on March 10, 2011 by Jerry Fahrni
5 Comments

UCSF: “Although it won’t be obvious to UCSF Medical Center patients, behind the scenes a family of giant robots now counts and processes their medications. With a new automated hospital pharmacy, believed to be the nation’s most comprehensive, UCSF is using robotic technology and electronics to prepare and track medications with the goal of improving patient safety.

Not a single error has occurred in the 350,000 doses of medication prepared during the system’s recent phase in.”

Robotics is nothing new, but it seems like everyone is taking notice of the new robotics in the pharmacy at UCSF. I suppose all the people pointing it out to me has something to do with the fact that UCSF School of Pharmacy is my alma mater, but you never know. Anyway, I’m pleasantly surprised to see UCSF taking such an active role in advancing pharmacy practice. When I spoke with some colleagues sill working for UCSF a little over a year ago they were still practicing pharmacy invented in the dark ages. Not any more.

Now I’m trying to get a hold of someone at UCSF that will let me stop by for a tour, and all of a sudden no one knows me. Poetic justice I suppose.

Categories: Automation | Tags: Patient Safety, Pharmacy Automation, Pharmacy Technology, Robotics

Medscape Mobile available for Android

Posted on February 15, 2011 by Jerry Fahrni
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Opened my spam folder today and found an email announcing the availability of Medscape for Android. While it’s not my favorite drug information resource, it’s decent and it’s free. The application can be downloaded here.

Medscape Mobile is also available for the iPhone, iPad and BlackBerry, just in case you don’t have an Android device.

Categories: Mobile Computing | Tags: Android, Drug information, mobile pharmacy, Pharmacy Technology, Smart phone

Going cartless

Posted on January 24, 2011 by Jerry Fahrni
5 Comments

I spent some time recently speaking with the director of pharmacy (DOP) from a large acute care facility about operations and various dispensing models. In this particular instance, the hospital utilizes a cartfill model, decentralized pharmacists in satellites to handle first doses, batched IV’s and automated dispensing cabinets for pain meds and other “PRN” medications.

At one point the conversation drifted toward a discussion of using a cartless dispensing model. The DOP wasn’t a fan. The reason cited was a fear that utilizing automated dispensing cabinets in a cartless model would create a workflow logjam in the pharmacy as the entire day would be dedicated to “massive ADC [automated dispensing cabinet] fills”. I understand the thought process, but have found through experience that this simply isn’t true. In a well-constructed workflow a cartless model is quite efficient.
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Categories: Automation | Tags: ADC, Pharmacy Automation, Pharmacy Technology, PPMI, Workflow

Pharmacy goals, a reality check and insanity – what the heck are we doing?

Posted on December 27, 2010 by Jerry Fahrni
4 Comments

I’ve been conversing with several pharmacists about the future of pharmacy practice, specifically about the PPMI developed earlier this year by ASHP. This is a sharp group of people, but what I continually hear is the same thing I’ve heard for a number of years. While I’m not as experienced as many of my esteemed colleagues due to a late start to my career, I have worked in several acute care facilities. I’m not sure who said it, but Einstein gets credit for defining insanity as doing the same thing over and over again and expecting different results.

The literature presented in support of a new practice model is, in reality, based on current practice. It’s all looking at how best to apply the pharmacist’s current knowledge and resources to the current practice model. Economic outcomes improved by a pharmacist; great, but not new. Improved patient outcomes with a pharmacist in a team approach; awesome, but not new. Use a pharmacist as a prescriber; cool idea, but not new. These models are easily ten years old and we’re still talking about them as if they were new ideas. See a trend here? I think this is exactly what Einstein had in mind when he defined insanity.
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Categories: Uncategorized | Tags: ASHP, Pharmacy Future, Pharmacy Technology, PPMI
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