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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More thoughts on standardization

I’ve mentioned this before several times on this blog, but feel like I have to say it yet again; we need to start standardizing certain things about health information technology. The lack of standardization reared its ugly head at me again last week when our Pyxis med stations kept dropping medications off of patient’s active profiles. It appeared to always be the same drug, IV ketorolac. It took me a while to figure out the problem, but it turns out that Pyxis and our pharmacy system don’t agree on certain basic elements of time. Go figure.
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Quick Hit – “I don’t see the icon”

blind_computerSeveral times on this blog I have discussed the need to advance pharmacy through the use of new and exciting technologies. Yesterday I experienced something that brings light to the reason pharmacy practice is still in the Stone Age, where it may live forever.

We had a minor pharmacy system upgrade yesterday. The system was down for about 45 minutes. Although minor, the upgrade required the removal of the previous version of the pharmacy software prior to installing the new version. Overall the process went smoothly. However, within a few minutes of giving the pharmacists the all clear I began receiving phone call after phone call because the upgrade “didn’t work” and they couldn’t “get into Siemens”. The problem: the install client failed to put the shortcut icon for the pharmacy system on their desktop. Seriously, that’s the problem? Wow!

The “problem” brought the pharmacy to a standstill. So, the next time you talk about carousel technology, automated packaging, or clinical decision support software, remember that many pharmacists still struggle with using a computer; a device that is common in nearly every household in America.

I bet Steve Jobs doesn’t have these problems. ;-)

Siemens Innovations ’09 – The End

Siemens Innovations has officially come to an end. My time in Philadelphia was good, but I will be happy to get home to the “dry heat”. The information I picked up was very valuable and I made some great contacts. I’m excited to get back to work and see what damage I can cause with my newly acquired knowledge.

As I wrap up my time here at Innovations ’09 a few thoughts come to mind:
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Siemens Innovations ’09 – update, part deux

I spent the day attending the following educational sessions:

Where did My Mumps Job Scheduler (MJS) Go? – This was a pretty basic “how-to” session covering the new job scheduler, Cache, used in the latest version of the pharmacy system. Boring, but helpful.

Integrating Siemens Pharmacy to Maximize the Pharmacist Role – This was the most interesting presentation of the day, by far. Yakima Valley Memorial hospital is located in Yakima, Washington. Their pharmacy department is clinically solid and technologically advanced. They make extensive use of various custom pharmacy system reports to monitor antibiotic therapy, follow patients with poor glycemic control, and follow-up on patients with questionable orders. In addition, Yakima is in the process of writing advanced rules against their pharmacy system to track patients receiving warfarin therapy with no INR within the previous 24 hours. The warfarin monitoring is necessary to meet National Patient Safety Goal 3E. Much of the information is practical and can be reproduced at my facility.

Hitting the Mark with MAK! – Everyone wants to learn more about MAK, Siemens BCMA solution, and there have been presentations on just about every aspect of the system. This was no exception as the entire presentation was on how to develop a project plan for MAK implementation. This one nearly put me to sleep.

Leveraging MAK/MAR Integration to Achieve Increased Operational Efficiency – Centra State Healthcare System has done some pretty amazing things with their MAK data and the electronic medication administration record (MAR) found in Soarian. Soarian is Siemens system for collecting and displaying clinical information such as labs, allergies, patient assessments, physician notes, etc. Centra managed to create an integrated solution that offers physicians a one-stop-shop for clinical information as well as previous, current, and future medication administration. I was impressed. It appears I have a little reading to do when I get home.

I spent most of the afternoon talking with other pharmacists about computerized provider order entry (CPOE) and pharmacy automation. One pharmacist from CaroMont Health in Gastonia, NC was particularly interesting as his facility uses almost the exact same setup as ours; Siemens Pharmacy, Pyxis, and Talyst automation. He and I shared quite a bit of information. The time spent talking with other pharmacists was very valuable, possibley more valuable than all the presentations combined. 

Tomorrow is the final day of Innovations ’09 with more of the same on my agenda. Sessions on my radar for tomorrow include: Extending Patient Safety with MAK Beyond the Acute Inpatient Setting, Building the Bridge between MAK and Soarian, and Raising the Bar for Patient Safety. After that, it will be time to pack up and head for the airport; until then.

Siemens Innovations ’09 – update

I just finished my last session of the day here in Philadelphia, and overall I would have to say it was a productive one.

My first session today was an update on various future enhancements to both the Siemens Pharmacy System and their barcode medication administration system (BCMA), fondly referred to as MAK. The future enhancements bring much needed functionality to a system that, in my opinion, wasn’t ready for prime time.
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Making PCOs easier to use in the Siemens Pharmacy System.

Siemens utilizes an unfortunately complicated system for building reusable order sets in their pharmacy system. Unlike Meditech where you can use formulary medications, enter them the way they appear on the order set, give the newly created order set a name and save it; Siemens Pharmacy requires that you first construct a series of “Predefined Common Orders” (PCOs) and use those as building blocks for each order set. PCOs are not only used as building blocks for order sets, but can be used to create shortcuts for medication order entry as well. Each PCO must have a unique name and be specific to the order set from which is hails. Reusing PCOs in multiple order sets creates maintenance issues when one order set makes a revision and the other does not.
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KLAS says providers are integrating pharmacy systems

Heathcareitnews.com:”One of the most striking examples of the impact of integration within the closed loop is Siemens, Hess notes. On one hand, providers who rated the Siemens Pharmacy product alone gave it a relatively low overall score of 70.8 out of 100. However, those providers who rated both Siemens Pharmacy and the Siemens bar-coding at the point of care product – Medication Administration Check (MAK) – scored the pharmacy product much higher, giving it an overall satisfaction rating of 83.9. That BPOC/pharmacy integration is one of the key reasons that Siemens Pharmacy earned the second-highest satisfaction score in the study.” - This was mentioned earlier in the week by Todd Eury at PTR, but I wasn’t able to get a close look at the article until now. I am a Siemens Pharmacy user and am not surprised by their low satisfaction score. The Siemens pharmacy system has a lot to be desired and their product support is seriously lacking. I am happy to see, however that the satisfaction with the system increases with MAK, which we will be implementing later this year.