Call to slow down EMR development for better security.

HIT Consultant Blog: “The law [HITECH, the law gives incentives to healthcare organizations to digitize personal health information before 2020], which also updates parts of HIPAA, gives the Secretary of Health and Human Services until mid-August to define what constitutes an electronic medical record. In Schmidt’s view initial requirements should start with strong authentication and encryption, and so far, the Secretary has done just that. Citing existing NIST and FIPS standards, HHS guidance includes healthcare data at rest, data in motion, as well as the proper destruction of Protected Health Information. Unfortunately, some health practitioners have begun purchasing e-health systems before the full complement of standards is known.” – No matter how you slice it, security is always going to be a problem. Even now, security is a primary concern for any healthcare facility in the United States. As you expand outside the walls of your existing system it is only going to get worse. I agree that practitioners should slow down and wait until some of this gets worked out. There’s nothing worse than investing in a system that has to be scrapped secondary to jumping the gun.

Cool Technology for Pharmacy

NEPS Healthcare: “Managing the distribution of pharmaceuticals throughout the healthcare delivery process in hospitals and other healthcare institutions can provide opportunity for errors in both administration of medications and cost accounting. In addition to ensuring the five pharmaceutical “rights”— the right patient, the right drug, the right dose, at the right time, with the right route of administration—Health e-Connect can ensure a closed loop process for pharmaceutical cost accounting within the healthcare institution.” - NEPS provides an integrated software solution (called Health e-Connect) for the creation of pharmaceutical labels on a variety of direct thermal printers.  The software compliments the functionality of the pharmacy information system (in our case Siemens  Pharmacy) by  providing  a  label  printing  solution with virtually  unlimited  formatting  capabilities. The features that caught my attention include tall man lettering support and real time label formatting changes. I liked the product so much that I put it in the pharmacy IT budget for the upcoming fiscal year.

KLAS says providers are integrating pharmacy systems”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.

Well, I asked for it. Comments and suggestions from previous posts.

If you float something out over the internet, someone is going to see it and keep you honest. Remember what I said, “There is always someone smarter, harder working, more motivated and better informed than me, and those are the people I want to hear from.” Well, those people have responded with some great information pertaining to barcoding and pharmacy automation. 
Continue reading Well, I asked for it. Comments and suggestions from previous posts.

EMRs as a tool for patient safety.

A short jaunt over to the EMR and HIPPA weblog led me to an interesting article in Time written by Scott Haig, MD. While Dr. Haig touches on a couple of positive features of electronic medical records (EMRs), he like many physicians, focuses on the negatives. He concludes that “Doctors and patients live in a world of painful, pressing questions. The great physicians I’ve known seek answers through personal commitment to each patient and judgment born of practical experience — neither of which I have found in a machine.” I think he is missing the point of an EMR.
Continue reading EMRs as a tool for patient safety.

Taking advantage of your carousel space.

gapinshelvesI have posted many times on our system for barcoding medications in the pharmacy. The posts have included reference to our efforts to increase storage space.  Our goals have always been to store as many medications as possible within the carousel to take advantage of the software’s many safety features and inventory functionality. 

Like all pharmacy departments we have several medication items that do not require significant storage space. I am talking about items like ophthalmic drops, otic preparations, small ointments and creams and some injectable items that are stocked in small quantities secondary to expense and lack of use. 

Small bins for storing opthalmic preparations.

During installation of our carousels we noticed small gaps in the shelving units. We approached one of the White Systems engineers on site and inquired about the small gaps. I don’t recall exactly why they were there, but the small size made the space virtually useless. Fortunately for us, the Talyst consultant that was on site to help us with the installation process sat down with us to come up with a solution. It was a simple idea really, but quite ingenious.  We purchased small bins that fit perfectly into the empty spaces. The size of the bin limited their utility for storage, but worked nicely for the smaller items mentioned above. The addition of the smaller bins created several empty spaces in the larger bins, giving us significantly more storage. 




Cool Technology for Pharmacy

Pyxis PARx: “The Pyxis PARx® system automates the pick-check-delivery process to provide increased security during medication replenishment throughout the hospital. The system utilizes bar code scanning technology for real-time tracking and monitoring of medication handling, pharmacist review and delivery of medications. By providing a complete chain-of-custody on medications during distribution to the nursing unit and helping to ensure the right medication is getting to the right station and the right pocket in the station, the Pyxis PARx® system is a valuable technology that provides improved patient safety and supports compliance with Joint Commission requirements.
Continue reading Cool Technology for Pharmacy

Problems with barcodes.

ISMP Medication Safety Alert! May 21, 2009 Vol. 14, Issue 10: “Please let us know if you identify problems bar_barcodewith  a company’s unit dose package barcode. An example of an ARICEPT (donepezil) unit-dose package with a barcode  problem appears in Figure 1 (shown in the PDF version of the newsletter). Note that the labeling material has been applied to the unit-dose package in such a way that tearing the doses apart destroys the barcode! Problems like this are due to inadequate quality control and are by no means isolated to one company. When issues like this occur, staff are forced to take extra steps to maintain the quality of the barcode, or they have to relabel products so they can be scanned at the bedside. This, of course, takes time and also increases the risk of a labeling error. If you send barcode problems to us along with a publishable photo, it will help us remind companies about the need for adequate quality control.”  Fortunately for us we haven’t seen anything like this, yet.