Today’s presentation on pharmacy automation

The health care system I work for, Kaweah Delta Health Care District, uses quite a bit of automated technology from Talyst in our inpatient pharmacy. Well, today I spent the day in Bellevue, WA with the good folks from Talyst talking about all kinds of pharmacy automation and technology.

The day started with me giving a brief presentation at their quarterly meeting about Kaweah Delta’s experience installing Talyst equipment, and ended with a tour of their warehouse facility in Preston that included a peak at their process for managing and testing canisters for their AutoPack Oral Solid Packaging System; very interesting stuff.

Talyst was a wonderful host and I had a great time visiting their facilities and speaking with a bunch of very intelligent and interesting people. I learned a lot and had fun at the same time. You can’t ask for more than that.

View more presentations from Jerry Fahrni.

Cool Technology for Pharmacy – CHS 7X

Bar-Code Point-Of-Care (BPOC), also known as Bar-Code Medication Administration (BCMA) has been a hot topic in health care for a while now. Some people love it while others hate it. Regardless of how you feel about bar-coding it is here to stay for a while and the technology, both hardware and software, is pretty cool.
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What’s the lifespan of a tablet PC in use by pharmacists?

In early September last year (2009) our hospital purchased some Dell XT2 tablets for me to roll out to the pharmacists; I got mine at the same time. My XT2 has performed pretty well for the most part with only an occasional glitch here or there. Unfortunately I can’t say the same for the tablets in use by the pharmacists on the nursing units.

Over the past couple of weeks I’ve had several complaints from the pharmacists; blue screens, lost wireless configuration, loss of bezel button functions, inability to rotate the screen when in slate mode, etc. Today the ICU pharmacist dropped off his tablet in my office because none of the buttons along the outer bezel would work (CTRL, rotation and tools buttons). It turned out to be an issue with the drivers, but what caught my attention was the condition the poor tablet was in. It’s only been in use for just over 6 months and it looks pretty beat up. Apparently the XT2 isn’t designed to take the rigors of a pharmacists daily routine.

With all the iPads we have running around our hospital now it got me wondering how they’re going to hold up once we start pounding on them day in and day out. I’m guessing not well. I suppose no device is perfect as is so eloquently described by James Kendrik at jkOnTheRun, but I don’t mind saying that I’m more than a little concerned. Oh well, I guess we’ll find out soon enough.

Just in case you were wondering, the Motion J3400 used by the pediatric pharmacist has held up much better and is still in good shape. That’s something to keep in the back of my mind for the future.

My first “cloud” letdown

The cloud punched me in the nose recently and it’s still a litter tender. I’m a huge proponent of cloud based solutions from simple things like online document collaboration and storage to web-based enterprise SaaS solutions, and I have been slowly migrating my digital life away from the desktop toward the cloud. The cloud and I have been very happy together for well over a year now, but we had out first argument last week and I lost. It’s not serious enough to consider divorce, but it was a wake up call to re-evaluate the relationship.

I use both Live Mesh from Microsoft and Dropbox to manage and synchronize documents on multiple computers. The combination has worked very well for me. I use both applications because I like to try new things; Live Mesh came first followed by Dropbox at the recommendation of my brother.
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Quick Hit – Time to change the way healthcare information is disseminated

I spend a fair amount of time reading various medical, pharmacy and technology journals. Why? That’s a very good question. I was taught in pharmacy school that you need to read a host of journals every week to stay up to date on current trends for the betterment of your knowledge base and the patients you care for. So like any self-respecting pharmacist that’s what I’ve been doing for the past 13 years.

With that said, my view of the medical literature is starting to change. The information in journals today is out of date by the time it’s published. This is especially true when it comes to any journal articles related to technology. A recent conversation with a friend and colleague verified this when he mentioned that much of his research findings could take as long as a year to grace the pages of a journal. That’s just plain crazy. If advancing technology has taught us one thing it’s that no one should have to wait a year to become better informed.
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Cool Technology for Pharmacy – BoxPicker

The Swisslog BoxPicker is an automated alternative to carousel technology for drug storage and retrieval. Unlike the open shelf architecture of automated carousel storage the BoxPicker offers access to medications via a single-opening/loading drawer process.

Once you get past the name, the technology is impressive. The most interesting thing about the Swisslog BoxPicker however, is that it is available in dual-temperature and refrigerated models. The “dual-temperature ™ option for BoxPicker allows automated storage and picking of temperature-sensitive drugs requiring refrigeration and room temperature storage within one automated compact unit.” And the “BoxPicker refrigerated option eliminates the need for pharmacy refrigerators and increases security with automated storage and dispensing of refrigerated medications.”

In addition, the BoxPicker is clean room compatible with positive pressure. The pass-through capability is a very nice feature for an automated storage unit featuring refrigeration. It prevents staff from moving in and out of the clean room environment to retrieve equipment or medications necessary for compounding.
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Hey, I’m a year old today!

This blog was started one year ago today. During that time I’ve learned a great deal about a great many things and have met some incredibly interesting people along the way. The site doesn’t generate much traffic, which just goes to show you that pharmacists are an interesting group that rarely crawl out of their comfort zone. To date not a single pharmacist that I work with is even aware that this blog exists. I’ve had one nurse and one person from the Quality Assurance department at Kaweah reach out to me about something I’ve posted, but that’s it; funny.
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Rxplore: a new way to explore medication side effects visually

Journal of Biomedical Informatics

Patients on multiple medications are at increased risk for adverse drug events. While physicians can reduce this risk by regularly reviewing the side-effect profiles of their patients’ medications, this process can be time-consuming. We created a decision support system designed to expedite reviewing potential adverse reactions through information visualization. The system includes a database containing 16,340 unique drug and side-effect pairs, representing 250 common medications. A numeric score is assigned to each pair reflecting the strength of association between drug and effect. Based on these scores, the system generates graphical adverse reaction maps for any user-selected combination of drugs. A study comparing speed and accuracy of retrieving side-effect data using this tool versus UpToDate demonstrated a 60% reduction in time to complete a query (61 s vs. 155 s, p < 0.0001) with no decrease in accuracy. These findings suggest that information visualization can significantly expedite review of potential adverse drug events. – J Biomed Inform. 2010 Apr;43(2):326-3

The visual support tool mentioned in the abstract above is called Rxplore and was developed by Jon D. Duke, M.D., a medical informatics fellow at the Regenstrief Institute and the Indiana University School of Medicine.
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A look at one pharmacists unwanted potential

A recent post by John Poikonen got me thinking about medication errors. They’re part of every pharmacists day, but we rarely give them much thought.

I’ve been a pharmacist for more than 10 years now and I’ve make my fair share of mistakes. I would like to think that none of those errors caused harm, but that would be naïve to say the least. And forget about the errors that were never detected because one can only speculate about those.
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Cool Technology for Pharmacy – eDoc Telemedicine System

Telemedicine is one of those technologies that is either going to be unbelievably useful or a complete waste of time. Only time will tell. Recent articles like the one in Archives of Internal Medicine suggest that it may have a place in healthcare. Pharmacists may find telemedicine a useful tool for communicating with patients or physicians over great distances. I can see value in that.

While not specifically designed for pharmacy, the eDoc Telemedicine/EHR System is a cool piece of technology. For information to be useful it needs to be collected and made available at the point of care, which is exactly what this system does.

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