#ASHPMidyear 2010 part deux

Today was a great day to be at ASHP Midyear 2010. Things really got going as the sessions were kicked into high gear and the exhibit hall officially opened.

I spent the day tracking down pharmacy automation and technology. Did you really expect me to do anything else? I don’t ever recall being as excited as a clinician as I am being an informatics pharmacist. Anyway, here are some things I found interesting:

• The first session I attended today was Better Patient Care and Safer Staff with IV Compounding Automation presented by Eric Kastango, RPh and Tom Crampton, PharmD.
  • Kastango shared some great information on how automation can be used to not only assist pharmacies in meeting USP <797> standards, but provide increased patient safety as well. He presented some eye opening facts regarding the number and severity of mistakes created during the IV compounding process. While he didn’t speak specifically about a single automated compounding device (ACD), he did present the conceptual value of such devices. He referred to them as “idiot savants”, which I find strangely accurate. My favorite quote from his presentation comes from Bill Gates, “The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.” This is a truism.
  • Tom Crampton spoke about his experiences with automation and technology in IV preparation as the director of pharmacy at Allegiance Health in Michigan. He laid out quite an extensive history of their journey from little automation to where they are today. In addition he presented some great data showing the value that automation has brought to his department as well as how it has had a positive impact on patient safety. One take-away from Crampton’s talk was that you shouldn’t forget about the human element while implementing automation and technology because as humans we always find a way to mess things up. I was impressed by his vision and implementation of pharmacy automation and technology. Allegiance Health would be a great place to visit.
  • I walked away from this presentation with a question burning in my mind; has the implementation of USP <797> been shown to reduce drug errors and decrease patient infection rates? Seriously, I don’t know. Presenters talk about USP <797> with absolute confidence, but I don’t recall ever seeing any solid evidence that it alone has made a significant difference in drug errors or patient safety. If anyone knows differently please don’t hesitate to educate me.
• Following the presentation on ACDs I took a field trip to the exhibit hall where I spent some time looking at all the different ACD vendors. The two devices that caught my attention were RIVA and i.v.STATION, and of those two I was more impressed with i.v.STATION. The i.v.STATION device had a much smaller footprint and moved smoothly and efficiently through the compounding process. I thought it was pretty cool. Here’s a video courtesy of McKesson and Health Robotics showing i.v.STATION in action.

• I spent the late morning and early afternoon meeting with some colleagues and talking specifically about pharmacy technology in the acute care setting before making my way to the poster sessions. There were quite a variety of posters on display, from your typically IV stability studies and impact of pharmacy services on various areas of care, to how pharmacists are using social media like Twitter and Facebook. If you get the opportunity I would highly recommend checking out the posters. There’s always a couple of gems in there, you just have to root them out.
• My afternoon concluded with a session titled “Clinical Rule Development and Sharing: The Power of Collaboration” presented by John Poikonen, PharmD and Allen Flynn, CPHIMS, CHS. This session focused on the development of clinical rules for use in various pharmacy systems and the struggles associated with developing these rules in a standardized, reusable format. During the presentation John and Allen spent about 20 minutes developing a theoretical clinical rule with the help of the audience. By the time various pieces of logic were built into the rule it became obvious why developing a set of these rules is so difficult. In addition to developing the templates for the clinical rules John touched on some collaborative efforts that are under way to develop an open source cloud based set of rules that could be leveraged against existing pharmacy information systems. What a great concept.
• And just to top it off I returned to my room to discover that a Podcast interview that John Poikonen and I did with Todd Eury for Pharmacy Technology Resources had been posted.

It really doesn’t get much better than that, but then again there’s always tomorrow.