Some Random Thoughts

A week or so ago a colleague tagged me on Twitter in reference to a Reddit post in which my name, or rather my site came up. The thread was basically pharmacists listing places to go to get pharmacy related “informatics” information. My site popped up as a place to go. However, someone correctly pointed out that the blog has been quiet for a while now.

This got me thinking, why haven’t I written anything? Or more accurately, why haven’t I posted anything that I’ve written? I sat in my thinking chair and gave this question my full attention.

Three things came to mind: 1) lack of something new to write about, 2) a correlation between interest in my job and volume of written material, and 3) content creation and ownership.

Nothing New Under the Sun

First and foremost, there’s nothing new and exciting in the world of pharmacy automation and technology. As I have mentioned many, many times before, pharmacy moves at a glacial pace. That hasn’t changed. I’ve racked my brains over the past week to come up with something new and exciting in pharmacy that would be worth putting pen to paper. I came up empty. Nothing, nada, zilch.

There are technologies that I still find interesting, like RFID and IV room stuff, but they remain basically unchanged from when I first became interested in them nearly ten years ago. Yes, a decade ago, at least.

I continue to stay abreast of many healthcare-related technologies, but most of the effort inside companies these days is focused on integration and electronic health records (EHRs). Good things for healthcare to be sure, but I have almost no interest in EHR’s. And for companies trying to create integrated systems, they’re only kidding themselves. Several companies have been telling me for years that they are “working on a bi-directional interface with [insert system here]”. Some are close or appear to be close, but none that I’m aware of have completed the task. By the time these companies get a completely functional bi-directional interface up and running, it won’t matter. The ship will have sailed, as the saying goes.

Case in point, one of my favorite pharmacy technologies five years ago — IV workflow management systems — is dying a slow, painful death. Yes, adoption rates for these systems is the highest it has ever been. However, not only is there a lack of interest in these systems from inside the profession, but companies like EPIC are building many of the same features directly into the EHR. The IV workflow functionality that I’ve seen inside EHRs is limited and poorly designed, but it doesn’t matter because it’s readily available and free. Soon, acute care pharmacies will be using substandard IV workflow management software without giving it a second thought. And once it takes hold, it will almost certainly spell the end for many, if not most, of the companies competing in this space.  

Interest in My Job

I found an interesting correlation between my writing and my job. The more interested and engaged I was in my job, the less I wrote. I suppose that makes sense. When I’m bored, I go in search of something to do, hence reading and writing about stuff.

For example, for the last 14 months I’ve been working on a project like no other I’ve ever been involved with. From the outside, much of the work would seem mundane and boring. However, it’s work that I had not previously done and the learning curve for the first few months was steep. My interest was held by learning new things about the job. I wasn’t actively seeking anything outside my job to hold my attention.  Simple, really.

With that said, interest in my job is only a minor reason for the lack of blog posts. The real killer is below. 

Content Creation and Ownership

When I started, I never thought that I would have to worry about the things I wrote. But the world is a strange place.

When I write something and post it, I’m putting it out there for the world to use however they see fit. Basically, I believe it’s open source. Take it and do whatever you want with it. Some companies, however, wanted to “own” my content, i.e. my thoughts. So I stopped putting my ideas in writing on the web. Not that I was ever going to do anything with them, but it felt wrong that a company could do such a thing. As a result, many of my ideas remain on the pages of notebooks sitting on my bookshelf.

Others companies preferred that I not post anything about any of the technologies or processes that they used. And by preferred, I mean they threatened me. That made things difficult. At times, I had to significantly limit what I wrote for fear of reprisal. This was a killer for me.

Finally, when I started consulting full time I found it increasingly difficult to be completely frank with my readers. I sometimes worked for companies that made the products I was writing about. I had to be careful not to offend anyone that was or could potentially be a client. Composing blog posts became akin to walking through a virtual minefield.

Parting Thoughts

For the most part, I couldn’t find a way around the obstacles described above. Over time, it became so difficult to create content that it was no longer interesting or fun. And when that happens, it’s time to put on the brakes and re-evaluate.

I remain interested in pharmacy, especially automation, technology, and workflow design. I still write from time to time, but not often. I still love to talk about this stuff, so if you see me out and about, please engage me in conversation.

I am planning to attend ASHP Midyear in December. I’m truly looking forward to it as it will be the first time in many years that I will be attending as “just another pharmacy”. I can see and say whatever I like (smile).

1 thought on “Some Random Thoughts”

  1. Jerry,

    Sorry you’re in a state of “blog malaise.”

    I agree that the rate of change for pharmacy is glacial… That’s behavior learned from the practice of medicine – mostly for good reason. Moreover, the profession has spent most/all of its allotment of “addressing change” on CPOE, reimbursement, and managing fluid and drug shortages….

    I disagree that EPIC’s limited but free functionality is somehow a tipping point event that will kill of IVWF systems.

    Two reasons:

    1. Yes, EPIC customers will have one more free option when – and IF – they might decide to recognize and address the significant process issues/patient safety hazards latent in their fully manual IV rooms. However, EPIC doesn’t have a monopoly on making IVWF software essentially free for deals involving infusion pumps, IV fluids, drugs/nutrition, pharmacy automation systems and compounding devices such as TPN compounders. EPIC is unlikely to give away hardware (for any reason) – the competition has that path available when this is part of a bigger competitive deal.

    2. EPIC’s solution doesn’t attempt to mitigate the majority of patient safety risks inherent in manual IV compounding. Pharmacy leadership that invests the time to define their desired outcomes from deploying an IVWF system will figure this out in a hurry – and will then need to work through the tradeoff between “FREE but very limited” and “addresses our patient and staff safety goals”.
    (EPIC has literally zero incentive to pursue enhanced functionality in IVWF – their price eliminates creating an ROI for any enhancements at all. I know they will add camera support – but that’s just one more “glacial” change.)

    ECRI has issued their first – ever evaluation report on IVWF. They are customer-driven – their customers asked for help in IVWF product selection.

    Now that the “500-pound Gorillas” of pharmacy automation (truly a term of respect for their resources, capability, and focus) have launched IVWF systems, their installed customers will be hearing from them on all the ways that the IV room was/is a natural part of their world – which it is NOT for EPIC/Cerner/Medetech et al.

    So in this case, “What doe NOT kill you makes you stronger” applies, in my view.



    Dennis Schneider
    OnPoint Marketing Inc.

    (and a member of the team that created IntelliFlowRx – now Baxter DoseEdge)

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