Jerry Fahrni

Author: Jerry Fahrni

  • What are you going to do with all that data?

    info_overloadInformationweek.com: “The rollout of e-prescription, digital medical record and other clinical systems by healthcare providers is undoubtedly creating gigantic new mountains of data. The next big challenges for healthcare is in using that data to make better clinical decisions and save costs, and becoming more proactive in helping patients avoid imminent medical problems. “It’s estimated that in five years, one-third of world’s data will be medical data,” Noffsinger [Richard Noffsinger, CEO of Anvita Health] says. “There are tons of medical data now, and that’s growing,” he says.” – Pharmacists are, by nature, driven by data. We analyze hundreds of data points every day; lab values, medication dosages, cultures, patient demographics, etc. Gathering data has never been a problem, knowing what to do with it is a whole different story. Finding someone that can turn raw data into discrete packets of usable information is like finding your very own genie in a bottle. It sounds like a good job for an IT pharmacist.

  • Thoughts on the “cloud”

    cloud-question-marByteandSwitch.com:” ‘Most IT executives are sold on the benefits of cloud computing, but many of their colleagues who are business decision makers still need convincing on the value of the technology, according to a survey released Monday [August 3, 2009]. A total of 28% of IT execs are planning to deploy private computing clouds by the end of 2009, according to the survey results. The most-cited benefit (41%) of private cloud computing is its perceived ability to improve efficiency. Other benefits mentioned were: “resource scalability,” cited by 18%; “cutting costs,” 17%; “experimenting with cloud computing,” 15%; and “improving IT responsiveness,” 9%. The survey, conducted by grid and cloud provider Platform Computing, detected a major stumbling block for deployment: 76% of the IT executives believe that business decision makers don’t understand the potential value of private clouds.” – One of the most difficult things to do in healthcare is to change the culture of the practitioners around you. I’ve died on many hills when “we’ve always done it that way” was the only argument against planning and implementing a new strategy. Based on current trends in interoperability, storage requirements, and limited IT labor pools, “the cloud” model will become more prevalent in healthcare. Even now, companies like Rackspace (the rackspace cloud) and Amazon (Amazon S3) are leveraging themselves against a future that includes cloud services. In addition, a recent article in InformationWeek regarding the storage of medical images makes an indirect case for cloud computing in healthcare. As storage space for medical images increases and providers demand easy access to images from any location, the idea of storing the information in the cloud becomes an attractive solution. Advantages include on demand storage, built in backup plans, outsourced support services, and decreased hardware costs; making it an ideal solution for storage hogs like CT scans, MRIs, etc.

  • Is the Cleveland Clinic prejudice against the obese?

    This has nothing to do with pharmacy informatics or technology, but sometimes I run across something that is so ridiculous that I feel compelled to comment.
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  • “What’d I miss?” – Week of August 9th

    As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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  • Cool Technology for Pharmacy

    There were several vendors strutting their stuff at Siemens Innovations this week in Philadelphia. Here are a couple of products I thought were pretty cool.

    imprivata

    Imprivata OneSign Platform:”Imprivata helps organizations secure employee, contractor and temporary hire access to desktops, networks, applications, and transactions – – enforcing who gets access; providing visibility into what was accessed; and ultimately, terminating all of a user’s network and application access, instantly. Imprivata OneSign® is an identity and access management platform that strengthens user authentication to networks; streamlines application access; and simplifies the process of compliance reporting–all delivered through a secure, self-contained appliance that requires zero modifications to existing IT infrastructure, and is centrally managed from a single administrative console. “ – The Imprivata OneSign Platform offers single sign-on to all enterprise applications. This is something I’ve been interested in as pharmacists have to log into no less than five different systems to do their job; at our facility anyway. It makes sense to me to use information from a single location to create single sign-on access for employees. The OneSign Platform is pretty flexible, allowing users to choose from password validation, proximity cards, RFID, biometric scan, and flash drives among other options for user authentication.

    toughbook_t8Toughbook T8: “Lightweight, yet Durable – Weighing in at 3.3 lbs., the Toughbook® T8 business-rugged laptop combines light weight and durability, with a built-in a magnesium alloy case, sanitizable rubber hand strap, embedded wireless, and added security and remote management with Intel® Centrino® 2 with vProâ„¢ technology. Built with legendary Toughbook reliability and unparalleled portability, the drop- and spill-resistant Toughbook T8 keeps up with today’s busy mobile professionals.” – I had an opportunity to play with this tough little dude and I have to say I was impressed. The T8 is light enough to hold securely in one hand via the strap located on the underside. It’s not a full blown tablet PC, but does offer a nice touchscreen interface, which allows you to move around the screen with only your finger. And it’s tough. The T8 is designed to survive a fall of 2.5-3 feet. The only thing missing, in my opinion, was a swivel screen.

  • 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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  • Tablet PCs in pharmacy practice – Barriers

    Today we finish our discussion of tablet PC use in pharmacy practice with the last of our four part series.
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  • IT departments may be stuck without enough help to go hi-tech

    This from the July 2009 issue of Hospitals & Health Networks: “Experts worry that hospitals may not have the resources to keep up. As if it already weren’t tough enough to find and retain quality health information technology professionals, the recent passage of the Health Information Technology for Economic and Clinical Health Act as part of the Obama administration’s broader economic stimulus package may only make the task more difficult. “We had a shortage of talent before this stimulus was initiated,” says Timothy R. Zoph, chief information officer at Northwestern Memorial Hospital in Chicago. “This will exacerbate the problem.”” – I’ve mentioned before that I think healthcare IT is headed for a rude awakening with all the new technology beginning to trickle our way. Demands placed on IT departments to develop solutions for BCMA, CPOE, cloud computing, increased security and a host of other computer based advancements will eventually lead to system failure secondary to limited resources. When you bring a new system online, the work isn’t necessarily finished. Continued development and maintenance are ongoing processes that require dedicated resources. If IT departments aren’t adding additional resources to manage these new systems then you have to ask yourself if everyone was sitting around watching videos on YouTube before the new systems came on line, or are resources going to be stretched paper thin after implementation. If the answer is the latter, then you’re in trouble. With the steep learning curve in healthcare informatics, in part due to legacy systems, I think it’s time to take a good, hard look at outsourcing. Just my two cents.

  • 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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