This mornings opening session for Siemens Innovations ’09 was delivered by Janet Dillione, CEO of Health Services Siemens Healthcare. Not surprisingly, the opening speech was focused on the American Recovery and Reinvestment Act (ARRA) and healthcare reform. Healthcare information technology took center stage from about an hour.
Some items of interest to me were:
Based on the presentation slides, it appears that Siemens is betting on CPOE being the gate through which all hospitals will have to travel to qualify for “meaningful use” healthcare dollars. However, Dillione does not necessarily believe that most hospitals will be able to accomplish CPOE implementation by the end of 2011. This statement is particularly interesting when you consider that Siemens has a unique insight into their customer base, and would love nothing more than to install CPOE in hundreds of healthcare systems across the United States. It makes me wonder how hospitals will choose to handle CPOE over the next 18 months.
Soarian will be the focus of Siemens implementations over the next year as they build the foundation for CPOE with better clinical functionality and documentation. Dhillone spent a lot of time hyping the speed and stability of the most recent Soarian release.
Doing more with less was a common theme throughout the opening remarks. Focus was placed on hospitals doing a better job of managing patients with chronic healthcare conditions like diabetes, asthma, and heart failure by making better use of “clinical people”, specifically physicians and nurses. That’s right, pharmacists were never mentioned.
Not one time did Dillione mention pharmacists or advancing their line of pharmacy based products. I found this a little disappointing as pharmacists have been shown to be cost effective when used appropriately. In addition the Siemens Pharmacy system is tied into many other Siemens products, including CPOE, BCMA, admitting, financials, and lab.
“Integration†is out and “Interoperability†is in. Time was spent discussing the need to make Siemens products interoperable. I think we need to develop some standards for much of the software available in healthcare before claiming interoperability. As far as I’m concerned all Siemens products should be plug-and-play out of the box when utilized with other Siemens products. The problem exists when a third party vendor needs to tie into your primary system (i.e. Siemens Pharmacy, Siemens MAK, Siemens Soarian, etc.). To the best of my knowledge basic guidelines may exist, but there is certainly no standard. Did I hear someone say “cloud� Well, I certainly think that’s an approach we should be investigating. It’s difficult to ignore interoperability when all the information is centrally located and all you have to do is create access to it.
Sessions I’m attending today include: Siemens Pharmacy/Med Administration Check Solutions Update, A Detailed Approach to Workflow Data Collection and MAK Design, and Barcoded Medication Administration: Is It a Luxury or Standard of Care?.
Technology Review: “Later this year, Philips will introduce a handheld electronic device that uses magnetic nanoparticles to screen for five major recreational drugs. The device is intended for roadside use by law enforcement agencies and includes a disposable plastic cartridge and a handheld analyzer. The cartridge has two components: a sample collector for gathering saliva and a measurement chamber containing magnetic nanoparticles. The particles are coated with ligands that bind to one of five different drug groups: cocaine, heroin, cannabis, amphetamine, and methamphetamine.†– When bound to the offending drug, the ligands – dig out the chemistry books everyone – will delivery a color coded test result in about 90 seconds. Philips has been working on the technology since 2001 and hopes to begin shipping the devices later this year. That’s some pretty cool technology.
Healthcare IT Consultant: “Buoyed by the encouraging use of its PHR and Twitter based Clinical Trial matching service, TrialX is readying to release its iPhone application this month. This application, designed for doctors and patients, further underscores TrialX’s commitment to drive technology enabled consumer-driven healthcare. Using the TrialX iPhone App, doctors can search for clinical trials that their patients may be eligible for and email the results to the patients right away. They can filter clinical trials by location, medical condition, treatment, institution conducting the trial and other parameters. Similarly, patients and/or their loved ones can use this application to search for clinical trials. A video demo and screenshots of the new application are available at TrialX Mobile (http://trialx.com/mobile).” – You can search for clinical trials at the TrialX website as well. In addition, TrialX can identify clinical trials that may fit your condition based on your Google Health or MicrosoftVault profile. Take a second to browse around their site, it’s pretty slick.
Healthcare IT Consultant Blog: “Pharmacists’ representatives have claimed that use of private health record services such as Google Health and Microsoft HealthVault could risk fragmentation of electronic patient records. The Royal Pharmaceutical Society of Great Britain said “the proliferation of these systems and indiscriminate use†could lead to information on drug allergies, possible interactions, duplications or dose adjustments not being available when it was needed. The society, which was responding to a consultation by the Nuffield Council on Bioethics on medical profiling and online medicine, said there could be “serious patient safety implicationsâ€. It argued that the single health record supports the seamless transfer of care between primary and secondary settings and promoted multi- disciplinary working.” – I don’t necessarily agree with “the society” about personal health records. Personal health records – like medication lists carried in wallets, purses, and pockets – serve as additional information to an already detailed health system record. The technology is in its infancy and further growth and development should be encouraged. I believe it empowers the individual with enough control to become interested in their own care. I wouldn’t remove a patient allergy from the pharmacy system based solely on the information in a patient’s personal medical record, but would certainly investigate the opposite. First hand information directly from the patient is a valuable commodity. I remember interviewing patients upon admission to Long/Moffit Hospital on the UCSF campus when I was a 4th year pharmacy student. Many times asking the right questions led to the patient remembering something they had forgotten. If that information would have been in a digital personal medical record, the patient’s lack of memory becomes a non-issue. UCSF had the luxury of 30 pharmacy students running around talking to patients. Most hospitals aren’t so lucky.
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. (more…)
ROBOT-Rx® from McKesson is a robotic pharmacy system that automates many of the day to day operations that a technician may perform in a hospital pharmacy, such as medication storage, selection, return, restock, and crediting.
From the manufacturer’s site:
Every year, more than a half billion medications are dispensed error-free by ROBOT-Rx systems installed in hospitals throughout North America. Patient-specific medications are dispensed into cassettes or envelopes, facilitating cart fill, first dose, stat and now deliveries. The ROBOT-Rx also supports cabinet restocking and medication deliveries to multiple hospital sites.
The ROBOT-Rx system provides a real-time, enterprise-wide picture of medications stored, dispensed, credited and administered through the system. The robot continuously tracks all online and offline inventory, checks itself for expired and slow-moving medications and generates restocking reports.Every year, more than a half billion medications are dispensed error-free by ROBOT-Rx systems installed in hospitals throughout North America. Patient-specific medications are dispensed into cassettes or envelopes, facilitating cart fill, first dose, stat and now deliveries. The ROBOT-Rx also supports cabinet restocking and medication deliveries to multiple hospital sites.
The ROBOT-Rx system provides a real-time, enterprise-wide picture of medications stored, dispensed, credited and administered through the system. The robot continuously tracks all online and offline inventory, checks itself for expired and slow-moving medications and generates restocking reports.
I’ve recently been moonlighting at a hospital that uses the McKesson Robot-Rx system. It gets a “10” for coolness, but I haven’t been impressed with its performance. Because the robotic system utilizes barcoded medications designed for storage on peg racks, many medications require additional packaging (over-wrapping) prior to stocking (see images below). The over-wrapping requires a lot of extra technician time and labor, as well as pharmacist time to check. The system is certainly an advance in automation, but I prefer the carousel technology I use at my full-time gig.
Robot-Rx over-wrapping – Front (left) and Back (right)
The Business Journal: “The UCSF School of Pharmacy has launched a new service in Fresno to address the urgent need among Central Valley residents and their health care providers for assistance in managing their prescriptions. The service will start scheduling appointments this week and will officially open for in-person patient consultations on Sept. 1. Through the program, patients will meet one-on-one with an experienced clinical pharmacist to evaluate the prescriptions they currently use, ensure the medications are safe and effective for them, and help them manage their daily drug regimens.” – This is a great service and people should take advantage of it. I’ve reviewed the medication regimens of several members of my own family and you would be shocked to learn what I’ve discovered. My review of family medication regimens have revealed a duplicate therapy, a significant drug interactions, one medication causing side effects that were being treated as a medical condition, a medication being used for the wrong condition and one medication that was never prescribed; it was accidentally added to the patient’s profile by mistake in the pharmacy. I recommend that all pharmacists review the medication regimens for all their family members. If you find something weird, I’d love to hear about it.
Today we take a look at how some pharmacists are investigating tablet PCs in their practice settings. Enjoy the third part of the four part series. (more…)
Anyone that knows me won’t doubt for a second that I’m a fan of the tablet form factor for a computer. I am patiently waiting for the Apple tablet (Mac Tablet, TabPod, iTablet, iPad, AppTab, etc) to arrive, as well as looking forward to test driving Windows 7 on a tablet PC. Tablet PC information on the internet is typically sparse, with little bits of information here and there. The last couple of days however, have seen an explosion in activity. (more…)
The Healthcare IT Guy: “Physicians know that better exists. They have experienced Google, Amazon and e-Bay. Game lovers know that Electronic Arts’ “Tiberium,†now 15 years old, exceeds the capabilities of their professional health care software. They know from Yahoo and MSN the value of configuring a home page suited to delivering niche-information of their own preference. They know from using Word and Word Perfect that they can create precision documents merely by tweaking a template. They know they can use voice commands to make a phone call on their Blackberry. They know that they can find drug information more easily on Google than proprietary software. They suspect that if their EHRs and EMRs had physician-specific home page functionality, that they could drop and drag orders, answer FAQs, dictate letters, and save time with templates with many fewer clicks. Ordering medications should be as safe and uncomplicated as using E*Trade.” – Once again I ask you, healthcare vs. consumer tech, who’s more advanced? In reality a good EHR/EMR should be like a microwave oven; just open the door, push a few buttons, and pull out your finished product in 30 seconds. Most people don’t worry about how the microwave oven works, they just use it. Like the rest of use, physicians want simplistic design with ultimate functionality. Who can blame them, really, but they will have to give a little as the technology is still in it’s infancy within healthcare. For some yet to be determined reason, healthcare is always behind other industries when it comes to high-tech. Read the entire article if you get the opportunity, it contains some great information.
