Jerry Fahrni

Author: Jerry Fahrni

  • “What’d I miss?” – Week of June 29th

    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…)

  • RFID vs. barcode

    Barcode.com: “RFID, or radio frequency technology, uses a tag applied to a product in order to identify and track it via radio waves. The 2 parts that make up the tag are an integrated circuit and an antenna. While the circuit processes and stores information, the antenna transmits signals to the RFID reader, also called an interrogator, in order to interpret the data in the tag. In contrast, a barcode is an optical representation of data that can be scanned and then interpreted. The data is represented by the width and spacing of parallel lines, and are often used in POS applications, in addition to tracking objects throughout the supply chain.” – The article goes on to give the advantages of both technologies. The more I read about RFID technology, the more interested I become. While the technology hasn’t really caught fire in health care, I think the utility of RFID demands further investigation.

  • Cool Technology for Pharmacy

    Lexi-Drugs for the iPhone: “.. our most comprehensive drug database, with content that addresses all patient populationsand covers clinical specialties such as Pharmacy, Internal Medicine, Cardiology, Oncology, Psychiatry, Anesthesiology, and others. Independently ranked as the #1 drug database for the PDA, Lexi-Drugs includes up to 67 fields of  information, including Adverse Reactions, Canadian Brand Names, Contraindications, Dosing, Medication Safety Issues,  Pharmacodynamics and Kinetics, Special Alerts (including new FDA warnings), plus International BrandNames from 125 countries. Includes drug pricing.”
    (more…)

  • Bye bye paper medical records

    HIT Consultant: “N.Y. medical group to ditch paper records by 2010 – Rep. Chris Lee toured the Buffalo Medical Group’s offices Monday as part of what he calls his effort to bring local ideas about health-care reform to Congress. Buffalo Medical Group, which handles 415,000 outpatients per year, is in the process of updating its data systems and patient records to a paperless electronic format. CEO Daniel Scully said the electronic records will replace a warehouse full of 5,000 boxes of patient record. Scully said he expects the transition to be complete by the end of 2010.” – I love this idea. It’s aggressive, it’s green and it’s much more efficient. Searching through a well indexed electronic database is much faster than looking through hundreds (possibly thousands) of paper files, no matter how well organized you are. How many times have you seen this order in a chart: “have the patient’s old medical records sent over”, or some equivalent phrase. That would be a thing of the past with a paperless electronic medical record.

  • Apple patent details RFID tag reader.

    9to5mac.com: “RFID reader built into the screen?  We’re not quite sure why they’d need to do this (as opposed to putting the reader somewhere else in the device) but Apple has put a patent application on this.” – In addition, the US Patent and Trademark Office lists the following: “The efficient incorporation of RFID circuitry within touch sensor panel circuitry is disclosed. The RFID antenna can be placed in the touch sensor panel, such that the touch sensor panel can now additionally function as an RFID transponder. No separate space-consuming RFID antenna is necessary. Loops (single or multiple) forming the loop antenna of the RFID circuit (for either reader or tag applications) can be formed from metal on the same layer as metal traces formed in the borders of a substrate. Forming loops from metal on the same layer as the metal traces are advantageous in that the loops can be formed during the same processing step as the metal traces, without requiring a separate metal layer.” – I can think of several uses for an iPhone with a built in RFID Tag reader, it can already read barcodes. The iPhone just keeps getting cooler and cooler.

  • Where is pharmacy informatics headed?

    Recently I read an interesting article in the American Journal of Health-System Pharmacy. The question of what defines a pharmacy informaticist was raised. I’ve mused over that question many times myself. Because there is no standardized definition for a pharmacy informaticist, it is extremely difficult to define their role. A look at the many different job descriptions for IT pharmacists posted on the American Society of Health-System Pharmacists (ASHP) website is testimony to that.
    (more…)

  • Possible restriction on acetaminophen dosing

    Medscape.com: “The FDA should put new restrictions on acetaminophen, an advisory committee recommended Tuesday, saying the move would protect people from the potential toxicity that can cause liver failure and even death.” – Acetaminophen (a.k.a. Tylenol) is a very safe medication. According to the article “billions of doses of acetaminophen are used safely every year.” That’s billion, with a “b”. So why would you want to restrict it? That’s a good question. I certainly don’t have an answer.

    Here are a few things to consider if you use acetaminophen:

  • Keep the dose to a maximum of 650mg if you’re a healthy adult.
  • Check with your doctor or pharmacist if you have any health related issues prior to using acetaminophen (liver problems are especially problematic).
  • Make absolutely sure there is no acetaminophen in any of the prescription medications you take (i.e. Vicodin, Norco, Tylenol #3, etc).
  • Don’t take acetaminophen more often than every 6 hours unless directed so by your physician.
  • Be cautious when using over the counter (OTC) medications with multiple ingredients. READ THE LABEL. If the item claims to take care of aches and pains, then it probably has an analgesic in it. You would be surprised to learn where acetaminophen pops up.
  • Don’t drink alcohol when taking acetaminophen; your liver will not be happy if you do.
  • When giving acetaminophen to a child, make absolutely sure to read the directions before use and use only the measuring device supplied with the medication. If you need to measure more than the device is capable, either the child is too old for the dosage form or you’re giving the wrong dose.

    • This issue isn’t so much about the safety of acetaminophen as it is about common sense. Use your head people.

  • NQF calls for pharmacists to take greater role in patient safety

    HealthLeadersMedia.com: “Literature shows that when pharmacists are involved in care, the result is improved patient care, fewer adverse events, and reduced costs,” said Andrawis, speaking about Safe Practice 18. “But, in order for that full benefit to be realized, it’s really important that those pharmacists be given appropriate authority, and consequently that they continue to take accountability for patient outcomes.” – The article goes on to say that pharmacists should be involved in all facets of patient safety including leadership, technology and clinical rolls. Pharmacists are uniquely qualified to address patient safety issues. This is especially true when it comes to the pharmacists roll in the medication distribution model and implementation of new technology such as smart pumps, automated dispensing and barcoding. As the public becomes more aware of issues related to patient safety, the pharmacists roll in saving lives (and money) associated with medication errors will become even bigger.

  • The patient centered medical home and pharmacy

    From the Pharmacy Technology Resources (PTR) blog:

    “Patient Centered Medical Home” (PCMH) – is likely to be the best opportunity for aligning physician and patient frustration, demonstrated models for improving care, and private and public payment systems to produce the most profound transformation of the health care system this far. Wait a second – what about the Family Pharmacist or Consultant Pharmacist? How does pharmacy play into this model? What relationships are being formed today between the community retail pharmacy and these home-care physicians? What active correlation or network can be established nationally to group together seamless health-care services between the home-patient, the physician, and the pharmacy?

    First – we’ll say – its ePrescribing with all the industry attention this mode of communication brings between doctors and pharmacists – however – I say it takes more than an electronic network to ensure the proper care is given to the patient. This medical home based model sounds similar to the model from the 1990’s of managed care that was about decreasing costs. Is this system designed to help patients instead of insurers? The relationship between the “local” doctor and the “local” pharmacy is imperative. We have come full circle – where in the 1950’s the relationship between physician and pharmacist was much more prevalent. Today – the home-care doctor can grab his iPhone and digitize the necessary communications with pharmacy for a seamless and completed transaction for the patient. But what about the relationship between the doctor and pharmacist and the periodic medication review for the home-care patient?”

    As I have mentioned before, the technology to provide real-time access to patient data is currently available. This provides a genuine opportunity for pharmacist involvement in the medical home model. The PTR blog recommends pharmacists partner with local physicians using the PCMH model, and I think this is a great idea. This is a golden opportunity for all you pharmacists that want to expand your practice setting. What are you waiting for? The time is now.

  • Beyond technology – nurse/pharmacist collaboration for patient safety

    Advanceweb.com via SafetyNurse on Twitter: “Pharmacists and nurses are essential professionals entrusted with medication safety. However, the medication delivery and other resources provided by pharmacy are not always well received by nursing, and vice versa. Nurses complain medications are not delivered on time. Gurses and Carayon (2007) noted that delays in getting medications from pharmacy as one of the most common nursing performance obstacles. Pharmacists complain they never received the order. Many blame today’s technology while others clamor for more advanced modes of medication delivery. Recently, studies have suggested computerized prescriber order entry can lead to new types of errors, especially during the early phase of technology deployment and dissemination. Technological advancements are not enough to ensure patients’ medication safety; collaboration between nurses and pharmacists is critical.” - I can tell you from years of experience that nursing and pharmacy frequently have issues and continuously play the “blame game.” I can also tell you that a good working relationship between pharmacy and nursing is key to successful patient care. I spent five years in a critical care satellite working closely with nursing. The more time I spent in the unit, the better my working relationship with nursing became. Trust developed and patient care was improved. While it is clear that technology is a tool that can improve patient safety, a solid nursing/pharmacy relationship is necessary to make it successful.