Author: Jerry Fahrni

  • Cool Technology for Pharmacy

    Alaris System: “The Alaris® System by Cardinal Health is designed for infusions and patient monitoring. It helps protect the patient and clinician from consequences of medical errors and helps positively affect patient outcomes through continuous improvements in clinical practice. The point-of-care platform standardizes every type of infusion on a common user interface and adds respiratory monitoring and bar coding as needed. Also a state-of-the-art computer, it bridges the gap between IV and IT to help prevent harm and optimize care.”
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  • ISMP launches first self assessment of ADC safety

    ISMP.org: “More than 80% of US hospitals have implemented automated dispensing cabinets (ADCs) as an important part of their drug distribution system, making the evaluation of practices surrounding this technology an essential step in ensuring patient safety. To help meet healthcare organizations’ growing need for assistance in this area, ISMP has introduced the first Medication Safety Self Assessment for Automated Dispensing Cabinets. The assessment contains 12 core elements that support the safe use of ADCs, which are based on guidelines developed by a national forum convened by ISMP comprising practitioners and vendors with expertise in the safe use of ADCs.** Many of the core elements represent system improvements and safeguards that ISMP has recommended in response to analysis of medication errors and problems identified during onsite ISMP consultations with hospitals. ” – ISMP offers some great resources and their self assessments are are a good way to see exactly where you stand against their “standards”. I would encourage every acute care facility using ADCs to complete the survey and submit their data to ISMP, confidentially of course.

  • Making PCOs easier to use in the Siemens Pharmacy System.

    Siemens utilizes an unfortunately complicated system for building reusable order sets in their pharmacy system. Unlike Meditech where you can use formulary medications, enter them the way they appear on the order set, give the newly created order set a name and save it; Siemens Pharmacy requires that you first construct a series of “Predefined Common Orders” (PCOs) and use those as building blocks for each order set. PCOs are not only used as building blocks for order sets, but can be used to create shortcuts for medication order entry as well. Each PCO must have a unique name and be specific to the order set from which is hails. Reusing PCOs in multiple order sets creates maintenance issues when one order set makes a revision and the other does not.
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  • Visit to Northwestern Memorial Hospital in Chicago

    During my recent trip back east I had the opportunity to drop in on the inpatient pharmacy at Northwestern Memorial Hospital in downtown Chicago. The reason for the visit was simple. I was already in Chicago for the ASHP Summer Meeting and Northwestern utilizes some of the same pharmacy automation as Kaweah Delta. One would think that the same automation would equal the same procedures, but nothing could be further from the truth. This is one of the fundamental problems with hospital pharmacy in general. Lack of standardization equates to the inability to share information across multiple facilities. Best practice is elusive when talking about automation in pharmacy.
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  • ASHP Summer Meeting – day 2

    This has been an interesting and exciting day so far. I spent the morning at the ASHP exhibit hall looking at two products that had piqued my interest the day before: AutoCool and AutoSplit from Talyst.
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  • Hello from the ASHP Summer Meeting in Chicago

    Today was my first official day at the ASHP Summer Meeting in Chicago. I spent the first half of the day in the exhibit hall checking out the vendors and all the cool stuff they had on display. The exhibit hall wasn’t open to everyone, but I had the unexpected surprise of receiving a vendor’s badge. Many of the exhibits weren’t ready for “prime time”, so I plan on returning tomorrow for a closer look.

    The second half of the day was spent at the Talyst User Group Meeting. The meeting covered several great topics, but centered around advances in Talyst’s AutoPharm software geared toward patient safety and a new customer portal that will offer access to articles, product updates and valuable customer forums for open discussion. Both items should be available by the end of the year.

  • Barcodes on patient wristbands.

    wristbandbarcodeBarcode.com: “Often times, information that Hospital administrators would like to include in the barcode is far too much in relation to the wristband space. While 1-D barcodes cannot always fit all of the information, they can be scanned by all types of barcode readers, unlike 2-D barcodes which can fit more information, but require a 2-D capable scanner. In addition, when the end of the barcode curve around patients wrists, it is difficult to scan, thus, it is necessary to choose a barcode symbology that will fit on the flat part of the wristband, but also hold all of the necessary information. Rather that choosing a UPC code, which is commonly used in retail applications, it would be wise to choose a dense barcode symbology, such as Code 128, which can hold a lot of information in a small amount of space. - Wristbands are a popular item for discussion in any barcode medication administration (BCMA) project. They’re just not user friendly. Even though 2-D barcodes require an upgraded scanner, I prefer them because of their small footprint. Their size allows multiple copies of the same barcode to be placed on the wristband in several strategic locations for easy access. The difficulty associated with scanning a patient wristband is one more reason why RFID may be worth a second look.


  • “What’d I miss?” – Week of June 7th

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

    zebra-r110xi-rfid-printer-encoderRadio-frequency identification (RFID) printers.

    RFID refers to small electronic devices that consist of a small chip and an antenna. They are capable of carrying quite a bit of information. To retrieve the information an RFID device must be scanned much like a barcode. While barcodes require a “line of sight” to be recognized by the scanner RFID labels can be scanned independent of position relative to the scanner and may be read up to 20 feet (or more) away.

    RFID is an interesting alternative to barcoding for medication tracking and administration. The advantages are their ability to carry increased amounts of information and the relative ease of scanning mentioned above. It is unclear why RFID hasn’t become more main stream, but one reason could be the relative cost when compared to a traditional barcoding system. RFID would certainly make tracking inventory a little easier.

    The printer pictured here is the Zebra R110Xi RFID Printer. For more information about Zebra RFID printers, as well as other RFID products, visit IDAutomation.com.

  • End-user virtualization in a hospital.

    InformationWeek:”Norton Healthcare, the largest health care supplier in the Louisville, Ky., region, has adopted end-user virtualization as a means of giving doctors and nurses a desktop that follows them on their rounds.

    The five-unit acute-care hospital chain and supplier of 11 neighborhood clinics is in the process of providing 1,000 thin clients to end-user end points, such as nursing stations, clinic treatment centers, and 50 physician offices. With three shifts a day, most end points have three different users every 24 hours, noted Brian Cox, director of IT customer services.

    With VMware view set up, Cox has been able to let doctors and nurses move around the hospital and still access their desktop from the closest thin client, often at the nursing station of a wing instead of having to go back to their own desks. Their desktops can be called up from any location and used to enter patient information or look up patient records.” – Thin clients can be a useful piece of hardware in a hospital setting and I’ve touched on them before. The article doesn’t make it absolutely clear, but your personal desktop actually follows you around regardless of what machine you use to log on. Thin clients are also easier to manage and maintain than traditional desktop PCs from an IT standpoint. I realize this is not cloud computing, however it’s the same basic idea on a small, internalized scale.