Jerry Fahrni

Author: Jerry Fahrni

  • Technology + Medical Home = Pharmacist Opportunity

    Modernmedicine.com:

    “Pharmacists certainly have the skills, training, and knowledge to be prime players in a coordinated approach,” said Judy Cahill, executive director of the Academy of Managed Care Pharmacy. “An inherent shortcoming to this idea, however, is lack of pharmacist access to patients’ medical records. For them to play a pivotal part in care management, the medical record is essential.”

    Keckley agrees. Lack of pharmacist access to patient medical records currently limits the role of pharmacist to medication management only, rather than offering an opportunity to manage care between patients and providers, such as nutritionists and physical therapists, he saids.

    Two developments can change that: the increasing use of electronic medical records and the industry-wide promotion of electronic prescription transmission. EMRs will allow pharmacists access to diagnostic rationales and long-range patient treatment histories. For example, an EMR can give pharmacists access to laboratory data. HIPAA privacy concerns may have to be addressed through authorization forms, and state boards of pharmacy may have to reexamine current regulatory practices.

    But these concerns are already being addressed through medication therapy medication initiatives across the country — many sponsored by health plans that see a cost advantage in having pharmacists counsel patients. E-prescribing not only gives pharmacists access to insurance information — data available through pharmacy benefit management software — it also enhances communication with physicians.

    Several emerging e-prescribing models, sponsored by health plans, include e-prescribing as a component of EMRs. “Bring into that the use of clinical management tools, which are the tools that DM companies now market, and pharmacists will be able to offer a degree of coordination, especially for patients with chronic diseases, that no other provider, including physicians, are as readily able to provide,” said Keckley. “Plans could consider paying for that service.”

    This is a prime example of how technology can be used to expand the pharmacist’s role in patient care.

    Get more information about a medical home here.

  • New LCD technology may be the solution I’m looking for.

    A week or so ago I made a comment wishing that someone would make an e-ink screen for laptop or desktop use. E-ink would be an ideal solution as it offers several advantages over current screen technology. Screens using e-ink offer a great reading experience even in bright light environments, they don’t put undue strain on the eyes and draw very little power (e-readers like the Kindle can last up to 40 hours on a single charge). No longer a wish, a company called Pixel Qi has developed new technology that isn’t quite e-ink but definitely a step in the right direction. Their new LCD technology is viewable in full sunlight and looks very similar to epaper. To see what I’m talking about take a look at this video comparing Pixel Qi’s new LCD screen to the Kindle’s e-ink screen. Of course this new technology shouldn’t be confused with the Kindle’s e-ink technology, but it still looks fantastic.
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  • Barcode scanning technology continues to improve patient safety.

    Am J Health Syst Pharm (2009;66 1110-1115): “A total of 1465 medication administrations were observed (775 preimplementation and 690 postimplementation) for 92 patients (45 preimplementation and 47 postimplementation). The medication error rate was reduced by 56% after the implementation of BCMA (19.7% versus 8.7% , p < 0.001). This benefit was related to a reduction associated with errors of wrong administration time. Wrong administration time errors decreased from 18.8% during preimplementation to 7.5% postimplementation (p < 0.001). There were no significant differences in other error types. Conclusion. The implementation of BCMA significantly reduced the number of wrong administration time errors in an adult medical ICU.” – I’ve touched on this before. In a pre-barcode era mistakes at the bedside weren’t caught and patients suffered the consequences. Barcoded medication administration has tremendous potential. I am hopeful that hospitals will continue to develop its potential in this age of technology, and in doing so drive medication administration errors to zero.

  • “What’d I miss?” – Week of June 1st

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

    POMS (Paperless Browser Based Pharmacy Order Management System) is an electronic document management (EDM) system from Integrated Informatics, Inc.
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  • Not everyone is happy with the idea of ePrescribing

    The Angry Pharmacist: “Don’t say that your pharmacy associations don’t do anything for you! Now GNP pharmacies get [$%#@] by their own for the low-low cost of only $0.30/eRx.  Here’s something about “quality, safety, and efficiency”: I have seen more errors, decimal point, and unit [$%#@] via SureScript eRx in one week than YEARS OF PAPER PRESCRIPTIONS.  In fact, I keep a file of all of the eRx [$%#@] that I get (it gets about 2-3 a day, that’s 15 a week) so when doctors say how WONDERFUL it is, I show them how many lives I have saved.  I’ve seen injection dose written instead of an oral dose, blatant overdoses, everything you can imagine.  I’ve even had controlled substances faxed to 2 different pharmacies 1 min apart for a cash paying patient MULTIPLE TIMES.  Hows that for safety and quality! …Now here’s the dirty secret of eRx’s …  You see, the “old fashioned way”, doctors had to sign each Rx they gave out to the patient.  However those days are long gone thanks to ePrescribing.  Now all some idiot has to know is the doctors password and ANYONE IN THE OFFICE CAN SEND OFF PRESCRIPTIONS.  That’s right, this bullshit doesn’t save the pharmacies any time, but it saves the doctor a bunch because its pretty much giving anyone who works in the office the power to sign and give patients legit prescriptions (even for controlled substances!)  Before, you had to steal the doctors pad and write out phonies, now anyone in the office with access to the eRx terminal can splatter out narcotics to every pharmacy that takes eRx’s and nobody would be the wiser.” – The author has some pretty interesting things to say about ePrescribing in general. I guess the process isn’t exactly ready for prime time. Take a minute to read the entire article, but only if you don’t have sensitive ears.

  • Thinking about a better Automated Dispensing Unit (ADU)

    Automated Dispensing Units (ADUs), also referred to as Automated Dispensing Cabinets (ADCs), are nothing new to hospital pharmacy. Over 80% of hospital pharmacies use ADUs. The most common is a product from Cardinal called Pyxis MedStation. Others include Omnicell SinglePointe, McKessen AutoDose-Rx and medDISPENSE (part of Emerson Electric Co.). Currently Pyxis is the clear front runner, and for good reason. They offer a great product.
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  • Barcodes ‘help face recognition’

    BBC News: “Faces are made up of “barcodes” which help us recognise each other, according to scientists. The researchers at Stirling University and UCL manipulated the faces of celebrities such as Marlon Brando and George Clooney for their study. Their results suggested that most of the information needed to identify someone could be found in the lines formed by the eyebrows, eyes and lips. They hope their research will help improve face recognition software.” – Just when I thought I had heard about every use for a barcode someone goes and barcodes my face. 

  • Talking “meaningful use” with our CIO.

    The American Recovery and Reinvestment Act of 2009 (ARRA) is an $850 billion stimulus package passed by Congress aimed at encouraging economic growth in various industries through government spending. If you’re in healthcare, then you may be able to take advantage of $51 billion that has been allocated to the healthcare industry, $19 billion of which is aimed at the adoption and implementation of Electronic Health Records (EHRs), also known as Electronic Medical Records (EMRs). The only way to get your share of the money is to demonstrate that you are a “meaningful user” of an EHR system. The problem is figuring out what a “meaningful user” is.

    My curiosity about being a “meaningful user” led me to the office of our CIO, where I casually asked him if we were going to qualify for any of the funds allocated by the ARRA. He informed me that “meaningful user” had not been completely defined, and is currently a hot topic of discussion.

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  • Sperm-like nanopropeller is smallest swimmer ever

    Newscientist.com: “REMOTE-CONTROLLED nano-devices that look like sperm but mimic the corkscrew motion of flagella may one day deliver drugs to where they are needed in the body.”  -The applications here are limitless. I had the opportunity to work on something along these lines when I was an undergrad (Chemistry). We used polyaniline to carry drugs to a specific location. Once at the location, a current was applied directly to the polyaniline, releasing the drug. Of course we had no remote control and our experiments were performed in a beaker, but it was still pretty darned cool. I still have my lab notebooks from back then. Thumbing through them brought back a lot of good memories. Being involved in any type of R&D is exciting and fun, I highly recommend it (if you get the chance).