Author: Jerry Fahrni

  • Saturday morning coffee [April 6 2013]

    MUG_AlienJerkySo much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    Welcome to April 2013 everyone. The year is flying by.

    The coffee mug to the right comes straight from Alien Fresh Jerky in Baker, CA. Baker is small town located near the Nevada border. The population is less than a thousand people, but they do have the worlds tallest thermometer, and of course Alien Fresh Jerky. My family and I drive right past Baker, CA every time we head to Las Vegas. I’ve seen the Alien Fresh Jerky sign a hundred times, but for one reason or another had never pulled in for a visit. This time I decided to swing in and take a look. Turns out that it was a good decision. Not only did I pick up a coffee mug, but I purchased some seriously good jerky. I’m a traditional kind of guy so I stuck with the beef in two flavors: Honey Teriyaki and their Road Kill Original. Great tasting jerky. Oh, I’d recommend staying away from their “Invisible Jerky”, it just doesn’t fill you up like the others.
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  • NFC medication tracking system

    Well, well, well, here’s one page in my idea book that I can put a big read “X” through [December 6 2011 – Page #42]. And for all those people that told me it was a stupid idea – you know who you are – I have one word for you: Harvard. Yeah, that’s right, Harvard. It seems that some intelligent, forward thinking people over at Harvard Medical School have developed an NFC system for medication administration at the bedside.

    Ah, justification. Feels good. Sorry, sometimes being petty feels good.

    NFC World: “Harvard Medical School’s teaching affiliate Brigham and Women’s Hospital (BWH) has developed an NFC system aimed at making it easier for nurses to track and administer each patient’s medication.

    The new bedside system uses a combination of Google Nexus 7 NFC devices, which run the new application and store details of each patient and their prescribed medications, and NFC tags attached to patient wristbands, medication packages and employee ID badges.

    When administering medication, nurses use the NFC tablet to tap the tags on the patient’s wristband, on the medication and on their ID badge. The application running on the tablet then checks to see if the medication and dosage is the correct one for the patient and records which medication was administered to the patient and by whom.”

    Booyah!

    Research: Dr. Adam Landman: Near-Field Communication Technology at the Patient Bedside from BWH Public Affairs on Vimeo.

  • Clinical Dilemmas and a Review of Strategies to Manage Drug Shortages [article]

    Here’s an interesting article in the Journal of Pharmacy Practice. The article, Clinical Dilemmas and a Review of Strategies to Manage Drug Shortages appears online ahead of print (doi: 10.1177/0897190013482332). Unfortunately you’ll hit a paywall, so if you don’t have a subscription all you’ll get is the abstract.

    That’s unfortunate because according to the article “The expanded phased approach outlined here [in the article] provides a consistent, systematic approach for the management of drug shortages“. You would think they’d want everyone to know about the expanded phased approach due to the “health care crisis” created by drug shortages. Just sayin’.

    Abstract
    ———————————————-
    Objective: The objectives of this article are to review the clinical implications of drug shortages highlighting patient safety, sedation, and oncology and introduce an expanded phase approach for the management of drug shortages. Data Sources: Literature retrieval was accessed through a PubMed search of English-language sources from January 1990 through April 2012 using the medical subject heading pharmaceutical preparations/supply and distribution and the general search term drug shortages. Study Selection and Data Extraction: All original prospective and retrospective studies, peer-reviewed guidelines, consensus statements, and review articles were evaluated for inclusion. Relevance was determined considering the therapeutic class, focus on drug shortages, and manuscript type. Data Synthesis: The increased number of drug shortages has created significant challenges for health care providers. Two particularly vulnerable populations are critically ill and oncology patients. A lack of therapeutic alternatives in critically ill patients may impact patient safety as well as treatment outcomes. Similarly, a chemotherapy agent in short supply may contribute to adverse outcomes in oncology patients. Conclusions: The mounting number of drug shortages has created a health care crisis, requiring changes in management strategies as well as clinical practice. The expanded phased approach outlined here provides a consistent, systematic approach for the management of drug shortages.

  • Gamification for medication compliance: Mango Health

    mango-health1GigaOM: “Mango Health, founded by former executives from mobile gaming company ngmoco, is using game mechanics to get people to be more conscientious about managing their health.

    Mango Health… believes that by combining game mechanics with an intuitive, fun design and useful features, they can keep patients on track. Since August, the company has been beta testing the app with a small set of users, but on Tuesday it said it had launched in the app store.

    The app offers several tools, including a simple way to check for medication interactions and timed reminders to take your meds. The app’s colorful, clean design is more inviting than many health apps on the market. But the real trick to getting people to stay hooked is a reward system. Each day, users have the opportunity to earn 10 points for letting the app know that they took their medication. Over time, those points can be redeemed for perks like Target gift cards and charity donations.”

    Details at the Mango Health website are a bit sketchy, and I couldn’t locate a video of the app in action.

    Mango Health is available only for the iPhone, which is a bit of a bummer.

  • What report service/software does your pharmacy use?

    I wrote about Pandora back in December 2009. It was a great piece of software back in the day.

    I remember a time when nearly everyone in pharmacy that used Pyxis ADC’s to control their medication distribution at nursing units also used Pandora to generate reports, look at data, and detect controlled substance diversion. The two simply went hand in hand. If you had Pyxis, you used Pandora.

    Pandora was acquired by Omnicell a few years ago, and since that time it’s popularity appears to have declined. Maybe it’s just my imagination, but it sure feels that way. I talk to a lot of pharmacy personnel, and recently it appears that pharmacies are starting to use solutions other than Pandora.

    Carefusion’s Knowledge Portal seems to be a popular response these days when I question people about their metrics, reports and analytics. I suppose that makes sense when you consider that a majority of hospitals in the U.S. use Pyxis ADC’s, which we all know are made by Carefusion.

    Perhaps the acquisition of Pandora by Omnicell had something to do with it. Maybe my cross section is skewed. Who knows. This will be something that I will pay close attention to over the next several months. I’ll think I’ll add this to my list of standard questions when I visit pharmacies.

    Data is important, and becoming more important by the day. Whoever has the best solution wins.

  • Saturday morning coffee [March 30 2013]

    MUG_MPSo much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug to the right comes straight from Moonstone Pottery in Los Osos, California. It’s a pretty cool mug. It was a gift from my brother, Robert. Thanks bro.

    The Croods was #1 at the box office last weekend to the tune of nearly $44 Million. I didn’t see that one coming. I knew that the movie was out, but had no interest in seeing it. My family chose instead to see Olympus Has Fallen. It was terribly predictable and a bit corny, but I liked it. It was full of lots of gratuitous violence and gun play, which makes it my kind of movie. Just for the record, Jack the Giant Slayer has officially flopped at the box office.
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  • The loss of Google Reader will be tough and here’s why

    The news that Google Reader is going to be sunset in July of this year has created somewhat of a panic among many, including myself.  The internet has been abuzz with articles on potential replacements. I’m sure people will look at many of these and find something to meet their needs, but what I’ve found thus far has been disappointing. I assume that’s because Google Reader was truly more than just a RSS aggregation tool for me.  A lot of the functionality that I used was the result of many third party developers that wrote plugins and scripts to do everything from rearranging the information on the page to removing ads. Google Reader was popular and mature, and it showed.

    ReaderSTATS

     

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  • Saturday morning coffee [March 16 2013]

    MUG_ASHPSM2011So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug to the right was presented to me as a gift from ASHP for winning the 2011 ASHP Summer Meeting Twitter Contest. Not to be confused with the one I put up last August for the 2010 ASHP Midyear Twitter contest. The mug was accompanied by a $50 Best Buy gift card; very nice. The meeting was held in Denver, CO and was the first ASHP Summer Meeting I ever attended. The Summer Meeting is quite a bit different from the Midyear Meeting held in December each year. Midyear is much larger and has a much wider variety of educational sessions. Midyear also has a bigger exhibitor area. With all that said I found the Summer Meeting quite enjoyable as it had several informatics related sessions that I was able to attend. It was the last pharmacy conference that I was able to enjoy as an attendee.
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  • Center for the study of pharmacy automation and technology [idea]

    MadScientistEarlier this week I put up a post about a Prezi created by Dr. Robert Hoyt called Evidence Based Health Informatics: Replacing Hype with Science. It was a great presentation about a lot of the technology that healthcare has adopted over the years without any real evidence to back it up. I wish you could all see it, but it appears that someone has pulled it down. The link I have for the Prezi is dead. Bummer

    Anyway, the Prezi got me thinking about how we have many technologies in pharmacy that have precious little, or no data to support their use. We use carousels, high-speed packagers, tabletop packagers, robotic medication distribution, robotic IV preparation along with other IV room technologies, smart IV pumps, automated storage cabinets, and so on. The data we do have for these items is typically provided by the manufacturer’s themselves, which makes it biased in the best of situations and completely worthless in the worst cases.

    Pharmacy is in desperate need of an academic center for the study of pharmacy automation and technology. The center would study the use of pharmacy technology in different use cases, collect data, and provide the pharmacy community with the information. Look at robotics versus carousels for distribution. Analyze cross contamination in high-speed packagers versus tabletop models. Perform time-motion studies on cart fill vs. automated dispensing cabinets for medication distribution, and compare the safety of one over the other. Analyze pharmacy inventory costs of one technology over the other. And so on, ad infinitum.  Conclusions wouldn’t be necessary as simply presenting the information in an easy to understand format would suffice. Let the end users draw their own conclusions. Every practice setting is slightly different, and what may work for one may not work for another. But understanding how a piece of technology or automation fits into a particular practice model might be a significant benefit to many.

    The center would tear the automation and technology apart, both figuratively and literally to unveil all there is to know about each and every piece.

    Such a place would have to exist at a well respected academic research center as it is the only way to ensure some semblance of impartiality.

    How would it be funded? Ah, there’s the rub. Getting funding for such an endeavor would be difficult at best. A lot of this equipment is expensive. Of course the best place to troll for money would be the pharmacy technology vendors themselves. After all, they have all the equipment that would be needed to perform the research. Unfortunately this is unlikely to happen as most companies will not be willing to drop resources into a project that they have no control over. What if the outcome of such research reflected poorly on their products? That would not only be embarrassing, but could potentially hit them in the pocketbook. No, they couldn’t risk it. How about the federal government? Perhaps, but that might be like getting blood out of a turnip these days.

    Getting the equipment and funds would definitely be the hardest part. There’d be no shortage of pharmacists interested in doing that type of work. What pharmacist could resist playing with giant toys all day long?

    Time to get out my crayons and start drafting a proposal….

  • Visualizing data – Tableau Software

    I spent the day in San Francisco attending the Tableau 8 Roadshow event.

    Tableau is an amazing piece of software that helps you link to data in various forms – SQL databases, Excel spreadsheets, Google analytics, and many, many more – and use that information to create stunning visualizations. It’s insanely easy to use, and quite frankly is one of the most impressive pieces of software I’ve ever used to present data in an easy to understand manner.

    Tableau
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