Author: Jerry Fahrni

  • Results from ISMP’s survey on IV storage and beyond use dating show confusion, lack of standards

    Beyond use dating (BUD) is a bit of a hassle in acute care practice. The reason is that regulatory bodies have muddied the water with information that isn’t always the most recent or evidence based. ISMP recently published information from a survey of 715 pharmacy professionals on drug storage, stability, and beyond use dating of injectable drugs, and the results are a bit disappointing. There’s clearly a lot of confusion out there, in addition to a plethora of different practice models.

    For me the reference of choice for stability, storage and compatibility was always the Handbook on Injectable Drugs, now in its 16th Edition. This reference was affectionately known as “Trissel’s” because the author of the book Lawrence A. Trissel is a legend in the field of injectable drugs. After Trissel’s I’d do a literature search to see if I could find something that wasn’t in there; typically I couldn’t. And finally, if I couldn’t find it in Trissels’s or the literature, I’d look at the manufacturer’s information.
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  • ASHP Summer Meeting 2012 full of pharmacy informatics stuff

    I attended the ASHP Summer Meeting last year in Denver, CO for the first time ever. The Summer Meeting was much smaller than the infamous Midyear Meeting, but I must say that there were some great informatics sessions. You can read about my experience last year here:

    Well, it looks like the 2012 Summer Meeting is primed and ready to offer just as much interesting informatics stuff this year. The meeting takes place in Baltimore, Maryland June 9-13, 2012. Hope to see you there.
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  • A couple of really nice webinars from Pharmacy OneSource coming up

    I received an email today from Pharmacy OneSource outlining their upcoming webinars. Pharmacy OneSource has been offering great webinars for a while now, but these really piqued my interest.
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  • Telerounding with an iPad at Henry Ford Hospital

    PRWeb:

    The surgeon and his patient are actually 25 miles apart in two different hospitals, each armed with an iPad equipped with the live video chat software FaceTime.

    Through face-to-face video calls on iPads and other tablets, Henry Ford is initiating the next wave of high-tech communication at hospitals called “telerounding.”

    “Patients are looking for us to use current technology in a way that improves their care, and ‘telerounding’ with the iPad really fits that need in enhancing the communication and care following surgery.”

    The iPad fills a critical need for Henry Ford surgeons like Dr. Rogers – who perform operations each week at both Henry Ford Hospital in Detroit and Henry Ford West Bloomfield Hospital – to communicate with their patients in the clinic or inpatient setting, even when they’re not in the same city.

    Previously, the surgeon would call the patient on the phone if he wasn’t on site. By replacing a phone call with a video-chat on the iPad, patients are able to have a personal and confidential conversation with their surgeon.

    I love this concept. I talked to a pharmacy director at the end of last year that was doing something similar with the iPad for patient medication consultation at the time of discharge. Discharge medications were filled by the pharmacy and delivered to the patient’s bedside by a pharmacy technician toting an iPad. If the patient desired consultation with a pharmacist the technician fired up FaceTime. Cool use of technology.

  • Don’t ignore the evidence for the sake of argument

    I regularly read a website called Medinnovation. It’s written by Dr. Richard Reece who tends to rant about healthcare in a refreshing way that you don’t often see online. He basically gives you his opinion with both barrels and it typically runs counter to what most people have to say. I like it.

    This morning (broke my rule about Sunday morning reading, Doh!) I read his latest post, Medical Experts and the American People. This is one time when I think he got it wrong. In the article Dr. Reece basically chastises evidence based medicine (EBM). “I say “presumably” because many patients or doctors do not necessarily buy the experts’ advice [i.e. evidence based recommendations] or follow instructions.” Uh-oh.
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  • Reviewing an #archetype

    I’ve been meaning to write this for a while, but you know how things go.

    While at HIMSS12 in Las Vegas last month I was asked to do a little review work. That’s not all that uncommon. People ask me to do things on occasion; review a blog post, review an app, give my opinion on something and so on. But this was completely different as Dr. Heather Leslie (@omowizzrd), Director of Clinical Modeling for Ocean Informatics and Editor for the openEHR Clinical Knowledge Manager asked me to review an archetype. A what? Yeah, that was my response when Heather and I first spoke about the topic nearly two years ago.

    According to good ol’ Merriam-Webster an archetype is “the original pattern or model of which all things of the same type are representations or copies: also : a perfect example“. Simple enough, but still too vague for my brain so I went in search of a better explanation which I found at Heather’s blog – Archetypical.
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  • Cool Pharmacy Tech – Phocus Rx

    Ever heard of Phocus Rx? Neither had I until a couple of days ago when my boss sent me a link to this story about Children’s Hospital Los Angeles receiving Phocus Rx as a charitable donation.

    Phocus Rx is camera system used in pharmacy clean rooms to document and validate the IV compounding process. It consists of two compact 5 megapixel cameras mounted outside the hood in the clean room ceiling or on articulated arm and workflow management software. That’s quite a departure from the other systems I’ve seen where the camera sits in the hood. In addition Phocus Rx includes the obligatory image capture that allows pharmacists to remotely review the compounding process. Pretty cool stuff.

    By my count we now have four of these systems on the market, including PHOCUS Rx. Getting pretty crowded in there. Although I have to say that DoseEdge is far and away the most talked about of the IV workflow management systems on the market today. I’d love to play with them side by side to compare features and functionality.

    The other systems that I’m aware of include:

    From the PHOCUS Rx website:

    PHOCUS Rx is a powerful camera verification system combining hardware and software. It enables pharmacists and technicians to remotely document and validate the preparation of IV drugs. Two ultra compact 5 megapixel cameras are located outside the hood in the clean room ceiling or on articulated arm. Bi-directional communication software enables pharmacists to review high resolution images and validate or send a warning message.

    FEATURES

    • scalable and modular system
    • non invasive – no wires or devices in hood
    • server located outside compounding area
    • validate and store images
    • barcode recognition
    • based on client/server structure
    • simple workflow screens
    • historical and activity reports
  • Medscape application now available for the Kindle Fire

    I’m sure by now everyone has heard of the Kindle Fire. If not just know that it is the 7-inch color media device from Amazon based on the Android operating system. The device has been uber popular to this point. It’s difficult to tell how popular exactly, but one thing is for sure, you know a device has gained some ground by the applications that get developed for it.
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  • AJHP optimized for mobile access

    Looks like the little elves over at AJHP have been busy making their journal easier to access from mobile devices. That’s pretty cool. I spent a few minutes playing around with the site on my Nexus and it worked well. I was able to pull up Implementing smart pumps for epidural infusions in an academic medical center and read through it without any major obstacles. The only recommendation I have for AJHP would be to make the process of logging in easier. The optimized site bounces you to the full blown web page for login. Overall, well done.

     

  • Technology still can’t beat pen and paper

    I am a tablet PC guy, no question. My tablet of choice is the Levnovo x201t, but I’ve tried several and enjoy the constant hunt for a new one. I don’t travel with it much these days as I’ve grown tired of carrying multiple machines, dealing with security, etc. But when I’m at home my tablet PC is a workhorse. Between Microsoft OneNote and Evernote I’ve basically eliminated my need for a notebook. Or so I thought.

    For whatever reason I decided to take a long hard look at my note taking needs this week. I’ve been rather irritable lately and found myself nitpicking many of the cons associated with using a tablet PC for taking notes that I previously overlooked. The shortcoming of using a tablet PC are obvious: battery life, “boot time”, size and the mother of all….you can’t take notes on a tablet of any kind when it’s turned off, which has been a real issue for me while traveling.
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