Jerry Fahrni

Author: Jerry Fahrni

  • Cool Technology for Pharmacy – Spiroscout Inhaler

    The Spiroscout Inhaler Tracker by Asthmapolis is a small device that attaches to the top of an inhaler. The unit is GPS capable so that each time the inhaler is used, the GPS unit records the time the medication was taken and the patients location.

    What a great tool to not only help asthmatics control their disease, but provide physicians with great real-time data. I suppose the next step would be to integrate devices like this into the electronic health record similar to what has been done with me blood glucose and blood pressure monitoring devices.

    The Spiroscout Inhaler Tracker is used in conjunction with the Asthmapolis mobile diary to help patients map and track their asthma symptoms, triggers and use of medications.
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  • It may be time to consider robotic IV preparation at the bedside

    Hospitals make a lot of intravenous (IV) preparations. That makes sense when you consider that most people admitted to the hospital are there because their acute illness requires more care than can be administered at home; not always, but in most cases. This is especially true for patients in the intensive care unit, i.e. the ICU.

    A fair number of the medications used in the ICU are prepared on demand for a host of reasons including stability, differences in concentration, difficulty in scheduling secondary to rate variability, etc. Any pharmacist or nurse reading this will understand what I’m talking about. Example medications that fall into this category include drips like norepinephrine, epinephrine, phenylephrine, amiodarone and nitroprusside.

    Last year I mused about using devices on the nursing stations designed to package oral solids on demand at the point of care. I still like the idea for several reasons, all of which can be found in the original post.  Based on currently available technology the same concept could be applied to preparation of IV products at the bedside. Robotic IV preparation has come a long way and these devices could be used at the point of care to make a nurses, and patient’s, life a whole lot easier. The use of robotic IV preparation at the bedside could reduce wait times for nurses and lesson the workload on pharmacy.
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  • Do you think this is the future of mobile computing, or the past?

    I came across this post at Mobile Health Computing, one of the many blogs of Dr. Joseph Kim.

    Is this the future of mobile computing?

    Here’s a great photo of an Apple iPad on a stand with a keyboard on the desk. Is this the future of mobile computing? Will we all end up using thin slate tablet computers that are held up on stands? While we’re sitting on a desk, we may use the keyboard. When it’s time to go, we grab the slate and we run off. No keyboard needed since we’re probably going to be computing on-the-go.

    The image from Dr. Kim’s post reminded me a similar setup I’ve seen in a pharmacy before. The image to the right is a J3400 tablet PC attached to the Motion FlexDock. The FlexDock offers support for an external monitor, RJ45 nectwork connectivity and multiple USB ports for keyboard, mouse and printer. In addition the FlexDock includes a charging bay with room for an additional battery.

    Would it surprise you to learn that the setup to the right was introduced more than a year ago (early 2009), and that the J3400 is an “older” model tablet PC that was recently replaced by the J3500? I find that interesting.

    Either setup would be great.

  • Top blog posts and searches from last week (32)

    I always find it interesting to see what brings people to my website and what they decided to read once they get here.

    Most read posts over the past 7 days:

    1. Cool Technology for Pharmacy (June 18,2009 – Alaris Smartpumps)
    2. Best iPhone / iPod Touch Applications for Pharmacists
    3. Update: Siemens Innovations 2010 final day
    4. Update: Siemens Innovations 2010 parting thoughts
    5. Curriculum Vitae
    6. Cool Technology for Pharmacy – Practice Fusion EMR
    7. We need a better system for medication reconciliation
    8. Update: Siemens Innovations 2010 – Day 1
    9. Cool Technology for Pharmacy (September 10, 2009 – The Capsule Machine)
    10. Update: Siemens Innovations 2010 Presentation

    Top searchterm phrases used over the past 7 days:

    1. “alaris pump”
    2. “medication reconciliation”
    3. “jerry fahrni“
    4. “transparency ”
    5. “cloud computing“
    6. “iv pump“
    7. “medscape mobile“
    8. “siemens pharmacy“
    9. “siemens innovations conference“
    10. “pyxis medstation 4000“

  • Small labeling changes to phenytoin unit dose cup causes confusion

    August 12, 2010 issue of the ISMO Medication Safety Alert the issue of : “We have received a number of reports about the labeling of Xactdose unit dose liquid containers from VistaPharm, Inc., of Birmingham, AL. The company recently changed the way the drug concentrations are expressed on their labels. An example is phenytoin oral suspension which went from emphasizing 100 mg/4 mL to listing 125 mg/5 mL. The company rightly notes that the 125 mg/5 mL container delivers 100 mg or 4 mL (due to the heavy liquid consistency of phenytoin suspension), but the message doesn’t necessarily translate to nurses who are confused by the new label and need to give an exact dose. The good news is, we learned last week that VistaPharm is returning to the old style label. That will no doubt lead to less confusion, but nurses should also know not to rinse the residual suspension from the cup. Doing so would approximate as much as a 25% overdose. The company said they expect to release products with revised labeling by the end of the month.”
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  • Musings on poor resource management in healthcare

    I’ve recently had the displeasure of running up against some significantly poor resource management that has had a negative impact on my ability do my job, and it got me thinking about what kind of overall impact poor resource management has on healthcare. I’ve held a full time position as a pharmacist in four hospitals and worked either part time or per diem in two others. That’s a total of six separate facilities in five different cities, so I’m going to assume that I have a fair sampling. No two facilities were the same, but they all suffered from the inability to manage resources, i.e. people, hardware, software, reference material, etc.

    I’m sure running a hospital doesn’t come cheap, but I believe you have to create a balance that gives you not only the ability to move forward, but also creates an environment that allows one to perform at a high level.  The problem I see in healthcare is a general lack of foresight when it comes to moving forward.  For example, you can’t purchase a new piece of automation hardware for the pharmacy and expect it to run itself forever at no cost for maintenance, optimization and upgrades. But that’s how we, i.e. healthcare, view things. While I’m general speaking about things related to pharmacy because that’s what I know, the basic principles can be applied to almost anything.
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  • Toughbooks aren’t just cool, they save money too

    I’ve mentioned Panasonic Toughbooks on this website before. I’m a real fan of the Toughbook C1 tablet PC with its multi-touch digitizer, 10 hour battery life, spill-resistant keyboard and tough magnesium alloy exterior. It’s definitely on my short list of most desired devices.

    It turns out that Toughbooks are more than just cool technology, they may actually save healthcare a little money when used the right way. NHS Kirkless, a primary care trust in the UK estimates that they are saving more than $900,000 per year by deploying 600 Toughbooks to their care providers in the field.
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  • Update: Siemens Innovations 2010 parting thoughts

    Innovations 2010 is in the books and I’m back home after a four day stent in Orlando. It’s not uncommon for me to get a little overwhelmed at a conference because there’s simply too much information to digest at one time. Sometimes it takes me a few days to mull over the information and decide what I’m going to do with it. After all, I can’t use everything I learned because some of it simply doesn’t apply to my situation. In addition I spent more time talking with people one-on-one this year than in years past. I feel like I get more out of people when I can direct the conversation where I want it to go.

    Well, it turns out that long plane rides and airport delays are a good time to get your thoughts together, toss around some ideas and make some decisions. While I have a long list of Siemens specific items to look over when I get back to work tomorrow, I won’t bore you with those here. Instead I thought I would share some general thoughts about my Innovations 2010 experience.
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  • Update: Siemens Innovations 2010 final day

    Today is my final Day at Innovations and I’ve managed to pick up quite a bit of good, useful information that has the potential to improve our operations back at the hospital. I’ve been in my current position as an IT pharmacist for about 2 1/2 years now and this is my third Innovations conference. I finally have enough experience under my belt to start putting the pieces together in a manner that allows me to gather information in a more strategic fashion, rather than just running around trying to gather enough information to put out fires.

    This years Innovations conference was heavy with sessions on ARRA, meaningful use and CPOE. I’m not surprised as this is where all the money will be for vendors involved in HIT over the next several years.

    Anyway, I feel there are a couple of presentations I attended yesterday that are worth mentioning.
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  • Update: Siemens Innovations 2010 Presentation

    Today was the big day. I gave my presentation at about 11:00 am and it cleared the room. There were about 100 attendees for the CPOE presentation just prior to mine and about 90 of those people got up and left when it came time for me to do my thing. I guess mobile pharmacy just isn’t interesting to most people.

    Anyway, the presentation is below. There is an embedded video near the end that didn’t pull into SlideShare. It’s about a 30 second look at how we use Citrix on the iPad to access various clinical applications. I attempted to upload in to YouTube, but kept getting an error. I’ll try again later. If you want to see the elongated version of the videos simply go to YouTube and type in “Kaweah Delata iPad“, or something similar, and several options will pop up.