Jerry Fahrni

Author: Jerry Fahrni

  • My first “cloud” letdown

    The cloud punched me in the nose recently and it’s still a litter tender. I’m a huge proponent of cloud based solutions from simple things like online document collaboration and storage to web-based enterprise SaaS solutions, and I have been slowly migrating my digital life away from the desktop toward the cloud. The cloud and I have been very happy together for well over a year now, but we had out first argument last week and I lost. It’s not serious enough to consider divorce, but it was a wake up call to re-evaluate the relationship.

    I use both Live Mesh from Microsoft and Dropbox to manage and synchronize documents on multiple computers. The combination has worked very well for me. I use both applications because I like to try new things; Live Mesh came first followed by Dropbox at the recommendation of my brother.
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  • Quick Hit – Time to change the way healthcare information is disseminated

    I spend a fair amount of time reading various medical, pharmacy and technology journals. Why? That’s a very good question. I was taught in pharmacy school that you need to read a host of journals every week to stay up to date on current trends for the betterment of your knowledge base and the patients you care for. So like any self-respecting pharmacist that’s what I’ve been doing for the past 13 years.

    With that said, my view of the medical literature is starting to change. The information in journals today is out of date by the time it’s published. This is especially true when it comes to any journal articles related to technology. A recent conversation with a friend and colleague verified this when he mentioned that much of his research findings could take as long as a year to grace the pages of a journal. That’s just plain crazy. If advancing technology has taught us one thing it’s that no one should have to wait a year to become better informed.
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  • Cool Technology for Pharmacy – BoxPicker

    Cool Technology for Pharmacy – BoxPicker

    The Swisslog BoxPicker is an automated alternative to carousel technology for drug storage and retrieval. Unlike the open shelf architecture of automated carousel storage the BoxPicker offers access to medications via a single-opening/loading drawer process.

    Once you get past the name, the technology is impressive. The most interesting thing about the Swisslog BoxPicker however, is that it is available in dual-temperature and refrigerated models. The “dual-temperature ™ option for BoxPicker allows automated storage and picking of temperature-sensitive drugs requiring refrigeration and room temperature storage within one automated compact unit.” And the “BoxPicker refrigerated option eliminates the need for pharmacy refrigerators and increases security with automated storage and dispensing of refrigerated medications.”

    In addition, the BoxPicker is clean room compatible with positive pressure. The pass-through capability is a very nice feature for an automated storage unit featuring refrigeration. It prevents staff from moving in and out of the clean room environment to retrieve equipment or medications necessary for compounding.
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  • Hey, I’m a year old today!

    This blog was started one year ago today. During that time I’ve learned a great deal about a great many things and have met some incredibly interesting people along the way. The site doesn’t generate much traffic, which just goes to show you that pharmacists are an interesting group that rarely crawl out of their comfort zone. To date not a single pharmacist that I work with is even aware that this blog exists. I’ve had one nurse and one person from the Quality Assurance department at Kaweah reach out to me about something I’ve posted, but that’s it; funny.
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  • Rxplore: a new way to explore medication side effects visually

    Journal of Biomedical Informatics

    Abstract:
    Patients on multiple medications are at increased risk for adverse drug events. While physicians can reduce this risk by regularly reviewing the side-effect profiles of their patients’ medications, this process can be time-consuming. We created a decision support system designed to expedite reviewing potential adverse reactions through information visualization. The system includes a database containing 16,340 unique drug and side-effect pairs, representing 250 common medications. A numeric score is assigned to each pair reflecting the strength of association between drug and effect. Based on these scores, the system generates graphical adverse reaction maps for any user-selected combination of drugs. A study comparing speed and accuracy of retrieving side-effect data using this tool versus UpToDate demonstrated a 60% reduction in time to complete a query (61 s vs. 155 s, p < 0.0001) with no decrease in accuracy. These findings suggest that information visualization can significantly expedite review of potential adverse drug events. – J Biomed Inform. 2010 Apr;43(2):326-3

    The visual support tool mentioned in the abstract above is called Rxplore and was developed by Jon D. Duke, M.D., a medical informatics fellow at the Regenstrief Institute and the Indiana University School of Medicine.
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  • A look at one pharmacists unwanted potential

    A recent post by John Poikonen got me thinking about medication errors. They’re part of every pharmacists day, but we rarely give them much thought.

    I’ve been a pharmacist for more than 10 years now and I’ve make my fair share of mistakes. I would like to think that none of those errors caused harm, but that would be naïve to say the least. And forget about the errors that were never detected because one can only speculate about those.
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  • Cool Technology for Pharmacy – eDoc Telemedicine System

    Cool Technology for Pharmacy – eDoc Telemedicine System

    Telemedicine is one of those technologies that is either going to be unbelievably useful or a complete waste of time. Only time will tell. Recent articles like the one in Archives of Internal Medicine suggest that it may have a place in healthcare. Pharmacists may find telemedicine a useful tool for communicating with patients or physicians over great distances. I can see value in that.

    While not specifically designed for pharmacy, the eDoc Telemedicine/EHR System is a cool piece of technology. For information to be useful it needs to be collected and made available at the point of care, which is exactly what this system does.

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  • Lack of interoperability, standardization and simplification is risky

    I’m not a big fan of the using the “best of” model for hospital information systems (HIS). You know, when you buy the best pharmacy system you can find, and the best lab system you can find, and the best ED system you can find, and so on. All this does is create a giant headache for everyone involved because the systems don’t always play nice with each other, which means data gets lost or hijacked between systems by the Interface Noid. Data gets pushed, moved, shuffled, altered, chopped and converted, and it doesn’t always come out the way you intended. Or worse yet, you have a case where the systems aren’t interfaced at all.

    I recently heard of a case where a hospitals ED system wasn’t interfaced with the rest of the facilities information systems and disastrous results ensued. A patient came in through the ED with a very specific allergy; noted in the ED system. The information wasn’t available in the nursing or pharmacy systems. The patient was admitted and transferred to the floor. The little detail about the allergy wasn’t passed on during report and the patient ended up receiving that very medication based on the attending physician’s order. To make a long story short, the patient had an anaphylactic reaction and won a three day, all expenses paid trip to the hospitals intensive care unit.

    I wonder how often things like this happen due to short sided HIS implementation and deployment. Technology might not be the answer to all our problems in healthcare, but you have to admit it certainly could have helped in this particular example.

  • Cloud Computing in Health Care – Presentation

    Below is an embedded version of my recent presentation for Pharmacy OneSource. A PDF version of the slides can be found here.
    View more presentations from Jerry Fahrni.

  • Monday morning musings

    For some, weekends are a good time to sit around and relax. I tend to do that in the early morning hours of the weekends because the house is quiet and it doesn’t take away from any of the activities that happen during the “normal hours”. It gives me time to catch up on things that I like to do; surf the net and read articles.
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