Jerry Fahrni

Author: Jerry Fahrni

  • Pharmacy technology – Automated dispensing

    PROmanager-Rx is an automated system from McKesson designed for dispensing unit-dosed oral solids. PROmanager-Rx has a 12,000-dose capacity and uses a conveyor system and bar-code scanner to fill orders generated through the pharmacy information system.

    The system automates storage, dispensing, restocking, and various inventory management functions via the McKesson Connect-Rx software platform. And of course the system interfaces with McKesson’s pharmaceutical distribution system.

    According to the McKesson product brochure:

    The PROmanager-Rxâ„¢ system helps hospital pharmacies get the most out of manufacturer packaged oral solid medications. And relieves the burden of medication packaging.

    It’s the only fully automated system that directly stores and dispenses pre-packaged oral solids. PROmanager-Rx is ideal for patient-centric filling. Bar-code-driven robotics scan every dose for the greatest possible safety and accuracy.

    Pharmacists are freed from packaging and dispensing activities so they can play more integral roles on the clinical care team. Bar-code scanning also simplifies tasks such as managing returns, expired meds, and overall inventory.

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  • Epic launches Haiku, an iPhone EHR application

    “After three months of rumors, details surrounding Epic Systems’ partnership with Apple for a mobile phone-based electronic health record (EHR) application have come to light: Just a few days ago, Epic System’s iPhone application, called Haiku, became available on Apple’s AppStore. Haiku provides authorized clinical users of Epic’s Electronic Health Record with secure access to clinic schedules, hospital patient lists, health summaries, test results and notes. Haiku also supports dictation and In Basket access. Haiku works on both the iPhone and iPod touch,” according to the app’s description on the AppStore.”

    This is a very interesting turn of events as rumors regarding Apples new tablet entering the healthcare arena have been swirling around the internet. Could Haiku be the precursor to what we’ll see with the Apple tablet? I sure hope so.

    Source

  • Cool Technology for Pharmacy

    The ValiMed Medication Validation System by CDEX, Inc.

    According to the ValiMed website:

    CDEX’s technology stands alone, able to precisely identify medications in real time with its patented Enhanced Photoemission Spectroscopy technology.

    Energy at a preset wavelength interrogates the selected substance, capturing a unique emission spectrum which is then compared to the propriety signature, resulting in a simple “VALIDATED” reading when matched.

    Each medication reveals its own distinct and easily readable signature. By comparing the fingerprint of a tested medication against the signature for that medication in our data library, the ValiMed technology is able to verify a match, presuming there is one.

    The ValiMed Medication and Narcotic Validation System offers superior value to hospital medication safety programs and quality control processes by:

    – Providing immediate, real-time validation of the substance itself.

    – Providing an opportunity to standardize and optimize internal medication safety processes including Training, QA and Regulatory Compliance.

    – Providing a real-time means of validating narcotic returns and mitigating narcotic diversion.

    – Providing pharmacy staff and clinicians with a simple, fast, straightforward and cost-effective way to ensure that the RIGHT drug in the RIGHT dose is administered to the patient.

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  • Simplified and standardized intervention documentation

    Every pharmacist that has worked in an acute care environment is familiar with documenting interventions. Information from captured interventions is often assigned a dollar value and used by pharmacy and hospital administration to justify pharmacy services or additional pharmacist FTEs.

    Interventions captured can range from secondary issues like illegible handwriting and incomplete orders, to pharmacokinetic consults, renal dosage adjustment and prevention of adverse drug events caused by allergies, drug-drug interactions, disease-drug interactions, etc.

    Several methods have been used over the years to capture pharmacist initiated interventions, and no two have been the same. I’ve worked at several facilities over the years, and the systems used have included a paper method, a Microsoft Access database, a PDA system built with Pendragon Forms for the Palm Pilot, a third party software system and of course the pharmacy information system (PhIS) itself. Each had advantages as well as disadvantages. The two things they had in common were that they cumbersome and lacked standardization.
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  • Can the Apple tablet, i.e. the iSlate, resurrect interest for tablets in healthcare?

    I read an interesting blog today. In the blog the author states that:

    An Apple tablet would be the ultimate UI for electronic medical records. With a touch-screen display like the iPhone, using the EMR during an encounter would be simplified. For example, selecting an evaluation and management (E&M) code could be as easy as “dialing in” the code with a swipe of a finger.

    Using the iPhone’s intelligent keyboard technology, the device could have a very sophisticated automatic coding tool. Some EMRs can already auto-generate E&M codes based on information collected during the patient encounter. Combine this with the iPhone’s keyboard word suggestion tool, and physicians could rapidly select codes. Additionally, just as the iPhone adapts its keys and layout for different applications, the Mac Tablet could display a unique keyboard setting for each EMR function.

    Using iPhone speech recognition technology, physicians could dictate directly into an EMR to create notes, draft narrative reports or generate custom patient instructions. Mac design programs could be repurposed to make a really slick tablet drawing tool for anatomical diagrams that illustrate procedures and diagnoses.

    There is no question that I think tablets are underutilized in healthcare. I have pushed them into the hands of pharmacists at my facility and have tried various different things to encourage their use. While I would love to see tablet computers adopted in mass among healthcare systems, I just don’t think it’s in the cards for the iSlate for several reasons.
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  • Reading pharmacy literature on the go

    Like many pharmacists I read a lot of journal articles. This is especially true because of the dual role I play at my hospital. It’s not uncommon for me to read a couple of articles a day through the week and a few more thrown in on the weekend. The articles come from various medical and technology journals that I regularly visit plus the occasional article recommended by a friend or colleague. I still receive some journals in hard copy, but many now arrive electronically. Because I look into a computer screen 12-14 hours a day, I’m not particularly fond of reading articles on my laptop or tablet pc; it gives me a headache. As I’ve said many times, looking at a normal LCD monitor is like looking into a flashlight. Instead of reading PDFs on my computer I print them out and take them with me wherever I go (I can hear the collective moan from the conservationists in the crowd; sorry). This kind of defeats the purpose of having electronic documentation and certainly isn’t very “green”. With that said, advances in e-ink technology and e-reading devices may change my approach.

    I’ve been waiting for an e-reader that will allow me to read PDF files without having to zoom in and out or dance around the screen. I’ve tried reading on my Droid and my iPod Touch, and while possible, I wouldn’t want to do it for an extended period of time. It’s just not convenient.

    The Kindle DX was the first e-reader to hit the market with a screen big enough to accommodate my needs, and it was my front runner for quite a while. However, before dropping $500 on the DX I wanted to see some of the new devices that have been “on their way” since early 2009. Some of these devices are listed below.

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  • Looks like there is at least a little interest in Android and pharmacy

    I happened to check some statistics on my website this morning and found that the top searchpharases that brought people to my site over the weekend were related to the Droid and Lexi-comp (image below). I find this very interesting as well as encouraging.

  • “What’d I miss?” – Week of January 3rd

    As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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  • Cool Technology for Pharmacy

    Biometric scanning is an interesting notion. It’s nothing new and I’ve blogged about the possible uses of speech recognition and facial recognition in the past. Many facilities utilize basic forms of biometric identification, such as fingerprint scanning, as a deterrent on devices like automated dispensing cabinets, i.e. Pyxis. While fingerprint identification is certainly a nice security feature, it can also be a royal pain at times. Well, Fujitsu has taken fingerprint scanning to a whole new level.

    The Fujitsu PalmSecure is a palm vein authentication system that takes a snapshot of the veins in your hand as your hand hovers above the scanner. Apparently the vein pattern in an individual’s hand is unique, giving the device the ability to identify the person. It is quick, painless, accurate, and appears to be much easier than finger print scanning.
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  • Quick Hit – The Monkey Theory

    Several years ago a member of pharmacy leadership at the hospital I was working for told a bunch of pharmacists, me included, that he could get a monkey to do our job. The statement became a running joke in the department as the pharmacists began bringing in monkey stuffed animals, monkey pencil toppers and putting up wanted posters with photos of monkeys offering a reward for information.

    As funny and insulting as the statement was, there was a hint of truth to it based on what my job duties were at the time. The “monkey statement”, as it was known, led to me re-evaluating my position there and ultimately to a job change.

    So what is the monkey theory? Well, it boils down to this; if you can teach someone to do something in a couple of hours without any prior experience or critical thinking involved then that task falls under the monkey theory. Everyone knows what I’m talking about and every job has monkey related tasks.

    I held several manual labor jobs prior to entering pharmacy school. In fact, those jobs are what made me decide to go back to school in the first place. I worked in a lumber yard, a machine shop that built flood gates for dams, as a nobody in the military and as a night watchman. Strange, but the jobs in the lumber yard and machine shop didn’t really qualify as part of the monkey theory. Both jobs required certain physical skills that many people don’t have. There was also some strange gratification gained from doing hard, physical labor day in and day out.

    Pardon me, I am reminiscing. Back to the monkey theory. What duties qualify under the rules of the monkey theory? They’re easy to figure out, just give it some thought.

    Now the big question, what percentage of monkey work is acceptable to a pharmacist? Good question, and most likely a personal choice. I’ve met pharmacists that like the “monkey work” and I’ve also met pharmacists that hate the “monkey work”. Everything is a give and take. How much are you willing to take?

    Think about it.