Jerry Fahrni

Category: Barcoding

  • Cool Technology for Pharmacy

    In a previous post I mused about using an automated packaging system like InSite from Talyst as a type of automated dispensing cabinet for acute care patients. InSite was designed for long-term care and would simply be too large for the needs of an acute care nursing unit, but the technology is ideal.

    However, the ATP-71 (PDF) from Swisslog is a bulk packager that can hold up to 71 canisters in a relatively small footprint: 31.5 inches wide x 29.6 inches deep x 30.6 inches high. For comparison, a Pyxis MedStation 4000 2-drawer main unit is 22.8 inches wide x 26.7 inches deep x 27.7 inches high. I would say that makes the two units comparable in terms of size, and I can tell you from personal experience that a 2-drawer main isn’t very big up close.
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  • Cool Technology for Pharmacy

    The DoseEdge Pharmacy Workflow Manager, formerly IntelliFlowRx Workload Management Software by Baxa, is a system designed to track and manage intravenous (IV) medication dosages prepared by pharmacy personnel in a clean room environment. The system is touted as “The world’s first and only fully integrated workflow manager for the IV room.”

    The system is designed to flow something like this:

    – IV medication orders entered by the pharmacist, or other healthcare professional, are sent to the DoseEdge system where they appear on the DoseEdge touchscreen.
    – When the technician, or pharmacist in some cases, accesses the order via the touchscreen instructions for preparation of the product are displayed.
    – The product label is generated.
    – The barcode on each injectable ingredient used for the preparation of the IV product is scanned to ensure the correct medications have been selected. Items identified as incorrect result in an audible message of “product not allowed for this dose.”
    – The barcode on the IV product label generated by the pharmacy is scanned to ensure that ingredients are appropriately matched.
    – Each ingredient is drawn into a syringe.
    – An image of the syringe with appropriately drawn medication is taken for review by the pharmacist, or technician, whichever the case may be. This is a nice feature as it allows one to see the actual amount of drug drawn into the syringe prior to shooting it into the fluid bag.
    – Ingredients are injected into the fluid bag and an image of the final product is taken.
    – A final scan of the product barcode is done to complete the fill.

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  • Quick hit – Barcode scanner consistency

    Part of the process of implementing barcode medication administration (BCMA) is evaluating hardware; mostly scanners. There are several makers of barcode scanners including Honeywell, Symbol, Metrologic, Datalogic and Code Corp. Having so many choices always makes the selection process interesting.

    One suggestion from several hospitals I spoke with that were already live with BCMA, was to use the same barcode scanner on the nursing floors that were used in the pharmacy. That sounds logical, right? Sure, if the barcode scans correctly in the pharmacy, then nursing should be able to scan the same barcode using the same scanner.

    The scanner of choice in our pharmacy department is the the Code Reader 3500 from Code Corp. So of course this is the scanner I recommended in my report to the BCMA hardware sub-committee. For whatever reason, the committee decided to go with a different brand of scanner. Unfortunately the scanners we purchased won’t scan some of the more complex barcodes coming out of pharmacy, making them virtually useless. The scanners purchased by the hospital are on their way back to the wholesaler as I patiently await for round two.

    Take away lesson: use the same barcode scanner for the nursing units that the pharmacy department uses to meet their barcoding needs.

  • Code Corp bar code scanners

    As I’ve mentioned before our AutoCarousel system from Talyst utilizes barcode scanners from Code Corp, specifically the Code Reader 3.0 (CR3). As you my or not be aware, I’ve been working with Code Corp and Talyst over the past several months in an attempt to replace our aging CR3 with Code Corps newest version of the scanner, the Code Reader 3500.

    The Code Reader 3500 uses newer technology over the CR3 and performs much better with our carousel. The reader is easier to use due to its wider target area and “reflection and glare reducing illumination”. It’s also quite a bit faster. The technicians love it.
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  • Barcode scanner dilemma

    barcode_scanAs barcoding in pharmacies grows in popularity I get exposed to more and more barcoding equipment; particularly barcode scanners. Our carousels utilize barcode scanners from Code Corp, our AutoPack system utilizes a barcode scanner from Honeywell – previously Handheld – and our barcode medication administration system will use a yet-to-be-determined scanner. In addition, I’ve accumulated a nice collection of various scanners in my office including wireless, Bluetooth and tethered.
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  • Exhibit Hall ASHP #Midyear2009

    I finally had an opportunity to roam around the exhibit hall at the ASHP Midyear today. Of course I had to sacrifice a session to attend, but it was worth it. If you’ve never been in the exhibit hall at one of these events you owe it to yourself to check it out.
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  • Computer options for nurses using BCMA

    Our facility is in the process of implementing bar code medication administration (BCMA) at the bedside. A large part of the process involves selecting hardware for the nurses to use on the floor. In addition to bar code scanners, the nurses will need access to computers for documenting not only medication administration, but other patient specific information as well.
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  • Google showing a little bar code love this morning

    My browser homepage is set to Google. Imagine my surprise this morning when I saw the Google homepage was sporting a bar code in place of the typical “Google”. Cool!

    googleBC1

  • Thoughts on creating a BCMA cross reference file

    zebra_barcode2Our facility is gearing up to implement bar code medication administration (BCMA) in February 2010. Part of getting ready is making sure that all the medications dispensed from the pharmacy are bar code ready. If the medication isn’t bar coded or won’t scan, then it won’t do the nurse much good at the bedside. We’re in pretty good shape secondary to our carousel install in February of 2008. Everything that gets stored in the carousel is already bar coded. I had hoped that the file stored in our AutoPharm, i.e. carousel, cross reference file could simply be dropped into our Siemens Pharmacy cross reference file, but that would have been too easy. Siemens refused to play nicely with the data.
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  • BCMA vs. CPOE, Which Comes First? Webinar Results

    argumentPharmacy OneSource hosted a webinar “debate” today that had two excellent speakers presenting their cases for which technology should implement first; Computerized Physician Order Entry (CPOE) or Bar Code Medication Administration (BCMA). The webinar was well worth the time.

    The case for CPOE was presented by John Poikonen, Pharm.D. John is the Clinical Informatics Director at UMass Memorial Health Care, an Academic Medical Center and health system in central Massachusetts. John is an interesting informaticist as he has repeatedly spoken out against the lack of evidence supporting BCMA. It was a good fit for him to argue for CPOE implementation ahead of BCMA. He brought up some great points and presented a fair amount of literature to back them up. You can read more of John’s musings at RxInformatics.com.

    The case for BCMA was presented by Steve Rough, the Director of Pharmacy at the University of Wisconsin Hospital and Clinics, and Clinical Assistant Professor at the UW-Madison School of Pharmacy. Steve has done quite a bit of work with bar code medication scanning technology and presented an excellent case for BCMA.

    Both presenters had valid reasons and good arguments for their positions. I for one am in favor of both CPOE and BCMA, but would personally push for BCMA ahead of CPOE for several reasons. CPOE requires a much larger investment in resources, both human and financial, when compared to BCMA. There is also a reasonable expectation that BCMA will stop errors at their most vulnerable point, the administration phase. I’ve mentioned this before and Steve brought up some of the very same points in his presentation. Finally, CPOE requires buy-in from physicians in order to be completely successful. And if there is one thing you can count on it’s that physicians will fight you tooth and nail when it comes to technology and change.

    You can grab a copy of the presentation slides here.