Jerry Fahrni

Category: Database

  • What report service/software does your pharmacy use?

    I wrote about Pandora back in December 2009. It was a great piece of software back in the day.

    I remember a time when nearly everyone in pharmacy that used Pyxis ADC’s to control their medication distribution at nursing units also used Pandora to generate reports, look at data, and detect controlled substance diversion. The two simply went hand in hand. If you had Pyxis, you used Pandora.

    Pandora was acquired by Omnicell a few years ago, and since that time it’s popularity appears to have declined. Maybe it’s just my imagination, but it sure feels that way. I talk to a lot of pharmacy personnel, and recently it appears that pharmacies are starting to use solutions other than Pandora.

    Carefusion’s Knowledge Portal seems to be a popular response these days when I question people about their metrics, reports and analytics. I suppose that makes sense when you consider that a majority of hospitals in the U.S. use Pyxis ADC’s, which we all know are made by Carefusion.

    Perhaps the acquisition of Pandora by Omnicell had something to do with it. Maybe my cross section is skewed. Who knows. This will be something that I will pay close attention to over the next several months. I’ll think I’ll add this to my list of standard questions when I visit pharmacies.

    Data is important, and becoming more important by the day. Whoever has the best solution wins.

  • Visualizing data – Tableau Software

    I spent the day in San Francisco attending the Tableau 8 Roadshow event.

    Tableau is an amazing piece of software that helps you link to data in various forms – SQL databases, Excel spreadsheets, Google analytics, and many, many more – and use that information to create stunning visualizations. It’s insanely easy to use, and quite frankly is one of the most impressive pieces of software I’ve ever used to present data in an easy to understand manner.

    Tableau
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  • Data visualization and dashboards

    A wise colleague of mine once told me that lots of people collect data, but few people know what to do with it. I didn’t understand what he was talking about at the time, but I’ve come to have a better understanding over the years. It basically boils down to the difficulty that many of us experience when it comes to the best way to handle information. Our brains do some amazing things, but fail to “see” things when the perspective is all wrong.

    Data surrounds us. It’s in everything we do, from the bank statements we receive in our personal life to the mountains of data collected by every healthcare institution. Regardless of the data collected, there are basically three things that can be done with it. Data can be ignored, it can be archived or it can be used. Unfortunately only one of those three things is truly useful; using it. Many people chose to ignore or archive data not because the information isn’t valuable, but because they are overwhelmed with the amount of information they receive and the way that the information is presented.
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  • Quick hit: approaches for standardized healthcare data

    When my brother, Rob and I get together it often brings our wives to tears with boredom as we often get deeply engrossed in long conversations about computers, software and technology in general. Super Bowl weekend was no different. Rob and I started talking about strategies for connecting various pharmacy systems to other hospital systems and the issue of a lack of standardized information in healthcare came up. I mean we have standards, right? Of course we do. There’s SNOMED-CT, RxNorm, ICD-9, ICD-10, LOINC, GLNs, GTINs, NDC, bar-code “standards”, HL7, NCPDP SCRIPT standards and so on and so forth ad infinitum. I realize the list above includes a hodge-podge of standards that don’t really belong in the same category, but I did it to illustrate my point. And that point is that we have too many stinking standards. Trying to figure out which standard to use is an exercise in futility. Standards typically make sense to the people that invent them or study them, few others. And someone always has an idea for a better standard, hence the plethora of standards.

    As healthcare inches forward interoperability of systems will hold a key role in the success of the government’s plan for electronic health records. So as Rob and I discussed how to integrate various services and products we pondered how one goes about creating a standard that everyone can live with. Well, how does one create a standard that everyone will use? Heck if I know, but we decided that there are basically two approaches. The first is to create a standard and try to cram that standard down everyone’s throat. Microsoft has been fairly successful with this approach. With that said, few people have the resources that Microsoft has to throw at a problem. The second approach is to offer the standard as part of a free solution that comes with your product; this way people can use your product and use your free, open-source solution to tie the systems together. I assume this is the smart approach for companies that have limited resources; kind of a grassroots approach. Of course it would be wise to build this free, open-source solution on top of an existing standard that’s prominent in the market, otherwise you’re trying to re-invent the wheel. And we all know what happens when someone re-invents the wheel. Uh, you get a wheel. We don’t really need any more of those. Both approaches have pros and cons.

    Now the question becomes which standard makes sense as you design your solution. If only I had a crystal ball. We’re at least a decade away from having a truly inter-operable healthcare system; optimistic, I know.  Ultimately, the standard of choice won’t be driven by what makes sense, but rather will be driven by adoption rates. Things often become a standard without even trying.

  • More thoughts on standardization

    I’ve mentioned this before several times on this blog, but feel like I have to say it yet again; we need to start standardizing certain things about health information technology. The lack of standardization reared its ugly head at me again last week when our Pyxis med stations kept dropping medications off of patient’s active profiles. It appeared to always be the same drug, IV ketorolac. It took me a while to figure out the problem, but it turns out that Pyxis and our pharmacy system don’t agree on certain basic elements of time. Go figure.
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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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  • What we need is a system-neutral data structure for healthcare

    During a web browsing session the other day I came across a very interesting blog post by Louis Gray titled “The Future: Operating System And Application-Neutral Data”. I enjoy reading Louis’ posts because I think he has a great vision for the future of personal computing, data, and “the cloud”

    The blog speaks specifically to the ownership of personal data versus allowing companies to sit on it and possibly hold it hostage secondary to a lack of compatibility with other systems. The information you throw onto the internet defines who and what you are, more now than ever before, and you need to be able to move it around anytime from anywhere.
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  • Cool Technology for Pharmacy

    Pandora Data Systems (PDS) is a company that, in the past, has designed software solutions to take information from automated dispensing cabinets (ADCs) like Pyxis, store it, manipulated it, run queries against it and produce reports that allow pharmacy departments to view medication usage trends; including trends to identify diversion.PDS now appears to be expanding their role with the introduction of PandoraVIA.

    PandoraVIA is the next generation of data crunching software from the company. According to the PDS website “PandoraVIA is the new, full-featured reporting system from Pandora Data Systems. It’s designed to be a highly scalable and affordable platform built with Microsoft’s latest technologies. These technologies take the full functionality from our Pandora (Legacy Edition) and PandoraSQL products and move them to the next level.”

    The new software framework is designed to accommodate various modules depending on the needs of the customer. The system currently supports Pyxis, AcuDose, Omnicell, MedDispense and Cerner. However, after spending some time with the Pandora representatives at AHSP Midyear they informed me that their new system could add custom data from almost any source based on need.

    PandoraVIA utilizes XML, SOAP, and WSDL to meet the needs of the healthcare system, and is capable of a host of reports that can be exported in a variety of formats.

    A system that can aggregate data from many different sources offers real value to many healthcare disciplines, especially pharmacy which is often driven by data. Data mining is important, but not always easy because of the myriad of systems utilized and the general poor quality of integration. In addition, many IT departments aren’t equipped with the necessary resources to handle a project of this magnitude; believe me, I’ve tried.

    Data I would like pulled into such a system include our Alaris Smart Pump data, our pharmacy information system (Siemens Pharmacy) data, our automated dispensing cabinet (Pyxis) data, our carousel, packaging and inventory control (Talyst) data, and our bar code medication administration data. Aggregate data from these systems could be mined for an infinite number of possible trends and uses.

    Posted via email from fahrni’s posterous

  • Getting pharmacists to lay down their 3×5 cards

    The decentralized pharmacy model brings with it the opportunity for pharmacists to be an integral part of the medical team. This includes following teams of healthcare provides, physicians, nurses, respiratory therapists, etc, on morning rounds. And like all good little pharmacists we like to be prepared with as much information as possible about the patient. Several methods for collecting data have been developed over the years, including the all time favorite; the 3×5 index card. The problem with this system is obvious; it’s prone to human error. Taking information from one source and transcribing it somewhere else simply increases the chance for error. In addition, the information may be inaccurate as things can change rapidly with hospitalized patients, especially in areas like the ICU.
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  • Sum(1) ..how could something so simple be so frustrating

    This time of year always comes with a lot of requests for medication usage data from the Pharmacy Clinical Coordinator.  This year has been no exception. The most recent request was for a report identifying all medications in the pharmacy drug master that were used less than ten times in 2008. Seemed simple enough. Right. 
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