Jerry Fahrni

Category: Pharmacy Informatics

  • #HIMSS12 Day 1

    The Healthcare Information and Management Systems Society Annual Conference & Exhibition, i.e. HIMSS12, started today in Las Vegas. Actually a lot of pre-conference stuff started today. I didn’t do much besides get situated, print my registration badge, figure out where everything was, visit the HIMSS bookstore and Social Media Pavilion, etc.

    The real action for me will start tomorrow with the opening keynote delivered by Biz Stone, Co-founder of Twitter at 8:00 am. From there it’s pretty much one session after another until the Exhibit area opens at 1:00 pm, which is always my favorite part of a conference like this. The exhibit area is a place to see what’s going on in healthcare without having to stick to a schedule. There’s a Tweetup hosted by @HPHealthcare at 3:00 pm in the Sands Expo and Convention Center that I’m planning on attending as well. Should be a good day.

    The only problem I see is the tough choices I’ll have to make on which sessions to attend; it’s a pretty impressive list.

    I’ll be Tweeting off and on all week using the #HIMSS12 Hashtag (@JFahrni).

  • Digital edition of U.S. Pharmacist off to a bad start

    I received the announcement below in my email just a short time ago. So being the good little pharmacist that I am, I headed on over to the U.S. Pharmacist website to check it out. Imagine my surprise when I clicked on the digital issue link and was greeted with a “Service Unavailable” message (bottom image). Bummer. Hopefully they’ll get it up and running shortly.

    Update: Looks like they got it working within 5 minutes of me posting this. It’s a nice format. Check it out for yourself here.

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  • Yo, wouldn’t a high-tech laminar air flow hood be cool

    We have so much technology around these days. I mean we have real-time patient monitoring, near field communication, telemedicine, smartphones, music and video in the cloud, and so on ad infinitum. So why is it that hospital pharmacies use the same old horizontal hoods that they’ve always used?

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  • Domain expertise in healthcare can go a long way

    mobilehealthnews: “[John] Sculley said [while speaking at the Digital Health Summit, CES 2012] that some companies have put too much emphasis on style over substance.

    “The thing that is missing is getting the people with the domain expertise aligned with the people with technological know-how to turn ideas into branded services,””

    I think these comments ring true for many of us that realize the disconnect between the people designing and building products for healthcare, and those actually using them. I can attest to the fact that it exists in many aspects of pharmacy automation and technology where things have a way of being forced down your throat. It becomes a game of which product is the “least bad”. It’s called settling for something, and it never really makes anyone happy. That’s why we’ve seen so many homegrown systems in pharmacies over the years.

    There once was time when terrible usability at least meant great functionality. Unfortunately many companies have chosen to improve the usability at the expense of the functionality, which ultimately leads to a crappy product. I’ve experienced this many times during my career, especially with pharmacy information systems where improved UI’s have often resulted in poor performance, more mouse clicks and frustration.

    Do the industry a favor and ask the end users what they need, instead of giving them what you think they want.

  • Staying up to date with medical literature isn’t easy

    One of the problems I’ve experienced since leaving pharmacy is keeping up with the medical literature. I no longer have unlimited access to pharmacy journals, medical journals, engineering journals, etc; not to mention less mainstream literature.

    While looking at the table of contents from my favorite journals and reading through the abstracts has value, it falls short of providing the same level of information one gets from digging into an article, looking at the data, viewing the tables and graphs, etc.

    In an attempt to improve my access to information I signed up for a service called MedInfoNow.

    MedInfoNow touts itself as “A personalized weekly email that quickly summarizes the latest journal article abstracts and citations from Medline® important to you.”

    MedInfoNow is easy to use. You simply select topics that interest you, the services searches through those topics, puts them into a simple summary and emails them to you once a week. The service provides obvious value by giving me access to several journals in a single location, but MedInfoNow definitely falls short of my expectations. I was already doing much of what the service provides via RSS feeds, Twitter and frequent visits to my favorite informational websites.

    The one thing I really need is access to full-text articles. Unfortunately MedInfoNow doesn’t do that. While it does provide links to some full-text articles, those articles are freely available to anyone and don’t require a paid subscription to the journal or MedInfoNow. Bummer.

    Is MedInfoNow worth the $129/year I’m paying? Hardly. My subscription expires in June 2012. I won’t be renewing.

  • Effects of interruptions in healthcare [article]

    A recent article in the Journal of the American Medical Informatics Association1 caught my eye. The article, A systematic review of the psychological literature on interruption and its patient safety implications, looks at various tasks and variables associated with interruptions in healthcare. The article is a meta-analysis, and we all know what that means, but it is interesting nonetheless. The authors of the article say that it’s a complex issue, but I think at the heart of the matter interruptions are simply bad. Our brains just don’t multi-task the way we’d like them to, and interruptions cause a break in concentration and therefore a break in our focus. I know it always takes me a few seconds to regain my thoughts when someone interrupts me. This is especially true when I’m performing a complex task. And wouldn’t you consider providing care to patients a complex task? I would.

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  • MedVantx launches medication adherence program

    EMR Daily News:

    MedVantx, Inc., has announced the deployment of its patent pending Patient Profile™ patient medication and adherence reporting engine across its network of 3,600 high prescribing primary care providers participating in the Company’s integrated program of initial free medication therapy, adherence management and home delivery program. This new program utilizes the Company’s proprietary automated ATM like sample management system (“MedStart™“) and an integrated secure web reporting portal to provide physicians visibility to their patients’ adherence to chronic medication therapy…

    The MedStart™ system automates the traditional sampling process for the physician; captures physician sampling data for inclusion in the patients’ claims history medical record and provides consumers access to highly relevant drug and disease state educational materials. Since patients don’t always get prescriptions filled, physicians can enhance adherence by providing their patients with initial therapy and better informational tools to manage their conditions right from the office…

     

    Now with the availability of the MedVantx Patient Profile™, physicians are able to view data about how patients, on an individual basis, are complying with their prescribed medication treatments.  By showing exactly when a patient fills prescriptions, physicians can detect late refills, gaps in medication fulfillment, discontinued treatments and more to accurately access and improve patient compliance.

    Interesting concept. I often wonder if simply getting rid of chain and grocery store pharmacies, and going back to neighborhood community practices would be the best way to improve patient medication compliance. I’ve worked in chain, grocery store and community pharmacies and have always felt that the small community practice knows their patients best and provides the best patient care when it comes to medication management. Something to think about anyway.

    More on the system mentioned above can be found at the MedVantx website.

  • Model for scheduling complex medication regimens

    The abstract below caught my attention. I can’t read the entire article because I don’t have a subscription to the journal (a pet peeve of mine – just sayin’). Nonetheless I found the abstract quite interesting. I think the conclusion is a bit overly optimistic, but the use of computers to calculate an optimized medication schedule for individual patients is a promising idea. (Comput Methods Programs Biomed. 2011 Dec;104(3):514-9. Epub 2011 Oct 5.)

     

    Abstract
    Medication adherence tends to affect the recovery of patients. Patients having poor medication adherence show a worsening of their condition and/or increased complications. Unfortunately, between 20% and 50% of chronic patients are unable to manage their medications. This study proposes a model to improve the patients’ medication compliance by reducing medication frequency.

    Published studies have shown that, based on the patients’ lifestyle, simplification of the medication frequency and remodeling of the medication schedule is able to help improve medication adherence. Therefore, this study tried to simplify medication frequency by combining therapies. Moreover, by adjusting according to lifestyle, the study also tries to remodel medication timing in relation to mealtimes to create personal medication schedules.

    In this study, we used 19,393,452 outpatient prescriptions from the National Health Insurance Research Database to verify our system (algorithm optimized). At the same time, we examined the differences between the frequency summarized by general public and experts’ advice medication behavior. Compared with the experts’ advice method, this system has reduced the medication frequency in about 49% of prescriptions.

    Using combined medication to simplify medication frequency is able to reduce the medication frequency significantly and improve medication adherence. Furthermore, this should also improve patient recovery, reduce drug hazards and result in less drug wastage.

  • Tarascon Pharmacopoeia available for Android and iPad

    I received the email below a few days ago announcing that The Tarascon Pharmacopoeia is now available for Android and the iPad. I’m not a big fan myself, but the reference appears to be popular with certain crowds. Historically it’s more popular with community/retail pharmacists than hospital pharmacists. This might have something to do with the availability of drug pricing in the Tarascon Pharmacopoeia. Who knows.

    Link to Android version is here.

    Link to iPad version in iTues store is here.

    tarascon

  • Send a prescription by snapping a photo? Why not?

    I recently accompanied my mother to UCSF for a follow-up procedure after her liver transplant. When it was time for her to be discharged home the nurse handed me the prescription below. Forget for a second that there are about a half dozen things wrong with it and just focus on the distinct nature of the prescription blank.

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