Jerry Fahrni

Category: Pharmacy Informatics

  • 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 The information in journals today is out of date by the time it’s published.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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  • 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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  • Time to nominate someone for the ASHP PPMI Summit

    I briefly touched on the Pharmacy Practice Model Initiative (PPMI) last week. As part of the initiative ASHP will be holding a PPMI Summit in Dallas, Texas, November 7-9, 2010 where a lot of brilliant minds will come together to work towards advancing pharmacy practice.
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  • Pharmacy practice model spotlight in ASHP PPMI eNewsletter

    ASHP and the ASHP Research and Education Foundation have partnered to take a long hard look at what pharmacy practice looks like now and what it needs to look like in the future. The venture is called the Pharmacy Practice Model Initiative, or PPMI. According to the ASHP PPMI website “there is an urgent need to create a forward thinking hospital and health-system pharmacy practice model.“ I couldn’t agree more.

    The current pharmacy practice model is more than 3 decades old and is sorely in need of an overhaul. Of course the changes will represent not only the services pharmacists provide and how pharmacists participate in patient care and safety, but also how to best utilize technology to accomplish the ultimate goal; a better pharmacy practice model.

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  • Speaking of healthcare data, is Microsoft the elephant in the room?

    In a previous blog I discussed the need for a uniformed data structure in healthcare. The concept got me thinking about how to accomplish such a monumental task, and make no mistake, it would be a monumental task. There aren’t many “people” out there that could develop the hardware and software infrastructure solid enough to handle the needs of the complex data stream coming out of the healthcare industry.

    Then I noticed a trend at a lot of the web sites that I frequent: Microsoft has slowly, and quietly, been positioning itself to jump into the healthcare market.
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  • SaaS and speech recognition for EHRs

    CMIO: “In the past, major barriers to EHR adoption included high upfront costs and lack of IT resources to implement and maintain the technology,” the report stated. “A SaaS model solves both of these issues and Ovum believes it is the best approach for physician offices and small hospitals. With a predictable, monthly expense, a subscription-based SaaS EHR is a much easier cost for providers to swallow.” Speech recognition tools have helped increase EHR adoption among clinicians by increasing the accuracy of the patient health record—providers don’t need to make as many corrections. Speech recognition should feed directly into the PHR without the lag time of transcription, according to the report.” – It makes sense that Software-as-a-Service (SaaS) and speech recognition could be used to increase EHR adoption rates. Together they offer several potential benefits as well as creating a better user experience. In fact, I’m a fan of both and have blogged about how I think they could be used in pharmacy; here and here.  However, in regards to speech recognition, an educational session at the 95th Annual Meeting of the Radiological Society of North America (RSNA) reports that “a study by Zoltani and colleagues conducted at their facility found that 68 percent of more than 17,000 finalized reports contained errors, 15 percent of which could potentially change the meaning of the report. A radiologist’s experience, sex and caseload were not associated with significant differences in error rates.”

  • What is the future of pharmacy informatics as a career choice?

    Over the weekend I spent a little time looking at trends in pharmacy and technology. As expected the healthcare technology market is expanding rapidly and this expansion is creating a need for pharmacists with technology know-how. To prove my point I created a job trends graph from indeed.com using the following search criteria: “pharmacy informatics”, “clinical pharmacist” and “director of pharmacy”. As expected the search trends for “clinical pharmacist” and “director of pharmacy” are relatively flat, but the trend line for “pharmacy informatics” is striking. It looks like a new pharmacy career path is born.

  • DynaMed – an evidence based medicine point of care tool

    Our facility is running a trial of  DynaMed, “an evidence based medicine point-of-care” database. It reminds me of UpToDate.

    From the DynaMed site:

    • According to the National Academy Press (2001) 44-98,000 American deaths per year occur due to preventable medical errors; medical errors are estimated to cost the U.S. $17 to $29 billion annually
    • Using the “best available evidence” for clinical decision-making improves health outcomes and reduces health care costs
    • Busy clinicians use “fast and easy” resources expected to answer most of their questions instead of resources designed to provide the best current evidence
    • Clinicians sometimes turn to textbooks and online resources with substantial breadth, but these resources do not use the best available evidence
    • Physicians and other health care professionals need a resource where they can reliably answer most questions quickly and accurately (i.e., with the best available evidence)

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  • Pharmacy workflow on life support

    A friend from Talyst stopped by the pharmacy and spent the greater part of Monday afternoon and Tuesday morning taking a look at what it means to work in an acute care hospital pharmacy. We have several pieces of Talyst automation and technology in our pharmacy and he was interested in how we used it and how it fit into the general scheme of things. As we roamed the pharmacy, I began describing our Pyxis system, how we handle our replenishment, how we put our order away, how we package bulk medications, how we barcode syringes, how we handle an IV batch, how we handle infusions for our smart pumps, and so on and so forth ad infinitum. It was a good exercise for me as it often improves my understanding of something when I try to explain it to someone else.
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  • Pillbox – a website for tablet/capsule identification

    The National Library of Medicine has a website know as Pillbox beta that allows anyone to use various identifiers on a tablet or capsule, i.e. imprint, shape, color, size and/or scoring, to quickly identify a medication. I’ve used systems like this many times for the emergency department when a patient would roll in the door with ten different medications all thrown together in a plastic baggie. The nurse would bring them to the pharmacy and say “I need you to tell me what these are”. I tried holding the baggie to my head like the Great Carnac on Carson, but most of the time I had to use other references to help me out.


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