Jerry Fahrni

Blog

  • Hybrid cloud to speed things up?

    ByteandSwitch: “Every week or so one major internet service or another goes down for a moment, Amazon S3, Google Apps, Twitter etc… Let’s face it, if you store data in the cloud there are a hundred variables between you and your data and if any one of those variables decides to, well, be variable, then you may not be able to get to your data for a period of time. This does not mean that you can’t use the cloud, it means that you can’t put data that you are going to need immediate access to solely in the cloud.  What this does mean is using a hybrid model for cloud storage. As we demonstrate in our latest video “What is Hybrid Cloud Storage?” a hybrid cloud is an appliance that is placed on the customer’s site to act as a intermediary storage location for data that is in route to the cloud. The appliance serves many purposes: translation from CIFS/NFS to more internet friendly protocols, local cache for rapid restores of last copy of a backup or archive and as a place to get to data that would otherwise be inaccessible due to some sort of connection issue.”

    Hybrid_cloud

    – This actually makes perfect sense to me. One issue that often comes up when discussing a cloud environment, besides access to data, is speed. We have started using thin clients here at the hospital in place of desktop machines, and there is little doubt that performance has suffered. With the option discussed in the article above, data would move quickly between you and the local environment while in use, but slowly moved into the cloud in the background. I like it.




  • Hi-Tech patch for migraine relief

    ZelrixZelrix is a transdermal patch containing sumatriptan for the treatment of acute migraine headache developed by NuPathe, a pharmaceutical company specializing in the treatment of neurological and psychiatric disorders. The patch is based on NuPathe’s proprietary SmartRelief™ platform, which according to the manufacturer’s website is “a non-invasive technology that utilizes low-level electrical energy to transport drugs through the skin in a safe and effective manner. The rate and amount of drug delivered is controlled electronically, so that the patient receives consistent therapy each and every time. Iontophoresis is an established drug delivery technology with multiple applications currently being used by physicians.” The SmartRelief™ iontophoresis utilizes pre-programmed, embedded electronics in the patch to provide consistent therapeutic drug levels. This is very interesting technology with many potential applications. Imagine the uses in professional sports where iontophoresis is frequently utilized to administer NSAIDS and corticosteroids for the treatment of inflammation

  • “What’d I miss?” – Week of August 16th

    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

    glowcapThe Vitality GlowCaps is a wireless internet enabled cap for prescription bottles that uses light and sound to notify patients when it is time to take their medication. When the GlowCap is removed from the prescription bottle, the information is documented on Vitality’s server. Vitality uses this information to send the patient and physician a monthly compliance report to help monitor therapy. Of course, that’s assuming that the patient doesn’t just open and close the lid when the reminder goes off. When you stop to think of all the time, energy and money spent on patient compliance with medication, you begin to realize that the GlowCap is pretty cool pharmacy technology.
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  • At least developers think cloud apps are important

    InformationWeek: “Software developers believe developing applications to run on private clouds will become one of their main tasks over the coming year. Out of 500 surveyed, 48.9% said they expect to be doing cloud applications within the year. The Cloud Development survey is the first by Evans Data, an independent research firm that conducts periodic surveys of developers. A total of 29.7% said they are current working on applications for private cloud environments. Another 19.2% said they expect to be engaged in cloud development within the next 12 months. The largest group of respondents, 48%, said they think that Java is the best language for developing in the cloud; Microsoft’s C# was the number two pick. Evans Data surveys have tended to slant somewhat toward Java developers, since participants self-select or sign up to participate in numbers that are not precisely reflective of what languages are in use throughout the world of programming.” – This survey is of particular interest because software developers tend to heard the reset of us toward the future of computing. How do you think the iPhone became so popular; developers embraced the technology and began writing applications that can do everything from updating your Twitter page to helping physicians with their EMRs. It’s inline with Kevin Costner in Field of Dreams, “if you build it, they will come”. However, I find it strange that Java is the language of choice with Microsoft C# (c-sharp) coming in second. I’ve had a lot of issues with Java applications in the past secondary to version control. I think I’ll stick with the limited C# knowledge that I have and expand on it. My brother has been trying to get me to learn C# for years. It’s on my to-do list, just below win-the-lottery.

  • A little assistance for choosing the right barcode reader

    barcode.com: “With all of the data capture solutions on the market today, choosing a barcode scanner may seem overwhelming. However, after analyzing all of your needs, making the right choice should come easily. It’s important to analyze both the requirements of your business and what your budget allows. First and foremost, ask yourself, “what barcode symbology will I need to be scanning?” While laser scanners are a cost-effective option, they aren’t able to scan 2D barcodes (aside from the PDF-417, a 2D-like symbology), which digital imagers can. With the use of 2D barcodes on the rise, it may be wise to invest in a digital imager so that it will better accommodate future progressions in technology. On the other hand, digital imagers can decode 2D barcodes, which can be encoded with a significantly greater amount of information than their 1D counterparts. In addition, imagers allow for omni-direction barcode reading, eliminating the need to accommodate the scanning device. Area imagers can even read Direct Part Marking (DPM), a method of permanently marking a product, allowing the product to be tracked throughout its life.” – Our facility uses a combination of barcode scanners in the pharmacy, and I can honestly say choosing the right one can make all the difference. I have personal experience with a few barcode scanners from Code Corporation and Honeywell (previously Handheld). In my opinion the Honeywell products are better. They are easy to use and very forgiving when it comes to scanning medication barcodes. The Code scanners require a little manipulation and better aim, which can be frustrating when you’re in a hurry.

    For more information on barcode readers, try barcode.com, barcoding.com or idautomation.com.

  • Medicated patch slips into wrong ADC pocket

    cubie

    Hospital Pharmacy: “During the process of with drawing a patient’s nicotine patch from an automated dispensing cabinet (ADC), a carousel pocket opened to reveal 2 nicotine patches and 1 fentaNYL 50 mcg/hr patch. The nurse using the ADC immediately called the pharmacy to report the discrepancy. The pharmacy investigated and found that it was not a dispensing error. Both patches (nicotine and fentaNYL) were stored in the same medication carousel, and the fentaNYL patch slipped over the top of one pocket and into another pocket that contained nicotine patches. Generally, the hospital reserved ADC carousel pockets for controlled substances, but there was a history of pilferage of the nicotine patches when stored in matrix drawers. To deter pilferage, the pharmacy began stocking them in secure carousel pockets with the tracking feature on to count the product. FentaNYL was in a nearby pocket by itself, but when the carousel turned, patches sticking up from the fentaNYL pocket were caught and dragged to another pocket that housed nicotine patches.” - This type of occurrence is more common than you might think. To prevent this type of thing from happening, many hospitals will utilize a system similar to the Pyxis CUBIE system. Pyxis CUBIE pockets are small containers with a clear plastic lid. The lid remains closed until that medication is accessed via the Pyxis medication terminal. This prevents items from jumping to another location.

  • Yep, there’s an EMR app for the iPhone

    Healthcare IT Consultant Blog: “It appears Caretools has thought of this, offering its iChart EHR for the iPhone, immediately available to anyone on the iTunes store. Before you scoff that it must be a limited-functionality, toy of an EHR, consider this: it offers ePrescribing, transmission of lab reports, ICD9-compliant billing code functionality, and a sophisticated menu system to quickly create SOAP and Procedure notes. It might not be CCHIT-certified (yet) or guarantee your eligibility for “meaningful use” funding, but at such a low price point, it could be a great way to get your physicians comfortable with standard EHR functionality.” – I took a quick jaunt over to the Caretools website and gave the application the once over. I think it’s pretty cool. At a mere $139.99 it’s about the cheapest EMR system you’re going to find on the market. You can read more about it at the iPhone Life website. Next thing you know, you’ll even be able to make phone calls directly from your iPhone.

  • Integration and standardization are still stumbling blocks in healthcare

    I spent a good chunk of my morning in meetings and workgroups for the implementation of our barcode medication administration system (BCMA). Most of these sessions are dominated by nursing as many consider BCMA a nursing system.
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  • Visual aid for House Democrats’ health plan. Really?

    I’m a visual type of guy. I can frequently work something out on paper long before I can conceptualize it in my “mind’s eye”. That is until I saw the organizational chart of the House Democrats’ Health Plan (image below). Any questions?

    healthplan_dia