Jerry Fahrni

Blog

  • Beyond patient safety with technology and automation

    I had reason to do some thinking about healthcare automation over the weekend, and after much thought decided that healthcare, specifically pharmacy, was a little strange in several ways. As an industry, healthcare rarely looks beyond patient safety when talking about technology and automation. Let’s face it, patient safety is the rally cry for any department in need of a jumpstart to complete a project that has stalled for one reason or another. Unfortunately the investment of time, energy and capital resources typically stops immediately after implementation secondary to meeting the patient safety goal. However, this model seldom allows for technology and automation to be taken to the next logical step.
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  • Open source software for hospital use.

    HIT Consultant Blog: “…But bringing state-of-the-art technology to health care is expensive, often running well into eight figures. Still, there are ways to keep the cost down and also provide excellent care. Forbes caught up with David Whiles, CIO of Midland Memorial Hospital in Midland, Texas, to look at ways to save huge amounts of money without sacrificing quality…So what did you do? – We came across the VistA (Veterans Health Information Systems and Technology Architecture) system, which was developed by the Veterans Administration. That’s used by all the 160-plus VA hospitals in the United States, plus all of their outpatient ambulatory clinics. It’s been in use by the Veterans Administration for more than 20 years. It’s a very mature system. It’s won a number of accolades from the Institute of Medicine.” – Imagine that, open source software being used in a hospital. The software may be a few years old, but thinking outside the box and implementing open source software in a hospital sure sounds cutting edge to me. Where do I apply?

  • “What’d I miss?” – Week of June 29th

    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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  • RFID vs. barcode

    Barcode.com: “RFID, or radio frequency technology, uses a tag applied to a product in order to identify and track it via radio waves. The 2 parts that make up the tag are an integrated circuit and an antenna. While the circuit processes and stores information, the antenna transmits signals to the RFID reader, also called an interrogator, in order to interpret the data in the tag. In contrast, a barcode is an optical representation of data that can be scanned and then interpreted. The data is represented by the width and spacing of parallel lines, and are often used in POS applications, in addition to tracking objects throughout the supply chain.” – The article goes on to give the advantages of both technologies. The more I read about RFID technology, the more interested I become. While the technology hasn’t really caught fire in health care, I think the utility of RFID demands further investigation.

  • Cool Technology for Pharmacy

    Lexi-Drugs for the iPhone: “.. our most comprehensive drug database, with content that addresses all patient populationsand covers clinical specialties such as Pharmacy, Internal Medicine, Cardiology, Oncology, Psychiatry, Anesthesiology, and others. Independently ranked as the #1 drug database for the PDA, Lexi-Drugs includes up to 67 fields of  information, including Adverse Reactions, Canadian Brand Names, Contraindications, Dosing, Medication Safety Issues,  Pharmacodynamics and Kinetics, Special Alerts (including new FDA warnings), plus International BrandNames from 125 countries. Includes drug pricing.”
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  • Bye bye paper medical records

    HIT Consultant: “N.Y. medical group to ditch paper records by 2010 – Rep. Chris Lee toured the Buffalo Medical Group’s offices Monday as part of what he calls his effort to bring local ideas about health-care reform to Congress. Buffalo Medical Group, which handles 415,000 outpatients per year, is in the process of updating its data systems and patient records to a paperless electronic format. CEO Daniel Scully said the electronic records will replace a warehouse full of 5,000 boxes of patient record. Scully said he expects the transition to be complete by the end of 2010.” – I love this idea. It’s aggressive, it’s green and it’s much more efficient. Searching through a well indexed electronic database is much faster than looking through hundreds (possibly thousands) of paper files, no matter how well organized you are. How many times have you seen this order in a chart: “have the patient’s old medical records sent over”, or some equivalent phrase. That would be a thing of the past with a paperless electronic medical record.

  • Apple patent details RFID tag reader.

    9to5mac.com: “RFID reader built into the screen?  We’re not quite sure why they’d need to do this (as opposed to putting the reader somewhere else in the device) but Apple has put a patent application on this.” – In addition, the US Patent and Trademark Office lists the following: “The efficient incorporation of RFID circuitry within touch sensor panel circuitry is disclosed. The RFID antenna can be placed in the touch sensor panel, such that the touch sensor panel can now additionally function as an RFID transponder. No separate space-consuming RFID antenna is necessary. Loops (single or multiple) forming the loop antenna of the RFID circuit (for either reader or tag applications) can be formed from metal on the same layer as metal traces formed in the borders of a substrate. Forming loops from metal on the same layer as the metal traces are advantageous in that the loops can be formed during the same processing step as the metal traces, without requiring a separate metal layer.” – I can think of several uses for an iPhone with a built in RFID Tag reader, it can already read barcodes. The iPhone just keeps getting cooler and cooler.

  • Where is pharmacy informatics headed?

    Recently I read an interesting article in the American Journal of Health-System Pharmacy. The question of what defines a pharmacy informaticist was raised. I’ve mused over that question many times myself. Because there is no standardized definition for a pharmacy informaticist, it is extremely difficult to define their role. A look at the many different job descriptions for IT pharmacists posted on the American Society of Health-System Pharmacists (ASHP) website is testimony to that.
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  • Possible restriction on acetaminophen dosing

    Medscape.com: “The FDA should put new restrictions on acetaminophen, an advisory committee recommended Tuesday, saying the move would protect people from the potential toxicity that can cause liver failure and even death.” – Acetaminophen (a.k.a. Tylenol) is a very safe medication. According to the article “billions of doses of acetaminophen are used safely every year.” That’s billion, with a “b”. So why would you want to restrict it? That’s a good question. I certainly don’t have an answer.

    Here are a few things to consider if you use acetaminophen:

  • Keep the dose to a maximum of 650mg if you’re a healthy adult.
  • Check with your doctor or pharmacist if you have any health related issues prior to using acetaminophen (liver problems are especially problematic).
  • Make absolutely sure there is no acetaminophen in any of the prescription medications you take (i.e. Vicodin, Norco, Tylenol #3, etc).
  • Don’t take acetaminophen more often than every 6 hours unless directed so by your physician.
  • Be cautious when using over the counter (OTC) medications with multiple ingredients. READ THE LABEL. If the item claims to take care of aches and pains, then it probably has an analgesic in it. You would be surprised to learn where acetaminophen pops up.
  • Don’t drink alcohol when taking acetaminophen; your liver will not be happy if you do.
  • When giving acetaminophen to a child, make absolutely sure to read the directions before use and use only the measuring device supplied with the medication. If you need to measure more than the device is capable, either the child is too old for the dosage form or you’re giving the wrong dose.

    • This issue isn’t so much about the safety of acetaminophen as it is about common sense. Use your head people.

  • NQF calls for pharmacists to take greater role in patient safety

    HealthLeadersMedia.com: “Literature shows that when pharmacists are involved in care, the result is improved patient care, fewer adverse events, and reduced costs,” said Andrawis, speaking about Safe Practice 18. “But, in order for that full benefit to be realized, it’s really important that those pharmacists be given appropriate authority, and consequently that they continue to take accountability for patient outcomes.” – The article goes on to say that pharmacists should be involved in all facets of patient safety including leadership, technology and clinical rolls. Pharmacists are uniquely qualified to address patient safety issues. This is especially true when it comes to the pharmacists roll in the medication distribution model and implementation of new technology such as smart pumps, automated dispensing and barcoding. As the public becomes more aware of issues related to patient safety, the pharmacists roll in saving lives (and money) associated with medication errors will become even bigger.