Jerry Fahrni

Blog

  • The patient centered medical home and pharmacy

    From the Pharmacy Technology Resources (PTR) blog:

    “Patient Centered Medical Home” (PCMH) – is likely to be the best opportunity for aligning physician and patient frustration, demonstrated models for improving care, and private and public payment systems to produce the most profound transformation of the health care system this far. Wait a second – what about the Family Pharmacist or Consultant Pharmacist? How does pharmacy play into this model? What relationships are being formed today between the community retail pharmacy and these home-care physicians? What active correlation or network can be established nationally to group together seamless health-care services between the home-patient, the physician, and the pharmacy?

    First – we’ll say – its ePrescribing with all the industry attention this mode of communication brings between doctors and pharmacists – however – I say it takes more than an electronic network to ensure the proper care is given to the patient. This medical home based model sounds similar to the model from the 1990’s of managed care that was about decreasing costs. Is this system designed to help patients instead of insurers? The relationship between the “local” doctor and the “local” pharmacy is imperative. We have come full circle – where in the 1950’s the relationship between physician and pharmacist was much more prevalent. Today – the home-care doctor can grab his iPhone and digitize the necessary communications with pharmacy for a seamless and completed transaction for the patient. But what about the relationship between the doctor and pharmacist and the periodic medication review for the home-care patient?”

    As I have mentioned before, the technology to provide real-time access to patient data is currently available. This provides a genuine opportunity for pharmacist involvement in the medical home model. The PTR blog recommends pharmacists partner with local physicians using the PCMH model, and I think this is a great idea. This is a golden opportunity for all you pharmacists that want to expand your practice setting. What are you waiting for? The time is now.

  • Beyond technology – nurse/pharmacist collaboration for patient safety

    Advanceweb.com via SafetyNurse on Twitter: “Pharmacists and nurses are essential professionals entrusted with medication safety. However, the medication delivery and other resources provided by pharmacy are not always well received by nursing, and vice versa. Nurses complain medications are not delivered on time. Gurses and Carayon (2007) noted that delays in getting medications from pharmacy as one of the most common nursing performance obstacles. Pharmacists complain they never received the order. Many blame today’s technology while others clamor for more advanced modes of medication delivery. Recently, studies have suggested computerized prescriber order entry can lead to new types of errors, especially during the early phase of technology deployment and dissemination. Technological advancements are not enough to ensure patients’ medication safety; collaboration between nurses and pharmacists is critical.” - I can tell you from years of experience that nursing and pharmacy frequently have issues and continuously play the “blame game.” I can also tell you that a good working relationship between pharmacy and nursing is key to successful patient care. I spent five years in a critical care satellite working closely with nursing. The more time I spent in the unit, the better my working relationship with nursing became. Trust developed and patient care was improved. While it is clear that technology is a tool that can improve patient safety, a solid nursing/pharmacy relationship is necessary to make it successful.

  • Deinstallation of EMRs

    HealthcareITNews.com: “Physician groups in Phoenix are canceling their EMR contracts as a result of training, functionality or affordability issues. This is especially prevalent among smaller physician groups, the report says. ” – Software vendors take note. No matter how “cool” you think your product might be, people won’t use it if it is cumbersome and expensive. Unfortunately, this appears the be the rule in healthcare rather than the exception.

  • “What’d I miss?” – Week of June 22nd

    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

    I’ve decided to do something a little bit different this week. Below is a presentation I had to give following the completion of our pharmacy remodel and the implementation of our pharmacy barcode system. More images of the implementation can be found here.

    Barcoding Solution In Pharmacy

  • A rose by any other name….

    HealthBlog: “Monday evening, I was invited to attend a dinner with my fellow panelists (Dr. David Kibbe, Ravi Sharma, Steve Adams, Martin Pellinat) and others to discuss the idea of clinical groupware.  If you are not familiar with that term, clinical groupware is described as a set of practice management, electronic medical record, decision support, prescription writing and other solutions that could be delivered to clinical practices as services over the Internet.” – Hold the phone. Isn’t that the same thing as SaaS or clound computing or simply and extension of EMR/EHR? Sounds like it to me. Maybe we should all agree on a standard naming convention as different names for the same thing is more confusing than helpful. I’m just sayin’…

  • Use AutoPharm Remote Ordering to restock your clean room.

    Prior to the days of a clean room, most pharmacies had a designated area with one or move laminar flow hoods where they compounded intravenous (IV) medications. For lack of a better term this area was cleverly called the “IV Room”. The laminar flow hoods created a sterile work environment from which the pharmacy technicians could work. It was not uncommon for anyone making an IV preparation to simply leave the “IV Room” and wonder around the pharmacy looking for supplies when they ran short.
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  • Pen and paper versus technology.

    Early morning hours on the weekend often provide me with a little quiet time to get some work done. Usually my wife and kids are still asleep and the day hasn’t really started yet. Last Saturday morning was one of those days. As I got up from my work to get another cup of coffee I felt a little amused at the image in front of me. My days are spent working with various types of pharmacy technology, computers, automated storage devices, barcoding equipment, etc., but there on the table in front of me was a paper notepad and an ink pen.
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  • Insight into poor handwriting and why EHRs are important.

    Florence dot com: “1. People who prescribe medications should use a system more sophisticated than the pine straw delivery guy’s [pen and paper] to communicate high-stakes drug information. 1,400 commonly prescribed drugs have names that look-alike or sound-alike. People can, and do, die when drug names are confused with one another.

    2. Pharmacies should be able to receive prescription data in a format that does not require the tenacity of a middle-school math teacher on summer holiday to decipher.

    3. Your electronic medication history–housed with your physicians, pharmacy, and any consumer portal you choose–should move seamlessly into hospital data repositories and be accessible, with your consent, during planned and emergent encounters.”
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  • Physician’s stolen laptop contains patient information

    EMR and HIPPA: “This story made me think of two things:
    1. Why is PHI being stored on the laptop in the first place? I wish I could find out if there was an EMR involved. If there was, then the EMR should be storing all of the patient information on the server and none of that data should be stored on the laptop. So, if it gets stolen there’s no breach. That’s the beauty of an EMR these days. There should be no need for this to happen.
    2. There’s some really cool technology that’s been coming out in recent laptops that will allow you to remotely wipe out the laptop if it ever gets connected to a network. Basically, once your laptop is stolen you report it stolen and they start tracking it down kind of like they do with stolen cars (same people from what I understand).”     – The story associated with this blog goes on to say that “Patient names, treatment dates, short medical treatment summaries and medical record numbers were stored on the computer.“  This wouldn’t have been an issue if all the patient information was stored in the “cloud” and viewed and updated via a secure connection when necessary. Security aside, data stored on a local hard drive increases the chance for lost or duplicate data. Anyway you slice it, this was a bonehead move.