Jerry Fahrni

Blog

  • The benefits of an EHR may or may not be real

    I’ve had reason to think about Electronic Health Records (EHRs) these past few weeks. There is a lot riding on their success or failure. There’s no question that EHRs will be the future of all documentation in healthcare, but I’m not convinced that healthcare is ready for the transition. At least not yet.

    The potential advantages of EHRs are many. In theory they offer real-time information, integration of many systems across a single platform, the ability to store, access and manipulate massive amounts of data (“business intelligence”, analytics, “big data”, etc), they provide information that follows a patient regardless of where they go or who they see, the offer potential for patients to view, edit, use, and add to their own medical information, and so on.

    These are all good things. If only the potential was reality. The current state of EHRs is far from their future potential.
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  • On demand controlled substances dispensing at the point of care (NarcoMedic®)

    NarcoMedic is a product from Pearson Medical Technologies. Pearson is a small company out of Alexandria, LA. They’ve made a business out of bar code labeling and packaging technologies. You’re probably most familiar with their iPackRx unit dose packager and m:Print software; either as the direct product or possibly as an OEM’d version for another company.

    A colleague sent me a marketing email a few days ago from Pearson announcing NarcoMedic, a “decentralized management platform” for controlled substances. It caught my attention as I thought about something like this several years ago.

    As with other automated dispensing units, NarcoMedic is designed to dispense medications at the point of care, i.e. nursing unit. With that said, what caught my attention were the following points:

    • Tabletop design – 38”H x 23”L x 32”D. Med rooms tend to be cramped. It’s nice to have the option for a small unit.
    • Packages and dispenses in individual patient-specific bar coded packages (packages on demand from storage locations)
    • Packages and dispenses tablets, vials, ampules and syringes in individual packages.

    Pretty interesting. As I said, it’s not a new concept, but perhaps it’s time has come. Regardless, it’s nice to see someone out there trying something new.

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  • Saturday morning coffee [August 9 2014]

    “If you think a weakness can be turned into a strength, I hate to tell you this, but that’s another weakness.” -Jack Handey

    So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug below is relatively new. It’s one of two that I picked up in Las Vegas at M&M World during one of my daughter’s volleyball tournaments earlier this year.

    Orange M&M's Coffee Mug
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  • Keeping up with the Joneses, or how pharmacies choose technology

    Recently a colleague sent me a link to the FierceHealthIT article below. Much of what the article had to say rang true for me.

    Hospitals covet neighboring facilities’ technology: “Facilities were more likely to acquire a new surgical robot if neighboring hospitals had done so, according to a study from a group of private and government researchers published in this month’s Healthcare journal… The authors found that a hospital whose neighbor had acquired a surgical robot was more likely to also get one….According to the authors, the results suggest that tech adoption may be driven “in part by competition among neighboring hospitals rather than solely by the mission to provide optimal patient care.”

    This is consistent with what I’ve witnessed in pharmacy technology over the past several years. In my experience pharmacies rarely choose the technology that’s right for them. It’s much more likely that pharmacies will make decisions based on usage patterns of other local hospitals, i.e. word of mouth. That’s why it’s so important for companies in the pharmacy technology sector to get people using their products. It’s not like the consumer market where new technology can often unseat an incumbent with a whiz-bang feature or some clever marketing. No, in pharmacy it’s likely that once a decision is made that decision will stick for many years.

    It’s also important for pharmacies to ensure that they’re making a wise decision when it comes to implementing new technology. They should ask themselves two questions: 1) what do I need it to do, and 2) will it fit my workflow. Answer those two questions and you’ll know if it’s right for you.

  • Cool Pharmacy Technology – TelePharm

    Telepresence has seen its ups and downs over the years. The technology is certainly nothing new, but it has been underutilized in both the inpatient and outpatient healthcare space. This is especially true when it comes to pharmacy, which is odd because one would think that telepresence technology could be used to give pharmacists the freedom they crave.

    TelePharm is a telepresence system aimed at the ambulatory pharmacy space. It’s difficult to elicit much detail from the website, but ultimately the system appears to use cameras and a web-based application to remotely monitor technicians, and provide patient consultations via video conference.

    “Pharmacists are provided captured images of all work products (hardcopy prescriptions, labeled containers, medications (tablets/capsules), stock bottle containers, and stock bottle. They compare all this information to the system information and stock images provided to verify the prescription has been filled properly.”

    It appears that patient consultations can take place on any web-enabled device. “A pharmacist needs an audio/video enabled device with internet to access the TelePharm application. Patients need to have an internet and audio/video connection through a tablet, mobile phone, or home PC.”

    The TelePharm service reminds me of what Envision Telepharmacy does with acute care pharmacies and infusion centers.

    Anyone out there used TelePharm or seen it in person? If so feel free to leave a comment below.

  • Saturday morning coffee [August 2 2014]

    “A journey of a thousand miles begins with a single step.” – Lao-tzu, Chinese philosopher (604 BC – 531 BC)

    So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug below is relatively new. I picked it up in Las Vegas at M&M World during one of my daughter’s volleyball tournaments earlier this year.

    Yellow M&M Mug
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  • Medical errors remain a problem despite years of effort

    I recently read an article at Senator Bernie Sanders website about preventable medication errors. The article lists preventable medical errors in hospitals as the third leading cause of death in the U.S. behind only heart disease and cancer.

    The article goes on to say that “the Journal of Patient Safety recently published a study which concluded that as many as 440,000 people die each year from preventable medical errors in hospitals. Tens of thousands also die from preventable mistakes outside hospitals, such as deaths from missed diagnoses or because of injuries from medications.” I’m not exactly sure what article they’re referencing here as they didn’t provide a link or additional information, but I assume they’re referring to the article by James in September 2013. Just a guess, I could be wrong.1 Regardless of the actual reference, the bottom line is that the number of patients that die from preventable medical errors is high.
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  • Saturday morning coffee [July 26 2014]

    “Everything happens for a reason, and sometimes that reason is you’re stupid and make bad choices” – unknown

    So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug below is relatively new. I received it as a gift from my brother Robert and his wife, Kim. Very cool. I’ve had a running joke about monkeys for years. Once upon a time, not too many years ago, an administrator in the pharmacy where I worked told me that a monkey could do my job. Made me pretty angry. Sad part was he was right.

    MUG_Monkey
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  • Desire to see more collaboration between pharmacies and local universities

    Bitwise Industries in Fresno is an interesting place. It’s basically a tech hub pulled together by some great local minds. Located in a nice little area in downtown Fresno, BitWise has tasked itself with taking “a burgeoning tech industry that was growing in silos in California’s heartland, add places that inspire community, collaboration, and growth, create accessible education that equips and empowers a homegrown army of technologists, deploy talent to execute technology success stories”. I visited the facility with my brother, Robert when it first opened. Impressive and inspiring.

    But this post is not about BitWise. It’s about something I’ve been thinking about for a couple of years. BitWise was simply a catalyst to remind me to revisit my idea.
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  • Moving from the Motorola Moto X to the Samsung Galaxy S5

    s5_blackA short time ago I was an unwilling participant in my Moto X being dropped on a concrete floor.

    Over the past year or so I’ve been working with a colleague on a book about the state of automation and technology in pharmacy IV rooms. During this time I’ve made several site visits to acute care pharmacies to look at the technology, workflow, etc in their IV rooms. As part of the data collection process I not only take a lot of notes, but snap lots of photos and record video of technicians working with the technology. I find the photos and video invaluable when reviewing my notes.

    Prior to entering the cleanroom at one large hospital back east, the pharmacist in charge insisted that he wipe down my Moto X with alcohol. I wasn’t thrilled with the idea, but it was either let him do it or not take it in. I opted to let him wipe it down. During the process he dropped my Moto X. It hit the concrete floor pretty hard and bounced. The back popped halfway off. Not good. Since that time my Moto X has been acting weird, freezing up, not taking voice commands, and so on. I finally decided to replace it through the insurance I carry on the device.
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