Blog

  • Center for the study of pharmacy automation and technology [idea]

    MadScientistEarlier this week I put up a post about a Prezi created by Dr. Robert Hoyt called Evidence Based Health Informatics: Replacing Hype with Science. It was a great presentation about a lot of the technology that healthcare has adopted over the years without any real evidence to back it up. I wish you could all see it, but it appears that someone has pulled it down. The link I have for the Prezi is dead. Bummer

    Anyway, the Prezi got me thinking about how we have many technologies in pharmacy that have precious little, or no data to support their use. We use carousels, high-speed packagers, tabletop packagers, robotic medication distribution, robotic IV preparation along with other IV room technologies, smart IV pumps, automated storage cabinets, and so on. The data we do have for these items is typically provided by the manufacturer’s themselves, which makes it biased in the best of situations and completely worthless in the worst cases.

    Pharmacy is in desperate need of an academic center for the study of pharmacy automation and technology. The center would study the use of pharmacy technology in different use cases, collect data, and provide the pharmacy community with the information. Look at robotics versus carousels for distribution. Analyze cross contamination in high-speed packagers versus tabletop models. Perform time-motion studies on cart fill vs. automated dispensing cabinets for medication distribution, and compare the safety of one over the other. Analyze pharmacy inventory costs of one technology over the other. And so on, ad infinitum.  Conclusions wouldn’t be necessary as simply presenting the information in an easy to understand format would suffice. Let the end users draw their own conclusions. Every practice setting is slightly different, and what may work for one may not work for another. But understanding how a piece of technology or automation fits into a particular practice model might be a significant benefit to many.

    The center would tear the automation and technology apart, both figuratively and literally to unveil all there is to know about each and every piece.

    Such a place would have to exist at a well respected academic research center as it is the only way to ensure some semblance of impartiality.

    How would it be funded? Ah, there’s the rub. Getting funding for such an endeavor would be difficult at best. A lot of this equipment is expensive. Of course the best place to troll for money would be the pharmacy technology vendors themselves. After all, they have all the equipment that would be needed to perform the research. Unfortunately this is unlikely to happen as most companies will not be willing to drop resources into a project that they have no control over. What if the outcome of such research reflected poorly on their products? That would not only be embarrassing, but could potentially hit them in the pocketbook. No, they couldn’t risk it. How about the federal government? Perhaps, but that might be like getting blood out of a turnip these days.

    Getting the equipment and funds would definitely be the hardest part. There’d be no shortage of pharmacists interested in doing that type of work. What pharmacist could resist playing with giant toys all day long?

    Time to get out my crayons and start drafting a proposal….

  • Visualizing data – Tableau Software

    I spent the day in San Francisco attending the Tableau 8 Roadshow event.

    Tableau is an amazing piece of software that helps you link to data in various forms – SQL databases, Excel spreadsheets, Google analytics, and many, many more – and use that information to create stunning visualizations. It’s insanely easy to use, and quite frankly is one of the most impressive pieces of software I’ve ever used to present data in an easy to understand manner.

    Tableau
    (more…)

  • Great Prezi on Evidence Based Health Informatics

    Thanks to Tim Cook over at Google+ for the lead on this one.

    I’m familiar with Prezi’s, but have never created one. I played around with the technology once, quickly became frustrated, and gave up. Anyway, the Prezi below from Dr. Robert Hoyt - Evidence Based Health Informatics » Replacing Hype with Science – has a lot of great information in it.

    Update 3/13/2013: Looks like the presentation was pulled down. Not sure why, but the link is dead. Unfortunate as it was a great presentation.

    Update 8/21/2013: The presentation is back! Dr Hoyt left a comment on this post letting me know that the presentation is up with new and improved content.

    You can see the full presentation here or view it below.

  • Saturday morning coffee [March 9 2013]

    MUG_genericSo 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 to the right isn’t one of my personal mugs. Instead it’s the kind of generic mug you get in cheesy hotel restaurants. And that’s because I’m not at home. I’m in Las Vegas for my daughter’s volleyball tournament. In lieu of that, and the fact that I had to crawl off into a “quiet” corner to open my laptop, I’m going to make this quick.

    Jack the Giant Slayer was #1 at the box office last weekend. Not a big surprise as again there was little in the way of competition at the box office for a second week in a row. Jack brought in a measly $27 Million on its opening weekend. Not too bad, but when you consider the $195 Million production budget that makes it a flop. Yikes! My family and I saw Jack over the weekend. We enjoyed it. Identity Thief continues to do well as it came in second place for weekend box office totals.
    (more…)

  • CPOE reduces likelihood of error by nearly 50% [article]? I’m skeptical

    There’s quite a bit of talk floating around the internet about a recent article in JAMIA that looks at reduction of medication errors in hospitals secondary to CPOE adoption (J Am Med Inform Assoc doi:10.1136/amiajnl-2012-001241). The article is available for free so I read through it last weekend. By the end I was looking at something that wasn’t all that impressive. The authors use a lot of sleight of hand, i.e. statistical models to tell a story about how CPOE “decreases the likelihood of error on that order by 48%”, which ultimately could potentially lead to a reduction in medication errors by approximately 12.5%”. That would be great, except that the entire thing is based on statistical models, assumptions, survey data and a great big meta-analysis.

    ChiefStatistian
    (more…)

  • #1 thing to consider when buying pharmacy automation and/or technology…

    There are a ton of things to consider when you’re thinking about putting new technology in the pharmacy. You have to consider the cost, the impact on your operations, the reputation of the company that you’re buying from, what type of technology you’re going to buy, and so on and so forth ad infinitum.

    However, the number one thing you must consider before taking the plunge is whether or not the technology fits your dispensing model. Do you still do a cart fill? Are you completely decentralized? Are you using a just-in-time dispensing model? Will the technology that I’m looking at fit what I hope to accomplish? You need to think about that long and hard before making a decision.

    It’s like buying a new vehicle. You certainly don’t buy a Toyota Prius if you need to pull a 24 foot Centurion Enzo SV244 – a really nice boat – to the lake on weekends. No, instead you buy a new Ford Super Duty truck. I know that makes perfect sense to you, yet I hear people frequently say “it doesn’t fit the way we work” when talking about pharmacy automation and technology. When they say that, the first thing that pops into my mind is “then why did you buy it?”. It’s a question that needs serious consideration because some of this stuff is expensive.

    I experienced this firsthand in my previous role as an IT pharmacist. We installed new technology that didn’t really fit our distribution model all that well. We tried to cram the technology into an manual process. Didn’t work. I fought it for a few months until the light bulb finally went off. Once we got out act together we redesigned the process around the technology. We took advantage of the automation and filled in the gaps where necessary. It fundamentally changed the way we did things, and in the process improved the overall distribution process.

    So before you go and buy a robot, or a carousel, or a high-speed packager, or a compounding machine, make sure you ask yourself how you’re going to use it.  This stuff isn’t top secret. Do a quick Google search. Watch some videos. Talk with hospitals that do the same things as you.

    In a nutshell do your homework before taking the plunge because once you take the plunge and decide you’ve made a mistake you can only do one of two things: 1) change automation, or 2) change the way you work.

  • MedFolio, more medication compliance technology

    Seems like everyone has some piece of technology designed to help patients with medication adherence and/or compliance.

    What’s interesting to me is the number of different approaches there are out there to solve the problem. MedFolio looks similar to the old style medication organizers. It’s probably the most labor intensive solution I’ve seen, but then again it may be the most useful. Hard to say. From the videos I found on YouTube it looks like it’s been around for a while.
    (more…)

  • Computers, bags and TSA screening

    TPassTag

    Mobile Health Computing: “Electronic devices that are smaller than a standard laptop can stay in your bag. There is no need to pull them out. The TSA told us this back in 2010.” Good to know.

    I was told by TSA that anything with an SSD (vs. a standard HD) can remain in your bag; iPad, Android tablet, eReader, etc. I tried to apply this logic to my laptop, but it didn’t work. The TSA is inconsistent with how they apply the rules. I only travel about 20 times a year, but it can be different from one airport to another. Most handle things the same way, but it’s not 100% across the board.
    (more…)

  • Saturday morning coffee [March 2 2013]

    MUG_WisconsinWelcome to March everyone. 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….

    I picked up the coffee mug to the right in Fitchburg, WI last summer while on a business trip. I drove there from Chicago after stopping off to visit a hospital in Winfield, IL. Wisconsin was a pretty nice place to visit in the summer. I wasn’t able to do a bunch of touristy stuff, but I did get a chance to see a movie at one of the nicest movie theaters I’ve ever been in. The theater was big, and it had a piano in the lobby. Strange thing about Wisconsin, they have the nicest highway rest stops I’ve ever used. If you’re ever in California I’d avoid the rest stops; good place to skip.
    (more…)

  • Cool Pharmacy Technology – AdhereTech “smart pill bottle”

    AdhereTechI came across this today, the AdhereTech “smart pill bottle”. Not sure exactly how it works as the information on the website is a bit vague, but it appears to utilize sensors inside the bottle to measure content. What’s cool about it is that the bottle will provide information on both oral solids as well as liquids. That’s unique in the products that I’ve seen in the past.

    Our bottles measure the exact amount of pills or liquid in the bottle in real-time, wirelessly send this HIPAA-compliant data into the cloud, and remind patients to take their medication via automated phone call or text message.”

    Medication adherence is a hot topic in healthcare these days, and AdhereTech is obviously trying to take advantage of it. Their blog is full of articles related to the topic.

    I would like to have provided more information on the AdhereTech bottle, but information on the product is scarce. I couldn’t find a single video explaining the product in detail.

    According to Josh Stein, the co-founder and CEO the company is preparing for several pilot projects to test the efficacy of their bottles compared to standard medication vials. The tests are scheduled to start in Q2 of 2013 at Walter Reed Army Medical Center and The University of Pennsylvania.

    One other cool thing about AdhereTech is that they have an open API. “AdhereTech can integrate with all existing apps, programs, and adherence solutions.”

    I’ll be keeping an eye out for updates on this product. It’s an interesting concept. I hope to see it in the wild very soon.