Healthcare is beyond repair, and I can prove it

Before we begin let me get a few things out of the way. First, I am a healthcare professional. Yes, a pharmacist is a healthcare professional. Second, I’ve spent a large portion of my adult life working in the healthcare industry, both inpatient and out. This includes more than a decade working in a hospital as either a “staff” pharmacist or a “clinical” pharmacist. Third, the average person has no idea what goes on in a hospital or their physician’s office. A majority of people that are misdiagnosed, receive unnecessary labs, get the wrong drug, etc. will never know because they have no reason to think they’re getting anything but the best of care. And finally, I’ve been called a pessimist. I don’t see it that way, but I’m simply giving you all the data I have.
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Death of intellectual curiosity, due diligence and our profession

Over the weekend I read a tweet from a friend and colleague @kevinclauson. The tweet shared a link to an article titled “Young Adults’ Credibility Assessment of Wikipedia”. I don’t have a problem with the article. On the contrary, it just reinforces my dislike of Wikipedia as a healthcare reference source.

From the abstract: “This paper found that a few students demonstrated in-depth knowledge of the Wikipedia editing process, while most had some understanding of how the site functions and a few lacked even such basic knowledge as the fact that anyone can edit the site. Although many study participants had been advised by their instructors not to cite Wikipedia articles in their schoolwork, students nonetheless often use it in their everyday lives.” Kevin also links to the pre-print version of the article here (PDF).
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“What’s in it for me?”

I spent some time this week in Las Vegas attending some NCPDP work groups on standards, e-prescribing and pedigree/track and trace. Because I’m relatively naïve in these areas I learned a lot. The NCPDP is an interesting organization that appears to be doing a lot of the right things in driving standards and improving e-prescribing in the outpatient setting. Unfortunately acute care hasn’t been as aggressive in adopting these standards or implementing e-prescribing. That’s for another blog post.

Following the scheduled meetings I found myself sitting in on a few impromptu after hours sessions where I got my first glimpse of the political side of the pharmacy underbelly. Let’s just say that there are a lot of special interest groups involved in the process and much of what they want has little to do with better healthcare or improved patient care. Instead it’s a what’s-in-it-for-me mentality. It was disturbing to see the good work that NCPDP was doing overshadowed by groups looking to make a buck or make sure that their competitors didn’t get the upper hand.

Even though I was enlightened by the work done by NCPDP, I was troubled by the behavior of “industry leaders” and large healthcare providers. I believe we have forgotten the reason we’re in healthcare in the first place. I’m just sayin’.

Year end thoughts for 2010

2010 brought many new and exciting changes not only in my personal life, but in the world of pharmacy and technology as well. I’ve learned many new things, gained some new skills, made some new friends, explored the world of social media more deeply, traveled more than ever before and discovered that I once again know nothing. I am more excited about next year than I ever thought possible.

Below is a list of opinions I’ve gathered over the past 12 months. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.

And here we go…
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The National Drug Code (NDC) is a gremlin in the works of pharmacy

The National Drug Code, or NDC number as it’s affectionately called in pharmacy, is a set of numbers used to uniquely identify “human drugs and biologicals“. Every pharmacist is familiar with the NDC number, but if you’re not it’s basically a  unique number assigned to each package of medication. It’s an 11 digit number in a 3-segment format, i.e. XXXXX-XXXX-XX.

The first segment consists of five digits and indicates the manufacturer of the drug. The second segment is four digits used to identify the medication and strength. And the final segment of two digits represents the package size.
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What to do, the case of the unhappy pharmacist

I read an article today at the CEO Blog of the American Pharmacists Association (APhA) that talks about the predicament of the retail/community pharmacist.

According to the post “Pharmacists feel it when they’re asked to fill hundreds of prescriptions per shift, provide immunizations on demand, make outbound calls to promote adherence with patients and to do so with less technician help because management just saw another big contract pricing level get cut. And pharmacists are feeling less respected as the supply of pharmacists has increased and employers find positions are easier to fill.”
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Standardized Numerical Identifiers (SNIs), say what?

A couple of weeks ago a friend and colleague shot me an email asking me if I’d heard about the new “pedigree stuff on barcoding”. I consider myself pretty well informed for the most part, but I had no idea what she was talking about. Upon further inquiry she sent me a PDF document titled “Guidance for Industry Standards for Securing the Drug Supply Chain – Standardized Numerical Identification for Prescription Drug Packages” (the SNI document). The document is also available in non-PDA format at the FDA website here. I asked other pharmacists about the SNI document while at the Siemens West Coast User Group Meeting on September 16, but no one had a clue what I was talking about; not event the Siemens product manager that was in attendance.
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Don’t miniaturize your application, redesign it instead

Anyone that’s read this blog knows that I am a fan of mobile devices and touchscreen technology; from the smartphone to tablet PCs and the iPad. My love affair with mobile technology actually began with the HP 200LX palmtop computer when I was in Pharmacy School. I couldn’t believe that something so small could have so much power; funny now, but a marvel at the time. Now fast forward to early 2000 when I purchased a TRGpro, my first Palm OS device, and never looked back.
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Unforeseen barrier to tech-check-tech endeavor

I’ve been on a mission, however small it may be, to get pharmacy technicians more involved in the operational aspect of acute care pharmacy. And by more involved I mean using a tech-check-tech model to free pharmacists up for more patient related clinical activities. I’ve posted my thoughts on the use of tech-check-tech before.

The reason for rehashing the issue is due to a conversation I had with a colleague last week. This particular colleague and I were having a light hearted discussion over the possibility of using a tech-check-tech model with automated packagers like those I described in a post earlier this week.
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