Jerry Fahrni

Tag: BCMA

  • New medical tablet from Sanwell offers RFID, barcode scanner

    Samwell has introduced a tablet PC designed specifically for the medical industry. The tablet is dubbed the MCA9 and offers a 1.6GHz Atom processor, a two megapixel camera, a RFID reader and optional bar code scanner, and an 8.9-inch TFT-LCD touch screen that is readable in sunlight.

    According to Samwell: “designed for medical application, the ability for data capture, record and transmission is highly valued. The built-in 2-megapixel camera is centrally mounted on the backside. The 1D/2D Barcode Scanner and 13.56 RFID reader support electronic medication administration records, reliable patient identification, and medical tracking.”

    I’m skeptical of tablets with built in bar code scanners designed for “medical application”. The Motion Computing C5 tablet has a similar design. Our facility trialed a C5 tablet earlier this year and nurses found it difficult to use and too heavy to carry for extended periods. The two megapixel camera and small screen may also present a problem for documentation and viewing patient data.

  • Computer options for nurses using BCMA

    Our facility is in the process of implementing bar code medication administration (BCMA) at the bedside. A large part of the process involves selecting hardware for the nurses to use on the floor. In addition to bar code scanners, the nurses will need access to computers for documenting not only medication administration, but other patient specific information as well.
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  • “What’d I miss?” – Week of November 5th

    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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  • Thoughts on creating a BCMA cross reference file

    zebra_barcode2Our facility is gearing up to implement bar code medication administration (BCMA) in February 2010. Part of getting ready is making sure that all the medications dispensed from the pharmacy are bar code ready. If the medication isn’t bar coded or won’t scan, then it won’t do the nurse much good at the bedside. We’re in pretty good shape secondary to our carousel install in February of 2008. Everything that gets stored in the carousel is already bar coded. I had hoped that the file stored in our AutoPharm, i.e. carousel, cross reference file could simply be dropped into our Siemens Pharmacy cross reference file, but that would have been too easy. Siemens refused to play nicely with the data.
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  • BCMA vs. CPOE, Which Comes First? Webinar Results

    argumentPharmacy OneSource hosted a webinar “debate” today that had two excellent speakers presenting their cases for which technology should implement first; Computerized Physician Order Entry (CPOE) or Bar Code Medication Administration (BCMA). The webinar was well worth the time.

    The case for CPOE was presented by John Poikonen, Pharm.D. John is the Clinical Informatics Director at UMass Memorial Health Care, an Academic Medical Center and health system in central Massachusetts. John is an interesting informaticist as he has repeatedly spoken out against the lack of evidence supporting BCMA. It was a good fit for him to argue for CPOE implementation ahead of BCMA. He brought up some great points and presented a fair amount of literature to back them up. You can read more of John’s musings at RxInformatics.com.

    The case for BCMA was presented by Steve Rough, the Director of Pharmacy at the University of Wisconsin Hospital and Clinics, and Clinical Assistant Professor at the UW-Madison School of Pharmacy. Steve has done quite a bit of work with bar code medication scanning technology and presented an excellent case for BCMA.

    Both presenters had valid reasons and good arguments for their positions. I for one am in favor of both CPOE and BCMA, but would personally push for BCMA ahead of CPOE for several reasons. CPOE requires a much larger investment in resources, both human and financial, when compared to BCMA. There is also a reasonable expectation that BCMA will stop errors at their most vulnerable point, the administration phase. I’ve mentioned this before and Steve brought up some of the very same points in his presentation. Finally, CPOE requires buy-in from physicians in order to be completely successful. And if there is one thing you can count on it’s that physicians will fight you tooth and nail when it comes to technology and change.

    You can grab a copy of the presentation slides here.

  • Pediatric labels for bar code medication administration (BCMA)

    One of the questions marks surrounding BCMA, known as MAK in Siemens language, is how to label pediatric oral syringes. Unlike most adult unit-dosed medications, pediatric dosages come in a variety of sizes. Where an adult patient may receive 25mg of captopril, a pediatric patient may receive a range of doses based on weight (0.15-0.3 mg/kg/dose for infants). The captopril tablet used by adults is barcode ready from the manufacturer. The pediatric dose, on the other hand, is not. For pediatric patients we compound a 0.75mg/mL oral suspension and pull the doses into oral syringes based on the provider’s order. Captopril is only one example as we do the same for hydralazine, spironolactone, propranolol, sildenafil, etc.
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  • Is bar code scanning really safer for pharmacy?

    This is a great questions and one that I previously would have said is a no-brainer. I believe a bar coding system for medication dispensing from the pharmacy is an improvement in patient safety, but I would be hard pressed to prove it. A colleague of mine (John Poikonen at RxInformatics.com) is fond of saying that there is no evidence to support the use of bar coding. Here’s a quote from John: “The pharmacy profession is drunk with the notion that BCMA works for patient safety, in the face of little to no evidence.“ He has a point.
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  • Integration and standardization are still stumbling blocks in healthcare

    I spent a good chunk of my morning in meetings and workgroups for the implementation of our barcode medication administration system (BCMA). Most of these sessions are dominated by nursing as many consider BCMA a nursing system.
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  • Siemens Innovations ’09 – update

    I just finished my last session of the day here in Philadelphia, and overall I would have to say it was a productive one.

    My first session today was an update on various future enhancements to both the Siemens Pharmacy System and their barcode medication administration system (BCMA), fondly referred to as MAK. The future enhancements bring much needed functionality to a system that, in my opinion, wasn’t ready for prime time.
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  • A failure modes and effects analysis on bar code medication administration

    Over the past several months I’ve been involved with a committee tasked with performing a failure modes and effects analysis (FMEA) on our bedside scanning initiative. An FMEA is a procedure for analyzing potential failure modes within a system and classifying those potential failures by frequency and severity. The failure modes can be actual or potential. It’s a way to plan for holes in the system before they actually develop, and can be quite useful in creating possible solutions for future problems. Being proactive is always easier than being reactive, I think.
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