Jerry Fahrni

Tag: BPOC

  • More problematic barcodes

    Recently I’ve heard of hospitals having problems with barcodes on pre-mixed IV bags. The problem isn’t related to the legibility or quality of the barcodes, but rather the location and/or the information contained within the barcode itself.
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  • RFID still a solid alternative to barcoding

    There’s an interesting article in the most recent issue of Patient Safety & Quality Healthcare (PSQH) about the use of RFID technology in healthcare and what advantages it may offer over current barcoding technology.

    I’ve been interested in the use of RFID technology in healthcare for quite some time. I think there’s real value in the use of RFID secondary to the ability to encode significant amounts of information in the tag. The information contained in an RFID tag could potentially include a patient’s medication regimen, allergies and medical condition. The value become obvious when you consider the possibilities during medication administration in the acute care setting.
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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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  • Laser etched bar-code may help curb counterfeit drugs, among other uses

    One Nucleus: “The technique will allow faster identification and resolution of any manufacturing quality problems but will also prove invaluable as an anti-counterfeit measure because the specific coding and validation systems are almost impossible to copy.

    Currently most components within diagnostic kits, medical devices and other healthcare products and equipment are ‘stamped’ with a lot code at the point of manufacture. However, these codes are of limited use for quality improvement unless products are produced in very small batches. As a result, regulatory bodies across the world are now putting manufacturers under increasing pressure to invest in much more sophisticated traceability systems, while manufacturers are looking for effective ways to prevent the growing problem of counterfeiting of pharmaceuticals and other healthcare products.

    The breakthrough approaches being developed by Innomech will enable manufacturers to mark products with a code that is either unique to the item or shared by only a small number of items produced together.

    The codemark is an unobtrusive two-dimensional dot matrix identifier that is linked to a look-up database. In effect the matrix code acts as a ‘key’ to access much more detailed information, such as the specific batch codes of raw materials used during production, the time of manufacture, the production line and so on. A version of the database could be accessible online for anyone to verify the item is genuine.

    The codes can be printed or laser etched onto products, applied to virtually any substrate and can even be added onto the surface of pharmaceutical capsules or coated tablets. Matrix codes can be as small as 2 mm by 2 mm holding the code for up to 10 billion numbers. The codes can be read by widely available readers or in many cases from a picture taken with even the simplest camera phone, making them ideal in the battle against counterfeit medicines.”

    This is an interesting approach to an age old problem. I wonder if this technology could be used to embed drug information directly on the medication as well, an idea that I hijacked from the Nursetopia website where Joni Watson muses that “Both companies and pharmacies could add a QR code/Microsoft Tag to the medication label for patients and/or healthcare professionals to scan and directly access the patient medication information sheet.” Why not put the QR code directly on the medication itself? Why not indeed.

  • Automated unit-dose packagers for acute care pharmacy

    State of Pharmacy Automation. Pharm Purch Prod. 2010; 8

    I was doing a little Sunday morning reading and came across an interesting set of slides at the Pharmacy Purchasing & Products (PPP) website  (registration required to access the slides). I haven’t spent much time reading PPP Magazine, but I should because they always seem to have something good about pharmacy automation and technology in just about every issue.

    Anyway, I’ve been looking at various automated packaging machines lately and thought the information at the PPP website was rather timely. According to information found at the site “After a slight dip in the number of facilities packaging medications in bar coded unit dose in 2009, this process realized a significant rebound in 2010. Nearly three quarters of all facilities now have such an operation in place. Hospitals taking advantage of the increased data capacity offered by two-dimensional bar codes also bounced back this year. In conjunction with these improving adoption rates, pharmacy directors are also reporting rising satisfaction rates with their operations. Despite a staunch minority that sees no need for a unit dose packaging operation, the vast majority of those without such a system plan to implement one shortly.” The graph in this post is from the PPP slide deck and shows the percentage of facilities using bar-code unit dosed packaging for medications over the past several years. This comes as no surprise when you consider the relative inexpensive nature of this technology when compared to other pharmacy automation, the ease of which it can be implemented and the push for BPOC in healthcare. Call it a perfect storm.
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  • Update: Siemens Innovations 2010 – Day 1

    Today was the first real working day at Innovations. Yesterday was taken up by all the registration stuff that you have to do when you arrive at a conference, and the welcome reception. Most of the morning was fairly benign as a good chunk of it was taken up by the opening session. I’m not a big fan of opening sessions as they tend to all sound the same. However, I did manage to squeeze in a couple of good sessions in addition to spending some time at the expo. I general love roaming the expo, but this year’s vendor selection is quite small and not really that interesting. It only took me about an hour to run through all the booths and collect a little reading material for later.

    One unplanned event that I have to mention was the pleasure of eating breakfast next to Johnathan Paul, a senior engineer in enterprise R & D at Siemens. He casually sat down next to me this morning and asked me what sessions I was planning on attending. I promptly gave him my spiel about attending the various pharmacy sessions, but in addition I lamented the fact that I was going to miss the presentation on “Virtualization, Cloud Computing, SOA, Elasticity, De-Duplication…What Do These Technical Terms Really Mean and How Do We Apply Them?” because it was at the same time as the pharmacy update. I didn’t know at the time, but he was the presenter for that session. After I got past my initial embarrassment we had a great conversation about many of the topics he planned to cover. I came away with some great information and knowledge that Siemens is doing things behind the scenes that makes me downright giddy.
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  • Quick Hit – A couple of interesting bar-coding tidbits

    There were a couple of things about bar-coding in the web-stream that caught my attention today.

    The first item was a tweet from @hospitalrx mentioning an application at USA.gov for the iPhone and Android OS that can be used to identify product recalls. The application is appropriately called Recalls.gov.

    Now, those recalls are right at your fingertips, thanks to the new RECALLS.GOV mobile application. Whether you’re at your child’s day care center or a yard sale, whether you’re at a store or at home, you can now type a product’s name into your phone and learn immediately whether that product has been recalled because of a safety concern. You can also see photos of recalled products and learn what to do with recalled products in your homes.

    Even though the website is lacking detail, the application does offer the ability to scan the bar-code on a given item to determine its recall status, although I have not tested this functionality. Additional mobile applications from USA.gov can be found here.

    And from Barcode.com: “Motorola has released a tiny new barcode scanner called the CS3000. The CS3000, shown below, is just about 3.5 inches long, 2 inches wide and less than an inch thick. It weighs only 2.45oz according the Motorola spec sheet. It is capable of scanning 1D barcodes and has a 24 hour battery life. The CS3000 has a USB connector and also Bluetooth. It’s 512MB of flash memory can hold roughly a million bar codes.“

    These things are neat. You can download the spec sheet for the Motorola CS3000 scanner here (PDF).

  • Top blog posts and searches from last week (27)

    I always find it interesting to see what brings people to my website and what they decided to read once they get here.

    Most read posts over the past 7 days:

    1. An almost disastrous bar-coding mishap
    2. Cool Technology for Pharmacy – Post from before I started putting the name of the cool technology in the blog title. This particular post was from September 10, 2009 and covered the capsule machine.
    3. Cool Technology for Pharmacy – Another post from before I started putting the name of the cool technology in the blog title. This particular post was from June 18, 2009 and covered Alaris Smartpumps.
    4. Best iPhone / iPod Touch Applications for Pharmacists
    5. Quick Hit – Mobile devices in our pharmacy – This post elicited a couple of interesting comments.
    6. Curriculum Vitae
    7. “What’d I miss?” – Week of June 27
    8. Cool Technology for Pharmacy –NDC Translator
    9. About -People checking up on me.
    10. Motion J3500 gets a wicked update – People are still interested in tablet PCs, even with that other device grabbing all the press.

    Top searchterm phrases used over the past 7 days:

    1. “ feton capsule filling machine ”
    2. “ alaris pumps ”
    3. “ cerner and pandora data systems ”
    4. “ dell xt2 ”
    5. “ alaris pump ”
    6. “ capsule machine ”
    7. “ alaris infusion pump ”
    8. “ pharmacokinetics iphone ”
    9. “ free lexi-drugs windows mobile free ”
    10. “cloud computing”

  • Is the 30-minute rule for medication administration good or bad?

    The June 17, 2010 issue of ISMP Medication Safety Alert I received has an interesting article on the unintended negative consequences of the Centers for Medicare & Medicaid Services (CMS) regulation requiring medications to be administered within 30 minutes of their scheduled dosing time. I’m sure that the CMS 30-minute rule was created with good intentions in mind, but in reality it creates a lot of anxiety and bad habits. According to the ISMP article, the CMS 30-minute rule “may be causing unintended consequences that adversely affect medication safety. While following the 30-minute rule may be important to hospitals, many nurses find it difficult to administer medications to all their assigned patients within the 30-minute timeframe. This sometimes causes nurses to drift into … unsafe work habits.” Those unsafe work habits include removing meds from automated dispensing cabinets (ADC) for multiple patients at once, removing meds ahead of time, falsifying documentation to meet the 30-minute rule and preparing doses ahead of time; all dangerous practices.
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  • Cool Technology for Pharmacy – NDC Translator

    Last week I posted about some bar-coding troubles we were having. One of the comments regarding the information in the post was left by a pharmacist named Max Peoples. Max offered up some great information and mentioned a piece of software called NDC Translator from RxScan.

    From Max’s comment: “One answer to the medication NDC # barcode scanning problem is to use the software called NDC Translator(TM) with your barcode scanners. Information at http://www.rxscan.com/rx.shtml

    It intercepts the raw data coming from the barcode scanner, evaluates it’s content and if it contains the 10 digit NDC # (required to be there by law in a medication barcode) it converts the raw data into the 11 digit NDC # format and then sends the 11 digit NDC over to the application you are scanning into, in this case Jerry’s barcode labeling software.”
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