Jerry Fahrni

Tag: Database

  • What report service/software does your pharmacy use?

    I wrote about Pandora back in December 2009. It was a great piece of software back in the day.

    I remember a time when nearly everyone in pharmacy that used Pyxis ADC’s to control their medication distribution at nursing units also used Pandora to generate reports, look at data, and detect controlled substance diversion. The two simply went hand in hand. If you had Pyxis, you used Pandora.

    Pandora was acquired by Omnicell a few years ago, and since that time it’s popularity appears to have declined. Maybe it’s just my imagination, but it sure feels that way. I talk to a lot of pharmacy personnel, and recently it appears that pharmacies are starting to use solutions other than Pandora.

    Carefusion’s Knowledge Portal seems to be a popular response these days when I question people about their metrics, reports and analytics. I suppose that makes sense when you consider that a majority of hospitals in the U.S. use Pyxis ADC’s, which we all know are made by Carefusion.

    Perhaps the acquisition of Pandora by Omnicell had something to do with it. Maybe my cross section is skewed. Who knows. This will be something that I will pay close attention to over the next several months. I’ll think I’ll add this to my list of standard questions when I visit pharmacies.

    Data is important, and becoming more important by the day. Whoever has the best solution wins.

  • 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
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  • 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.
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  • Patient collected information and the role of pharmacists

    I had an interesting phone conversation this morning with Kevin Sneed, Pharm.D.(@DeanSneed), Dean at the University of South Florida College of Pharmacy (USF COP). I’ve been trying to connect with Dr. Sneed for a while now, but as you can imagine his schedule is pretty full. Fortunately for me I was able to grab about 30 minutes of his time this morning. And what a great 30 minutes it was. I was so impressed with what he had to say that I’m planning to visit USF COP sometime in the next couple of months to continue the conversation and get a first hand look at what’s going on there.

    While I could expound on our conversation for several pages, one comment that Dr. Sneed made struck me as so profound that I thought I would quickly share it.

    During the conversation we started talking about data, and where it’s coming from. Pharmacy is a data driven science, but never has the data come from so many directions. Dr. Sneed commented that patients are taking control of information these days, and not only are they more informed, but they are generating much of the information that will be used in their care. Patients are becoming connected more and more. This is especially true with the advent of mobile technologies that wirelessly transmit tons of data for everything from exercise regimens, to weight, glucose readings, heart rate measurements, and so on. Dr. Sneed sees a future where patients will present this information not only to physicians, but other healthcare professionals such as pharmacists as well; it will be used as currency to start conversations and facilitate care. I’ve heard people in healthcare refer to data as currency before, but I never really made the connection until now.

    It’s clear that we’re in a new age of heatlchare, and pharmacists need to be prepared to collect this information and utilize it to provide better pharmaceutical care. This may sound superficial on the surface, but it is a very important point. Think of a time, not so far in the future, when pharmacists will have a lot more information about patients at their fingertips. This will likely occur across all pharmacy environments, i.e. outpatient, long term care, acute care, etc. This information will give pharmacists an ever increasing role in direct patient care.

    Something to think about as pharmacists prepare for a future healthcare model that is rich in information provided by their patients. Exciting opportunities lie ahead if we’re prepared to accept them.

  • DrugCite, a searchable database of drug side effects reported to the FDA

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  • Portable storage media, the scourge of patient privacy

    LA Times: “Altogether, 16,288 patients’ information was taken from the home of a physician whose house was burglarized on Sept. 6, according to the UCLA Health System.

    The data were on the physician’s external hard drive, officials said. Though the hard drive was encrypted, a piece of paper with the password was nearby and is also missing. The physician notified UCLA the next day and officials began identifying patients affected.”

    I am continuously amazed at the number of security breaches involving patient healthcare information caused by careless use of portable storage media like external hard drives, flash drives, and even laptop hard drives. Patient information should never be stored or transported this way. I believe that utilizing cloud computing with simple browser access is a much better solution. 

    What makes this particular incident so bad is the cause; reckless behavior by a physician. This wasn’t UCLA’s fault, per se. Sure, the medical center must accept a share of the responsibility, the lion’s share of the blame falls in the lap of the physician. Not only did the physician have sensitive patient information on an external hard drive, but was dumb enough to have the password to access the drive on a piece of paper next to it. Kind of defeats the purpose of encryption and passwords, doesn’t it.

    For an eye-opening look at the magnitude of data loss and security breaches drop by DataLossDB.org sometime. It’s scary stuff.

  • Patients still not diggin’ the idea of an EHR

    EHR outlook: “Patients are still worried about how secure their data will be when stored in an EHR systems, a new study suggests. Xerox Corporation found that of 2,720 poll respondents:

    • 80% were concerned with stolen personal information
    • 64% were concerned with lost, damaged or corrupted files
    • 62% were concerned with the misuse of information”

    I’m not surprised by the numbers. In general people are afraid of change and the unknown. With that said, I think all you need to do is walk a patient through the paper processes that we use now to give them some insight into how bad things really are. Stolen and lost personal and medical information is a major problem within the current healthcare system. It’s not uncommon in any given week to hear about patient records that have been lost or stolen. And as far as misuse of information, well lets just say that’s all too common as well.

    The advantages to an EHR outweigh the concerns listed above. Just sayin’.

  • Data visualization and dashboards

    A wise colleague of mine once told me that lots of people collect data, but few people know what to do with it. I didn’t understand what he was talking about at the time, but I’ve come to have a better understanding over the years. It basically boils down to the difficulty that many of us experience when it comes to the best way to handle information. Our brains do some amazing things, but fail to “see” things when the perspective is all wrong.

    Data surrounds us. It’s in everything we do, from the bank statements we receive in our personal life to the mountains of data collected by every healthcare institution. Regardless of the data collected, there are basically three things that can be done with it. Data can be ignored, it can be archived or it can be used. Unfortunately only one of those three things is truly useful; using it. Many people chose to ignore or archive data not because the information isn’t valuable, but because they are overwhelmed with the amount of information they receive and the way that the information is presented.
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  • Quick hit: approaches for standardized healthcare data

    When my brother, Rob and I get together it often brings our wives to tears with boredom as we often get deeply engrossed in long conversations about computers, software and technology in general. Super Bowl weekend was no different. Rob and I started talking about strategies for connecting various pharmacy systems to other hospital systems and the issue of a lack of standardized information in healthcare came up. I mean we have standards, right? Of course we do. There’s SNOMED-CT, RxNorm, ICD-9, ICD-10, LOINC, GLNs, GTINs, NDC, bar-code “standards”, HL7, NCPDP SCRIPT standards and so on and so forth ad infinitum. I realize the list above includes a hodge-podge of standards that don’t really belong in the same category, but I did it to illustrate my point. And that point is that we have too many stinking standards. Trying to figure out which standard to use is an exercise in futility. Standards typically make sense to the people that invent them or study them, few others. And someone always has an idea for a better standard, hence the plethora of standards.

    As healthcare inches forward interoperability of systems will hold a key role in the success of the government’s plan for electronic health records. So as Rob and I discussed how to integrate various services and products we pondered how one goes about creating a standard that everyone can live with. Well, how does one create a standard that everyone will use? Heck if I know, but we decided that there are basically two approaches. The first is to create a standard and try to cram that standard down everyone’s throat. Microsoft has been fairly successful with this approach. With that said, few people have the resources that Microsoft has to throw at a problem. The second approach is to offer the standard as part of a free solution that comes with your product; this way people can use your product and use your free, open-source solution to tie the systems together. I assume this is the smart approach for companies that have limited resources; kind of a grassroots approach. Of course it would be wise to build this free, open-source solution on top of an existing standard that’s prominent in the market, otherwise you’re trying to re-invent the wheel. And we all know what happens when someone re-invents the wheel. Uh, you get a wheel. We don’t really need any more of those. Both approaches have pros and cons.

    Now the question becomes which standard makes sense as you design your solution. If only I had a crystal ball. We’re at least a decade away from having a truly inter-operable healthcare system; optimistic, I know.  Ultimately, the standard of choice won’t be driven by what makes sense, but rather will be driven by adoption rates. Things often become a standard without even trying.

  • The cloud still slow to gain acceptance in healthcare

    There’s an interesting article at InformationWeek about healthcare and the cloud. The article talks a little bit about the concerns surrounding security in the cloud and what I believe is an undeserved fear of using cloud based services and storage for healthcare information.

    In the article a pediatrician that is also director of clinical informatics for Atrius Health is quoted as saying “At the moment I’m not convinced that there’s a secure enough place in the cloud or that the functionality exists for us to do everything that we need to do in the cloud. The cloud allows for a tremendous amount of interconnectivity between computers because it’s using data storage that’s free amongst different networks and I wouldn’t want healthcare information being scattered in a way that I couldn’t protect it appropriately.” I’m not sure I understand the perceived insecurity of the cloud as the existing infrastructure for storing patient information in healthcare is, by design, insecure.
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