Jerry Fahrni

Tag: IV ROOM

  • Cool i.v. room technology – Drugcam Assist

    [Update 12/22/2013: I received an email from one of the inventors/developers of Drugcam software informing me of a new website that contains more information about the system. The site is eurekam.fr, which contains pages describing both Drugcam Assist and Drugcam Control. It’s still not a great amount of information, but at least it’s more than I had.]

    I’ve talked about technology for the i.v. room extensively on this weblog. It’s no secret that I think the i.v. room is the next frontier for pharmacy technology. The reason I think this is simple, the i.v. room is dangerous, and precious few healthcare systems are using technology to its fullest in that environment.

    I’m not the only one that thinks the i.v. room is important. As of December of 2012 I knew of basically four i.v. room workflow management systems: DoseEdg DoseEdge by Baxa, Pharm-Q In The Hood by Envision Telepharmacy, SP Central Telepharmacy System by ScriptPro, and Phocus Rx by Grifols.

    Joining the fray are at least two more systems that I saw at the ASHP Summer Meeting just last week: Cato software, which is now owned by DB, and Drugcam Assist by Getinge. Unfortunately you won’t find much about Drugcam Assist online, which is really too bad because it’s an amazing system. The website offers more information and a video demonstration for those that are willing to fill out a form and register. I was not willing.

    Drugcam Assist
    (more…)

  • Saturday morning coffee [February 9 2013]

    MUG_ArizonaIt’s hard to believe that it’s February already.

    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….

    Last weekend I was on the road attending my daughter’s Power League volleyball tournament in Sacramento.  My brother Robert filled in for me admirably. I didn’t ask him to take up the reins, but I certainly appreciate him filling in the gap. Thanks, bro. Dig the mug by the way.

    I went through Phoenix, AZ twice this week while traveling for work, which made me think of the coffee mug to the right. It was once of four sent to me by Jason DeVillains last year. Jason is better known to many as The Cynical Pharmacist. Jason and I met via Twitter(@TheCynicalRPH) and have been chitchatting via the web ever since. Perhaps the next time I touch down in Phoenix I can lay over for a day and Jason and I can grab a cup o’ joe together. Jason also blogs over at The Cynical Pharmacist. Check it out.
    (more…)

  • Cool Pharmacy Technology – Diana Hazardous Drug Compounding System

    I came across the Diana Hazardous Drug Compounding System from icumedical while doing a little internet surfing the other day. As the name implies it’s a small, closed-looped system designed for compounding hazardous medications, i.e. chemotherapy.

    The “Diana System” utilizes a dual channel system, one for small volume and another for larger volumes. It’s a little difficult to understand exactly what the device does without seeing it in action, which is what the video below is for. It’s a pretty cool concept. I like the fact that it’s compact and needleless, but there are a couple of things I’d like to see added to the device. It appears that there is a lot of manual programming with the “Diana System”. It would be nice if it was integrated with the pharmacy information system so that it could utilize barcode scanning to automate the programming, much like what we see on the newer generation of smart pumps that are hitting the market.

    From the website:

    Accurate, safe, and efficient hazardous drug compounding technology right at your fingertips.

    • User-controlled automated compounding for maximum accuracy & safety. Unlike automated technologies that require huge investments and do not fit within existing workflows, the Diana system cost-effectively keeps pharmacists and technicians in control of the compounding process from beginning to end.
    • Closed system assures safety of clinicians and the sterility of the mix.The Diana system fits under the hood of your biological safety cabinet and protects clinicians from exposure to hazardous drugs and accidental needlesticks while protecting the patient preparation from exposure to environmental contaminants.
    • Reduces risk of repetitive stress injuries. Free up pharmacists and technicians from many of the repetitive motions required during preparation and reconstitution and reduce the stresses and injuries that can occur as a result.
    • Increases efficiencies and reduces drug waste. By helping you improve the efficiency of high-volume compounding, the Diana system can deliver workflow efficiencies while helping you reduce drug waste by extracting every drop of drug from every container.

  • IV room workflow management system comparison [table]

    There are basically four IV room workflow management systems that I’m aware of: DoseEdge by Baxa, Pharm-Q In The Hood by Envision Telepharmacy, SP Central Telepharmacy System by ScriptPro and Phocus Rx by Grifols. Here’s a little table I’ve put together comparing them based on what I know.

    Product

    DoseEdge

    Pharm-Q In The Hood

    SP Central Telepharmacy

    Phocus Rx System
    Popularity

    High

    Medium

    Low

    Low
    Hardware Stationary camera stand, remote workstation Stationary camera mounted on i.v. bar in hood, remote workstation Stationary camera stand, remote workstation Two compact 5 MP cameras mounted outside hood**New hood with integrated cameras and workstation
    Software SaaS model “IV Workload Management Solution”; photo capture; pharmacist work queue; barcode verification “Web-based”; photo capture; pharmacist work queue; video messaging Photo capture;  web-based pharmacist check queue Photo capture; bi-directional com; image capture; pharmacist check queue
    Acute Care Focus

    High

    Medium

    Low

    High
    Interesting features SaaS model; per-dose pricing;  barcode scanning; telepharmacy remote checking; SAS70 compliant hosting/storage site; automated volume calculations; kitting Telepharmacy remote checking;  video messaging between tech and pharmacist; patented camera for use in hood; multiple configurations Telepharmacy remote checking; integration with central pharmacy workflow system; “call button” for pharmacist interaction Camera mounted outside hood;  barcode scanning; pharmacist queue can be accessed via mobile device; configurable stage verification**New hood design with camera and workstation built into hood.
    Advantage(s) Head start in the market; market penetration; name recognition; Baxa backing (resources); photo capture; iv room specialty; Use of telepharmacy technology (have been doing telepharmacy for a while); camera design; photo capture Use of telepharmacy technology; name recognition (although not in AC) Unique camera feature; acute care focus; i.v. room specialists; only product with camera and workstation built directly into the hood**Integrated camera and monitor in hood
    Biggest Weakness Cost; no new features in a while Small; no market penetration Relative unknown in AC; poor online information and marketing Relative unknown product

  • Upon further review – thoughts on ASHP Midyear 2012

    I’ve just returned from a week in Las Vegas, NV at ASHP Midyear 2012. The ASHP Midyear conference is the pinnacle of clinical meetings each year for most acute care pharmacists. For me it’s not that interesting anymore as I don’t attend as a pharmacist. It just more work days for me; long work days. I didn’t attend a single “session”, but did manage to find some time to walk through the exhibit hall once and catch up with some old friends.

    Enough of that, on with the thoughts:
    (more…)

  • What the NECC fiasco means for automation in pharmacy IV rooms

    According to the CDC website, the fungal meningitis outbreak linked to a tainted batch of steroid injections made by the New England Compounding Center in Framingham, Massachusetts has resulted in more than 500 case reports and 36 deaths (as of November 28, 2012).

    A lot of things happen when something like this occurs. People become fearful, regulatory agencies begin to scrutinize processes and practices, organizations like ASHP begin to formulate statements and create plans to deal with questions and backlash, healthcare systems begin to reconsider how they do things, and people begin to change the way they think. It’s a natural progression. I’ve seen it happen more than once during my career; never to this extent, but I’ve seen it before. It typically leads to practice changes and an entirely new market for consultants.

    The NECC case has caused quite a stir in the pharmacy community. I’ve seen a wild swing in topics of discussion among pharmacists in the acute care setting, i.e. hospitals. Two things in particular have caught my attention: 1) all of a sudden everyone is worried about compounding safety in the IV room, and 2) everyone is talking about robotics. I’ve talked to a couple of friends that are still practicing pharmacy and they are “in the process of looking at IV robots”. Both cited NECC as the reason for their new interest in robotics.
    (more…)

  • Health Robotics ASHP Midyear press release includes mention of RFID

    I came across this press release yesterday. The press release is from Health Robotics, a company that builds and distributes automation and technology aimed squarely at the I.V. room. Their product line includes several robots designed for specialized I.V. room compounding, including i.v.STATION ONCO, i.v.STATION, CytoCare and TPNstation.

    It looks like the company is taking advantage of recent events surrounding sterile I.V. preparation to promote the safety of robotic compounding. They will be presenting data from recent studies from various hospitals across U.S. This all makes sense. But what I found interesting was the quote from Gaspar DeViedma, Health Robotics’ EVP.

    “… I invite all ASHP attendees to compare and contrast our company’s track record now yielding streamlined robotic “live” installations within 60 to 90 days from purchase order; new RFID solutions tracking temperature-controlled I.V. doses from the offsite sterile compounding sites to the hospital pharmacies, on to delivery carts and refrigerated cabinets and all the way to the patient; and finally to witness the new standards in Chemotherapy and Monoclonal Antibody Therapy IV Automation.”

    The emphasis is mine. That part about RFID almost slipped past me when I first read it. RFID is gaining popularity in the pharmacy world. Health Robotics certainly has my attention. I’m curious to see what they’re up to. I hope to have an opportunity to visit their booth at Midyear. I’ll keep you posted.

  • More on the meningitis outbreak caused by contaminated steroid injection

    Things just keep getting worse: death toll rose to 14 and people affected was up to 172 in 11 states as of this afternoon. It’s difficult to find accurate information on the exact cause of the meningitis, but it appears that most of the cases are related to either Aspergillus or Exserohilum.

    Fungal infections are notoriously difficult to treat, especially when they’re in the central nervous system (CNS). The CNS is designed like a fortress to keep things out, like fungus and bacteria, thus keeping you safe and healthy. Unfortunately it doesn’t discriminate and does a great job of keeping medications out as well. That’s why it’s hard to treat infections in the CNS.

    I’ve been involved with several meningitis cases over the years, but rarely those involving a fungus. The outcome generally depends on several variables including how quickly the infection is discovered, how soon treatment is started, how aggressive the treatment is – you can never be too aggressive when treating meningitis – and the general health of the person you’re treating. A little divine intervention is always desirable as well. However, as I mentioned above, meningitis is difficult to treat and the outcomes associated with fungal meningitis aren’t great.

    The CDC has released treatment recommendations. You can find them at the ASHP Pharmacy News site here.

    “The Centers for Disease Control and Prevention (CDC) recommends i.v. voriconazole and liposomal amphotericin B as initial therapy for patients who meet the current case definition for fungal meningitis.

    According to CDC, the antifungal therapy for patients with meningitis should be administered in addition to routine empirical treatment for potential bacterial pathogens.

    CDC Medical Epidemiologist Tom Chiller said during an October 10 conference call that broad-spectrum antifungal therapy is advisable because it is “unclear as to how many potential fungal pathogens could be involved” in the outbreak.

    For patients who meet CDC’s current case definition for fungal meningitis, the recommended dosage of voriconazole is 6 mg/kg administered every 12 hours. Chiller said the dosage should be maintained “for as long as the patients tolerate it.”

    Liposomal amphotericin B should be administered intravenously at a dosage of 7.5 mg/kg/day, according to CDC. The agency stated that liposomal amphotericin B is preferred over other lipid formulations of the drug.

    The optimal duration of therapy is unknown but is presumed to be lengthy.”

    Emphasis above is mine.

  • Outsourcing sterile product preparation and the importance of quality assurance

    I’m sure you’ve heard about the recent meningitis outbreak tied to a contaminated batch of preservative-free methylprednisolone acetate. The story has received significant attention as more that 100 people have been sickened and as many as eight have died as a result of receiving an injection of the contaminated steroid (this data is already out of date since I started composing this post yesterday).
    (more…)

  • Cool Pharmacy Technology – RxAdmix

    In this issue of The Imaginary Journal of Pharmacy Automation and Technology (IJPAT) we take a look at RxAdmix, a system designed to provide barcode scan verification in the IV room. Now why didn’t I think of that? Great concept when you consider the dangers associated with compounding an intravenous medication incorrectly. Doxorubicin? Daunorubicin? Eh, what’s the difference.
    (more…)