Jerry Fahrni

Tag: Medication Safety

  • Cool Technology for Pharmacy – RxVerify

    While reading through a pharmacy listserv I came across a seemingly simple piece of software that fills an important gap in the pharmacy distribution process. RxVerify, by Pharmacy Ideas, is a bar-code verification system used during the medication restocking phase for code boxes, anesthesia trays, transport boxes, etc.
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  • OTC drug interaction analyzer for smartphones

    Medilyzer is a smartphone application designed to provide mobile information and drug interaction checking for various over-the-counter (OTC) medications. The application is available for both the iPhone and Android smartphones, and according to the Medilyzer website a BlackBerry edition is on its way.
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  • A recent trifecta for bar-coding

    Bar-code medication administration has been around for a while, but hasn’t gained the same notoriety as other forms of healthcare technology like computerized provider order entry (CPOE) and clinical decision support (CDS). However, it looks like the tide is starting to change as we’re currently in a unique position to see bar-coding from several different angles.
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  • A look at one pharmacists unwanted potential

    A recent post by John Poikonen got me thinking about medication errors. They’re part of every pharmacists day, but we rarely give them much thought.

    I’ve been a pharmacist for more than 10 years now and I’ve make my fair share of mistakes. I would like to think that none of those errors caused harm, but that would be naïve to say the least. And forget about the errors that were never detected because one can only speculate about those.
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  • Lack of interoperability, standardization and simplification is risky

    I’m not a big fan of the using the “best of” model for hospital information systems (HIS). You know, when you buy the best pharmacy system you can find, and the best lab system you can find, and the best ED system you can find, and so on. All this does is create a giant headache for everyone involved because the systems don’t always play nice with each other, which means data gets lost or hijacked between systems by the Interface Noid. Data gets pushed, moved, shuffled, altered, chopped and converted, and it doesn’t always come out the way you intended. Or worse yet, you have a case where the systems aren’t interfaced at all.

    I recently heard of a case where a hospitals ED system wasn’t interfaced with the rest of the facilities information systems and disastrous results ensued. A patient came in through the ED with a very specific allergy; noted in the ED system. The information wasn’t available in the nursing or pharmacy systems. The patient was admitted and transferred to the floor. The little detail about the allergy wasn’t passed on during report and the patient ended up receiving that very medication based on the attending physician’s order. To make a long story short, the patient had an anaphylactic reaction and won a three day, all expenses paid trip to the hospitals intensive care unit.

    I wonder how often things like this happen due to short sided HIS implementation and deployment. Technology might not be the answer to all our problems in healthcare, but you have to admit it certainly could have helped in this particular example.

  • Cool Technology for Pharmacy

    Bar code medication administration (BCMA) is nothing new, but remains a hot topic in healthcare nonetheless. Another topic that has generated significant interest in healthcare over the past couple of years is the use of smart pumps, which I have posted on before. Unfortunately for most hospitals the two remain independent of one another with no appreciable integration. The integration of smart pumps with BCMA was one topic of discussion at this years ASHP midyear. I attended a couple of presentations from healthcare systems that had successfully integrated information from their pharmacy information system (PhIS) directly into their smart pumps for use with their BCMA system. Like many other ideas presented at large conferences, the situation is the exception rather than the rule.
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  • We need a better system for medication reconciliation

    Medication reconciliation is defined by JCAHO as “the process of comparing a patient’s medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.” The process should be fairly straight forward, but it is actually very difficult and time consuming.
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  • Sad, but all too common experiences with healthcare

    I read Warner Crocker’s musings at GottaBeMobile as well as his Tweets via the @LPH/tablet-pc-enthusiasts list on Twitter. Warner also has a second blog called Life On the Wicked Stage: Act 2, which I do not read with any regularity. I was, however, driven toward his personal blog secondary to a Twitter post. The post, titled Rush and My Mom: Two Different Care Experiences, talks a little about his experiences with his mothers medical care. She is apparently very ill with lung cancer. I sympathize with Warner as my mother-in-law, Mary Lou, succumbed to lung cancer in December of 2008. I also understand much of what he is talking about as my wife and I experienced similar problems during Mary Lou’s chemotherapy, pain management and surgeries.
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  • Update ASHP #Midyear2009

    Today was a good day for informatics at ASHP Midyear.

    Pharmacy 2.0: How the Web is Changing How We Practice
    This was a great session moderated by John Poikonen (@poikonen), PharmD or RxInformatics.com. John defined Pharmacy 2.0 as the combination of ASHP’s practice model, participatory medicine, health reform, and self-reform, i.e. changing the way you work. In an interesting move Poikonen asked the audience how many of them were familiar with the term “hashtag” and mentioned the use of #Midyear2009 as a way to follow the meeting on Twitter. Unfortunately very few pharmacists raised their hand to acknowledge the term. I wish we had a way to quantify the number, but it was only 10-20 in a crowd of a couple hundred. It’s obvious that the crowd had an interest in the subject by their presence, but as I already suspected pharmacy has a long way to go before we can be considered tech savvy.

    Todd Eury (@toddeury) of Pharmacy Technology Resources and Pharmacy Web 2.0 presented on “Healthcare System Communications Evolution: Pharmacy and Web 2.0”. In his presentation he introduced many of the most commonly used social media available today; specifically LinkedIn, Twitter and Facebook. He did an excellent job of defining their role in pharmacy practice and communicating not only their benefits, but pitfalls as well. One thing of particular interest in Eury’s presentation was the need to monitor your online reputation and occasionally “Google yourself”. Try it; you’ll be surprised at what you find.

    Kevin Clauson (@kevinclauson), PharmD of Nova Southeastern University College of Pharmacy presented “A Pharmacist’s Web 2.0 Toolkit for Information Management.” He covered the use of RSS Readers, like Google Reader, PeRSSonalized, and Clinical Reader, as well as Twitter and Evernote as a way for pharmacists to keep up with the ever changing world of information that we have to digest and assimilate. I consider myself pretty well versed in the ways of the web, but Kevin offered up some great pearls of wisdom that I can immediately put into practice.

    The final segment of the Pharmacy 2.0 session was a video presentation by Dr. Daniel Sands (@drdannysands) in which he spoke about physician’s use of social media and the web to communicate with his patients. He also covered ways that patients can get involved in their own healthcare through the use of online societies specific to their condition. Dr. Sands spent several minutes in the video interviewing physicians in his own practice about their views on social media and its impact on their relationship with patients. Not surprising some physicians spoke positively about the technology, while others were not so flattering.

    Pharmacy Informatics Education Networking Session
    This session offered up some of the most interactive discussion that I’ve been involved with during my time here at Midyear. The discussion centered on what informatics education standards should be for pharmacy students and how that should translate into a “qualified informatics pharmacist”. It was interesting to see the difference in opinions from pharmacist to pharmacist. While I won’t go into exactly what was covered I think everyone in that room needs to remember that pharmacists are highly educated clinicians that deserve to practice informatics at that same level. A <insert title here; clinical informaticist, Informatics pharmacist, pharmacy informaticist, clinical informatics pharmacist, medication management informaticist> should not be the guy sitting in a cubicle writing reports day in and day out, or the guy that has to edit each line item in the pharmacy information system because “G” should be “GM”. The <insert title here> should be the individual involved in making sure that systems are designed to include pharmacy workflow, that the reports being written provide the necessary information to be clinically relavent, that current clinical standards are adhered to during implementation of new systems, be the representative at the table during discussions of integration and interoperability of hospital systems, etc. Pharmacy informatics is a young discipline and a step in the wrong direction can harm the profession for years to come.

    Informatics Bytes 2009: Pearls of Informatics
    This session, which is still going on, has a little bit of everything when it comes to pharmacy informatics and patient safety. They announced that the session would be recorded. Maybe they’ll even create a podcast out of it; one can only hope.

  • Update ASHP #Midyear2009

    The first, and most interesting, session I attended today was “Integrating Technology to Improve Medication-Use Patient Safety”. The session was sponsored by Hospira and consisted of three separate speakers covering areas of the medication–use process where breakdowns typically occur. The focus was on closed-loop medication administration. I’m sure there are different opinions on what closed-loop medication administration is, but for our purposes it consists of orders from the time written until the medication is administered to the patient. Many technologies were discussed, including computerized provider order entry (CPOE), bar code medication administration (BCMA), intelligent infusion devices (IIDs), and electronic medication records (EMRs) among others.
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