Jerry Fahrni

Tag: Pharmacy Informatics

  • Calling all students and professionals with an entrepreneurial spirit!

    Here’s something special happening in the local Fresno area….

    Calling all students and professionals with an entrepreneurial spirit! We’d like to invite you to join our new FREE HealthTech Initiative course. Find out more about this exciting class that will help develop healthcare products and services here: CHSU.ORG/HEALTHTECH-INITIATIVE

    We are looking for individuals to join teams with people from all types of disciplines including:

    • Health (Medical, Vet, Dental, Nursing, Pharmacy, …)
    • Computer Sci (Web/PC/Mobile app development, …)
    • Business (Entrepreneurship, marketing, pricing, …)
    • any individual interested in health care

    Class meets on Wednesday evenings from 5:30 pm to 7:30 pm at the California Health Sciences University (CHSU) in Clovis CA.

    • The class is FREE
    • The first class is August 23rd
    • The 15-week course ends on December 6th
    • Dinner is included

    Participants work in teams, and we will help you join a good team. You will not sit around for long-winded lectures. This course will provide participants with a “hands-on” introduction to leading an entrepreneurial enterprise by building a business model and constructing a prototype product or service. Participants work in teams, and all good ideas are acceptable.

    Teams will meet once a week to report progress. Teams demonstrate their prototype and business models to people or organization who are potential customers. Teams revise their prototypes and business models based on feedback. The step-by-step “Lean Startup” process is based on the National Institutes of Health (NIH) program to train medical scientists/entrepreneurs.

    Location: CHSU ANNEX BUILDING, ROOM 103-A, 45 N. CLOVIS AVENUE (NE CORNER OF SIERRA & CLOVIS), Clovis, CA 93612

    FOR MORE INFORMATION, CONTACT

    Dr. Charles Douglas at cdouglas@chsu.org or 559.573.8026.

    RSVP at: CHSU.ORG/HEALTHTECH-INITIATIVE

  • UPMC pilots pharmacogenomics program for heart patients

    Twenty years ago pharmacogenomics was supposed to revolutionize the way we practice pharmacy. Unfortunately, the revolution has been slow to evolve. That’s why this pilot program at UPMC is so exciting.

    UPMC is piloting a program to perform genetic testing on patients to determine medication response. “At UPMC, doctors are testing for that gene before prescribing medications to patients who receive a stent.” This is one of only a handful of healthcare systems in the country openly performing pharmacogenomic testing.

    “UPMC’s goal is to use clinical pharmacogenomics knowledge to individualize patient treatments – part of a broader program at UPMC that officials say could eventually include a wide variety of drugs to improve outcomes for patients…..The genetic and clinical information that is gathered for the PreCISE-Rx program, also feeds UPMC’s data analytics program, which is expected to lead to new scientific insights into how and why drugs work for some patients but not others, and to identify new drug targets.”As

    As pharmacists, we should be excited about this. We should also make sure that we’re waist deep in it. My hope is that UPMC has included clinical pharmacists in the program.

    This is a great step toward personalized medication.

    Source: UPMC pilots pharmacogenomics program, uses gene tests to target medications for heart patients

  • In the Clean Room: A Review of Technology-Assisted Sterile Compounding Systems in the US [report]

    For the better part of the past year I’ve been working on a project with Mark Neuenschwander of The Neuenschwander Company looking at technologies used in pharmacy clean rooms to prepare sterile compounds.

    The research into this area took much longer than originally anticipated. We discovered along the way that this subject is much more complex than it appears on the surface. Information is difficult to find, some of the technologies are little more than marketing material on a company website, and the subject matter is in its infancy.
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  • Is pharmacy informatics defined well enough to be a specialty?

    Pharmacy informatics remains in its infancy as a profession. What started out as a job for tech-savvy pharmacists with working knowledge of pharmacy has turned into an ever expanding career field.

    I’m looking through the ASHP Summer Meeting Informatics Institute schedule and the topics are varied. I see something on human factors, information management, clinical decision support, and e-prescribing. And that’s only on first glance.

    If you look at job descriptions for healthcare systems seeking informatics pharmacists you’ll see everything from involvement in strategic development of services to data entry by monkeys, and everything in between. There’s little consistency in what one facility is looking for versus another. That point alone is telling.

    This reminds me of pharmacy practice in acute care facilities 20 years ago. Outside of academic medical centers pharmacists were largely involved in operations, and only slightly involved in other care activities. That’s all changed as pharmacists practice in many different areas today and can specialize in a variety of disciplines, i.e. infectious disease, cardiology, etc.

    I think we’re heading in that direction with informatics as well. The field is so vast that being a informatics generalist will soon be impossible because the information will be more than one person can reasonably be expected to handle. The influx of consumer technology and the need for better interoperability between systems will ultimately drive informatics pharmacists to specialize in one, or perhaps a few, specialized areas.

    I consider myself an informatics generalist, but wonder how long before I won’t be able to keep up with new developments in the field. I’m already seeing signs of specialties within pharmacy automation and technology, it won’t be long now until we see it in other informatics areas.

    Ultimately pharmacy informatics cannot be a specialty as the subject area by definition requires generalist knowledge. Eventually I think we’ll see practice specialties like we do in pharmacy practice today. Until then creating a pharmacy informatics specialty makes little sense.

  • Great Prezi on Evidence Based Health Informatics

    Thanks to Tim Cook over at Google+ for the lead on this one.

    I’m familiar with Prezi’s, but have never created one. I played around with the technology once, quickly became frustrated, and gave up. Anyway, the Prezi below from Dr. Robert Hoyt - Evidence Based Health Informatics » Replacing Hype with Science – has a lot of great information in it.

    Update 3/13/2013: Looks like the presentation was pulled down. Not sure why, but the link is dead. Unfortunate as it was a great presentation.

    Update 8/21/2013: The presentation is back! Dr Hoyt left a comment on this post letting me know that the presentation is up with new and improved content.

    You can see the full presentation here or view it below.

  • Interview with Healthcare IS [audio]

    I was recently interviewed by Healthcare IS. The audio interview is only about 20 minutes long and covers me answering some general questions about pharmacy informatics, my thoughts on working as an IT pharmacist, etc.

  • Reviewing an #archetype

    I’ve been meaning to write this for a while, but you know how things go.

    While at HIMSS12 in Las Vegas last month I was asked to do a little review work. That’s not all that uncommon. People ask me to do things on occasion; review a blog post, review an app, give my opinion on something and so on. But this was completely different as Dr. Heather Leslie (@omowizzrd), Director of Clinical Modeling for Ocean Informatics and Editor for the openEHR Clinical Knowledge Manager asked me to review an archetype. A what? Yeah, that was my response when Heather and I first spoke about the topic nearly two years ago.

    According to good ol’ Merriam-Webster an archetype is “the original pattern or model of which all things of the same type are representations or copies: also : a perfect example“. Simple enough, but still too vague for my brain so I went in search of a better explanation which I found at Heather’s blog – Archetypical.
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  • #HIMSS12 Day 3

    Actually Day 3 was yesterday, but I’m just now getting around to putting some thoughts on paper.

    Best session I attended was Care Coordination in Practice: Managing Data Volume and Data
    Reconciliation    . The presentation was all about big data and how we’re failing to use it appropriately in healthcare. The slide deck was great. It’s available here if you’re interested.

    A couple of things I found interesting in the presentation:

    1. There are approximately 1-2 billion clinical documents produced in the United States each year. That’s mind boggling if you stop and think about for a minute.
    2. More than 60% of key clinical data are not found in coded lists.The remainder of the information is found in free text, scanned documents, etc. That’s a problem because a lot of clinical decision support is based on information in coded lists. So what are we missing? A lot.

    The takeaway from the presentation: “Get massive amounts of data flowing, then build structure slowly and incrementally. Don’t wait.” The presenter referred to this as “the Google approach to data”. I’m a fan of all things Google so that works for me.

    I had coffee with Pauline Sweetman yesterday (@psweetman). Pauline is a pharmacist from the UK that I’ve been tweeting back and forth with for a couple of years. We had a pretty interesting conversation around the differences and similarities between hospital pharmacy practice in the U.S. and UK. Good stuff.

    I also had a great conversation with Dr. Heather Leslie (@omowizard), a physician out of Melbourne, Austrialia that’s doing a lot of work with the openEHR project. During our short visit she persuaded me to participate in their Adverse Reaction archetype review; as a pharmacist of course.She’s always looking for additional help if anyone is interested. It’s a worthwhile project so at least have a look.

    I spent more time roaming around the exhibitor area, specifically looking at RFID technology. I’m a fan of RFID, but it doesn’t seem to be catching on in healthcare. There are several reasons why, but we should still be looking hard at it’s application. I’m not sure whether RFID will become important or it it’s a bridge technology to something else. But the only way to find out is start using it and see where it goes.

    One product that uses RFID technology that I found particularly interesting comes from a company called MEPS Real Time, Inc. Their product features a dispensing cabinet with real-time RFID driven inventory management to go along with a RFID med tray tracking system. Of course you wouldn’t use RFID for everything because it would be labor intensive and expensive, but for high dollar drugs it might make sense. It was pretty impressive.

    MEPS_HIMSS12

  • Digital edition of U.S. Pharmacist off to a bad start

    I received the announcement below in my email just a short time ago. So being the good little pharmacist that I am, I headed on over to the U.S. Pharmacist website to check it out. Imagine my surprise when I clicked on the digital issue link and was greeted with a “Service Unavailable” message (bottom image). Bummer. Hopefully they’ll get it up and running shortly.

    Update: Looks like they got it working within 5 minutes of me posting this. It’s a nice format. Check it out for yourself here.

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  • Model for scheduling complex medication regimens

    The abstract below caught my attention. I can’t read the entire article because I don’t have a subscription to the journal (a pet peeve of mine – just sayin’). Nonetheless I found the abstract quite interesting. I think the conclusion is a bit overly optimistic, but the use of computers to calculate an optimized medication schedule for individual patients is a promising idea. (Comput Methods Programs Biomed. 2011 Dec;104(3):514-9. Epub 2011 Oct 5.)

     

    Abstract
    Medication adherence tends to affect the recovery of patients. Patients having poor medication adherence show a worsening of their condition and/or increased complications. Unfortunately, between 20% and 50% of chronic patients are unable to manage their medications. This study proposes a model to improve the patients’ medication compliance by reducing medication frequency.

    Published studies have shown that, based on the patients’ lifestyle, simplification of the medication frequency and remodeling of the medication schedule is able to help improve medication adherence. Therefore, this study tried to simplify medication frequency by combining therapies. Moreover, by adjusting according to lifestyle, the study also tries to remodel medication timing in relation to mealtimes to create personal medication schedules.

    In this study, we used 19,393,452 outpatient prescriptions from the National Health Insurance Research Database to verify our system (algorithm optimized). At the same time, we examined the differences between the frequency summarized by general public and experts’ advice medication behavior. Compared with the experts’ advice method, this system has reduced the medication frequency in about 49% of prescriptions.

    Using combined medication to simplify medication frequency is able to reduce the medication frequency significantly and improve medication adherence. Furthermore, this should also improve patient recovery, reduce drug hazards and result in less drug wastage.