Jerry Fahrni

Tag: Pharmacy Technology

  • Keeping up with the Joneses, or how pharmacies choose technology

    Recently a colleague sent me a link to the FierceHealthIT article below. Much of what the article had to say rang true for me.

    Hospitals covet neighboring facilities’ technology: “Facilities were more likely to acquire a new surgical robot if neighboring hospitals had done so, according to a study from a group of private and government researchers published in this month’s Healthcare journal… The authors found that a hospital whose neighbor had acquired a surgical robot was more likely to also get one….According to the authors, the results suggest that tech adoption may be driven “in part by competition among neighboring hospitals rather than solely by the mission to provide optimal patient care.”

    This is consistent with what I’ve witnessed in pharmacy technology over the past several years. In my experience pharmacies rarely choose the technology that’s right for them. It’s much more likely that pharmacies will make decisions based on usage patterns of other local hospitals, i.e. word of mouth. That’s why it’s so important for companies in the pharmacy technology sector to get people using their products. It’s not like the consumer market where new technology can often unseat an incumbent with a whiz-bang feature or some clever marketing. No, in pharmacy it’s likely that once a decision is made that decision will stick for many years.

    It’s also important for pharmacies to ensure that they’re making a wise decision when it comes to implementing new technology. They should ask themselves two questions: 1) what do I need it to do, and 2) will it fit my workflow. Answer those two questions and you’ll know if it’s right for you.

  • Cool Pharmacy Technology – TelePharm

    Telepresence has seen its ups and downs over the years. The technology is certainly nothing new, but it has been underutilized in both the inpatient and outpatient healthcare space. This is especially true when it comes to pharmacy, which is odd because one would think that telepresence technology could be used to give pharmacists the freedom they crave.

    TelePharm is a telepresence system aimed at the ambulatory pharmacy space. It’s difficult to elicit much detail from the website, but ultimately the system appears to use cameras and a web-based application to remotely monitor technicians, and provide patient consultations via video conference.

    “Pharmacists are provided captured images of all work products (hardcopy prescriptions, labeled containers, medications (tablets/capsules), stock bottle containers, and stock bottle. They compare all this information to the system information and stock images provided to verify the prescription has been filled properly.”

    It appears that patient consultations can take place on any web-enabled device. “A pharmacist needs an audio/video enabled device with internet to access the TelePharm application. Patients need to have an internet and audio/video connection through a tablet, mobile phone, or home PC.”

    The TelePharm service reminds me of what Envision Telepharmacy does with acute care pharmacies and infusion centers.

    Anyone out there used TelePharm or seen it in person? If so feel free to leave a comment below.

  • Using facial recognition for medication adherence?

    While doing a routine search of Twitter I came across AiCure (@AiCureTech), which touts itself as “Computer vision and facial recognition technology to confirm medication adherence on mobile devices”. Ok, you got my attention. Unfortunately the Twitter account appears to be dead as the last Tweet listed on the account was from September 25, 2013. The AiCure website is a bit more recent, however. The last item posted to their News & Events section was from March of this year.

    There’s a video on the website that gives a basic overview of the process. I would have embedded the video here, but couldn’t figure out how to grab it, which is a real shame because it’s in their best interest to make information easy to share.

    After watching the video I’m not entirely sure that the process makes sense to me. The video shows a jogger running on a pier. The jogger receives a notification on her smartphone reminding her to take her medicine. She stops, pops the tablet in her mouth, records the transaction via facial recognition on her smartphone, and then merrily continues on her way. In my experience people that are as “with it” as the person portrayed in the video don’t have any trouble remembering to take their meds; calendar reminders, pill bottle next to the coffee pot, etc. And why is the jogger carrying her medication with her while out jogging? I assume her jogging session wouldn’t last more than an hour or two. Take the med before or after. There’s no sense of the importance of the medication to the patient’s condition, nor is their any sense of the person being so busy that they couldn’t remember to take their medication. It would have made more sense to show some teenager with a serious medication-dependent disease state going through a busy school day. Right? Having so much fun with their friends that they forget to take their medication?

    Thoughts on marketing aside, the concept of using facial recognition is intriguing.

    From the AiCure website:

    The combination of automated computer vision technology with dynamic patient feedback, offers a new gold standard in medication adherence monitoring. The computer vision platform is being extended to develop a robust identification and authentication system for medication.

    Much like a voice recognition system, which understands what the user says, AiCure’s sophisticated, patented computer vision system visually understands what the user is doing.

    The software-based technology is uploaded onto a smartphone or tablet computer. The user follows a series of pre-determined steps that are instantly recognized and confirmed through the webcam.

    Automated DOT® [Directly Observed Therapy] confirms facial identity, medication dosage, correct ingestion, and time of ingestion. In addition, built-in data tools allow for ongoing patient-provider feedback; reminders in case of nonadherence; positive feedback; self-reported data by the patient; and therapy information – all designed to ensure real-time adherence monitoring and improved patient adherence over time.

  • Additional thoughts on the use of gravimetrics for I.V. compounding

    Scale in PECSeveral months ago I wrote about my thoughts on using gravimetrics for I.V. compounding. At the time I wasn’t convinced of the utility, but my thoughts on the matter have changed. Over the past several months I’ve had the opportunity to dig deeper and mull over my thoughts on the matter.

    There was a session at ASHP Midyear back in December titled New and Emerging Strategies for Minimizing Errors in I.V. Preparation: Focus on Safety and Workflow Efficiency. The presentation covered several topics, but one thing that caught my attention was data presented on error rates for the preparation of compounded sterile products (CSPs)1 and the benefits of using gravimetrics in the process. I was skeptical about some of the numbers that were presented. Data is only as good as how it was collected, what it’s compare against, and how it’s presented. One should always question the data, especially when it runs contrary to previously held beliefs.
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  • IV hood sensors [idea]

    I saw a commercial for the Honeywell Wi-Fi Smart Thermostat the other day. It’s a neat little gadget that reminded me of something that I’ve been thinking about for years.

    The requirements for monitoring, cleaning, and analyzing conditions in an IV clean room are enormous. To get a feel for what I’m talking about I would encourage you to take some time to read through the list of surface testing, air sampling, and end product testing required by USP <797> for pharmacies that compound sterile preparations (CSPs). It’s fairly extensive and complex.
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  • Cool Pharmacy Technology – WillCall Rx from SencorpWhite

    I had an interesting call with an account executive from SencorpWhite last week. He and I talked about several things, but one thing I found particularly interesting is something the company is doing in the outpatient pharmacy space with horizontal carousels. Carousels are neat technology for those that have a need for automated storage space, i.e. you’re “space challenged” in your pharmacy. When coupled with bar-code scanning technology carousels are a good way to manage all kinds of inventory in a pharmacy.

    The system from SencorpWhite is referred to as WillCall Rx and consists of several components designed to store and retrieve prescription items that have been filled and are ready for patient pickup. I’m familiar with the WillCall Rx system and have had the pleasure of seeing it up close and personal in two large outpatient pharmacies attached to large medical centers. It’s a neat concept.
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  • Cool Pharmacy Technology – Verification by MedKeeper

    I had an opportunity to spend some time at MedKeeper headquarters in Westminster, CO last week. I’ve worked with MedKeeper before, but this was the first time I had the opportunity to visit the facility and meet their team.

    MedKeeper is a company that makes several products for acute care pharmacy, specifically they develop software targeted at pharmacy operations. Some of you may know them for their medication tracking system, MedBoard.
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  • Pharmacy system integration appears to be on everyone’s mind

    I’ve noticed an interesting trend recently. Healthcare systems, and more specifically pharmacies, have started to understand the importance of having integrated systems. I realize that the concept of having various systems talk to one another isn’t new, but you’d be surprised at how poorly disparate systems within the pharmacy communicate. Automated packager from company “A”, medication tracking system from company “B”, inventory management from company “C”, and so on. These systems rarely utilize a single master database of information, instead relying on frequent manual updates to multiple databases. The result of such a system is often inaccurate information if you’re lucky, or outright errors if you’re not.

    integration
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  • Automated Medication Preparation for Chemotherapy [PP&P December 2013]

    The December 2013 issue Pharmacy Purchasing & Products features a Q&A session with Anne McDonnell, PharmD, BCOP; Caryn Belisle, RPh; and Josephine Leung, PharmD, MBA from Brigham and Women’s Hospital, Department of Pharmacy

    I had the opportunity to visit Brigham and Women’s Hospital earlier this year while doing some research for a project I’m working on. It’s a very interesting facility that makes use of a lot of pharmacy automation and technology. Based on what you read below you’d think that everything was perfect. What I saw was interesting, but far from perfection.

    Worth noting in the Q&A session is that the products being used are never defined, i.e. what technology is being used. There’s mention of a robot, but which robot? They speak of gravimetic analysis, but don’t say what system they’re referring to. I know because I’ve been there, but other people might like to know as well don’t you think?

    Here are some of the questions and responses I found particularly interesting in the PP&P article.
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  • Anesthesia Check – O.R. syringe labeling and medication tracking system

    Got a chance to see the new Anesthesia Check system from KitCheck while at ASHP Midyear. The system is designed using RFID and bar code technologies to provide safety for syringe labeling in the operating room (OR), as well as chain of custody and waste tracking for all medications used by anesthesia during surgery.
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