Post Order Chaos

I recently decided to look back at all my blogs I have currently written and I realized something!  If I were an average individual reading my posts I would think this writer is all over the place!!!!! I wrote my posts in the order that I noticed different aspects of informatics in the hospital, but these topics definitely do not reflect the way an individual should learn about the topics I posted.  If you are new to pharmacy, I suggest that you at least read the following posts in this order:

1. What is informatics?
2. The Amazing MPI
3. DOSEEDGE
4. Pyxis
5. Nurse-to-Pharmacy communication

[All of the articles are independent factors of the pharmacy that don’t require any real sequential reading….as of right now ;-)]

If you have not read my posts already, I highly suggest that you read the previous ones in this order so you can understand how all of these functions intertwine. BUTTTTTT…. If you have already read them, please let me explain why they should be read in this order so I can clarify any loose ends.

 First of all, to understand anything about my posts, you must minimally acknowledge that something such as informatics does exist.  Since the post above specifically deal with the pharmacy, posts 2-5 is the general order things would actually occur.  Post 2 and 3 are similar in the fact that this is where everything starts depending on what medication is needed (FYI-there is also a unit dosing machine for oral liquids that I have not discussed). It explains what unit dosing is and how it’s able to happen.  Post 4 enables you, the reader, to have a more visual understanding of why we unit dose in the hospital.  In post 4, I did not fully explain that the Pyxis provides patient specific information.  In post 5, I also did not fully explain the aspects of communication the pilot system allows.  The image below was illustrated on post 5, but unless you zoom in, you probably did not read it.

Hopefully you now see how posts 4 and 5 relate.  A lot of the communication that is delivered through the pilot system is due to the medication not being available in the Pyxis.  At HIPPE, like other hospital pharmacies, we’re still developing. Since the Pyxis system is relatively new and it’s currently being adjusted to better suit individual hospital sections, we are striving to reach the goal of storing 90% of the needed medications in the Pyxis.  Until this 90% occurs, the notifications sent in though the pilot program will have a high influx rate of out of Pyxis notifications.

I hope I clarified any confusion I may have caused, but to be quite frank, I’m no expert in the field of pharmacy OR informatics, and since I’m still learning myself,  I cannot post things in a more sensible order if I don’t know they exist.  Please take your time in continuing reading my blogs so we can learn about pharmacy informatics together!

Pyxis

Have you ever watched a show like Nurse Jackie?  If so, you probably noticed that after the pharmacist got fired, they replaced him with a machine that dispenses individual unit dose medications to the nurses.  At HIPPE, this machine is called a ‘Pyxis,’ but it may have other names at other hospitals depending on the company who makes it.  In all actuality, a Pyxis cannot replace a pharmacist!  There are other machines that hospitals use to decrease the amount of pharmacy staff, but these machines are not a Pyxis nor would they be able to replace all pharmacists. 

            If you have never worked in a hospital, you probably have no idea what a Pyxis does even though you have seen it in a television show.  A Pyxis enables nurses to have easy access to medications in a unit dose form for their patients.  It may sound as if the pharmacist is obsolete if their not giving the medication to the nurses, but they’re not! The Pyxis actually enables pharmacist to primarily be used for their clinical knowledge in medications.  The Pyxis will NOT let a nurse take a medication out if a pharmacist has not approved the use of it for that SPECIFIC patient.  If the pharmacist finds something wrong with the doctors’ prescription or the nurses’ refill order, they can reject the order.   This is where the pharmacist gets to use all their schooling.  Previously when a doctor or nurse called in a medication, the pharmacist would have to rush to verify that the medication itself was correct, check its specific use for the patient, and then either deliver it directly to the nurse/patient or find someone to do it for them.  With the Pyxis, technicians have already brought commonly used medications that the pharmacists have already verified to the different floors.  So now when a medication is called in, all the pharmacist has to do is make sure its clinical use is the most optimum for the patient.

("Pharmacy automation," 2005)

            This week I had one of the pharmacy staff members introduce me to the Pyxis.  I asked how they decided which medications to stock in the Pyxis would be the best choice, and I received a great answer!  Although the pharmacy can easily create statistics to see which medications are used the most based on their past history, the Pyxis itself creates charts/graphs to show which medications are specifically used at each station in the hospital (since each section specializes in different segments of health).  The women in charge informed me that their goal is to have roughly 90% of all medications used at each station to be available in the Pyxis at any given time. 

            If you ever walk through a hospital and see a funky looking grey cabinet with a computer monitor on top of it, STOP and take a good look at it!  Think about how large a pharmacy must be to store ALL medications needed for ALL patients to try to minimize out of stock complications.  Now realize that the small area the Pyxis is taking up is storing roughly 90% of the medication variety that patients use on that floor.

I am personally amazed at what this technology does, but there is just too much to say considering the fact that I have never had access to it myself.  To learn more on the Pyxis, feel free to visit anyone of the links below!

RxAutomation

Carefusion

Pyxis training power point

Pictures from:

Pharmacy automation. (2005, November 06). Retrieved from

        http://www.uihealthcare.com/pharmacy/RxAutomation.html

Nurse-to-Pharmacy Communication

***PILOT***

            As I was reading up on tweets one day, I found an interesting article that discussed how a lot nurses spend more time with documentation then with their patients.  At HIPPE, the pharmacy is trying to improve the communication and safety of nurse-to-pharmacy communication.  They are starting to use a program called ‘Pilot’ so nurses can easily order refills, call in ‘retimes,’ or for any other reason if the medication is currently active in the ‘Med Charting’ system.

           

            This communication technique increases patient safety enormously!  If a nurse were to call in an order, there is a potential for medical errors by miscommunication and misunderstanding.  Also, sometimes the pharmacy is too busy and the nurse is put on hold, which decreases the time the nurse can be helping another patient.  If a nurse uses the pilot program, all the patient information is already in the system!  All the nurse needs to do is say specifically why she is contacting the pharmacy.  After I became familiar with the system, I found that I could complete the order within 30-45 seconds without any effort at all.  Since I work in the pharmacy, I could also see the orders sent in this way.  After reviewing several orders, I realized that it was much easier to understand the nurses this way then over the phone.  Also, now there is a HARD COPY DOCUMENTATION of the nurses directly contacting the pharmacy, so incase there is someone at fault for a specific situation, there is no “he said, she said” subjectivity. 

            Currently, it is my responsibility to train nurses at HIPPE how to use this program.  A third of the nurses already knew how to use it, but did not understand the importance.  Another third of the nurses absolutely loved the program and said with great enthusiasm that they used it “ALL THE TIME!”  The other third had never heard of it, but once I showed it to them, they all seemed highly impressed.  Some of the older nurses did not want to here about new technology and put up a fit.  After showing them one by one, I got responses such as “that was easy.”  I just looked at them and smiled and said “sure was!”  This system is great for nurses, pharmacists, but most of all, the PATIENT!  The hospital is all about patient safety and this system shows everything that everybody currently knows about that individual patient in one program.

Linkage

My sister visited her pharmacy the other week to pick up medication X.  Several weeks earlier she had visited a different pharmacy (in the same chain) to pick up medication Y.  About a week after taking both medications at the same time she experienced major gastrointestinal symptoms. 

            Several weeks later she visited her doctor to discuss her general health and the progression of her disease states.  She talked about her stomach issue and was informed by her doctor that medication X and Y together are known to cause serious adverse drug reactions.  After the appointment she called me to complain about the fact that her pharmacy missed the drug interaction of the two medications together.  My first response to her was “did you use to different pharmacy locations for the medication?”  She paused for several seconds and shouted back “YES!” Then she farther complained about her situation.

            When you or I visit a pharmacy, they create a record of what medications we’ve bought from them, what allergies we have, and any other important medical information they should know that would pertain to our medication therapy.  Now, if you went to Publix pharmacy and then visited a different Publix pharmacy or another chain all together, they would not be able to tell very important missing information because each stores profile contained for an individual is usually based on only that specific one store (even if it is part of a major chain). The point I’m trying to get it is the fact that the systems are not linked.  This is why pharmacies encourage patients to only use theirs and try to entice patients with coupons for transferred/new prescriptions.

            Unlike other pharmacies, I am employed by a major retail corporation that is developing a way to link their stores profiles together to account for patients using their chain in multiple locations.  (I will call this chain pharmacy MFR) Right now, MFR has stores that are located in the southern region of Florida linked in this system.  When a sick patient decides to visit the MFR I work at only because it’s on the way home from their doctors’ office, which is a different MFR then they usually go to, their home stores profile will be linked with mine.  This means I can safely confirm that the patient will most likely have few (if any) drug interactions, allergies, or medical issues due to complications of the newly prescribed medication with older ones. 

Systems like the one MFR employs are FANTASTIC!  They help increase patient compliance and pharmacist awareness.  MFR helps to assess a problem that would not have been caught otherwise.  Before MFR started using this new program last year, they would have to do a central search to see if the patient went to another MFR in the area.  Although they could see the other medications when ACTIVELY looking for them (ex. doing a transfer), it doesn’t mean that they would catch the drug interaction.

Although MFR is a great application, since it is new, it faces a multitude of problems.  For instance, I live in Davie and have all my prescriptions here.  When I go back to Orlando for a refill or new Rx, they are not linked with the Davie MFR because only limited regions have started using this program.  Also, if the program crashes from the main source, then all of the stores that are linked with it will stop working.  Since it is a relatively new program, their may be other problems that will arrive that have not occurred yet.

Although MFR is one of the first entering this new error of ‘linkage,’ just imagine if all pharmacies were linked together through a national database, and not just their own chains.  I know this sounds a lot like “big brother,” but how awesome would it be to know that the information you provided one pharmacy was linked with all others incase you ever need to use them (but would of course still abide by HIPPA).  This is my dream, and I truly believe this could easily become reality.

DOSEEDGE

I started out my day at HIPPE walking around the pharmacy asking anyone if they needed any help.  After several minutes, I gave up and saw one of the technicians using a machine I had never seen before.  By looking over his shoulder, I saw he was taking pictures of vials and IV solution bags.  Once he saw that I was interested he started to explain what he was doing.

Several months ago HIPPE received a machine called DOSEEDGE (Pharmacy Workflow Manager).  This machine enables technicians to take pictures of IV room medications and have the pharmacist approve them through a computer system instead of manually checking each one.  The technician is required to scan the medication and then take a picture of both sides of the vial and IV solution bag so the pharmacist can see all of the information; such as doses, names, and expiration dates.  When the pharmacist sees an error or cannot view what the picture is, he can choose that individual medication to be sent back because it allows tractability because it stores electronic records and provides audits of what was done.

You may be thinking that his makes a pharmacist lazy because he/she would only have to see the medication on a computer instead of in person.  Yes this technology does allow the pharmacist to stay comfortable in their office, but this program has many benefits!  For instance, DOSEEDGE helps eliminates medication errors through integrated drug verification and by providing dose and dilution calculations.  Also, if there is a need for an IV medication approval that is needed really fast, a pharmacist can verify it from anywhere as long as he/she is connected to the intranet. 

Since this is a new machine at HIPPE, I had to ask the obvious question “have there been any problems with it?”  Although the technician did say yes, the problems he described seemed minuscule.  He reported problems such as picture imaging and generic malfunctions of the use of the machine itself (ex. freezing).  From what I have read about this program, it seems to be safe, cost effective, and an efficient addition to pharmacy informatics. 

DOSEEDGE:

STEP 1-Use the touch screen to prepare the dose and the label will print

STEP 2-Scan the product (it will alert you if it is wrong)

STEP 3-Scan the label and attach it to the product

STEP 4-Draw up each ingredient

STEP 5-Take a picture of the vial and syringe

STEP 6-Make sure the computer has a clear image

STEP 7-Inject the ingredients into the final dose

STEP 8-Take an image of the final dose and scan the label again to finish

Doseedge. (2010). Retrieved from http://www.baxa.com/doseedge/

FACEBOOK: Social or Professional...OR Can it be Both?

The other day I was working at HIPPE with the slowest computer EVER!!! This computer would only let me type a single word ever five minutes.  So I decided to take out my iPod and visit the infamous Facebook.  After several minutes of catching up on the world I once knew before school started, I remembered a news report I had heard several weeks ago.  The news discussed how doctors were using Facebook to connect with patients.  You may be thinking how great this is, doctors and patients connecting on a personal level… But is this great? Does it abide by HIPPA? And is anyone documenting what they’re saying to each other back and forth????  These are just some of my questions.

Personally, I have learned NOT to use a social network to connect with people in my profession who really aren’t my friends because it can backfire.   When is a patient considered a friend and no longer a client?  Doctors are not only using Facebook as a way to connect on a more personal level with their patients, but they’re also using it to distribute medical information.  Personally, I find that splendid that a doctor would take his/her time to update patients on information.  Some doctors take distribution of general medical information a step farther.  By this, I mean that some doctors actually hold Q & A’s on their profile and talk about common questions their patients ask about during visits.  There is a thin boundary between distributing general medical information and personal information. 

What were to happen if a doctor saw a female patient with herpes, and right after she left his office he goes on his Facebook profile and posts a status update about reminding people to be cautious of sexually transmitted infections (STIs).  As this women walks out of his office, another patient in the waiting room sees the update and automatically believes Dr. Social is talking about her.  Using Facebook in a professional matter may not be the best idea for any career.  Medical professionals need to be very cautious on what they say about medical cases because it is easy to slip and violate HIPPA. 

Although Facebook can be used as a professional network, it is still looked at as a social network.  Ironically, socializing about medical issues can help deliver a cure even without a doctor.  For instance, last year during finals I was sitting in my room studying while going crazy and itching EVERYWHERE!  I thought stress was tarring me apart as I broke out into the itchiest rash I have ever had.  As I procrastinated, I went on my Facebook account and typed something along the lines “I CAN’T STOP ITCHING” on my profile.  This may not have been the smartest idea after viewing many of the horrific comments I received from ‘friends.’  BUT, one comment from a close friend said “me two!”  It was then we both realized why we were both ridiculously itchy.  It had nothing at all to do with stress.  The past week, it was Thanksgiving, so we decided to give ‘thanks’ by help cleaning out a park.  The park decided to give ‘thanks’ back by giving us the gift of allergic dermatitis from the plants we touched.  We both ended up receiving a steroidal cream and an antihistamine to take care of the problem.  If I had not posted this status on Facebook, the problem would have persisted longer because the doctor I visited proscribed me a medication for scabies….AND IT WAS NOTHING LIKE SCABIES!!!

In the end, it is really up to the patient whether they are ‘ok’ with their personal information being shared.  Doctors need to be cautious what they post and need to continue to abide by professional regulations.  Just remember, if you think you may be revealing too much personal information, you probably are, SO DON’T POST IT!

ISMP

Novolin/Novolog…Ephedrine/Epinephrine…Zyprexa/Zyrtec

How often do you read something and assume a word is something else?

            This may not happen to you, but it happens to me all of the time!  For example, on many tests, I will read correct instead of incorrect.  Doing this really upsets me because I miss the answer unless I notice it when I go through the test a second time.  I now try to CIRCLE those words that I easily misread when I catch them so I know to look back and see if what I read was correct.

            In the pharmacy, everyday is a test. If you and/or I fail to recognize something as minute as a one or two letter word differences, it could mean the end in a patients life.  Since so many medication names sound and/or look alike, it is beyond easy to grab the wrong one (especially when working at a fast paced).  Sadly, mistakes like this happen all the time and it then becomes the pharmacist job to do that double checking. 

The Institute for Safe Medication Practice (ISMP) tries to enable a safer practice environment for pharmacies.  One of the things they try to implement is proper labeling of medications of the look/sound-alike medications by using TALL man lettering (aka capital letters where the names differ).  Although there are tons of people who are lucky enough to rarely misread information, for the ones who are (like myself), these guidelines make working in the pharmacy so much safer.  It is up to pharmacy to implement the use of those labels that follow the guidelines.  This was my job yesterday.  I was in charge of changing all of the labels that stored oral medication to have matching labels that were easy to read based on ISMP guidelines. 

After a half an hour of typing the labels based off the old ones, I realized there were a lot of spelling errors and brand/generic name was missing.  For some of these medications that I already typed, I started pulling the bottles out of the bins to find the correct information (which not all of them had).  All of the sudden ‘POOF’ I had an epiphany.  I reached into my white coat and pulled out my iPod.  I started plugging in different medications in Epocrates and getting all of the answers I wanted.  (I could view all the brand/generic names, doses, use etc.) With the help of ISMP and Epocrates, I was able to contribute to the safe medical distribution of HIPPE.  Currently, my iPod has come in use for fun, home work, pharmacy knowledge, and now making a safer environment for patients.  It’s crazy to think that a tool that can do all of this fits right into my pocket.  Today’s use of technology in medication will save tomorrow’s patient.

Barium Form

At 8:30 A.M. I walked into HIPPE and started checking expiration dates of medications.

At 9:30 A.M. My preceptor walked in and told me that he needed a form that complied with HIPPA, the Board of Pharmacy, and Florida state laws that would enable a more efficient distribution of a Barium fluid. 

Previously at HIPPE, if a patient were to have an MRI or CT scan, they would need to pick up a barium fluid from the hospital pharmacy a day before the test.  There is no outpatient pharmacy at HIPPE, so the patients typically had to wait an hour to receive the prescription.  My preceptor wanted to allow the Ct scan center in the hospital that gave the tests to also be able to distribute the medication.  If you’ve ever received a medication from a pharmacy, you should have noticed that a paper came along with it.  It is mandatory that all pharmacies distribute this paper with all medications.  The information on it should contain ADRs, drug name, use, and directions.  The CT Scan center of the pharmacy had already been handing out a form with directions on it.  It was now my job to create a form the combined the majority of the previous forms information plus all other required information on ONE PAGE.  

            The pharmacist gave me 6 pages of information and told me he needed it done by 11 A.M. (it was now already 10 A.M.).  I had to determine what information was important out of all the 6 pages.  Just an FYI, but I really don’t know that much about pharmacy law, so I was quite skeptical about leaving out certain information.  By 11 A.M. exactly, I had finished and I quickly rushed it over to the pharmacist where he had already started to have a meeting on it.  I had to cut out a lot of common/minor side effects, simplify the do not take this medication if… section to “Do not use if you have had an allergic reaction to barium and make sure your doctor is aware of the patients medical history prior to all medication use.”  The only real side effect information that was left in there were the ones that a doctor needed to be called about ASAP.  This final form now just consisted of a brief information guide on what to know and really not much more. Now the pharmacist is working on a generic label that can be pre-printed and slapped on by the CT scan staff so it can be distributed to them without walking anywhere near the pharmacy.

            You may be asking yourself, what does this have to do with health informatics? Well…besides the grand idea that this process is now going to make the process more efficient, it will be distributing information to the patient that they must receive/know.   This new form will make the process of the pharmacy less in charged of the barium fluid in just about everyway.  All the pharmacy will need to do is collect the signatures, prescriptions, and carbon copy labels (which will all come after the fact that the barium has left the hospital).  This process allows for optimum distribution of the barium with one great problem, the form doesn’t contain ALL the information.  If you ever got one of those papers from CVS/Walgreens with all the information, you probably never even opened it, BUT, you had the option to review all it.  With this form, only SOME of the information is provided.  I didn’t include when that medication shouldn’t be used because the patient SHOULD have told the physician before hand.  What if the patient didn’t want to disclose information? Before, the patient would have seen not to take it if…., but now, they won’t know unless they actually go to a website and review it.  I can’t tell you if this form is more beneficial or detrimental to the patient, but I can tell you one thing.  By only providing the important information, the patient will probably now actually take the time to look at those few sentences and really take it all in. 

What do you think?  Would you rather be provided ALL the information OR would you rather just get what YOU NEED TO KNOW?

Tappa-Tappa-Tappa

Today’s knowledge is literally at our fingertips!  Everything you’ve ever wondered about is just a single ‘tap’ away.  Like many people, when I was little I didn’t see the point in knowing how to add, subtract, multiply etc. in my head because I could always have a calculator with me.  Not that I found these problems difficult, I just didn’t understand the concept of needing to know how to answer the problem without having it be 100% correct with a calculator.  Today, I feel like I could argue the same thing with just about every subject.

Thanks to technology such as BlackBerry’s, Smart phones, and Macs notorious iPod, information on just about anything and everything we’ve ever wanted to know if just a ‘tap’ away.  Instead of now clicking buttons, we just now tap the screen and ‘poof’, there’s my answer.  Recently, my friend purchased a Mac computer and with their new purchasing deals, she received a free iPod touch.  Since she already had an iPod phone, she sold me the touch for half the price.  I didn’t really care to buy it, I actually spent a month contemplating on whether it was worth it or not (since I knew I would probably drop it in the toilet or smash it on the ground by accident within the next year).  Long story short, I bought the iPod touch, and with the help of my fantastic boyfriend, I added such applications (aka apps) to the device such as MPR (monthly prescribing reference), Epocrates, gFlash, and so much more. With MPR and Epocrates, most of the information about medications that I need to know about are now just a single tap away.

("Med gadget," 2010)

Our world is changing, but something’s will always stay the same.  I could argue ‘what’s the point in me memorizing EVERY DOSE, ADR, MOA, DI, CI, INDICATION, AND NAME OF EVERY SINGLE MEDICATION…. ‘WHY WHY WHY???,’ but in reality, I wont because I know the point.  The point is, ANYONE and EVERYONE has the ability to look up the same information that I do.  So when someone comes to the pharmacy and asks me a particular question about a specific drug, and I need to grab my iPod to answer them, I will be making the entire field of pharmacy look like an overpaid foolish profession.  It is my responsibility to know everything that I can possibly know about all prescribed AND over the counter medications.  Also, there is information gaps within these programs, and as a pharmacist, I need to know why certain ADR (for example) will happen, and not just that ‘they may’ happen.  At some point, I will have to look things up because as the world changes, the information we have on certain medications will change and new medications will be developed.  This is what makes the applications so amazing.  They periodically update themselves!  All I have to do is sit back and tap the button that pops up sporadically when it lets me know it’s ready to add the new version/information.

In my pharmacy lab class at NOVA, we have a final that is open notes.  I asked the teacher about using the computer and he basically told me that wasn’t allowed.  He had asked his supervisor several years ago about using them, and the reason we weren’t allowed to was because not everyone had the ability to use one so it wouldn’t be fair to everyone in the class (considering that there’s only 1 computer for 4 students).  After he explained this to me, I grinned and said ‘well, now just about everyone in the class has one of these (as I pulled out my iPod).  To my surprise, he looked at me and actually agreed and thought that was a great point.  A week later, he announced to the entire class that now during the lab practical we are allowed to use such applications on our iPods, phones etc. but not on the in class test.  When he announced this information, I was kind of disturbed because I felt like I should really know EVERYTHING.  Several minutes later, I then realized that this all made sense.  It’s not fair if a student got the ONE SINGLE medication that they couldn’t remember even though this student knows everything else.  If this happened in the pharmacy, the pharmacist could look it up in a book (just like students did in past practicals).  Yesterdays advantage of having access to such books is today’s weakness because the books are so inefficient compared to using a program such as Epocrates. We are now living in such a fast pace world that we expect the answer in seconds.  People treat the pharmacy like McDonalds as they pull through the drive through, hand me their order and shout at my face “GIVE IT TO ME NOW.” It only makes sense to have a practical like it would actually be like in the REAL WORLD, and in the real world, if you’re not efficient, you can get fired.

Images from:

Med gadget. (2010, February 19). Retrieved from http://medgadget.com/archives/2010/02/2009_medical_weblog_awards_sponsored_by_epocrates_meet_the_winners.html

The Amazing MPI

                Currently I am working in a nearby hospital pharmacy for my IPPE site.  Unlike retail pharmacies (CVS, Walgreens, etc.), most hospitals, including mine, dispense medication by unit dosing.  Unit dosing is a technique that enables efficient and accurate dispensing of a single dose to the patient, in a non-reusable container.  Before I started working at this hospital that I will call ‘HIPPE,’ I thought that these unit dose packages came from the manufacturer.  In all actuality, HIPPE has a machine called a ‘MPI’ that packages individual pills itself.  To operate the MPI, a technician finds a medication that needs more unit dose packages, grabs the bottle of that medication, types the information in the computer, inserts each pill individually in a little slot, turns on the machine, logs what they filled, and then it is the pharmacists job to check over the medication and make sure all the data lines up.  The packaging of the unit dose medications at HIPPE has one side that says the strength, NDC, medication, etc., while the other side is a ‘see threw’ orange plastic.  Since you probably have not had the experience of seeing what the unit dose medications look like at HIPPE, it personally reminds me of going to Costco and getting a gummy vitamin sample that was packaged all alone with a tiny paper of information on inside.  

                                                           ("opack 150/6 automated," )

                The invention of the MPI is absolutely AWESOME!  It allows for a huge decrease in medical errors because each individual pill contains all the information on it that traces it back to the very single bottle it came from. Personally, I have noticed some possible errors this machine could cause.  Just imagine if a technician typed up the correct information for one medication, but accidently filled it with another ‘look alike’ pill.  When the pharmacist receives the pills to verify, hopefully he/she would catch this mistake.  I say hopefully, because if the pill looks similar to the other medication, it may be difficult to notice any differences because the orange plastic is very difficult to see the medications detail (unless it is opened).  I’m not sure because I never thought about this, but hopefully the pharmacist opens up at least 1 unit dose container to make sure it is the right pill; if it was a different medication, could  you imagine all the possible medical errors? Or on the other hand, what if only one of the unit dose containers got filled with the wrong medication?  Will the pharmacist catch it then, or will they notice when it goes out to the patient? (This is all just hypothetical FYI)

                                                              ("The changing faces," 2006)

                In my previous blog I told you that I’m not great with technology.  I didn’t mention that I happen to define Murphy’s Law as well.  For some reason, if it can happen, it just will!  Anyways, my second day at HIPPE one of the student technicians introduced me to the ­­­MPI and she demonstrated how to use it.  I was extremely fascinated and thought of all the fun things that could be done with this machine (like individually wrapping candy, or making funny labels like the ones they have at Spencers; FYI, I wouldn’t really do this, I just like to think about doing it).  Next thing I know, the machine stopped working correctly.  It ran out of the orange plastic film, so a technician had to come over and change it for us.  The student technician continued to fill several more pills of medication ‘Z.’  As the pills went through the machine, some of the labels were cut off in the wrong area, multiple Zs were put in one package or the packages had no Zs at all, and some Zs were even crushed.  In the end, the MPI wasted probably about 10 pills and probably about 30 potential labels and orange film backings.  If this happens often (which I don’t believe it does), is unit dosing really more efficient?? When it comes down to filling the actual medication within the pharmacy, the technician grabs a unit dosed package, scans it, puts however many the order needs in a bag, and sends it off to the pharmacist.  If the end product is going straight to the patient, does all the extra sequences in filling this medication make it worth it?  YES, it does!  If all goes right, each pill is INDIVIDUALLY AND CORRECTLY LABELED.  With all the errors this decreases, including patient compliance errors, just think of the decrease in costs due to medication errors alone. 

Images from:

opack 150/6 automated blister packaging machine. (n.d.). Retrieved from 

        http://www.pharmacyautomationsupplies.com/products.asp?dept=1106

The changing faces of unit-dose. (2006, March 3). Retrieved from

      http://www.patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2006/Mar3(1)/Pages/07.aspx

What is Informatics?

Hi, my name is Mariel and this is my first blog ever.  My dad is an engineer, and when I was ~7 years old (in the early 1990’s) my house actually contained not one, but several computers.  In fact, my father worked on some of the original computers, the ones that were so large they took up an entire room and were only useful to do a complex math problem.  This being said, you may think that I’m computer savvy because I’ve had such a great opportunity to learn and experience new technology as it is invented.  WRONG! To be honest, I hate trying to learn how to use technology.  I get upset and cranky when I can’t figure something out and I always want to end up throwing or hitting whatever I’m using. 

When I first found out about blogging several years ago, I thought to myself “really??? I never want random people to read my thoughts.”  A couple of years later, twitter came out and then I thought “oh my g-d, can people just get a life and interact in person?”  Now, I’m in a class called ‘consumer health informatics’ where it’s actually an assignment to post blogs and tweets.  After learning about the subject, I realized blogging/tweeting can be so much more then a random person letting off steam.  That being said, this blog site will be based on my interaction on the things I come across in pharmacy that deals with ‘informatics.’

To be quite frank, I still don’t really understand the definition of “health informatics,” so if I say something wrong or off topic, please, PLEASE, feel free to let me know! And for those of you who are reading this (if anyone is reading this at all), the definition of health informatics is the "scientific field that deals with biomedical information, data, and knowledge - their storage, retrieval, and optimal use for problem solving and decision making. It accordingly touches on all basic and applied fields in biomedical science and is closely tied to modern information technologies, notably in the areas of computing and communication (medical computer science)" ("Health Informatics").

            When I think of informatics, not much comes to mind.  In my blogs to come, I will be introducing you to pharmacy informatics that I find on a daily basis.  Since I currently don’t quite understand the definition of informatics, by searching for tools that fall in this category, I will hopefully open a door to a greater understanding/appreciation of technology and the knowledge that wouldn’t be as accessible otherwise.

Articles cited: "Open Clinical." Health Informatics. Richard Thomson, 15 Feb 2010. Web. 18 Sep 2010. <http://www.openclinical.org/healthinformatics.html>.