Technology

In the mid-1800s, Lady Sarah Winchester spearheaded the building of the bizarre California mansion that bears her name. While she did have a flair for design, her spontaneous plans and the results proved chaotic. Staircases led nowhere. Many doors opened to walls or steep drops, and a few bathroom doors had windows. The Victorian anomaly may be fun to visit, but it would be frustrating to live in.

In the information age, harmful mistakes from illegible prescription orders were to be reduced with the adoption of new electronic ordering systems. Although it was expected to sweep the country, partly because of growing national concern over patient safety and futuristic technology, implementation of computerized provider order entry (CPOE) systems is low, and rising healthcare costs threaten to detour hospitals from making the investment.

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A few days after Hurricane Katrina devastated the Gulf Coast, when it became obvious that thousands of evacuees no longer had their medications or even access to their prescription records, federal officials called on pharmacy to help build an emergency Rx database. The result has been called a technology miracle.

Vending machines for medications may be an idea whose time has come, but they are creating a firestorm of controversy among pharmacists

Mercy Hospital, Miami, Fla., is using discounted Rxs to lure patients into a preventive healthcare program. The hospital estimates that 4,000 patients saved an average of $140 for the 10,000 program prescriptions filled during the first quarter of 2005.

Hospitals and pharmacies will be adding radio frequency identification (RFID) tags in the years ahead to curb drug counterfeiting. What is RFID? According to the Association for Automatic Identification and Mobility (AIM), a basic radio frequency identification, or RFID, system consists of three components: an antenna or coil, a transceiver (with decoder), and a transponder, which is also called an RF tag and is electronically programmed with unique information.

Befitting its name, the recent National Association of Chain Drug Stores' Pharmacy & Technology conference offered a mother lode of new high-tech thingamajigs to improve patient compliance, avoid drug interactions, and help pharmacists in other ways.

Pharmacists trying to keep up with all the proposed state and federal health technology legislation can check out Web sites created by the Healthcare Information and Management Systems Society (HIMSS).

New gee-whiz technologies are improving patients' compliance with their drug regimens

Athough moving at a glacial pace, widespread implementation of bedside bar-code medication administration is inevitable, according to industry analysts.

The next generation of "smart" IV pumps is getting smarter. The new systems that are in place are designed to guard more rigorously against errors of administration, dosing, drug interactions, and other issues.

Automated medicine machines are a growing trend in retail pharmacies, according to Todd Brown, MHP, R.Ph., associate clinical specialist and vice chair, department of pharmacy practice, school of pharmacy, Northeastern University, Boston. "The number of prescriptions being filled annually is increasing as the population ages, and pharmacies have experienced significant growth in prescription volume," he said.

The competition between RxHub and SureScripts to dominate the e-prescribing market is cooling as each of the companies copes with an increasingly strong demand for e-prescribing technology. Representatives from both companies say they are pursuing the technology and service offerings they know best, replacing rivalry with synergy by targeting different but complementary components of e-prescribing.

Automation governs medication-dispensing systems in many health systems, enhancing safety and efficiency-as long as the computers that operate the systems don&t crash. A growing trend in automation aggressively addresses this problem by allowing vendors to remotely monitor automation computer servers in real time, preventing crashes before pharmacists even know there&s a problem.

Given that errors involving intravenous medications may carry the greatest risk of morbidity and mortality, health professionals are welcoming the advent of smart pumps with programmable safety features that alert hospital staff to potential errors in IV infusions. Implementing such systems involves getting technology vendors, along with pharmacy, nursing, and medical staffs, to communicate with each other so that infusion systems and medical records systems work together.

At Saint Francis Hospital and Medical Center in Hartford, Conn., the pharmacy department has been ahead of the technology curve for quite some time compared with most other hospitals. That's evident from a visit Drug Topics editors paid recently to the hospital.

Acquisitions, integration, and point-of-care strategies were dominant technology themes at the 2005 ASHP Summer Meeting in Boston in June. Topping the headlines was Cerner Corp.'s acquisition of Bridge Medical Inc. The $11 million deal will substantially expand Cerner's presence in the bar-code market at a time when pressure from regulatory agencies is driving hospitals to reduce medication errors.

Pharmacists can sign up for a free e-mail service to keep abreast of what's happening with the Medicare Rx drug benefit.

Pharmacists can sign up for a free e-mail service to keep abreast of what's happening with the Medicare Rx drug benefit.

Despite all the hype on bar-code technology, less than 5% of the nation's hospitals have installed a bedside bar-code system, even though there is mounting evidence that the technology combined with a comprehensive medication management system can substantially reduce medication errors and improve overall patient safety.

The NationaThe National Council for Prescription Drug Programs will host two educational summits later this year. "Future Standards Under HIPAA and MMA: New & Unfinished Business" will be held Aug. 15 at the Westin Philadel- phia in Pennsylvania. "Innovation and the Prescription Drug Benefit" summit will take place Nov. 8 at the Hilton Long Beach in California.

The hardest part of installing a CPOE (computerized physician order entry) system may be getting the physicians to use it. A hospital can have chosen good software and hardware and may have all the technology in place, but no system will work until physicians start to use it.

Pharmacists who want to transfer their licenses to another state can now download the application directly from the Web site of the National Association of Boards of Pharmacy.

The improper programming of an intravenous pump is among the most common mistakes made at the patient's bedside. A decimal point in the wrong place could be catastrophic. But what if a physician's order were electronically transmitted from a point-of-care medication management system directly to the infusion device at the bedside, with a safety check feature that ensures the pump is programmed properly and consistent with the physician's order?

How do you increase the dispensing rate of generic prescription drugs in a state that's in the backyard of some of the largest name-brand pharmaceutical companies? That was the dilemma facing Horizon Blue Cross Blue Shield of New Jersey and Horizon Healthcare Services Inc., New Jersey's largest health insurer.

The National Council for Prescription Drug Programs (NCPDP) has created a new work group focused on the long-term care marketplace. NCPDP decided to set up WG14 after a focus group of industry representatives demonstrated a need for a single place where companies and associations can come together to seek solutions for long-term care transaction issues. These issues include prior authorization, coordination of benefits, compounded drugs, and home infusion billing.

Recognizing a need for healthcare systems to be able to evaluate employee attitudes about patient safety and quality improvements, the Medical Errors Workgroup of the Quality Interagency Coordination Task Force (QuIC) sponsored the development of a survey tool. The tool will help hospitals, and their departments, evaluate employees' support-or nonsupport-of safety and quality issues.