U.S. To Be Short on Pharmacists and High on Prescriptions by 2020

According to Reliable One Staffing Services, the United States will be 157,000 professionals short on pharmacists by 2020. There will be 7.2 billion prescriptions to be filled per year by 2020 also, according to the press release, and that is over two times the number of prescriptions in 2001.

The Reliable One press release indicates that the shortage of staffing is already evident in retail pharmacies by the employees' being harried, their schedules overly long, and the greater turn around time in filling the prescriptions.

Reliable One Staffing Services is trying to meet the needs of pharmacies nationwide by offering premium pay to new graduates, pharmacists nearing retirement and other pharmacists looking to earn extra income by accepting out of state assignments. Out of state assignments will require additional licensing expenses, according to Dale Hetrick, Operations Director at Reliable One Staffing Services, and that factor is one of the reasons for the extra monetary incentives.

Hetrick gave statistics that exemplified the growing U.S. replacement needs with the shortage of pharmacists. Recently, one Ohio client of Reliable One Staffing Services asked for professional pharmacy coverage for an average of 700 hours per week for two weeks in just one area surrounding a large city whereas a Utah client asked for an average of 250 hours per week for six weeks in just one metropolitan area.

The gap between the number of pharmacists and the geometrically increasing number of prescriptions is expecting to continue to rise, and the situation is expected to get worse before it gets better, according to the press release.

"Even one pharmacist taking on a single additional shift each week would make a difference," stated Hetrick. He further added, "None of us want to think about our aging parents or children going without essential medications because the local drugstore was shut down.."

The Media is instructed that more information about the shortage can be obtained by calling Mr. Dale Hetrick at 1-800-640-2070 or by visiting the Reliable One Staffing Services website (http://www.ross1.com ).

Reliable One Staffing Services is a nationwide staffing services for pharmacists and other medical professionals. Its headquarters are located in the Detroit metropolitan area of Bloomfield Hills, Michigan. On the website are documents related to OSHA such as a zipped file containing the OSHA training manual, Fire Hazards training, Electrical training, etc. There are also other training documents such as one for methamphetamine training. There are individual applications for differing professionals

Sources

August 18th, 2007, Reliable One Staffing Services Press Release

URL:

http://www.24-7pressrelease.com/view_press_release.php?rID=32196

Reliable One Staffing Services Website

URL:

http://www.ross1.com

Source

Philips awarded state-wide telehealth equipment GPO contract by the California Association for Health Services at Home (CAHSAH)

ANDOVER, MA, USA - (HealthTech Wire) - Royal Philips Electronics (NYSE: PHG; AEX: PHI) and the California Association for Health Services at Home (CAHSAH) announced today that Philips has been awarded a group purchasing organization (GPO) contract for telehealth products and services. CAHSAH is the leading statewide home care association in the U.S., representing more than 400 providers in California, and has selected Philips Consumer Healthcare Solutions as a GPO telehealth vendor for remote patient monitoring services.

Due to increasing interest from home health agencies in the use of technology to enhance the quality and efficiency of their patient care and patient education, CAHSAH has added telehealth equipment to its GPO program.

“Remote patient monitoring has the potential for changing how the home care industry does business. Telehealth offers the opportunity to address some of the global issues of home care providers simultaneously – staff shortage/ productivity and patient compliance/ wellness,” said CAHSAH President Joe Hafkenschiel.

Philips is offering a comprehensive telehealth program to CAHSAH members: wireless telemonitoring measurement devices, robust clinical content—including patient education, validated health surveys and risk assessment tools—as well as innovative pricing models and wide-ranging service delivery and implementation support. Also available are Data Monitoring Services, where Philips will verify patient data if an alert is triggered, and then notify agency staff about flagged patients who may require their intervention—enabling home care agencies to focus their resources on improving outcomes. In addition, Philips offers Patient Stratification services – telephone-based screening to help agencies stratify patients based on risk, identify care intervention opportunities, and determine which patients may be suitable candidates for telemonitoring.

“We are pleased to offer a comprehensive telehealth solution as a GPO vendor to CAHSAH, who has recognized the potential for remote monitoring and early intervention to decrease readmissions and emergency care,” said Mike Lemnitzer, senior director, for Philips Consumer Healthcare Solutions. “We look forward to working with CAHSAH to deliver a telehealth program designed around the needs of both clinicians and patients: wireless telemonitoring devices, robust web-based assessment tools, and validated clinical content. Philips is committed to offering the highest level of customer service and satisfaction to the members and the patients they serve.”

Philips Consumer Healthcare Solutions offers a range of telehealth solutions for home care and disease management: remote monitoring for patients with chronic conditions, risk assessment services, and Motiva interactive platform for patient education and self-management. Philips Lifeline provides medical alert services and senior living solutions to help enable independent living for older adults. For information about Philips telehealth solutions, visit www.medical.philips.com/goto/telemonitoring or email telemonitoring@philips.com.

About the California Association for Health Services at Home
CAHSAH is the leading statewide home care association in the nation and the voice of home care for the western United States. CAHSAH represents more than 400 members and 750 offices who are direct providers of health and supportive services and products in the home. Provider members represent Medicare-certified home health agencies, licensed home health agencies, hospices, private duty organizations, home medical equipment providers, home infusion pharmacy providers and interdisciplinary professional services. The affiliate members include computer companies, consulting firms, insurance providers, and suppliers. More information can be found at www.cahsah.org.

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UK College of Pharmacy Welcomes Class of 2011

LEXINGTON, Ky. (Aug. 22, 2007) − The University of Kentucky College of Pharmacy recently welcomed 132 new professional Pharm.D. students in the Class of 2011 during its formal white coat ceremony at the UK Singletary Center. The new class brings total enrollment in the nationally top-10 ranked pharmacy program to 490 — the most students in school history.

During the white coat ceremony, UK and state pharmacy leaders welcomed students to the profession as student pharmacists. Those bringing greetings included Dean Kenneth B. Roberts; third-year pharmacy student Lindsey Clark, chair of the Kentucky Alliance of Pharmacy Students; Ron Poole, president of the Kentucky Pharmacists Association; Joan Barker Haltom, president of the Kentucky Society of Health-System Pharmacists; Ralph Bouvette, executive director of the American Pharmacy Services Corporation; and Peter J. Orzali Jr., president of the Kentucky Board of Pharmacy.

William Lubawy, associate dean for academic affairs, will be master of ceremonies. Mandy Jones, clinical assistant professor, and Trenika Mitchell, lecturer and laboratory instructor, assisted students in the coating ceremony. Anne Policastri, associate director of experiential education and a member of the Kentucky Board of Pharmacy, led students in the reciting of the Pledge of Professionalism at the conclusion of the ceremony.

The new class has 110 in-state students and is comprised of 15 minority students and includes 78 females and 54 males. The academic qualifications of the incoming students remain superior with the overall grade point average of admitted students at 3.6 on a 4.0 scale and an average score of 85.5 percent on the PCAT (pharmacy college admission test).

“We are excited to welcome another class of quality young men and women as they embark on a challenging yet rewarding health care career in the profession of pharmacy,” said Roberts. This is the third year the college has admitted an incoming class of 132 students in an effort to reduce the pharmacist shortage in Kentucky. Additionally, in 2010, the college will move to a new 186,000 square foot, state-of-the-art academic and research building currently under construction. It is being built to accommodate class sizes of up to 200 students per class.

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Wanted: Students with compassion

Natalie D. Eddington — doctor, professor and chairwoman of the Department of Pharmaceutical Sciences in the University of Maryland School of Pharmacy — became the seventh dean of the School of Pharmacy on July 2.

At the school, she leads a successful research laboratory, working to better understand the role biopharmaceutics and pharmacokinetics play in drug therapy.

Eddington graduated summa cum laude with a bachelor’s degree in pharmacy from Howard University and earned her doctorate from the University of Maryland School of Pharmacy in 1989. She joined the faculty in 1991 and was appointed director of the Pharmacokinetics and Biopharmaceutics Laboratory in 1999.

In 2003, she became chairwoman of the School of Pharmacy’s Department of Pharmaceutical Sciences and guided the launch of the Center for Nano-medicine and Cellular Delivery.

In 2006, Eddington brokered a unique partnership with Rexahn Pharmaceuticals to develop cancer-fighting drugs and central nervous system therapies.

As dean, Eddington will guide the first year of satellite classes in Rockville at The Universities at Shady Grove.

Q Why would a student choose University of Maryland School of Pharmacy?

A We’ve placed an emphasis for our pharmacists to become more clinically trained — what they call pharmaco-therapists.

Maryland was one of the schools that pioneered the PharmD [Doctor of Pharmacy] program, and upwards of 98 percent of our graduates pass their pharmacy boards every year.

We have nationally renowned faculty members, who are leading the way in developing cutting-edge drugs.

Q What do you look for in a student?

A Of course, we have standards in terms of test scores and GPA.

But we’re also looking for maturity, professionalism and a sense of empathy, because we work with patients. Their clients are patients, and we are looking to improve their treatment.

Q What challenges lie ahead?

A We’re now addressing the pharmacist shortage. We’re creating a pharmacy facility in Rockville specifically to attract those residents who would like to stay in that area.

There are a lot of biotech firms in the area that would like to partner and work with our faculty.

Q How will distance technology incorporate students from Rockville into this year’s class?

A When I was a pharmacy student, we sat in a classroom and looked at transparencies.

Do you know what a transparency is? Today’s students are not going to learn like that.

Students of the iPod generation would rather learn by looking at you on their laptops, rather than looking at you in person. Already in the Dental School, the students choose to watch electronically.

Q What is important for your students to know about the future of pharmacy?

A My research was focused on the challenging issues of new drug development.

A lot of time a new compound works very well in the lab and very well in animals, but it’s not very readily bio-available.

You may take 250 milligrams, but only 10 milligrams get into your bloodstream and into your tissues. When they are taken by mouth, they are metabolized and biodegraded. We want to see if there are ways to avoid those types of effects, so drugs can reach the systems of the body.

Nanotechnology is something that we’re working on. You might have a drug that’s very effective on breast cancer, but during the treatment it’s highly toxic to other tissues. With nanotechnology, it can focus the treatment at the cellular level and minimize the other types of toxic effects.

We also have a computer-aided drug-design center. We’re using [3-D] computer models in trying to identify if a protein is important in the progression of a disease and in trying to stop the disease.

Q Where do you want to take the School of Pharmacy?

A I would like to see our school lead innovative pharmacy practices. For many years, there has been a discussion of providing an intellectual component into patient service.

We would like to develop policy whereby pharmacists are compensated not only for dispensing medications, but also for their intellectual services. We’re ranked eighth nationally. I want us to be in the top three in five to seven years.

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U.Md. School of Pharmacy goes wireless

The University of Maryland School of Pharmacy is doing its part to make a dent in the shortage of pharmacists affecting the state.

This fall, an additional 40 students will work toward their doctorates in pharmacy at The Universities at Shady Grove in Rockville, taking classes through a secure Web site.

“Montgomery County serves as an excellent foundation for our faculty and students, given the wealth of hospitals, community pharmacies, federal agencies and research companies in the area,” pharmacist Heather Brennan Congdon, assistant dean for Shady Grove, said in a statement.

Rockville students will gain clinical experience in community, hospital and other health care and research centers in Montgomery County and throughout the region.

Opening the school and guiding the expansion of the Baltimore City campus are foremost on the mind of Dean Natalie D. Eddington.

“It’s really exciting for me coming in as a new dean to open the inaugural year of the new pharmacy facility,” she said.

“As of today, we’re still the only pharmacy school in the state. We’re focused on developing the mission of our school.”

Students at both campuses will receive the same instruction from the same faculty members and graduate with the same degree.

Lectures at the school in Baltimore City will be digitally recorded, and faculty members at each campus will lead small-group discussions, provide laboratory instruction and mentor in state-of-the-art facilities.

Dr. Henri Manasse, executive vice president of the American Society of Health Systems Pharmacy in Bethesda, said he is delighted.

“Local access to its programs, faculty and students will be a boon to the many organizations like mine that rely on first-tier academic institutions not only for their graduates, but also for partnerships in the research and business arenas,” he said in a statement.

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Editorial: Health monitoring saves lives, money

New technologies that remotely collect and transmit health data are available; more are being developed every year. Devices can monitor vital signs and heart conditions of patients at home, for example, to alert doctors to problems and prevent or reduce costly office and hospital visits.

But while such life-enhancing, cost-efficient technology exists, too many patients can't use it. Currently, Medicare does not reimburse doctors for the time it takes to analyze and use the information. As a result, the system creates built-in incentives for costly office visits instead of less expensive remote monitoring.

It's a payment problem that should be fixed. To that end, Sen. Norm Coleman, R-Minn., introduced the Remote Monitoring Access Act. Under the proposal, a new Medicare reimbursement category would be created to reimburse physician time spent analyzing transmitted data. The benefit adjustment would cover distance management for congestive heart failure, cardiac arrhythmias, diabetes and sleep apnea -- ailments that affect millions of Americans and cost billions every year.

Closely monitoring a patient at home or at work reduces the need for face-to-face office visits. Distance monitoring minimizes unnecessary travel and missed work, and can improve quality of life for seniors. Those are big benefits for people living far from the nearest doctor or hospital. An estimated 40 percent of rural citizens live in medically underserved areas, with care an average of 30 miles or more away.

Such monitoring is not intended to completely replace office visits, but it can reduce the number to trips to the doctor and make necessary visits more productive. Closely watching a patient via technology might trigger a trip to the pharmacy rather than the hospital. And remote monitoring provides instant feedback so that interventions can happen quickly, which often saves lives.

Extending Medicare benefits to cover this part of remote monitoring won't be cheap. Senate staff estimates that the cost could run $330 million over five years. But if spending that much for monitoring can save an estimated 10 times as much in care management, office visits, hospitalizations and other related costs, then it is clearly worth the investment.

Not surprisingly, AdvaMed, a national coalition of medical technology companies (including Minnesota's Medtronic and St. Jude Medical) supports this expansion of reimbursable fees; these companies develop and manufacture much of the cutting-edge technology. But they also have an interest as employers and consumers. With over 18,000 Minnesota workers, they want the most cost-efficient care too. And if Medicare reimburses, more private insurers will as well.

Congress should approve this smart change to both improve care and make it more convenient and cost-effective.

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Medical imaging goes filmless

The days of doctors posting X-ray images on lighted white boards are over at Hilton Head Regional Medical Center.

Instead of shuffling through envelopes full of negatives and using magnifying glasses to search for problems, doctors and radiologists now can view the images on powerful computers with screen resolutions higher than the human eye can process.

With a click of the mouse, physicians can magnify images to pinpoint tiny abnormalities in image scans -- a feature not available with printouts. What's more, those physicians can do it all from their personal practices or even in their homes.

As of this week, doctors will access MRIs, X-rays, ultrasounds and CAT scans through the hospital's new $2 million picture archiving and communication systems, also known as PACS.

Photo: Dr. Robert Clodfelter demonstrates the magnification capabilities of the new PACS system Monday in an emergency room office at the Hilton Head Regional Medical Center. Kristin Goode | The Island Packet

Photo: Radiology technicians Tiffany Schweitzer, left, and Victoria Riddle ask Eric Miller, PACS administrator, a question Monday at the medical center. Kristin Goode | The Island Packet

Physicians said saving time is the most important benefit of the electronic system.

In the past, technicians would have to take the films, develop them and deliver them to the radiology department for doctors to view. That could take as long as two days.

Now, as soon as the images are shot, they're uploaded directly to a high-speed transmission line and loaded onto doctors' computers. The entire process can take less than an hour.

"Waiting," said Dr. Robert Hewes, a radiologist, "is the worst thing we go through. Patients want answers. We want to be able to provide them as fast as we can."

Dr. Robert Clodfelter, medical director of the Emergency Department, said having the images available electronically aids in diagnosis, saves valuable time in emergencies and allows doctors to consult with radiologists off site in real-time.

Through a secure, online system, images can be accessed remotely from any computer with Internet access.

A radiologist "can be at home on his personal computer and look at the exact same image I'm looking at," Clodfelter said. "There's really no comparison to the old white-board way. ... It's a good time to be practicing medicine."

It's part of Hilton Head Regional's move toward an entirely electronic patient data system, which began last year when all paper was removed from the Emergency Department.

Within the last 18 months, medical records, the pharmacy system and some patient files were moved to the electronic system. In time, charts for inpatients will be paperless as well, said hospital CEO Elizabeth Lamkin.

"This is one of a series of things we're doing to take the hospital into the Information Age," she said.

The PACS system is fairly common among South Carolina hospitals, said Patti Smoake, a spokeswoman with the state hospital association.

Coastal Carolina Medical Center in Hardeeville has been using an older version of the computerized systems for a couple of years.

Within a year, Tenet, the parent company of Coastal Carolina and Hilton Head Regional, will upgrade that system so physicians have remote access to the images.

Source

IT Solutions Can Improve an ASC’s Bottom Line

Case Study #1:

Preventing Errors and Waste

In the operating room (OR), clear communication is supremely important. Extensive time is spent gathering patient information, and ensuring all the appropriate preparations are made. But, miscommunications and mistakes still occur resulting in potential medical mishaps and lost revenues. Within the confines of OR suites, full utilization of information technology (IT) can help prevent such errors and waste. Numerous people, operating on countless systems, are responsible for gathering all the necessary data, and a system that creates centralized storage for medical information can prevent technology gaps that plague many hospitals.

Judy Swanson, RN, joined Texas Children’s Hospital as director of perioperative services in February 2001, and discovered that the department’s existing perioperative information system was full of holes. Texas Children’s Hospital in Houston, located in the Texas Medical Center, is a 697-bed licensed, internationally recognized pediatric hospital, and is the largest children’s hospital in the U.S. The Texas Children’s surgical staff operates 24 hours a day in three different sites, treating patients ranging from newborns to adults. Managing all of the department’s vital data in order to maintain the hospital’s high-standard of safety and keep costs in check is a great challenge. Swanson, who has managed ORs like Texas Children’s for more than 19 years, led the implementation of department-wide automation technology to meet and exceed this challenge.

The Challenge

For years the department had been collecting information in several different applications that required a significant amount of manual data entry and failed to provide comprehensive reports. Surgeon preference cards were stored in Microsoft Word, and could not be tracked or organized in a significant way. Intraoperative nursing documentation and inventory control were done by hand, often with unreadable handwriting. Nurses documented surgical cases and calculated OR charges manually, resulting in numerous clerical errors. Bits and pieces of information were scattered across a group of disconnected systems, and each staff member used a personal method for documenting procedures. The lack of an agreed upon nomenclature and a central location for patient and billing information contributed to an inefficient workflow and inaccurate data. The information the system did gather could not be effectively analyzed, because the system did not generate statistical reports.

Additionally, the department’s unproductive system of data capture resulted in missing or erroneous information in approximately 40 percent of patient records. The billing department returned all errors to the OR for correction. This forced nurses to waste valuable time trying to track down correct information and caused numerous reimbursement problems. The department averaged more than $100,000 per month in late charges, and the staff time lost to manual documentation and backtracking was priceless.

The department was in desperate need of a comprehensive system that would institute an agreed upon language for all procedures being documented, and provide a single, central location for all information, from patient record details to billing codes. After initial research, it was decided that an upgrade to an all-inclusive OR management system would improve the hospital’s clinical documentation and make good sense for the hospital’s bottom line. The hospital launched a wide-ranging search for software that would document all phases of surgical care, from scheduling to preoperative care, through the OR and on to recovery, critical care and billing. Additionally, the system needed to provide a complete electronic record of the surgical event that enabled easy data access to promote patient safety, and allowed for analysis of this data to ensure the best allocation of time and resources.

A Singular Solution

In 2001, after an extensive assessment of all viable software systems on the market, the hospital team selected CareSuite OR Manager, a total perioperative automation solution from Picis, a Wakefield, Mass.-based company that specializes in high-acuity-care automation technology. The hospital chose this system because they felt it met its diverse clinical and administrative needs. OR data management and electronic record keeping from preoperative care through surgery to recovery, were all available as part of the system. Also, it easily interfaced with the hospital’s IDX admissions system and allowed for a multitude of ways for staff to capture and report statistical data without requiring manual entry.

After selecting OR Manager, Swanson and the department staff set out to fully implement the system. An implementation team was established and they examined, in detail, the functionality of the system and then streamlined organizational processes to maximize use of its capabilities. The team standardized surgeon preference cards and implemented online nursing documentation in the system to provide a complete electronic patient record of surgery, thereby erasing the need for the time consuming, often inaccurate, manual methods previously employed. Additionally, they adopted routine accounting principles in the department and focused on getting charges right before transmitting to billing. This included development of accurate and well-tested billing rules in OR Manager that automatically calculate perioperative charges based upon time, procedures, supplies and other factors. The entire staff, from clinicians to accountants, was now speaking the same language, and the focus shifted to accuracy and correctness during input, thereby greatly reducing the need for reconciliation.

Results

Texas Children’s Hospital went live with the Picis system in September 2002, and nurses began scheduling cases in OR Manager while tracking supplies and recording exceptions online. The data was then transmitted directly to the hospital’s billing system. Charge capture was improved, and lost time was decreased. Due to increased accuracy, online documentation and data analysis, Texas Children’s was then able to manage an increased number of surgical cases and meet the goal to drop the bill promptly.

Now, dependable and accurate reports allow staff members to continually see what is working and to fix what is not. With reports from OR Manager, the evaluation of staff performance, overall costs, use of supplies and other activities in the department is substantially simplified. All such reports were unavailable with the department’s old surgical information system. Reports also track staff members having clinical documentation issues, and log quality information.

Supply utilization and procedure times of individual surgeons can also be reviewed to improve the accuracy and management of schedules and supplies. By introducing a physician office link, they were able to decentralize scheduling and allow surgeons to schedule cases at their convenience into their block time. Physicians enjoy the increased flexibility, and remote scheduling has saved Texas Children’s Hospital the equivalent of two full-time positions while enabling an increase in the volume of cases. The schedule is more accurate with the offices doing their own scheduling. Additionally, the offices now can provide insurance information through the system directly to the admissions department. This has resulted in fewer delays for insurance hold.

Sweeping change across a department is never easy, and implementation of a new automation technology is no exception. But, it was worth the hard work, and hospital administrators see the effects, so they are happy. Before implementing the Picis system, it took Texas Children at least five days to process the correct patient bill. Now, the hospital captures accurate clinical, financial and statistical data during each phase of surgical care, and within 12 to 24 hours of surgical care the process is complete.

Now, less than 2 percent of OR charges contain errors. Within four months of go-live, the hospital recognized significant benefits of using the system: faster billing; an 80 percent reduction in monthly late fees; a department-wide language for documentation; and centralized data storage and reporting tools for easy access to meaningful reports. The result has been enhanced resource planning, which has physicians and staff praising the system.

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Case Study #2:

Achieving a Complete Patient Experience

In March 2007, SourceMedical, a provider of information management solutions to the ambulatory surgery center (ASC), surgical hospital, practice, rehabilitation clinic and diagnostic imaging markets, announced a strategic partnership with InstyMeds. The union establishes SourceMedical as the exclusive provider of the SourcePlus PrescriptionCenter, a fully automated, ATMstyle dispensing system for outpatient prescription medication services to ASCs and surgical hospitals. The complete outpatient prescription medication system is ideal for facilities who want to provide to patients fast, accurate dispensing every time, with the added benefit of safety and the convenience of receiving full prescription medication at the point of discharge. The system provides facilities a “complete patient experience” and differentiates them in the market and allows patients to return to the comfort of their home as quickly as possible. It will also support underserved communities that lack 24/7 pharmacy availability.

Today’s surgical facilities are always looking for distinct advantages over the competition while providing patients with compelling benefits never before seen at the point-of-care. The SourcePlus PrescriptionCenter acts as a new profit center — increasing revenue while reducing medication errors and supporting patient convenience.

Waseca Medical Center, located in Waseca, Minn. and part of Mayo Health System, has become one of the first healthcare providers in the region to offer a unique service that gives patients the option to have their prescriptions filled 24-hours a day, seven days a week. This service targets not only same-day surgery, urgent care and emergency room patients, but is available to all patients.

“Our patients have told us they want to be able to fill their new prescriptions around the clock,” says Michael Milbrath, executive vice president of Waseca Medical Center. “This new system gives our patients access to a pharmacy that never closes. They may no longer have to drive somewhere else to have their prescriptions filled, especially after hours.”

Getting a prescription through SourcePlus PrescriptionCenter works much like getting a prescription through a pharmacy. The patient’s insurance information is gathered and entered into the computer during the admission process.

The healthcare provider enters a prescription and gives the patient a prescription order number. At the SourcePlus PrescriptionCenter dispenser, located near the emergency room at Waseca Medical Center, an automated touch screen walks the user through the ordering process. The patient enters the prescription number and their birth date for verification.

The patient then enters a credit card, debit card or cash to cover the cost of the prescription or co-pay. The medication is automatically labeled and a comprehensive bar code check system ensures that the patient gets the correct medication. In most cases the medication is dispensed in less than five minutes.

“Although many of the most common prescriptions can be filed, not every medication is available from the InstyMeds (SourcePlus PrescriptionCenter) machine,” says Kim Rux, pharmacy director at Waseca Medical Center. “The machine will also carry some over-the-counter medications. InstyMeds (SourcePlus PrescriptionCenter) was added with our patients in mind. They are charged the standard retail price without any added fees or charges.”

A telephone located near the dispenser provides a direct line to a support center staffed by pharmacists and pharmacy technicians 24-hours a day, seven days a week. This is especially helpful for patients who may have questions about their medications, including when they should be taken, how they should be stored and possible side effects, if any.

“With the nationwide shortage of pharmacists, this is one way Waseca Medical Center can truly meet the needs of our patients,” says Milbrath. “We believe this is a good step toward reducing the amount of time patients have to wait to get their prescriptions filled, as well as reducing the number of medication errors.”

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Case Study #3:

PNDS, Electronic Medical Record Systems and Data

The Perioperative Nursing Data Set (PNDS) is an American Nurses Association (ANA)-recognized nursing vocabulary developed by the Association of periOperative Registered Nurses (AORN) to describe nursing care for patients undergoing a surgical or other invasive procedure from preadmission to discharge. As a controlled vocabulary, PNDS enables nursing care to be documented in a standardized manner. This will allow for collection of reliable and valid clinical data on perioperative nurse sensitive outcomes resulting from nursing interventions during a surgical or invasive procedure. PNDS is applicable in various perioperative practice settings including both inpatient and ambulatory surgery environments. Standardized documentation allows nurses to evaluate care across caregivers and practice settings.

While PNDS can be used in both paper and electronic documentation, the real advantage comes when it is implemented in the electronic health record (EHR). The manner in which data is documented, captured and mined is a critical factor for improving healthcare. PNDS is designed for the EHR as it contains the framework of uniquely coded clinical terms and knowledge that describe patient care provided during a surgical or invasive procedure regardless of the setting.

Using standardized nomenclature such as PNDS in electronic documentation provides the vehicle for gathering and aggregating data for analysis. The impact of using and mining the PNDS data is on several levels:

• The immediate impact is for the clinical perioperative nurse in terms of enhanced communication and the linkage to clinical support
• Healthcare organizations benefit from effective standardized outcome reporting and quality improvement activities
• PNDS provides reliable and valid clinical data that can be used by researchers to uncover new clinical relationships

Electronic Medical Record Systems

As described above, the electronic medical record is much more than just the replacement of your paper charts. Early attempts at solving the problem of storage space and access gave way to a misconception that simply scanning paper records or moving your paper forms to electronic copies of those forms was an electronic medical record. What advantage would one of those formats have over a paper record in making the use of PNDS any more practical or efficient? The answer is, none whatsoever because the image of an electronically stored document is still just an image and not useable data.

If a facility has decided to standardize the terminology and nursing diagnosis information contained in the PNDS, an EMR is the most efficient way to implement the system. Before selecting an EMR you must ensure that the required functionality is present and that the developer of the EMR has acquired the proper licensing from AORN.

Functionality is a key to the efficient use by the nursing staff. A few of the major points to look for are:

• Does the EMR contain all the required structured data elements (SDAs)?
• Can you obtain the detailed explanations of the SDAs easily?
• Can you easily access information on interventions and recommended activities?
• Does the EMR allow for recording of nursing diagnosis codes?
• Are there standard reports in the EMR for reporting on outcomes and nursing diagnosis codes?

Some of the benefits resulting from integrating PNDS with an EMR are as follows:

• Nursing as a profession benefits from documentation of outcomes and comparisons to procedures completed with a reduced amount of nurse participation.
• The integration of PNDS into an EMR will permit the measurement of nursing full-time employees (FTEs) involved in a procedure directly to a CPT code. This will further support their value in a clinical setting.
• Direct access to PNDS within the EMR (the recommended practice) will help support real-time nursing decisions.
• Facilities will be able to provide more detailed outcome studies with less cost. Comparative studies using paper charts could take as much as one, possibly two additional FTEs.
• Patient safety is a top priority among any healthcare organization. This type of solution would help determine if the correct steps were followed should a negative outcome occur. It provides risk mitigation without sacrificing productivity.
• Submission of outcomes data supported by PNDS to AORN’s national database will assist in enhancing and supporting changing or modifying practices on a national level.
• Electronic access to intervention and recommended activities improves actual utilization and reduces FTE’s when compared to information stored in paper or book format.
• Electronic maintain of nursing diagnoses and other information allows for a more current data set than a once-a-year hardcopy update.

Your unique needs may require other components and functionality to be examined in making your decision on which EMR will best suit your needs. Keep in mind that moving from paper to a true EMR will change your work flow and some duties for your staff. However, you want to look at the full scope of what changes and what you gain in making your decision.

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Shortage Closes Another Pharmacy

Oswego (WSYR-TV) - The pharmacist shortage strikes again. This time, the P&C pharmacy in Oswego shut down for three days, because there was no one around to run it.

Pockets across the country are having the same problem we are: there are more prescriptions, the population is getting older, but there aren't enough pharmacists to handle the demand.

All Bill Bellow wanted to do was to get his wife's prescription filled.

“One of pharmacists had vacation and was gonna take it. This morning, I found out that vacation was schedule for many months.”

Bellow says the P&C pharmacy shut down Friday and Saturday. It’s usually closed Sundays.

“They have a responsibility to people who expect to be able to come here and get their medication.”

The National Association of Chain Drug Stores says there are 120,000 pharmacist positions at places like Kinney Drugs. 6,000 of those jobs are vacant. P&C's pharmacy isn't considered a chain drug store, but it's affected just the same.

Penn Traffic, P&C’s parent company, issued this statement: "We are striving to do everything possible to avoid any interruptions in service...however we are not immune to what is happening overall in the pharmacy industry with respect to shortages of available pharmacists. We are focused on ensuring coverage and minimizing inconvenience to our customers."

But Bellow was inconvenienced. He says if there was a simple note on the door, he would have made other arrangements.

“Mine turned out not to be life threatening, however it's just a matter of time until it is.”

Bellow says a pharmacist told him that several P&C pharmacies in the Syracuse area will be shutting down here and there, throughout this month because of vacation time. Penn Traffic didn't comment on that.

From Tuesday, July 30, 2007:

Camillus (WSYR-TV) - The Wegmans School of Pharmacy in Rochester is just about a year old.

The Albany College of Pharmacy has been growing: in enrollment, programs, and campus buildings. Both schools are working to help alleviate the shortfall of pharmacists.

We went to the Kinney Drugs in Camillus to talk with a local student about why she wants to go into the field.

Amanda Vincentini is on summer break, but she's still learning, behind the counter.

“You can fill prescriptions, fill medications, almost everything a pharmacist can do except the final check where they bag it and it's ready to go.”

Amanda has worked there on and off through college, but it isn't an official internship. But, in her 6th year, she'll work in a lot of pharmacies; she'll do six 5-week rotations.

“Some are in hospitals and some are in retail settings, and I think that's great cause you'll get so much more experience.”

It's a tough course, heavy on math and science, and six years is a long time to go to college, but what started as a suggestion from her mom, has grown into a love of the field.

“You work with patients. It’s awesome. They come in and leave, say thank you so much. That’s all it takes in your stressful day, you're like, wow, this is all worth it.”

In less than 2 years, Amanda will graduate and have her name on a plaque in record time.

“I'm going to get out of college and get a job right away, what a great thing to know.”

An average starting salary of about $100,000 doesn't hurt, either.

In addition to the Albany College of Pharmacy and the Wegmans School of Pharmacy, there's the Schwartz College of Pharmacy and Health at Long Island University, the SUNY Buffalo School of Pharmacy, and St. John's University College of Pharmacy.

From July 26, 2007:

DeWitt (WSYR-TV) - With summer vacations, you may notice your pharmacy is short-staffed.

There's a shortage of pharmacists nationwide and here in Central New York.

Earlier this month, a number of Eckerd Pharmacies closed down because too many pharmacists took vacation at the same time. (Click here to read that story)

Allen Krassenbaum could probably do his job with his eyes closed. He comes from a long line of pharmacists.

“I love pharmacy. Been doing it for 41 years, couldn't think of doing anything else. I love it.”

Allen's domain is behind a K-Mart pharmacy counter. But, he could work anywhere he wanted.

“We get calls from head hunters all the time, trying to pull us away from our stores. It’s very, very common.”

Pharmacies are busier than ever. The population is getting older. And, more than 1 billion prescriptions have been written in the past decade.

Plus, there are only five pharmacy colleges in New York State. That’s one less than when Allen was a student. And the curriculum is tougher; it's now a 6 year program.

“When I went, it was a 5 year program, then it was a 4. When my father went, a 3, my uncle, a 2 year program. My father bought a store from a man who never went to school and was a druggist.”

There isn't just the corner drug store anymore. Most grocery stores, Wal-Marts, and Targets all have pharmacies. In North Syracuse, if you go up the street from a P&C, you've got the Eckerd at Sweetheart Corners. If you go south on Route 11, there's another Eckerd.

According to the State Board of Pharmacy, there are only about 462 pharmacists to go around in Onondaga County. To fill the holes, retired pharmacists are still working part time, and floaters try to fill the gaps.

Despite the shortage, the Albany College of Pharmacy tells us they've more than doubled their graduating class in the past decade.

Some of those graduates, though, are becoming mail-order pharmacists, working through the internet.

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