Dr. Tim Vanderveen, Vice President of the Center for Safety and Clinical Excellence for CareFusion, discusses trends in medication management at CareFusion’s Online Center for Safety. In his most recent post, Dr. Vanderveen, who has authored several patents in infusion technology and was one of the original creators of smart IV pumps – spotlights the 10-year anniversary of smart infusion pumps. He discusses how smart pumps have evolved and provides a glimpse into the future of medication safety.
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In February, we recognized the 10-year anniversary of “smart” infusion pumps – infusion devices with Dose Error Reduction Software (DERS).
I have often been asked why it took so long for manufactures to add “guardrails” into infusion pumps. The short answer is that until it was possible for hospitals to create in their pumps custom drug libraries and best practice drug limits, the idea of adding safety alerts was only a dream. Each time we heard about a death or injury due to an incorrectly programmed pump, we could only hope that caregivers would be more careful in the future. This was of little comfort knowing how easy it was to make a mistake and how vulnerable nurses were without a safety net.
The technological breakthrough was the flash EPROM – basically, a chip that could be programmed with a hospital-specific drug library. Because drugs may be used off-label and IV practices are often not standardized, infusion pump manufacturers began to market “dumb” pumps that hospitals could make “smart.” Thinking back to the first Alaris® smart pumps, it’s amazing that even the initially limited capabilities had such a game-changing impact on our industry. Suddenly, we were in the software business and working feverishly to expand pump safety features to meet the demands of early adopters. We helped hospitals interpret data collected from the near misses and good catches, and we worked with customers and thought leaders to reduce practice and library variation, fine tune drug limits and interpret what Dr. David Bates called the new “treasure trove” of infusion data that was stored in each pump.
Studies have shown the typical adoption cycle for new technology in hospitals averages 20-years and could be even longer in some cases. The adoption of smart IV pumps, however, is almost 70% after only 10 years. One fact that has accelerated smart pump adoption is analogous to air bags in automobiles –the safety features now come standard. And, the “good catches” that pump logs document are evidence that pumps with DERS have prevented many potentially serious and possibly fatal errors.
Over the past 10 years, we have made tremendous progress in creating a safety net for drug administration. Looking ahead, the focus will be on making infusion pumps part of a much larger medication ecosystem, where pumps inherently administer accurate doses, expanding guardrails to patient – not drug – specific capabilities.
Find out more at CareFusion’s Online Center for Safety.
Tuesday, February 28, 2012
Monday, February 20, 2012
From Trash to Technology: A better way to document supplies at the point of care
by Karen Conway on 2/20/2012 9:21 AM
Later today, I will climb on the plane and fly to Las Vegas to join 20 to 30 thousand of my colleagues in healthcare IT for the 2012 HIMSS Annual Conference and Exhibition. Sadly, once again this year, the role of the supply chain in meeting some of our most critical clinical and financial challenges in healthcare reform is absent from the agenda - with one notable exception. An impressive group of experts – from medicine and technology (including EMRs, clinical documentation, RFID, and system integration) will meet Wednesday afternoon at HIMSS to discuss the problems associated with inaccurate and incomplete clinical supply documentation at the point of use.
Research has shown that manual, duplicative and disjointed processes in the OR and other procedural suites result in more than $5 billion in waste each year in the US alone. To illustrate the point – while most likely the exception – a colleague recently told me about an OR where supply documentation consists of throwing packaging from supplies...
Read More »
Later today, I will climb on the plane and fly to Las Vegas to join 20 to 30 thousand of my colleagues in healthcare IT for the 2012 HIMSS Annual Conference and Exhibition. Sadly, once again this year, the role of the supply chain in meeting some of our most critical clinical and financial challenges in healthcare reform is absent from the agenda - with one notable exception. An impressive group of experts – from medicine and technology (including EMRs, clinical documentation, RFID, and system integration) will meet Wednesday afternoon at HIMSS to discuss the problems associated with inaccurate and incomplete clinical supply documentation at the point of use.
Research has shown that manual, duplicative and disjointed processes in the OR and other procedural suites result in more than $5 billion in waste each year in the US alone. To illustrate the point – while most likely the exception – a colleague recently told me about an OR where supply documentation consists of throwing packaging from supplies...
Read More »
Friday, April 22, 2011
Dim Bulbs
And the bright ideas emanating from the domed confines of Capitol Hill on how to fix healthcare and fuel reform just keep coming.
To wit, the federal government wants to impose a medical device excise tax on manufacturers to help finance the Patient Protection and Affordable Care Act of 2009. Surprisingly, this isn’t a shock because Sen. Max Baucus (D-MT) proposed it several years ago. Specifically, the ACA seeks to levy a tax “equal to 2.3 percent of the price for which a ‘taxable medical device’ is sold by a manufacturer, producer or importer.” This tax would apply to products made in 2013 and forward.
This has all the earmarkings and underpinnings of the government’s favored primary financing/fundraising mechanism, what we mere mortals among the unwashed masses would label a glorified legalized Ponzi scheme.
Like many disruptive pieces of legislation (Rep. Paul Ryan’s proposed Medicare and Medicaid reforms, anyone?) this one incites raucous debate and raises more questions than it answers.
Aside from whether it truly protects the patient or someone else in the chain and whether it really makes healthcare more affordable and for whom, the proposal’s language can be sliced and spread on wheat crackers. Yet more doctors than lawyers in Congress may not make a difference.
The proposal’s bubbly effervescence leaves the definition of manufacturer fuzzy and nebulous, but tries to persuade them and close the sale with good citizen talk about “shared responsibility” and dangling the prospect of income tax deductions.
Naturally, the providers are concerned that manufacturers merely would pass those additional costs to the hospitals that would then pass them on to the insurance companies and ultimately the patients themselves.
Save for explicitly interfering in capitalistic free enterprise by enacting rules that expressly and specifically prohibit such a shell game, taxpayers unfortunately will pay. While the government’s bailout of the banking and automotive industries may have established a precedent for the former, long-standing business and government history trumps it with latter. Good luck trying to change it.
Nevertheless, if everyone wants to benefit and prosper from a solid healthcare program that supposedly covers at least the basics for everyone then everyone should feel the growing and development pains as the fruit ripens.
Rather than belabor the foolhardiness and lambaste the silliness of this proposal any further, let’s make lemonade from this bushel of lemons with an alternatively bright idea.
Because nothing seems to please government bureaucrats more than to divert and shuffle funds from myriad projects and programs to keep all the bobbing buoys afloat, they simply should use the funds collected from healthcare providers and suppliers that run afoul of the law due to accounting improprieties, reimbursement tricks and product recalls. Within the last five years that amounts to hundreds of millions of dollars. And it’s all in the name of patient protection and safety anyway, right?
But if the government must tax (just like Tigger must bounce!), then let the government spin the tax closer to its intended message to the masses. The overarching theme interwoven throughout all healthcare reform measures is patient protection and safety to create and operate a system that delivers high quality service free of error. Although they stop short of calling it the silver bullet (count those denials among media reports since 2007) the primary weapon they promote as the saving grace is information technology.
So starting in 2013, impose a 2.3 percent income fee on every healthcare organization – provider, supplier (including manufacturer, distributor and service company) and payer that does not use IT for all healthcare financial transactions (that also would include patient records because they are tied to payments).
An 18-month lead time for adoption and implementation should be plenty even as the Food and Drug Administration mulls the eventual imposition of its Unique Device Identification (UDI) system. The feds could add a six-month grace period if it felt generosity or pity for procrastinators.
To operate as a taxpayer-funded, patient-focused accountable care organization you have to make meaningful use of rhetoric that reflects reality.
Comments?
To wit, the federal government wants to impose a medical device excise tax on manufacturers to help finance the Patient Protection and Affordable Care Act of 2009. Surprisingly, this isn’t a shock because Sen. Max Baucus (D-MT) proposed it several years ago. Specifically, the ACA seeks to levy a tax “equal to 2.3 percent of the price for which a ‘taxable medical device’ is sold by a manufacturer, producer or importer.” This tax would apply to products made in 2013 and forward.
This has all the earmarkings and underpinnings of the government’s favored primary financing/fundraising mechanism, what we mere mortals among the unwashed masses would label a glorified legalized Ponzi scheme.
Like many disruptive pieces of legislation (Rep. Paul Ryan’s proposed Medicare and Medicaid reforms, anyone?) this one incites raucous debate and raises more questions than it answers.
Aside from whether it truly protects the patient or someone else in the chain and whether it really makes healthcare more affordable and for whom, the proposal’s language can be sliced and spread on wheat crackers. Yet more doctors than lawyers in Congress may not make a difference.
The proposal’s bubbly effervescence leaves the definition of manufacturer fuzzy and nebulous, but tries to persuade them and close the sale with good citizen talk about “shared responsibility” and dangling the prospect of income tax deductions.
Naturally, the providers are concerned that manufacturers merely would pass those additional costs to the hospitals that would then pass them on to the insurance companies and ultimately the patients themselves.
Save for explicitly interfering in capitalistic free enterprise by enacting rules that expressly and specifically prohibit such a shell game, taxpayers unfortunately will pay. While the government’s bailout of the banking and automotive industries may have established a precedent for the former, long-standing business and government history trumps it with latter. Good luck trying to change it.
Nevertheless, if everyone wants to benefit and prosper from a solid healthcare program that supposedly covers at least the basics for everyone then everyone should feel the growing and development pains as the fruit ripens.
Rather than belabor the foolhardiness and lambaste the silliness of this proposal any further, let’s make lemonade from this bushel of lemons with an alternatively bright idea.
Because nothing seems to please government bureaucrats more than to divert and shuffle funds from myriad projects and programs to keep all the bobbing buoys afloat, they simply should use the funds collected from healthcare providers and suppliers that run afoul of the law due to accounting improprieties, reimbursement tricks and product recalls. Within the last five years that amounts to hundreds of millions of dollars. And it’s all in the name of patient protection and safety anyway, right?
But if the government must tax (just like Tigger must bounce!), then let the government spin the tax closer to its intended message to the masses. The overarching theme interwoven throughout all healthcare reform measures is patient protection and safety to create and operate a system that delivers high quality service free of error. Although they stop short of calling it the silver bullet (count those denials among media reports since 2007) the primary weapon they promote as the saving grace is information technology.
So starting in 2013, impose a 2.3 percent income fee on every healthcare organization – provider, supplier (including manufacturer, distributor and service company) and payer that does not use IT for all healthcare financial transactions (that also would include patient records because they are tied to payments).
An 18-month lead time for adoption and implementation should be plenty even as the Food and Drug Administration mulls the eventual imposition of its Unique Device Identification (UDI) system. The feds could add a six-month grace period if it felt generosity or pity for procrastinators.
To operate as a taxpayer-funded, patient-focused accountable care organization you have to make meaningful use of rhetoric that reflects reality.
Comments?
Wednesday, December 15, 2010
Glancing back at 2010
Reflecting on the last year’s events, here are 11 noteworthy happenings that piqued interest:
1. Obamacare perceptions.
2. ACOh please.
3. EHR goes LED.
4. Meaningful use.
5. Equipment spending.
6. Radiating personalities.
7. Mergers and acquisitions.
8. GLN sunrise date.
9. Uncalled-for recalls.
10. iGive up. iPhones and the new iPads gained prominence.
11. Florida elects former HCA chief Rick Scott as its new governor.
Use This Link to comment
1. Obamacare perceptions.
2. ACOh please.
3. EHR goes LED.
4. Meaningful use.
5. Equipment spending.
6. Radiating personalities.
7. Mergers and acquisitions.
8. GLN sunrise date.
9. Uncalled-for recalls.
10. iGive up. iPhones and the new iPads gained prominence.
11. Florida elects former HCA chief Rick Scott as its new governor.
Use This Link to comment
Wednesday, March 31, 2010
Rigorous Supply Chain Practices are not as Common in Healthcare – Why?
In a session at the GHX 2010 Supply Chain Summit, Brent Johnson, VP Supply Chain, Intermountain Healthcare said that rigorous supply chain practices are not being used in healthcare. Why?
Because of their not-for-profit presence that reduces the focus on running an efficient business; because of industry dependence upon GPOs & distributors for contract and supply chain management; lack of supply chain talent – pay & strategy opportunities are lacking; and hospital executives haven’t viewed traditional Materials Management as strategic – leaving them in the basement versus part of the C-Suite where they are in other industries.
Is this the same problem that your healthcare organizations are having?
Because of their not-for-profit presence that reduces the focus on running an efficient business; because of industry dependence upon GPOs & distributors for contract and supply chain management; lack of supply chain talent – pay & strategy opportunities are lacking; and hospital executives haven’t viewed traditional Materials Management as strategic – leaving them in the basement versus part of the C-Suite where they are in other industries.
Is this the same problem that your healthcare organizations are having?
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