Blogs

Could we apply this tool to our informatics practice?

By Dennis Tribble posted 01-31-2023
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I happened across another interesting blog entitled “ How simulation can overcome bias and objectively test design performance ” that I urge you to read. In this blog, two architects describe how their use of a simulation modeling tool allows them to test designs for physical space against the users and workflows that need to occur within them to overcome both the biases of the designers (design preconceptions) and the biases of those for whom they are designing. One sentence from this blog particularly struck me “ It can be difficult for clinicians to understand the implications of design decisions. Their perception of space is often more shaped by a memorable ...
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Seven Healthcare IT Trends to Watch

By Dennis Tribble posted 12-31-2022
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I happened across this blog on HIT Consultant describing seven trends in healthcare IT regarding the health IT operational burden. It is worthy of a read and made me think about how those burdens are reflected in pharmacy informatics. Most significantly, the blog presented a graphic that broke down IT operational burden into five categories and assigned a portion of operational burden to each, based on the responses of CIOs to a survey: Health IT resource retention and budget– 65% - are you seeing times when IT resources you require are just not available? Management of demand and prioritization while executing multiple initiatives – 11% - are pharmacy ...
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Why AI has not transformed healthcare

By Dennis Tribble posted 10-30-2022
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I just read an interesting article in Politico entitled “ Artificial intelligence was supposed to transform health care. It hasn’t . [1] ” The article highlights the prediction that AI capabilities would render the need for human radiologists obsolete and then notes this clearly has not happened. While the article does describe some real barriers, I would like to point out some very real issues about AI in healthcare (and other high-risk endeavors) that are fundamentally different than the commercial environments in which AI is clearly flourishing. Before we dive into that, let us review some high-level thoughts on why AI may be thriving in retail: ...
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Suggesting Enhancements to Your Software Vendor

By Dennis Tribble posted 10-01-2022
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With a little over 35 years on the vendor side of the software environment, I have read quite a few customer requests for software enhancements. Indeed, one of my current roles involves reviewing enhancement suggestions for software projects. Nothing in the list that follows is intended to keep you from suggesting changes to software. Enhancement requests represent an important conversation between you and your software vendor. The way those requests are phrased, however, can play an important role in how they are received and used by the vendor. As a result, I have some suggestions that may help users be more successful in getting their enhancements considered. ...
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More to say on a touchy subject

By Dennis Tribble posted 09-01-2022
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I was recently recruited to write a couple of thought pieces for a new on-line publication, one of which was entitled “ 7 Mistakes Pharmacies Make with Automation ”. It is a quick read and I encourage reviewing it first as it should make reading the rest of this clearer. My insights on the topic were constrained by word-count limits and it left me with additional thoughts I wanted to share on the subject. In re-reading the article after it was published on-line, my first thought was that I had things out of order. What was listed in the article as the 7 th mistake (Lack of an overall vision for automation) should have been the first due to its importance ...
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Dashboards

By Dennis Tribble posted 08-01-2022
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I reviewed an abstract for an article in JAMIA 1 evaluating the use of dashboards as clinical decision support tools. The short story is that they generally demonstrated little or no benefit when used as standalone tools, and mixed results when they were included with other automation tools depending on the disease state. I found myself thinking about my own experience with dashboards and what makes a dashboard likely to be useful. I have seen some that seem to be quite useful, while others not so much, sometimes to my surprise. Admittedly, most of my experience has been with dashboards as operational tools rather than as clinical tools, but I suspect that ...
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All Models are wrong; some are useful

By Dennis Tribble posted 07-01-2022
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I don’t know about you, but up until I wrote the blogs on More About AI and Real World Evidence , I had never heard of George Box. The latter contains a reference to a Wikipedia article that I wound up re-reading after a colleague of mine suggested there was a lot more to think about. The phrase that caught my attention in those discussions, attributed to Box, was “All models are wrong, but some are useful”. What turns out to be important for us, I think, are some of the examples that Box and others have cited about models we tend to treat as if they were factual representations of reality. PV = RT (where P = pressure, V = volume, T = temperature ...
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Why do we talk about preventing diversion?

By Dennis Tribble posted 06-01-2022
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Let me state up front that this is going to be a bit of a rant. I believe firmly that diversion is a problem, and that it is first and foremost a patient-safety problem. I also believe it is a problem that we can manage, but never solve, because its sources are beyond our control. First, addiction is not a matter of morals or will-power [1] . Addiction occurs because of a combination of psychological, physiological, and physical changes in the brain induced by these drugs that tends to enable and perpetuate addictive behavior. Addiction occurs as the result of a variety of factors that include environment, genetics, and development. Once it occurs, it becomes ...
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More About AI

By Dennis Tribble posted 04-01-2022
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Back in early February, I attended a webinar hosted by the Section on Pharmacy Informatics and Technology about Data Science and (by inference) artificial intelligence. It was actually pretty good and covered a lot of the ground that people need to know about how Data Science and Artificial Intelligence converge. It is available on the ASHP Learning Center, and I would recommend it for your viewing. The webinar brought to mind several things I find myself teaching repeatedly, so I am writing them here in the hope that others find them useful. They are the product of many hours spent training machine learning systems, and in trying to get data from disparate ...
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Thoughts on use of RFID in Medication Management

By Dennis Tribble posted 01-04-2022
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I have been working in automation for a little over 35 years now, and one thing I have long observed in our profession is a rapt interest in shiny new toys. Blockchain and RFID are two that come to mind. This is about RFID. I first considered some RFID applications years ago when Mark Neuenschwander was running the UnSummit and asked me to comment about potential uses of RFID as an alternative to bar codes in Bar Code Medication Administration (BCMA). More on that in a moment, but in preparing for that presentation, I learned a few things about RFID: The Wikipedia article on RFID seems reasonably complete. If you are not familiar with it, it might be ...
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Thoughts on CVs and Resumes

By Dennis Tribble posted 11-04-2021
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One of the activities I really enjoy is working with students and recent graduates on their curriculum vitae (CV)/resume documents. A lot of the feedback I get is that what helps most is a “50,000 -foot view” of what these documents are intended to achieve, which seems to be a new concept. So, I thought I would put these thoughts together in a blog to try to be helpful to others. Thank you to those students and new graduates who have entrusted me with your career goals and resumes. I have learned much of what follows from working with you. It is of first importance to remember that the purpose of either of these documents is not to land an appointment or ...
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COVID-19 Vaccine Mandates in Healthcare Settings

By Paul Abramowitz posted 08-03-2021
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Dear Colleagues, Pharmacists have been on the front lines of patient care throughout the pandemic, leading efforts to immunize millions of people across the nation and serving as medication use experts. Yet, in many communities, due to highly contagious variants, including the Delta variant, the number of cases of COVID-19, hospitalizations, and deaths are on the rise once again. ASHP, in collaboration with nearly 100 organizations and societies, including the American Medical Association and the American Nurses Association, took an important step by calling for all healthcare and long-term care employers to require their workers to receive the COVID-19 ...
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ASHP’s Advocacy to Protect the 340B Drug Pricing Program Yields Important HRSA Ruling

By Paul Abramowitz posted 05-25-2021
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Dear Colleagues, ASHP has been leading patient-focused efforts to protect the 340B Drug Pricing Program, and I am pleased to share with you that our steadfast advocacy has paid off. The Health Resources and Services Administration (HRSA), which manages the 340B program, recently announced that it has directed six drug manufacturers to comply with 340B pricing requirements or risk financial penalties. The 340B program is essential to many hospitals’ ability to provide healthcare services to vulnerable patients and communities, including providing access to medications for uninsured and underinsured patients. The 340B program is designed to allow providers ...
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OIG report card on DSCSA

By Dennis Tribble posted 05-21-2021
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For those of you who may have missed this (like I did), over a year ago the Office of the Inspector General (OIG) performed a study on the ability of the current compliance mechanisms for the Drug Supply Chain Security Act by tracing the movement of 44 drug products they characterized as high-risk "billed to Medicare Part D by high-risk dispensers" by reviewing tracing documents to "determine whether the information necessary to trace drugs was present and accurate". I recommend the document to your review. It is most enlightening. The observations were interesting: Ownership was traceable for 37 of the 44 selected drug products - the remaining 7 were ...
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ASHP Broadens Vaccine Confidence Outreach

By Paul Abramowitz posted 05-14-2021
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Dear Colleagues, This week’s announcement that the Food and Drug Administration has expanded the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine in adolescents 12 to 15 years of age, and the Centers for Disease Control and Prevention’s subsequent recommendation, is another encouraging step in our efforts to bring an end to this devastating pandemic. There are more opportunities than ever for pharmacists to lead vaccination programs, build community trust, and direct public education campaigns to protect our communities from COVID-19. Today, I want to share some important updates on the continued work that ASHP and our members are ...
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Important Wins in Expanding Access to Pharmacist Care

By Paul Abramowitz posted 04-22-2021
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Dear Colleagues, The COVID-19 pandemic’s impact has been immense in our communities and across the world. The public health crisis has also shined a critical light on the essential role of pharmacy practitioners, and helped to give way to some strong advocacy momentum as we work at the state and federal level to increase recognition of pharmacists as patient care providers. Expanding Medicare Patients’ Access to Pharmacists Today, I’m pleased to announce that provider status legislation that ASHP has long supported, the Pharmacy and Medically Underserved Area Enhancement Act, was reintroduced in Congress. The legislation would give millions of Medicare ...
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GTMRx Establishes National Task Force to Build Vaccine Confidence

By Paul Abramowitz posted 04-06-2021
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Dear Colleagues, As we pass the one-year mark of the global COVID-19 pandemic, it is encouraging to see some very positive signs as the availability of vaccines and the number of people who are receiving them increases. As of today, at least a dozen states have made COVID-19 vaccinations available to everyone 16 and over, with all remaining states announcing their plans to do the same. To support this positive momentum, it is vital that we as a healthcare community continue to work together to build widespread public confidence in the vaccines, as they are the key to ending the harm caused by COVID-19 and getting our lives back to normal. Today I am extremely ...
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Women History Month and Breaking the Glass Ceiling

By Sara White posted 03-21-2021
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Per Women’s History Month check out Melissa Murer Corrigan’s https://pointshistory.com/2021/03/12/zada-gloria-and-the-sisters-whm/ Her MelisRxScripts podcasts are excellent. You will find a recorded Conversations With Health Systems Most Influential Leaders Tribute to Gloria Francke on the ASHP Foundation’s Web site under the Leadership Development Tab, It plays on You Tube Breaking the “Glass Ceiling” Overcoming Invisible Barriers to Success from Mind Tools provides the following advice. Don't let who you are allow others to limit your horizons. Great strides have been made toward equality in the workplace but, even today, many people ...
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2021 Residency Match Day

By Paul Abramowitz posted 03-19-2021
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Dear Colleagues, The much-anticipated Match Day has arrived! On behalf of ASHP, congratulations to all who matched during Match Phase I of the 2021 ASHP Residency Matching Program! This year has been extraordinary as we all faced the continued challenges of the COVID-19 pandemic. For residency training programs, it required adapting in new and unique ways, including moving for the first time to virtual interviews as part of the application process. For learners, you may have experienced new adjustments in clinical learning environments. For all, it required new skills and being resilient to change. ASHP continues to be inspired by the creativity, adaptability, ...
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ASHP Marks 1-Year Anniversary of Pandemic with Efforts to Combat Vaccine Hesitancy

By Paul Abramowitz posted 03-11-2021
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Dear Colleagues, One year ago, the World Health Organization officially declared the COVID-19 outbreak a pandemic. Throughout the ensuing 12 months, our members have consistently stepped forward with relentless perseverance and dedication to provide exceptional patient care on the front lines, often facing immense challenges posed by evolving conditions and uncertain outcomes. ASHP staff, working remotely from home and without missing a beat, supported our members and all healthcare providers by developing evidence-based resources and tools to identify solutions and share knowledge to improve patient care. Today, we stand confident knowing that we have ...
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