Blogs

What should good manufacturing processes be for software as a medical device (SaMD)?

By Dennis Tribble posted 9 days ago
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This may be a duplicate as I thought I had scheduled it once before, but it isn't showing up in my blog or my schedule. I had a chance to read a blog today describing how our basic concept of device good manufacturing practices needs to be enhanced to deal with the increasing presence of medical devices that consist solely of software. I must confess I was expecting this discussion to be about “loosening the controls” for software and was pleasantly surprised to see a more serious discussion about how to interpret the requirements found in ISO 13485 (the fundamental basis of cGMP for devices) for application to software systems. For those of you who aren’t ...
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ASHP PELE SAG Blog - How to Help a Pharmacy Resident Overcome Imposter Syndrome

By Deanna Fliehman posted 28 days ago
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What is Imposter Syndrome? Impostor syndrome is a psychological pattern of successful individuals attributing their achievements to luck, rather than their own intellect, performance, and skill. 1-5 High-performing individuals feel like they are “impostors,” in their current positions and stress about being discovered as a fraud. 1,2 People who experience impostor syndrome doubt their knowledge, competence, and abilities. 1 Do pharmacy residents experience imposter syndrome? The literature has consistently shown that pharmacy students and residents experience imposter syndrome. A study by Medina et al. demonstrated that impostor syndrome was common ...
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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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ASHP APPE Student Takes Policy Week

By Adriana Weiser posted 09-22-2022
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Greetings Colleagues,    As a fourth-year APPE student with ASHP, I was honored to be selected for the rotation block that extended through the annual Policy Week. For those that are not familiar with ASHP’s Policy Week, it is a time where ASHP Council and Commission members from across the country convene in Bethesda. Throughout this week, members discuss and develop policies on various topics that impact our profession, as well as participate in Legislative Day on Capitol Hill. Additionally, there are numerous attendees that observe the discussions taking place and meet with legislators as well.    This year, I was fortunate to be one of the attendees ...
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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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The Option of Becoming a Traveling Pharmacy Technician By: Danielle Allen

By Ellen Smith posted 06-26-2022
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The Option of Becoming a Traveling Pharmacy Technician By: Danielle Allen   Opportunities to work in different pharmaceutical fields as a pharmacy technician can may seem limited. However, there are many more options, if you know where to look. One such opportunity is becoming a traveling pharmacy technician. It is common to see or hear about traveling nursing opportunities, but did you know we can travel as pharmacy technicians as well? A life on the road can initially seem appealing, but like most opportunities there are benefits and drawbacks.    To get started as a pharmacy technician you need to have at least 6 months of experience, with a majority ...
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Soft Skills and How They Can Position You for Career Advancement By: Ileen Kooyman

By Ellen Smith posted 06-17-2022
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Soft Skills and How They Can Position You for Career Advancement By: Ileen Kooyman Good technical skills are an essential aspect of growing your career as a pharmacy technician.  Technical skills are those that are developed through education or work experience.  But, are technical skills enough to position a technician to advance in pharmacy?  Developing and practicing a high level of soft skills can provide the advantage you need to advance and set yourself apart from others.  Soft skills are the personal traits that shape the way you approach work.  These would include communication skills, the ability to work as a team, and integrity.  In the fast-paced ...
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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 ...
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Leadership Recommendations for New Practitioners and Pharmacists

By Carolyn O'Donnell posted 05-24-2022
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By: Carolyn O’Donnell, PharmD; Chief Pharmacy Resident & PGY-2 Psychiatric Pharmacy Resident at University at Buffalo/New York State Office of Mental Health at Buffalo Psychiatric Center As many new practitioners are starting in their pharmacy careers, leadership roles may seem far away and leadership skills may be delayed until a later point. However, whenever we are working with teams, working with colleagues, or working toward a goal, we have opportunities for leadership even if our title is not Manager, Director, or Vice President. In completing an elective residency rotation with ASHP, I witnessed a culture where leaders were true mentors, innovation ...
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Meeting the Need: Pharmacists Providing Post-COVID Clinic Care

By Alicia Sawmiller posted 05-19-2022
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The COVID-19 pandemic has left patients with ongoing symptoms from their battle with COVID. Long-hauler symptoms have challenged healthcare professionals to find ways to help patients manage their symptoms with little research. Parkview Health, serving the northeast Indiana and northwest Ohio region, responded to this need by creating the Parkview Post-COVID clinic where patients are seen by a multi-disciplinary team. The clinic team consists of neurology, pharmacy, physical medicine and rehabilitation, neuropsychology, nursing, and physical therapy. Patients are evaluated on their top five ongoing symptoms that they are the most concerned about. Some of the ...
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ASHP SAG Ambulatory Care ESC Entry- Resources for Visually Impaired Patients in the Ambulatory Care Setting

By Janee Whitner posted 04-29-2022
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Resources for Visually Impaired Patients in the Ambulatory Care Setting   Management of patients in an ambulatory setting almost always requires a level of patient self-management. The tasks that we ask of our patients can vary from monitoring blood glucose levels, to using a blood pressure cuff, or even just taking daily medications. While open communication between the patient and provider can allow these strategies to greatly improve patient outcomes, the tasks can become much more of an obstacle when considering a patient with visual impairment. This post will outline some of the currently available options and techniques that can assist patients in overcoming ...
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Continuing Conversations for the Diversity, Equity, and Inclusion Podcast (Part 5)

By Vincent Do posted 04-28-2022
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Cultural competence is a key tool for any healthcare professional to be successful. Developing an individualized plan for patients will allow them to be heard and create a more productive environment. One example could be drawn from the management of diabetes. There are many aspects of caring for a patient with diabetes to take into consideration including dietary modifications and general cultural practices. For instance, the food that a patient commonly consumes may vary from culture to culture. Oftentimes, common recommendations are communicated to patients in the form of a handout that contains generic examples of food choices that are not staples in their ...
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How should your professional organization support your needs?

By Barbara Petroff posted 04-18-2022
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As I read recently ASHP has reached 60,000 members. That is really an impressive number, but it made me think about how an organization can support the needs of all those members. As a very long-term member I have seen many changes over the years. For years ASHP was the American Society of Hospital Pharmacists. The name changed to reflect the change in the makeup of the organization. When the sections were originally added it was a way to help support the needs of the various members. The home infusion pharmacists campaigned for a section and The Homecare Section was added. The section even had a cute little house on display at the Midyear Clinical Meeting. The ...
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Well-Being Resources for Pharmacy Students

By Nikhila Viswanathan posted 04-10-2022
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Feeling stressed from internship interviews, residency interviews, fellowship interviews or even exams? Pharmacy students are challenged with stressors from all avenues of life, but there are healthy ways to mitigate this stress. Did you know that ASHP recently received the Health Resources and Services Administration’s 3-year $2.3 million grant focused on promoting mental health to not only pharmacy professionals, but the health care workforce as well? Read more: Here ASHP strives for the development and care of professionals such as pharmacy students in the healthcare field. There tons of ways to manage stress through ASHP resources. In January, ASHP ...
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ASHP SAG Ambulatory Care Pharmacotherapy - A Thought from the Upcoming Diversity, Equity, and Inclusion Podcast

By Michelle Patterson posted 04-02-2022
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The increase in use of medical technology over the last few decades has improved the quality of healthcare for many individuals. Technologies such as electronic medical records, remote patient monitoring, and online messaging portals have increased patients’ access to information and improved patient satisfaction.1 However, there are many patients for whom these technologies are more of a burden than a blessing. One of the technologies that I frequently introduce to patients in my practice is continuous glucose monitors (CGMs). Several studies have shown statistically significant improvements in measures of glucose control including reductions in hypoglycemia ...
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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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Covid, Residency, and Wellness - Oh My!

By Jamie Stone posted 03-15-2022
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I’m current a PGY2 resident so you can imagine the busy-ness in my life between rotations, projects, teaching, and research. My productivity came to a halt in the beginning of this year when I tested positive for Covid-19 and I am still dealing with long haul symptoms of chest pain, fatigue, and shortness of breath. I know I’m not the first resident to have Covid and, sadly, I probably won’t be the last. With that in mind, I wanted to share with you my journey of health and wellbeing. I had to take a significant amount of time away from my rotation during the month of January due to the illness and the quarantine period. However, I was determined to stay on ...
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