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ASHP Activities with Smart Pumps Karl F. Gumpper, BS, BCPS, FASHP Director, Section of Pharmacy Informatics & Technology American Society of Health-System Pharmacists kgumpper@ashp.org

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2 Better Information, Better Care What are the numbers? Primary Members* 550 members Secondary Members* 3400 members Listserv Subscribers Members Only > 1950 participants (8/2010) *Members as of 5/2010

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3 Better Information, Better Care Organization of the Section Section Advisory Committees Section Advisory Group on Clinical Information Systems Section Advisory Group on Pharmacy Operations Automation Section Advisory Group on Ambulatory Care Informatics Section Advisory Group Pharmacy Informatics Education Executive Committee Educational Steering Committee Section Advisory Groups Work Groups Task Forces Nominations Committee

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4 Better Information, Better Care

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5 Section of Pharmacy Informatics and Technology Executive Committee 2010-2011 Chair: Chris Urbanski (Indiana) Chair-Elect: TBD (Ron Burnette or Allen Flynn) Immediate Past Chair: Chad Hardy (Texas) Director-at-large: Anne Bobb (Illinois) Director-at-large: Leslie Mackowiak (Tennessee) Director-at-large-Elect: TBD (Stanley Pestotnik or Sylvia Thomley) Board Liaison: John Armitstead (Kentucky)

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6 Better Information, Better Care Section Advisory Group on Clinical Information Systems Chair: Nancy Smestad Vice-Chair: Lynn Ethridge Executive Committee: Leslie Mackowiak Charge: CPOE Guidelines Seeking Board Approval August 2010 Decision support library coordination Promote original research with clinical information systems and patient safety Develop recommendations on the content of Clinical Decision Support for CPOE and pharmacy systems. Develop standard approach for managing patient drug allergies in pharmacy, CPOE systems, and Electronic Health Records (Functional Requirements) Deferred by SAG (2009-2010) Identify sites where pharmacy departments have been able to successfully educate appropriate C-suite personnel about changing role of pharmacist involvement in high-level CIS planning, vendor negotiations, etc. Make strategies/tactics available for membership of section by showcasing on the Sections Web-site. Develop recommendations for sharing and standardizing smart pump medication libraries Active ADE Surveillance Rule Sharing In progress by SAG

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7 Better Information, Better Care Section Advisory Group on Pharmacy Operations Automation Chair: Gwen Volpe Vice-Chair: Barbara Giacomelli Executive Committee: Chris Urbanski Charge: Develop a guideline on re-packaging and re-labeling medications for use with in hospitals and health systems to incorporate bar-code technology requirements and standardization In process by SAG Determine state of RFID implementation for supply chain management and make available for section membership Develop a position statement on the synchronization of medication formularies to better manage information with multiple systems and hospitals. Completed column submission 2010 Monitor the use and development of robotic technologies in hospitals. Multiple projects under way Monitor the use of smart pump technology in hospitals related to automation, interconnectivity, and integration to provide a closed-loop patient safety solution. Work Group addressing issues Develop a Statement on the use of bar-code technology for medication preparation and dispensing Completed HoD 2010

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2007 ASHP Survey on Informatics and Automation Craig A. Pedersen, R.Ph., Ph.D., FAPhA Associate Professor, College of Pharmacy, The Ohio State University Karl F. Gumpper, R.Ph., BCNSP, BCPS, FASHP Director, Section of Pharmacy Informatics & Technology, ASHP

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Survey Population IT Survey: All 6,944 U.S. Hospitals 4,112 in sample (email addresses available for Director of Pharmacy) 1,145 respondents n=1066 usable responses 26% of those surveyed 15% of all U.S. hospitals Population is different from ASHP National Hospital Pharmacy Surveys Focuses on the ~5,000 General and Childrens Medical Surgical Hospitals in U.S. ~1,300 surveyed (varies from year to year) ~550 respondents (varies from year to year) 9

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#11 Intelligent Infusion Devices (Smart IV Pumps) and PCA Definition: A smart infusion pump is a point-of-care computer that integrates the infusion pump with clinical best practice guidelines. Smart infusion pumps have software that checks programmed doses against preset limits specific to a drug and clinical location. The clinician may either override an alert (soft limit) or not be allowed to continue at all (hard limit), depending on preset limits. Some manufacturers include Baxter, Cardinal/Alaris, and Hospira.

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11 Smart Infusion Pumps

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12 Smart Infusion Pump Vendor

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13 Plans for Smart Infusion Pumps

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14 Pharmacy Maintains Smart Infusion Pump Drug Library

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15 QI logs are used to document user rates of overrides or near misses

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16 Smart Infusion Pumps are Wireless Enabled

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17 Smart Infusion Pumps are Interfaced with eMAR

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18 PCA Pumps

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19 PCA Pump Vendor

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ASHP Data Comparisons Plans (2007) Have it ASHP National Survey Within 1 yearNo plans CPOE/CDSS12%15.4% (2009)8%15% Robot10.1%16.2% (2008)4%79% Carousel12.7% n/a 6%65% ADC82.8%82.9% (2008)2%5% BCMA24.1%27.9% (2009)15%17% Smart Pumps44%56.2% (2009)11%19% EMR42.9%47.1% (2009) n/a Complete EMR5.9%8.8% (2009) n/a

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Links to AJHP Articles Craig A. Pedersen and Karl F. Gumpper ASHP national survey on informatics: Assessment of the adoption and use of pharmacy informatics in U.S. hospitals 2007 Am. J. Health Syst. Pharm., Dec 2008; 65: 2244 - 2264. http://www.ajhp.org/cgi/reprint/65/23/2244 http://www.ajhp.org/cgi/reprint/65/23/2244 Craig A. Pedersen, Philip J. Schneider, and Douglas J. Scheckelhoff ASHP national survey of pharmacy practice in hospital settings: Monitoring and patient education2009 Am. J. Health Syst. Pharm., Apr 2010; 67: 542 - 558. http://www.ajhp.org/cgi/reprint/67/7/542 http://www.ajhp.org/cgi/reprint/67/7/542

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Questions?