Computers are horrible…

I program these things for a living, and I’m here to tell you that the computer as a work device is as much of a liability as it is an asset. Doubly so in a sensitive business like a long-term care pharmacy, where data correctness and consistency is incredibly important and yet extremely difficult to achieve, with life-altering consequences for those whom the pharmacy serves.

The current state of the art for most companies that perform medication regimen reviews (MRR) is based around an outdated and brittle computing paradigm: many pharmacists with many laptops, each with their own instances of consulting software (primarily RxPertise), and each with their own collection of databases.

More computers, more problems. Let me explain.

What’s your problem?

If you offer MRR consulting services in your LTC pharmacy, or if you run a consultancy with a mix of in-house and contracted consultant pharmacists, I am sure you have experienced at least a few of these problems in the course of your work:

  • It’s the end of the month, and a pharmacist is out sick or otherwise unavailable when an MRR report is due. The data is trapped on their laptop and cannot be transmitted or otherwise gotten.
  • When reports are due, you have to commit one or more team members to collecting and collating hundreds of individual databases, refining the data, and producing reports.
  • When new CPs join or colleagues depart, you have to spend hours transitioning databases from one laptop to another.
  • When anybody needs to take a vacation or cover a colleague’s facilities, you need to orchestrate a lengthy and highly technical air-lifting operation, lifting many database backups from one laptop to another, mediated through complicated and expensive HIPPA-compliant data sharing platforms, with a thousand opportunities along the way for data inconsistency, duplication, and conflicts.

It all adds up to a stiff, brittle system. Excruciating to change, restrictive to work within, and needlessly complex.

We programmers have a term for these kinds of “side” problems: “accidental complexity”, which describes all of the annoying problems that come along while trying to solve the “essential complexity” of performing MRRs.

Minimize complexity

Now, managing all of that disparate data with a computer is tough. Managing it with paper would be even worse. Computers create a ton of ancillary problems on top of just doing the work, but they are a necessary piece of the puzzle considering the volume of data we need to work with.

Accidental complexity cannot be eliminated entirely; no such thing as silver bullets or free lunch. But it can be minimized. How do you reduce the problems while maximizing the benefits?

Let’s get mathematical for a moment. Take every single one of those problems from the preceding section, and multiply it out by the size of your staff. Let’s say you have an institution with 20 consultant pharmacists, each with one database containing one LTC facility. The number of permutations for how you may need to swap and share databases between your staff is 2 x 1e27. That’s two followed by 27 zeroes. Way more than the number of stars in the universe.

That’s a scary number. Let’s cut it in half: 20 CPs, but only 10 need to swap around their single database with their single facility: that comes out to 3,628,800. 3.6 million handoffs. 3.6 million moving parts. 3.6 million opportunities for errors, inconsistencies, and conflicts.

Still way too many points of failure. What can we do if even the “reduced case” has too much potential for errors? Well …

  • You can’t reduce the amount of data, that would amount to shrinking your business. 
  • You can’t reduce the number of consultant pharmacists, you need professionals to do the work. 
  • But you CAN reduce the number of computers!

Reducing 20 individual laptops with many databases down to one shared cloud database, accessed from any device with a web browser, tremendously simplifies your data problems.

TrioMRR offers this straight out of the box: your team shares one single database. 

Not all team members get to “see” all of the data of course. Admins have a “global view” of your entire org’s data within TrioMRR, and less-privileged user accounts are assigned to a subset of your facilities with a permissions system. 

Separating data out at the application layer via permissions instead of at the data layer via separate databases squares the data circle: you can enjoy the flexibility of sharing data amongst consultants that should be shared – autotext, recommendation categories, medication information – while separating out the data that should be separated – facilities, residents, recommendations. Need to swap facilities between pharmacists? Is someone leaving the org, going on vacation, taking on new or different responsibilities? It’s as easy as reassigning permissions for the relevant facilities to the relevant staff. No database airlifts, no data sharing platforms, no risk of inconsistencies, stale data, or mistakes.

On the next episode of…

This is all nice and good, but there’s a huge problem yet to solve. What do you do about those RxPertise databases that you already have? This fragmented and crazy database situation is still the world you’re living in, the very fundament of your operation. You can’t just ditch it entirely while moving to a new platform and still maintain continuity of service to your clients. 

How do we actually get to this better place from where we are?

In my next blog, we’ll cover how TrioMRR migrates data from your RxP databases to our cloud database. The accidental complexity in this process is considerable, but if you partner with us, you’ll find that we’ve rolled out the red carpet for you in order to make the transition easy and fast, so you can drop all of the technical weight you’ve been carrying and make the leap to our modern platform.

Stay tuned!

Side notes

The past is a wonderful lens into the present. This interview with an office worker in 1979 is a pretty incredible moment, right at the intersection of the old world of paper and the burgeoning world of the digital.

“Do you ever feel like you’re drowning under an ocean of forms?” 

“At least once a week.” 

“Do you ever feel like it’s going to get out of control?”

“Always, but not yet.”

When I get frustrated by computers, it’s helpful to remember that most professionals get a little jaded when musing on the problems of their domain:

“…it has been said that democracy is the worst form of Government except for all those other forms that have been tried.” — Winston Churchill