Tuesday, December 16, 2008

More BCMA Emotion, no science

At the BCMA networking session at the ASHP meeting, the floor was opened up for questions.  So of course, I needed to ask “the ROI question” to the panel that was assembled.

So here is my recollection of my question: Given the current financial situation and the fact that there are no good studies to show the value of BCMA, how do you justify the practice?

The responses where to the effect:

    • There is no ROI.  We are doing everything to make the medication administration safe at our hospital, that is what we are all about.
    • I put up all of the headlines of the medication administration errors to the Board and then told them a couple of incidence of near misses, and they sucked it up.
    • My kids swim team has layers of redundancy in the time keeping; shouldn’t we have protection for medication administration?
    • Wouldn’t you want this if your child was in the hospital?
    • We have the statistics on near misses that are very impressive.
    • Nurses are convinced that it works and would never go back to the old way.

The near miss statistic was uncovered as bogus, in a later story of how nurses have all of the insulin stickers on the back of their badges and scan until they get a correct scan.  Where, presumably each scan is logged as a near miss.

I could not help think of what my old room mate taught me with example after example of selling cars.  People buy with emotion and justify with logic.  I clearly heard lots of emotion from the panel.  They where making emotional arguments and justifying the practice with logic, devoid of any science.

Excuse me, but isn’t pharmacy a scientific profession.  Shouldn’t we have a scientific explanation for BCMA as a practice.

The science behind unit dose distribution was marvelous.  Yet, we continue to make emotional pleas for BCMA. 

This will not hold up over time, we need more science or we are toast.

2 comments:

  1. A lack of good evidence based studies hasn't prevented us from spending millions of dollars on CPOE systems. I have yet to read of a study that shows a reduction in mortality. Error rates are a little fuzzy.

    Secondly, wouldn't the CMS requirements make BCMA more rational?

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  2. Exhibit A
    Saving Lives, Saving Money: The Imperative for Computerized Physician Order Entry in Massachusetts Hospitals: Released Feb. 14, 2008 http://www.masstech.org/ehealth/cpoe/cpoe08release.html

    Government mandate for something that has little evidence for success, cost a ton but is justified with lots of emotion, devoid of fact? Lets see... The War in Iraq comes to mind. Hey, You might be on to something there!

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