Editors Note:
I recently had the privilege of interviewing Mr. Tom Hushka, founder and CEO of Homecare Solutions, Inc., a Chicago, Illinois based home infusion company and long-time CPR+ customer about his recent first hand experience dealing with a potentially deadly drug contamination. I’d like to thank Tom, Carol and Ms. Cooper for their willingness to bring this article to the Weekly Infusion.

At 4:30 pm on Monday, December 17, 2007, HomeCare Solutions, Inc. (HCS), a Chicago, Illinois based home infusion company, received an unexpected call from the Centers for Disease Control (CDC) alerting them of a "possible" contamination of heparin pre-filled syringes. Distributed under the name Sierra, lot number 070926H was thought to be contaminated with the bacteria Serratia Marcescens. Thirty minutes later, the local news lead with a story about 20 cancer patients from a local hospital that had to be hospitalized after receiving the contaminated heparin while receiving home infusion therapy and the next morning, the HCS staff read a post on the CPR+ Listserv reporting the news.

Founder and CEO Tom Hushka put it simply, "From a patient safety standpoint, it just doesn’t get any bigger than this. Our patients included a double transplant recipient and numerous other seriously compromised individuals." Mr. Hushka gathered his staff, led by Chief Clinical Pharmacist, Ms. Cooper, and the Office Manager, Carol Lauricella, to assess the situation. Said Ms. Cooper, “Our Clinical Meeting took on a whole new direction that day as we realized the severity of the situation." Within an hour of the CDC phone call, HCS staff had determined that they had in fact received shipments of the contaminated heparin and identified that they had dispensed it to 34 active patients over the previous several weeks.

The team ran numerous reports from CPR+, including Active Census, On-Hand Inventory, Prescriptions Dispensed and Lot Numbers Dispensed, that enabled them to determine the extent of the crisis. The reports confirmed they had received roughly 10 cases of the contaminated product. The team immediately began the process of contacting each of the patients, a task they completed in less than 3 hours. "What a task it was," says Carol. "We were very happy we had diligently entered each patient’s home, work and cell phone numbers into CPR+. Believe it or not, the most frequently used numbers came from the Emergency Contacts list. It was a life-saver."

"Time was of the essence," added Ms. Cooper. "We called patients at home, left messages at work, called them on their cell, we even called their relatives or neighbors - whatever it took. We also contacted each patient’s physician and referring hospital, as well as all of the Nursing Agencies that we work with."

In all, HCS made nearly 60 deliveries to pickup and replace the contaminated product from active and recently discharged patients who had received the contaminated lot. As a precautionary measure, one physician had the PICC lines removed from 3 patients, but thanks to their prompt action and meticulous record keeping, no patients had to be re-hospitalized or suffered any adverse affects.

Throughout the recall, the CDC, FDA, and the Chicago Department of Health each sent personnel in to investigate the situation. HCS received praise from all these agencies for their ability to quickly give them all the data they requested. Said Mr. Hushka, "I honestly don't know where we would have been without CPR+. Lot number tracking is an essential patient safety measure. We owe it to our patients to provide the highest level of care and it really paid off in this case. When patient lives were at risk, we were able to get the critical information we needed quickly and accurately so that we could do our jobs. This was a serious situation and it could have turned out much differently – Thank God it didn’t. We were thrilled with the outcome."

Return to Top of Newsletter

If you’re like most customers, you and your staff enter a lot of Progress Notes and Billing Notes. Your clinical staff probably document every patient contact, as well as all of their conversations with Discharge Planners, Physicians, Nurses, when labs are due and when you get the results, etc. Your reimbursement staff probably enters a Billing Note when they verify insurance, talk to a Case Manager, follow-up on an invoice and more.

Have you ever wished you could easily drill down into all that data and retrieve specific Notes based on defined criteria? For example, have you ever wanted to see all of the Progress Notes entered today, this week or this month, or by John Doe, or for Patient Smith, etc.?

Well Now You Can . . . with the Notes Manager!

Released in v8.0, the CPR+ Notes Manager is a powerful tool that quickly searches through thousands of Progress and Billing Notes, and retrieves only those that match the criteria you specify. To access the Notes Manager, click on the tool bar icon that looks like a “pencil & paper” or go to the Reports Menu, option #9.

Enter your desired search criteria into the available fields on the Notes Manager and click the Apply Filter button.

You can search for Notes by:

• Type of Note – Billing or Progress Notes
• Subject of Note
• Author of Note (Entered By)
• By Date Range
• By the Employee assigned to Follow-Up
• And more.

After you have entered the desired search criteria and clicked "Apply Filter", CPR+ will display all of the Notes that meet the criteria in a grid, listing the Date of the Note, Patient Name, Subject, Entered By, Follow Up Date, Follow Up Assigned To and Follow Up Completed. In the lower half of the screen, the Notes Manager will display a portion of each note, allowing you to scroll through the upper list and see the note below. The buttons at the bottom allow you to View Details (see the entire Note) and "Print" (which will print a report of all the Notes retrieved).

For Billing Notes, you can also use the "Find Invoice #" button to quickly jump to any note matching a particular invoice number. In addition, you can also click any of the column headers in the grid to re-order the list; and don’t forget the "Right Click, Count" feature, that allows you to count the unique occurrences of a given data item in the list.

If you’re new to v8.0, give the Notes Manager a try, we think you’ll like it.

Return to Top of Newsletter