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12/26/2001

Hardware Failure Can Lock Out Workers

Kate Traynor

As pharmacists come to rely on computers and other technology, they can find themselves responding to unforeseen issues when the system does not work as planned. 

"We’re very dependent on technology and very dependent on access to this technology via the [computer] network," said Dan Gueth, M.B.A., director of pharmacy at Miami Valley Hospital in Dayton, Ohio.

Gueth said automatic dispensing machines, the pharmacy information system, and a total parenteral nutrient compounding unit are all hooked into Miami Valley’s computer network. "And we’re just in the process of installing a robot," he added.

This past summer, a hardware failure brought home to the pharmacy staff a weakness in the hospital’s computer system.

"It locked our pharmacy department out," Gueth said. "The server was down for about four to six hours, I believe, so we didn’t have access to the pharmacy system."

The loss of access occurred because Gueth’s staff could not sign into the pharmacy’s secure computer system.

"Our state board of pharmacy requires that we have positive i.d. for medication order entry…[using] double sign-on access or biometric i.d.," Gueth said. "So we use a card reader for our secondary logon."

Gueth said the reader is attached to the computer like a keyboard. "You swipe your hospital i.d. badge through this card reader and it signs you on to the pharmacy system," he said.

The hospital, Gueth said, is "still struggling" with steps to take to prevent similar failures in the future. "The problem is having that positive i.d. during that down time," he said.

William T. Winsley, M.S., executive director of the Ohio State Board of Pharmacy, said the positive identification issue has generated "a lot of calls" to his office. But he said the board has long recognized that hospitals need to improve their computer security.

"Ever since 1991, we’ve realized here that, in the typical health care setting, passwords are worthless as a means of security," Winsley said. "When somebody enters a password, if you’re within five feet of them, you can get access to it."

Winsley said that biometric systems, which rely on physical characteristics to positively identify a specific person, can be incorporated into a hospital’s positive identification procedures.

"Biometrics is the up-and-coming thing," Winsley said. "Quite frankly, in a few years I think biometrics will be the only thing."

According to the Institute of Electrical and Electronics Engineers Inc., some biometric identification systems use voice-recognition technology. Others scan a person’s eye for patterns in the retina or iris, or rely on facial characteristics, fingerprints, or "hand geometry" to identify people.

But Winsley said the state board of pharmacy’s list of systems that provide positive identification is not limited to biometric units and other sophisticated machinery.

"Manual signature is there on the list," Winsley said, describing a signature check as "the old-fashioned way."

"When I worked in hospitals we used to keep a piece of paper that had a manual signature or manual initial on it....That was the document that was maintained as the record of dispensing," he said.

A drawback of the manual check is that it is not efficient, Winsley said. "That’s why we are pushing electronic records," he noted.