Department of Veterans AffairsConsolidated Mail Outpatient PharmacyAugust 3, 2011

Bob Gale R.Ph., MBAMedication Image Library PharmacistDepartment of Veterans AffairsConsolidated Mail Outpatient Pharmacy

CMOP Medication Image Library (MIL)

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The Idea for MIL Impact Goals Program Development Standardization Roll-Out Summary Questions

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MEDICATION IMAGE LIBRARY(MIL): AGENDA

VA T21 Initiatives“Enhance the Veteran’s Experience and

Access to Health Care”.“Increase Veteran client satisfaction with

health, education, training…”

Interactive VA Point of Service (VPS) KIOSKS

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THE IDEA FOR MIL: SUPPORTING OUR VETERANS

MIL: IMPACT ON OUR VETERANS AND THE VA

Improve Veteran Learning Environment Medication Reconciliation Directive Image Standardization Decrease Workload Across VA Future: Medication Image on RX Label

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MIL: GOALS

1.Catalogue Existing Images2.Include All VA Products3.Centralized4.Standardized5.Up to Date6.Accurate and Verified

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EXISTING PILL IDENTIFICATION SITES: ONLY ORAL SOLID DOSAGE FORMS

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VA DISPENSED MEDICATIONS- Existing CMOP Images

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VA DISPENSED MEDICATIONS - Existing CMOP Images

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MIL: GOALS

1. Catalogue Existing Images2. Include All VA Products

3. Centralized4. Standardized5. Up to Date6. Accurate and Verified

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CURRENT IMAGE LAYOUTS- Existing CMOP Images

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CMOP COLOR DESCRIPTOR FORNDC: 00781-1506-10 Listed Colors: Sky Blue Light Blue Medium Blue Gray-Blue

Colors Listed in Existing CMOP Image Database:

Sky Blue Light Blue Medium Blue Gray-Blue

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MIL: GOALS

1. Catalogue Existing Images2. Include All VA Products3. Centralized4. Standardized

5. Up to Date6. Accurate and Verified

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MIL: PROGRAM WORKFLOW

Define Technician and Pharmacist Roles Ability to Track NDC Progress through

Program Ability to Retrieve All Images for an NDC Move Image to Editing Program and Back. Confirm Data and Image Centrally Store Verified NDC Data and

Images

MIL: PROGRAM DEVELOPMENT

1. Retrieve Image and Data by NDC 2. Review, Edit, and Confirm Images3. Review, Edit, and Confirm Data4. Verify Image and Data 5. Store Verified Image and Data

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MIL: DEVELOPING STANDARDS FDA Data Standard Manual (DSM)

Standards: Color Scoring Shape Size Imprint Recording Image Format

NLM, NIH and FDA Patient Safety Initiative Recommendations:

Image Size Photographing and Image Editing

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MIL: DATA AND IMAGE STANDARDS

Based on FDA Standards and NLM/NIH/FDA Recommendations Colors Shapes Scoring Size Recording of Markings Medication Imaging and Editing

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MIL STANDARDS: COLORS

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MIL STANDARDS: SHAPES

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MIL STANDARDS: SCORING

Based on Numbering System Number of Equal Pieces that a Solid Dosage

Form can be Divided.Solid Capsule or Tablet – Score Value = 11 Score Line – Score Value = 22 Parallel Score Lines – Score Value = 33 Parallel Score Lines or Two Intersecting

Lines - Score Value = 4

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MIL: DATA AND IMAGE STANDARDS

Based on FDA Standards and NLM/NIH/FDA Recommendations Colors Shapes Scoring Size Recording of Markings Medication Imaging

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MIL STANDARDS: LAYOUT

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MIL PHASE I: EXISTING IMAGES

Editing Existing Image Database1. Review 109,000 NDC Images and Data2. Priority – NDC’s used by CMOP 3. CMOP’s - Continue Taking Own Photos4. Roll-Out of Image and Data Standards

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MIL PROGRAM: LOG IN

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MIL PROGRAM: SELECT NDC

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MIL PROGRAM: NDC STATUS

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MIL PROGRAM: TECH REVIEW

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3 4 5

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MIL PROGRAM: IMAGE REVIEW

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MIL PROGRAM: IMAGE REVIEW

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MIL PROGRAM: SELECT FOR EDIT

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MIL PROGRAM: IMAGE EDITING

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EDITING: BEFORE AND AFTER

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AFTER

BEFORE

MIL PROGRAM: NEW IMAGE

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MIL PROGRAM: DATA REVIEW

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MIL PROGRAM: DATA EDITING

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SHAPE: TEARCOLOR: PINKFRONT IMPRINT: DVBACK IMPRINT: NVRSCORE: 1

DRUG ID: TEAR/PINK/SCORE1/TABLET/DV;NVR

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MIL PROGRAM: RPH REVIEW

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MIL PROGRAM: RPH VERIFY

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MIL PHASE II: PHOTOGRAPHING

Photographing Phase 1. Begin Photographing Medication2. Customer Image Requests3. Maintain and Expand Library

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DATA AND IMAGE USE FUTURE:

Kiosks Labels

NOW: CMOP Prescription Filling and

Verification Process VAMC – CMOP National Web Application

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CMOP: CANISTER REPLENISHMENT

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CMOP: RETURN TO STOCK

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CMOP: PRESCRIPTION LABELING

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CMOP: RPH VERIFICATION

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DATA AND IMAGE USE FUTURE:

Kiosks Prescription Labels

NOW: CMOP Prescription Filling and Verification

Process VAMC – CMOP National Web Application

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VAMC: CMOP NATIONAL WEB APPLICATION

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Medication Image Library Veteran Education and Reconciliation CMOP Image Standardization Central, Standard Image Data Base

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Bob Gale Robert.Gale@va.gov 1-708-786-7820

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