Speaking of healthcare data, is Microsoft the elephant in the room?
In a previous blog I discussed the need for a uniformed data structure in healthcare. The concept got me thinking about how to accomplish such a monumental task, and make no mistake, it would be a monumental task. There aren't many "people" out there that could develop the hardware and software infrastructure solid enough to handle the needs of the complex data stream coming out of the healthcare industry. Then I noticed a trend at a lot of the web sites that I frequent: Microsoft has slowly, and quietly, been positioning itself to jump into the healthcare market.
Consider the following:
Motorola DROID getting some attention in the pharmacy literature
The February 2010 issue of Hospital Pharmacy (PDF) contains a review of the Motorola DROID, and the authors overall impression of the device is positive. I've had a DROID since its release in early November 2009. My initial impressions of the device can be found here.
As mentioned by the authors in the article the currently available pharmacy-related applications are limited when compared to devices like the iPhone, but the numbers are growing. Drug information resources like Lexi-Comp, Skyscape and ePocrates are now available for use on the DROID as well as some medical references like Merck Medicus, Unboud Medicine and UpToDate (via mobile browser). Unfortunately I don't have a list of available medical applications for the Android operating system nor do I know of a site that does, but the popularity of the Android operating system is growing and it's only a matter of time before other medical references start popping up.
One piece of advice in the article that I found interesting was to "begin by selecting the telecommunication service that is most reliable and has the best connectivity coverage for voice and data in the community where you live." Imagine that, selecting a mobile phone that first and foremost keeps you connected. I'll make sure to keep that in mind the next time I feel the need to purchase another smartphone. Then again maybe I won't. I guess that depends on how badly I want the device.
The Pharmacist's Guide to Meaningful Use
The Pharmacist’s Guide to Meaningful Use
What is Meaningful Use?
At the legislative level, Meaningful Use(MU) is a proposed rule created by CMS to implement the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA). It establishes criteria to promote the adoption of meaningful use of technology in healthcare. The primary goals are to improve the quality and value of healthcare in the United States through the use of technology such as electronic health records (EHR), computerized provider order entry (CPOE), medication reconciliation tools, and clinical decision support (CDS). It should be noted that as of 3/8/2010, the rule is not final. In addition, there may be incentives from CMS if your organization chooses to implement these criteria. More information on Health Information Technology is available at the CMS website (http://www.cms.hhs.gov/Recovery/11_HealthIT.asp).
Improving quality, safety, efficiency, and reduce health disparities
Objective: Use of CPOE for orders (any type) directly entered by authorizing provider (for example, MD, DO, RN, PA, NP)
Measure: CPOE is used for at least 10 percent of all orders
The RPh: Implementation of CPOE, building and maintenance of medication orders and order sets to support its use by physicians. This can require a significant number of pharmacy resources that are trained to configure the EHR for use.
Objective: Implement drug-drug, drug-allergy, drug- formulary checks Measure: The eligible hospital has enabled this functionality.
BCMA Implementation checklist and lessons learned
First off let me start by saying that I think BCMA is a worthwhile endeavor. It can have a positive impact on a healthcare system, not only in terms of safety, but with inventory management and billing . The other nice benefit is the ability to see the medication administration in "real-time". Pharmacists can look at vancomycin and aminoglycoside administration times online now instead of going to the paper chart, for example. And isn't that the whole idea behind electronic documentation? I think so. Our facility went live with out first BCMA unit last week. It's still early, but my initial take is that things went fairly well. We had a few minor issues, but nothing that couldn't be handled easily and quickly. No matter how well you plan for something there will always be some bumps in the road, and that is important to note. Below are some things that I picked up along the road to implementation. Some of these things we did well and some we didn't do at all. This list is my opinion and not the gospel on BCMA implementation by any stretch of the imagination. Please remember that as you read through it.
And now, on to my list of recommendations for BCMA implementation:
HIMSS Pharmacy IT Symposium Summary
Last weekend HIMSS sponsored a pharmacy symposium the day before all of the other festivities. Here is a brief summary and links to the PPTs.
First, thanks goes out to Michael McGregory PharmD, MBA for Chairing the event. I had the honor and privilege to serve with him on the planning committee.
First up was the Opening Keynote Address: Incorporating Evidence into Decision Making by the wonderful Anne Bobb. For those of you that do not know her, she is a informatics pro from Northwestern Memorial Hospital in Chicago, but hails from the Great State of Maine. She had the best line, not only of the day, but of the entire HIMSS week. Here is a Tweet that was ReTweeted many times through out the week. It only got better from there as she outlined the awesome evidence of CPOE and other interventions with pearls along the way.
Btw, I was live tweeting throughout the day. For a view of what caught my attention during the events check out my Twitter stream that has the hash tag #himss10
We then had a joint session with our Nursing colleagues for a romp around the medication use process and informatic interventions, entitled Multi-Disciplinary Joint Session: Medication Process, Closing the Loop
New peripherals for Motion C5 and F5 tablets
GottaBeMobile.com: Motion Computing is introducing a two peripherals and some software that should help tablet users that work in the healthcare industry. The motion folks are exhibiting their wares at the Healthcare Information and Management Systems Society Conference in Atlanta." - The peripherals being referred to are ReadyDock (PDF) for the C5 and F5 Tablet PCs and a new RAM Mount with integrated lock.
The ReadyDock is a cabinet designed to charge up to 20 C5 or F5 tablets at once. In addition the ReadyDock offers standard network connection to the tablets while docked granting remote IT support like data backup. The ReadyDock is nice if you have the need to charge several devices at once, but each cabinet will set you back about $2300. I think I like the standard C5/F5 docking station better because you can attach an external keyboard and mouse to it which allows you to continue working while the tablet charges.
The second peripheral, the RAM Mount with integrated combination lock, is actually supplied by a third party vendor. RAM Mounts makes mounting hardware for mobile devices like laptops and GPS units.
Banning Social Media in Hospitals - dumb idea
I came upon this blog post from the CEO of Beth Israel Deaconess Medical Center, Paul Levy. I would recommend this blog as a very good regular read as well.
"What'd I miss?" - Week of February 28th, 2010
As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here's a quick look at some of the stuff I found interesting.
Feedly - Google Chrome extension
Extensions > FeedlyFeedly by @feedly
(2071 Ratings) - 65,888 users - Weekly installs: 13,634
Feedly organizes your favorite sources in a magazine-like start page.
HIStalk Interviews Charlie Harp - Great Read
I share a lot of items around clinical and pharmacy informatics. While I post these on Twitter, my blog, collaborative blog and public Evernote site, every once in a while a piece comes by that encapsulates multiple thoughts and is just so good it needs to be publicized. This is one of those times. Here is an interview of a gentleman I have had the pleasure to speak with a lot lately. This interview is very good.
Cool Technology for Pharmacy - ATP-71
In a previous post I mused about using an automated packaging system like InSite from Talyst as a type of automated dispensing cabinet for acute care patients. InSite was designed for long-term care and would simply be too large for the needs of an acute care nursing unit, but the technology is ideal.
However, the ATP-71 (PDF) from Swisslog is a bulk packager that can hold up to 71 canisters in a relatively small footprint: 31.5 inches wide x 29.6 inches deep x 30.6 inches high. For comparison, a Pyxis MedStation 4000 2-drawer main unit is 22.8 inches wide x 26.7 inches deep x 27.7 inches high. I would say that makes the two units comparable in terms of size, and I can tell you from personal experience that a 2-drawer main isn’t very big up close.
According to Swisslog: “Swisslog’s high-speed packaging and barcoding solutions are not only fast and efcient, they provide many levels of patient safety. Color coded fll-to-light trays, locking canisters, and accurate labeling with barcode capabilities enable pharmacies in any size hospital to make patient safety the highest priority. Many additional accessories and interfacing capabilities complement the packager and provide gains in workfow effciency.”
No More NUPOR Mooing and Musing #8 post
It has been a while since the last muse on NUPOR; that would be Near Universal Pharmacists Order Review.
At the HIMSS Pharmacy IT Symposium, Stan Kent talked very briefly about a feature in an HIS that caught my attention. While he only mentioned it in passing, it turns out to be very important, perhaps a peak into a potential trend and pharmacy practice model.
There is a ranking algorithm for each drug order that is presented to the pharmacist for review. It turns out that this algorithm can be ranked by any number of factors. They use it to prioritize orders for review. The exact way it is calculated is a mystery at the moment. I will need to learn more.
While inquiring around, it also turns out that The Netherlands use this algorithm to rank drugs as well. There is a score under a pharmacist does not need to review the drug order at all!
This is very interesting and needs confirmation. So if anyone can shed light on the way The Netherlands handles this, that would be great.
This would be central to looking at a new pharmacist practice model in the U.S.
The Innovator's Prescription
- How disruptive innovation may lead to a cure for our ailing health system
- How decentralization leads to accessibility
- The futility of adding new technologies to old models
- The 3 universal business models, and how hospitals don't fit any of them
BetterHealthLLC's Channel
Here is a quick segment of HIMSS 2010. What I want to point out is that Dr. Val (twitter @drval) is emerging as a Web 2.0 Medical Media guru. This youtube channel and her excellent blog of physicians is well worth checking out.
http://getbetterhealth.com/
http://www.youtube.com/user/BetterHealthLLC
Posted via web from RxDoc.Org
::Great new Webinars on Patient Safety
New Web-based Continuing Pharmacy Education Activities
As presented at the 44th ASHP Midyear Clinical Meeting & Exhibition
Three Current Topics -
Outstanding Web-based Continuing Pharmacy Education
Integrating Technology to Improve Medication-Use Patient Safety
For complete activity information, visit ashpmedia.org/symposia/technology
Improving IV Medication Safety: Identifying the Risk Points
Facial recognition via your Android smartphone
VentureBeat: "Recognizr uses FaceLib, a mobile face recognition library from Polar Rose, which is available for Android and iPhone. FaceLib can recognize faces in photo or video but, in common with other facial recognition products, is more accurate for photos. Recognizr also uses Polar Rose’s server-side solution FaceCloud because you can’t store profiles of all potential matches in the phone — although recognizing people who are already in the phone’s address book can be handled locally on the device."
The application from Polar Rose combined with the interface from TAT (The Astonishing Tribe) pulls up information associated with the recognized faze from places like Facebook, YouTube and LinkedIn.
ePatientDave and Omnicell interviews from HIMSS
Just a sample of the diverse and interesting live streaming at HIMSS. Be patient with the feeds, it is easier than flying to Atlanta.
http://www.ustream.tv/channel/live-from-himss-what-s-hot-in-health-it
Ominicell
Posted via web from RxDoc.Org
What we need is a system-neutral data structure for healthcare
During a web browsing session the other day I came across a very interesting blog post by Louis Gray titled “The Future: Operating System And Application-Neutral Data”. I enjoy reading Louis’ posts because I think he has a great vision for the future of personal computing, data, and “the cloud”
The blog speaks specifically to the ownership of personal data versus allowing companies to sit on it and possibly hold it hostage secondary to a lack of compatibility with other systems. The information you throw onto the internet defines who and what you are, more now than ever before, and you need to be able to move it around anytime from anywhere.
Louis calls for people to host their own data in a standardized format instead of having data stored by one service provider or another. He goes on to say:
"If I chose to log in with GMail one day, I would authenticate who I was, and GMail would pull down my e-mail stream, complete with e-mail activity history (such as replies and forwards). The data would not be stored on GMail, but instead be more like a read-only process, whereby changes to data, including sent items, would not be stored in GMail, but written back to my personal "cloud", if you will.
Podcasts from AJHP!
More than a year ago. I lobbied AJHP to consider podcasts. I even went to the extreme to enter a resolution to the House of Delegates to include podcasts. In a series of public and private communications the Editor of AJHP had 'poor me' reasons why they can not possibly produce podcasts; too expensive, no staff, no expertise, oh poor me. Dude: Newsflash, print media is on life support. I am overjoyed that he was overruled and someone saw the light.
AJHP Podcasts Feature Authors of Upcoming Articles
Readers may now listen to AJHP podcasts that feature brief interviews with authors of upcoming AJHP articles. Each podcast is 10-15 minutes long and provides additional details about the authors' work and its implications on practice. Readers may listen to these podcasts as streaming audio at www.ajhp.org or subscribe to them through iTunes. Feedback or comments regarding this service can be sent to the Journal's editorial staff at ajhp@ashp.org.
Notion Ink’s slate tablet shouldn’t be ignored
The Notion Ink Adam tablet was a popular item for bloggers during the Consumer Electronics Show (CES) earlier this year. The device runs the Android operating system and offers some very interesting technology for the end user like a touchpad on the back of the device and a 10.1” 1024x600 Pixel Qi display.
The Pixel Qi screen offers the quick refresh of an LCD screen with the low power consumption and direct sunlight readability of e-ink. I’m excited about the Pixel Qi technology and have been waiting for their screens to appear in consumer devices for quite some time. In fact, I’m holding off my purchase of a Kindle DX until I see a Pixel Qi screen for myself. I’m just not a fan of reading PDF files on a backlit LCD display, and reading them on a Nook or Kindle isn’t a great experience either.
Contributor Blogs
Recent Podcasts
Recent blog posts
- Speaking of healthcare data, is Microsoft the elephant in the room?
- Motorola DROID getting some attention in the pharmacy literature
- BCMA Implementation checklist and lessons learned
- HIMSS Pharmacy IT Symposium Summary
- New peripherals for Motion C5 and F5 tablets
- Banning Social Media in Hospitals - dumb idea
- "What'd I miss?" - Week of February 28th, 2010
- Feedly - Google Chrome extension
- HIStalk Interviews Charlie Harp - Great Read
- Cool Technology for Pharmacy - ATP-71
Recent comments
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Yep, Nexus One
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Nexus One baby
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Nice!
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Intersting concept
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A step in the right direction, albeit a little slow
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Glad AJHP has added podcasts; balance
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Great post John!
