Xavier Lanier over at GottaBeMobile.com asks the question “would [users] pay extra to have touch capabilities on their notebooks? Keep in mind, we’re not talking slates, convertibles, UMPC, netbook or MID form factors here- just plain old 12″ to 17″ clamshell notebooks.” It’s no secret that I am a big fan of touchscreen technology, but I don’t think I would be willing to pay extra for a touchscreen on a notebook. Tapping the screen on a notebook seems like it would be a little awkward. However, a touchscreen on a convertible notebook would be a completely different story. I would be willing to shell out a little extra cash for that combination.
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Aug 242009
AMN Healthcare: “A new AHRQ-funded study found that of roughly 973,000 orders that physicians at a large, Midwestern hospital gave nurses over a 12-month period, roughly 20 percent were verbal orders. The hospital transitioned from a paper-based to computerized provider order entry (CPOE) system during the study period. The new study is one of the first to examine how the content of verbal orders or the context in which they are given might increase risk of error. Although more hospitals are converting totally or in part to CPOE, most experts expect verbal medical ordering to continue to be used extensively for the foreseeable future. According to the researchers, who were led by the University of Missouri’s Douglas S. Wakefield, Ph.D., five factors potentially contribute to verbal orders causing medical errors—type of care setting; time of day or week; type of communication and related variables, such as the physician’s and/or nurse’s accent and articulation; the providers’ knowledge of the patients for whom the order is being given and previous contact experience between the physician and nurse; and environment including background noise and staffing levels. The study, “An Exploratory Study Measuring Verbal Order Content and Context,” was published in the April 2009 issue of Quality and Safety in Health Care.” “– There really are very few excuses for giving verbal orders in a facility that utilizes CPOE. A couple that come to mind might be in a true emergency or in the case of a physician being unable to get to a computer. Unfortunately physicians frequently abuse the verbal order system out of laziness, creating a dangerous situation. I’ve had to clarify my fair share of verbal orders that were poorly transcribed from the physicians lips, to the nurses mind, and finally onto paper. There are simply too many variable during the process. It’s like the old game where you start a rumor with one person and have them pass it on to someone else and so on down the line. At the end of the line, you have a garbled mess. Verbal orders are like that. CPOE is implemented as a safety feature to reduce prescribing and transcription error, but to benefit from the feature physicians have to use it.
MotionApps has a piece of software for the Palm webOS called Classic. It is basically an emulator that allows webOS-based devices like the Palm Pre to run legacy Palm OS software. The benefits are obvious: you have access to tons of software and it allows you to hold onto your old Palm OS apps just a little bit longer. Classic creates a virtual Palm environment on the Palm Pre, similar to what VMware’s Fusion software does with Windows on the Mac.
Because the emulator runs inside webOS, the Palm created on the Palm Pre doesn’t have hardware buttons; however all the normal Palm buttons are available on the screen. You can continue to utilize all the basic Palm functionality, including your calendar, contacts, and memos. In addition, MotionApps is working on a software update that will allow users to HotSync the emulated Palm. I don’t know when the update will be available, but you can follow the MotionApps blog here.
Classic looks like a great piece of software, and for only 30 bucks you really can’t go wrong. If only Palm would have been smart enough to use Verizon as their exclusive carrier, or vice versa, I think I’d be using a Palm Pre right about now.
ByteandSwitch: “Every week or so one major internet service or another goes down for a moment, Amazon S3, Google Apps, Twitter etc… Let’s face it, if you store data in the cloud there are a hundred variables between you and your data and if any one of those variables decides to, well, be variable, then you may not be able to get to your data for a period of time. This does not mean that you can’t use the cloud, it means that you can’t put data that you are going to need immediate access to solely in the cloud. What this does mean is using a hybrid model for cloud storage. As we demonstrate in our latest video “What is Hybrid Cloud Storage?” a hybrid cloud is an appliance that is placed on the customer’s site to act as a intermediary storage location for data that is in route to the cloud. The appliance serves many purposes: translation from CIFS/NFS to more internet friendly protocols, local cache for rapid restores of last copy of a backup or archive and as a place to get to data that would otherwise be inaccessible due to some sort of connection issue.”
– This actually makes perfect sense to me. One issue that often comes up when discussing a cloud environment, besides access to data, is speed. We have started using thin clients here at the hospital in place of desktop machines, and there is little doubt that performance has suffered. With the option discussed in the article above, data would move quickly between you and the local environment while in use, but slowly moved into the cloud in the background. I like it.
Zelrix is a transdermal patch containing sumatriptan for the treatment of acute migraine headache developed by NuPathe, a pharmaceutical company specializing in the treatment of neurological and psychiatric disorders. The patch is based on NuPathe’s proprietary SmartRelief™ platform, which according to the manufacturer’s website is “a non-invasive technology that utilizes low-level electrical energy to transport drugs through the skin in a safe and effective manner. The rate and amount of drug delivered is controlled electronically, so that the patient receives consistent therapy each and every time. Iontophoresis is an established drug delivery technology with multiple applications currently being used by physicians.” The SmartRelief™ iontophoresis utilizes pre-programmed, embedded electronics in the patch to provide consistent therapeutic drug levels. This is very interesting technology with many potential applications. Imagine the uses in professional sports where iontophoresis is frequently utilized to administer NSAIDS and corticosteroids for the treatment of inflammation
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.
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The Vitality GlowCaps is a wireless internet enabled cap for prescription bottles that uses light and sound to notify patients when it is time to take their medication. When the GlowCap is removed from the prescription bottle, the information is documented on Vitality’s server. Vitality uses this information to send the patient and physician a monthly compliance report to help monitor therapy. Of course, that’s assuming that the patient doesn’t just open and close the lid when the reminder goes off. When you stop to think of all the time, energy and money spent on patient compliance with medication, you begin to realize that the GlowCap is pretty cool pharmacy technology.
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InformationWeek: “Software developers believe developing applications to run on private clouds will become one of their main tasks over the coming year. Out of 500 surveyed, 48.9% said they expect to be doing cloud applications within the year. The Cloud Development survey is the first by Evans Data, an independent research firm that conducts periodic surveys of developers. A total of 29.7% said they are current working on applications for private cloud environments. Another 19.2% said they expect to be engaged in cloud development within the next 12 months. The largest group of respondents, 48%, said they think that Java is the best language for developing in the cloud; Microsoft’s C# was the number two pick. Evans Data surveys have tended to slant somewhat toward Java developers, since participants self-select or sign up to participate in numbers that are not precisely reflective of what languages are in use throughout the world of programming.” - This survey is of particular interest because software developers tend to heard the reset of us toward the future of computing. How do you think the iPhone became so popular; developers embraced the technology and began writing applications that can do everything from updating your Twitter page to helping physicians with their EMRs. It’s inline with Kevin Costner in Field of Dreams, “if you build it, they will come”. However, I find it strange that Java is the language of choice with Microsoft C# (c-sharp) coming in second. I’ve had a lot of issues with Java applications in the past secondary to version control. I think I’ll stick with the limited C# knowledge that I have and expand on it. My brother has been trying to get me to learn C# for years. It’s on my to-do list, just below win-the-lottery.
Hospital Pharmacy: “During the process of with drawing a patient’s nicotine patch from an automated dispensing cabinet (ADC), a carousel pocket opened to reveal 2 nicotine patches and 1 fentaNYL 50 mcg/hr patch. The nurse using the ADC immediately called the pharmacy to report the discrepancy. The pharmacy investigated and found that it was not a dispensing error. Both patches (nicotine and fentaNYL) were stored in the same medication carousel, and the fentaNYL patch slipped over the top of one pocket and into another pocket that contained nicotine patches. Generally, the hospital reserved ADC carousel pockets for controlled substances, but there was a history of pilferage of the nicotine patches when stored in matrix drawers. To deter pilferage, the pharmacy began stocking them in secure carousel pockets with the tracking feature on to count the product. FentaNYL was in a nearby pocket by itself, but when the carousel turned, patches sticking up from the fentaNYL pocket were caught and dragged to another pocket that housed nicotine patches.” - This type of occurrence is more common than you might think. To prevent this type of thing from happening, many hospitals will utilize a system similar to the Pyxis CUBIE system. Pyxis CUBIE pockets are small containers with a clear plastic lid. The lid remains closed until that medication is accessed via the Pyxis medication terminal. This prevents items from jumping to another location.
