Update: Looks like they got it working within 5 minutes of me posting this. It’s a nice format. Check it out for yourself here.

I’ve said it many times before, the IV room (a.k.a. the cleanroom) in hospital pharmacies is in need of a major overhaul. Sure, we went through the big USP <797> thing a few years ago, but we didn’t really change anything inside the IV room.

After following the stream of cool technology coming out of CES 2012 a couple of weeks ago I’ve decided that new IV hoods need to make use of the following:

- Continuous data collection. An IV hood should be smart. It should collect information in real time; air quality, flow, etc, and provide feedback to the user as well as anyone else that needs to monitor these things.

- IV hoods need to have a heads-up display made from Samsung’s Transparent Smart Window. Basically it’s a full blown Windows 7 machine built into a transparent LCD screen; pretty stinking cool. It could be used to view patient information like allergies, current medication regimen, labs, etc. In addition the Smart Window could offer the person in the hood feedback on what they’re making. Two-way video communication with a pharmacist outside the IV room? No problem. Or you could just use it to check your social media.

- The surface of the hood should be something similar to Microsoft Surface. As things are placed inside the hood the surface could collect and analyze information on the item, including what it is (barcode, RFID, NFC), whether or not it’s compatible with other things in the hood, if air flow is blocked, check the items against the patient for whom the compounded is being made via clinical decision support tools, and so on. Real-time clinical and operational information. 

“The thing that is missing is getting the people with the domain expertise aligned with the people with technological know-how to turn ideas into branded services,””

I think these comments ring true for many of us that realize the disconnect between the people designing and building products for healthcare, and those actually using them. I can attest to the fact that it exists in many aspects of pharmacy automation and technology where things have a way of being forced down your throat. It becomes a game of which product is the “least bad”. It’s called settling for something, and it never really makes anyone happy. That’s why we’ve seen so many homegrown systems in pharmacies over the years.

There once was time when terrible usability at least meant great functionality. Unfortunately many companies have chosen to improve the usability at the expense of the functionality, which ultimately leads to a crappy product. I’ve experienced this many times during my career, especially with pharmacy information systems where improved UI’s have often resulted in poor performance, more mouse clicks and frustration.

Do the industry a favor and ask the end users what they need, instead of giving them what you think they want.

While looking at the table of contents from my favorite journals and reading through the abstracts has value, it falls short of providing the same level of information one gets from digging into an article, looking at the data, viewing the tables and graphs, etc.

In an attempt to improve my access to information I signed up for a service called MedInfoNow.

MedInfoNow touts itself as “A personalized weekly email that quickly summarizes the latest journal article abstracts and citations from Medline® important to you.”

MedInfoNow is easy to use. You simply select topics that interest you, the services searches through those topics, puts them into a simple summary and emails them to you once a week. The service provides obvious value by giving me access to several journals in a single location, but MedInfoNow definitely falls short of my expectations. I was already doing much of what the service provides via RSS feeds, Twitter and frequent visits to my favorite informational websites.

The one thing I really need is access to full-text articles. Unfortunately MedInfoNow doesn’t do that. While it does provide links to some full-text articles, those articles are freely available to anyone and don’t require a paid subscription to the journal or MedInfoNow. Bummer.

Is MedInfoNow worth the $129/year I’m paying? Hardly. My subscription expires in June 2012. I won’t be renewing.

A systematic review of the psychological literature on interruption and its patient safety implications
Simon Y W Li1, Farah Magrabi2, Enrico Coiera2

Abstract

Objective To understand the complex effects of interruption in healthcare.

Materials and methods As interruptions have been well studied in other domains, the authors undertook a systematic review of experimental studies in psychology and human–computer interaction to identify the task types and variables influencing interruption effects.

Results 63 studies were identified from 812 articles retrieved by systematic searches. On the basis of interruption profiles for generic tasks, it was found that clinical tasks can be distinguished into three broad types: procedural, problem-solving, and decision-making. Twelve experimental variables that influence interruption effects were identified. Of these, six are the most important, based on the number of studies and because of their centrality to interruption effects, including working memory load, interruption position, similarity, modality, handling strategies, and practice effect. The variables are explained by three main theoretical frameworks: the activation-based goal memory model, prospective memory, and multiple resource theory.

Discussion This review provides a useful starting point for a more comprehensive examination of interruptions potentially leading to an improved understanding about the impact of this phenomenon on patient safety and task efficiency. The authors provide some recommendations to counter interruption effects.

Conclusion The effects of interruption are the outcome of a complex set of variables and should not be considered as uniformly predictable or bad. The task types, variables, and theories should help us better to identify which clinical tasks and contexts are most susceptible and assist in the design of information systems and processes that are resilient to interruption.

1. J Am Med Inform Assoc 2012;19:6-12 doi:10.1136/amiajnl-2010-000024

Note: Something else I found interesting was the length of time between when the article was received (Sept 7, 2010) and when it first appeared online (Sept 23, 2011). That’s more than a year boys and girls. And people wonder why relevant information is hard to come by. I have a rant about that, but I’ll save it for another time.

MedVantx, Inc., has announced the deployment of its patent pending Patient Profile™ patient medication and adherence reporting engine across its network of 3,600 high prescribing primary care providers participating in the Company’s integrated program of initial free medication therapy, adherence management and home delivery program. This new program utilizes the Company’s proprietary automated ATM like sample management system (“MedStart™“) and an integrated secure web reporting portal to provide physicians visibility to their patients’ adherence to chronic medication therapy…

The MedStart™ system automates the traditional sampling process for the physician; captures physician sampling data for inclusion in the patients’ claims history medical record and provides consumers access to highly relevant drug and disease state educational materials. Since patients don’t always get prescriptions filled, physicians can enhance adherence by providing their patients with initial therapy and better informational tools to manage their conditions right from the office…

 

Now with the availability of the MedVantx Patient Profile™, physicians are able to view data about how patients, on an individual basis, are complying with their prescribed medication treatments.  By showing exactly when a patient fills prescriptions, physicians can detect late refills, gaps in medication fulfillment, discontinued treatments and more to accurately access and improve patient compliance.

Interesting concept. I often wonder if simply getting rid of chain and grocery store pharmacies, and going back to neighborhood community practices would be the best way to improve patient medication compliance. I’ve worked in chain, grocery store and community pharmacies and have always felt that the small community practice knows their patients best and provides the best patient care when it comes to medication management. Something to think about anyway.

More on the system mentioned above can be found at the MedVantx website.

Abstract
Medication adherence tends to affect the recovery of patients. Patients having poor medication adherence show a worsening of their condition and/or increased complications. Unfortunately, between 20% and 50% of chronic patients are unable to manage their medications. This study proposes a model to improve the patients’ medication compliance by reducing medication frequency.

Published studies have shown that, based on the patients’ lifestyle, simplification of the medication frequency and remodeling of the medication schedule is able to help improve medication adherence. Therefore, this study tried to simplify medication frequency by combining therapies. Moreover, by adjusting according to lifestyle, the study also tries to remodel medication timing in relation to mealtimes to create personal medication schedules.

In this study, we used 19,393,452 outpatient prescriptions from the National Health Insurance Research Database to verify our system (algorithm optimized). At the same time, we examined the differences between the frequency summarized by general public and experts’ advice medication behavior. Compared with the experts’ advice method, this system has reduced the medication frequency in about 49% of prescriptions.

Using combined medication to simplify medication frequency is able to reduce the medication frequency significantly and improve medication adherence. Furthermore, this should also improve patient recovery, reduce drug hazards and result in less drug wastage.

Link to Android version is here.

Link to iPad version in iTues store is here.

Consumers have been able to deposit checks for about a year now by simply snapping a photo of the front and back of the check and sending it to their bank. It’s kind of like having an ATM in your pocket. I realize that there could be some issues using such technology for prescriptions, but heck, why not? Seriously, why would anyone have an issue with a patient taking a photo of a prescription for ciprofloxacin tablets and sending it to their pharmacy? I wouldn’t.

You can find more information here.

Lexicomp’s I.V. Compatibility module is now available for your Lexicomp On-Hand subscription for Android™! By following the update instructions below, you can add this module to your existing Lexicomp On-Hand subscription. There is no additional charge for this enhancement.

The I.V. Compatibility module allows you to review compatibility and stability information for hundreds of parenteral medications and fluids. This module is based on information from the King® Guide to Parenteral Admixtures®. Thousands of clinicians are already using Lexicomp’s I.V. Compatibility module every day – now you can access this vital information on your Android smartphone or tablet as well.

To update your subscription to include I.V. Compatibility, follow these instructions:
Ensure you have a strong Wi-Fi or cellular connection.
On your Android device, tap the Market icon and search for Lexicomp.
Select Lexicomp and tap Update. When the warning appears, tap Accept & Download.
When the application is installed, tap the Lexicomp icon to access your software.