medGadget “…researchers at University of Florida are reporting that they developed a way to load topical anesthetics into contact lenses to provide extended delivery of pain relief in a uniform fashion.  And since many of the patients that undergo eye procedures have been wearing contacts prior, they’re already used to putting them on. From the study abstract in Langmuir:

Here we focus on creating dispersion of highly hydrophobic vitamin E aggregates in the lenses as barriers for drug diffusion for increasing the release durations. This approach has been shown previously to be successful in extending the release durations for some common hydrophilic ophthalmic drugs. The topical anesthetic drugs considered here (lidocaine, bupivacaine, and tetracaine) are hydrophilic at physiologic pH due to the charge, and so these cannot partition into the vitamin E barriers. However, these surface active drug molecules adsorb on the surface of the vitamin E barriers and diffuse along the surface, leading to only a small decrease in the effective diffusivity compared to non-surface-active hydrophilic drugs. The drug adsorption can be described by the Langmuir isotherm, and measurements of surface coverage of the drugs on the vitamin E provide an estimate of the available surface area of vitamin E, which can then be utilized to estimate the size of the aggregates. A diffusion controlled transport model that includes surface diffusion along the vitamin E aggregates and diffusion in the gel fit the transport data well. In conclusion, the vitamin E loaded silicone contact lens can provide continuous anesthetics release for about 1–7 days, depending on the method of drug loading in the lenses, and thus could be very useful for postoperative pain control after corneal surgery such as the photorefractive keratectomy (PRK) procedure for vision correction.

Cool, simply cool.

Check out the image and rest of the article “Transport of Topical Anesthetics in Vitamin E Loaded Silicone Hydrogel Contact Lenses” at the Langmuir site.

For those of you that haven’t experience “4G” you’re missing out. It’s quite snappy. I frequently use my Galaxy Nexus to watch movies on Netflix while waiting for my daughter at Volleyball practice. No lag. No buffering. Just a smooth movie watching experience.

The problem addressed by metal RFID of forgotten surgical tools, sponges and towels is a serious one. The Healthcare Informatics Company found in 2008 that in one out of every eight operations, surgical tools are not properly accounted for. Other statistics indicate such items are left inside a patient’s body in between 1 out of every 1,000 and 1 out of every 5,000 operations. When this happens, they can cause infections and require additional operations, putting a patient’s health at risk and costing a hospital time and money. Until now, hospital operating table personnel had to manually count each small item.

The solution comes from a new generation of small RFID tags. These new metal RFID tags are robust enough to be inserted into surgical instruments, towels and sponges at the time of manufacture and can be read from distances of up to two meters. However, they remain compatible with, and safe for the human body. Xerafy, a Hong Kong company specializing in this technology, has recently introduced a new range of such RFID metal tags. Now RFID for surgical instruments allows them to be tracked automatically, through the operation itself and even throughout sterilization and disposal.

Xerafy offers a couple of whitepapers on the subject worth reading. They can be found here.

All that changed when I was lucky enough to get a Chevy Cruz. There’s nothing particularly special about the car. It’s comfortable enough, has plenty of leg room, gets decent gas mileage and has enough pep to meet my needs, but that’s not the thing that caught my attention.

When I jumped into the car I noticed that all the instrumentation was nicely laid out, easy to read secondary to visual queues and gave me immediate feedback when I changed something. For example, when I changed the environmental controls the display in the dash told me whether the fan was on or off and where the air was coming from. When I turned the lights off and on I received immediate visual feedback as well. It was pretty slick.

It would be nice if healthcare systems were like that. Some of the stuff I’ve used in the pharmacy over the years was pure crap when it came to user interface design and useful feedback. Just sayin’.

During one conversation a pharmacist mentioned the concept of “witnessless waste”. Intrigued by the idea he and I started talking about ways to create a system that would allow nurses to waste controlled substances on the floor without the need for a second nurse to witness the process. The need to grab another healthcare professional to witness waste is a problem for any healthcare professional in a busy environment be it nurse, pharmacist or physician.

Anyway, I remember blogging about a system way back in 2010 that could potentially be the foundation for a witnessless waste product. The ValiMed system uses Photoemission Spectroscopy to quickly validate medication admixtures, including controlled substances. Depending on the solution being tested the ValiMed system can perform a comparison in anywhere from 1 second to 1 minute with as little as 0.15mL of fluid. It would be interesting to see a system such as this as a standalone witnessless waste system.

Imagine taking a system like this, developing additional functionality to measure the volume injected, record the nurses information, identify the waste and generate a permanent log of the transaction. These devices could be placed strategically throughout the nursing units for easy waste capture of controlled substances.

Another ideal place for a device like this would be in operating room s (ORs) where anesthesiologists are anything but meticulous with their record keeping when it comes to controlled substance waste. Below is an image taken from a actual OR where drugs were carelessly tossed in a box with no accountability. Can you imagine sorting through a mess like this? I can because I’ve had to do it at various times throughout my career. It’s no fun, and it lends itself to diversion.

A device that could analyze, measure and record waste in real time could go a long way in improving such a haphazard system. Of course this would only work for liquids. Now if I could only figure out how to liquefy tablets on the way into the machine….hmm. 

Lenovo T410S Laptop or Lenovo x201t Tablet PC – I go back and forth between these two machines. The T410S has a bigger screen, faster processor and more memory, but it’s not a tablet PC. The x201t is smaller, easier to use and I can take notes directly on the screen. The smaller size is especially important when I have a long flight; the T410S doesn’t fit well in the cattle-car seats on planes.

Motorola DROID – I love this phone and haven’t seen anything new to convince me to change, although I think I’ll have a Motorola DROID BIONIC shortly.

Kindle DX – Still nothing better than an e-ink screen for reading. Period. When I see a journal article worth reading I simple dump it in a “To Read” folder on my computer. Every so often I move those on to my Kindle DX and read them when I have down time. The DX’s large screen works well for PDFs.

Android Tablet (my rooted NOOK Color) – Games, email and social media in a small package with long battery life.

Verizon MiFi, a.k.a. “Mobile Hotspot” – Simply can’t live without connectivity

I recently purchased an HP TouchPad. It’s turned out to be a really nice tablet. I’ve enjoyed using it over the past few weeks.

On a recent trip to Cincinnati, OH I decided to leave my Kindle DX and Android tablet at home, and take the TouchPad instead. I used it for email, web surfing, social media and games; just like its Android counterpart. I tried using it for reading in place of the Kindle DX. It worked, but found that I like the e-ink screen better.

I’ve heard people say they use their tablets, specifically their iPads, for document creation, editing, etc. I managed to use the TouchPad to compose a blog post for another website while en route to Cincinnati, but I wouldn’t recommend doing it on a regular bases. Sure, I was able to create the post, but there were several things I missed. I’m not a natural writer and many of my blog posts go through several edits before getting pushed to the web. In my opinion a keyboard and mouse work better than a touchscreen for editing a document. Overall it worked, but certainly not as good as a laptop.

So, what’s the final verdict? The TouchPad could easily take the place of my Android tablet and my Kindle DX, but I still prefer the Kindle for reading. And you can forget about using something like the TouchPad in place of a laptop, it’s not even close.

Below are some of the laptops that I find aesthetically pleasing.

Lenovo ThinkPad T410S

Some people think the Lenovo ThinkPad line is too plain to be attractive. I humbly disagree. I find the simple black matte finish strangely alluring. The simple lines and no nonsense look of the machine appeals to me, whether I working on it or it’s simply closed sitting on my desk.  It’s a very professional looking machine.

The T410s is thin and light at only 0.8- inches thick and weighing in at just under under 4 lbs. It’s made of carbon fiber that looks bit like plastic, but not in a cheap way. Overall the machine is quite stunning.

Lenovo IdeaPad U260

Like the ThinkPad T410S above, the IdeaPad U260 is made by Lenovo and shares the same quality build. But that’s about where the similarities end. This is a slick little machine made to look like a book when it’s closed. Weird, yes, but cool nonetheless. I had the opportunity to play with one at the Microsoft Retail Store in Bellevue, WA on a recent trip.

The U260 is a very portable machine with a 12.5-inch screen. It’s made from a magnesium-aluminum alloy shell making it relatively light at 3.4 pounds. In addition to the good looks it has leather palm rests and a glass touchpad. While I wouldn’t use the U260 as my primary machine because of the small screen size, I certainly wouldn’t hesitate to carry it with me.

Toshiba Portege R700

I’ve always like Toshiba laptops, but have only owned one. The reason has nothing to do with the looks, but rather the poor battery life I’ve seen with many of their machines. The Toshiba Portege R700 is another in the long line of great looking thin and light machines. It’s slightly bigger than the IdeaPad U260 with a 13-inch screen, but it’s actually a little lighter at 3.2 pounds.

The R700 has a black magnesium cover, which looks a lot better than the silver body of its predicessor, the R600. Overall, it’s simply a great looking machine.

Samsung Series 9 Notebook

The Samsung Series 9 laptop is one of the thinist Windows based laptops I’ve ever seen. Even though this machine has a 13.3-inch display it comes in at a mere 2.88 pounds and is only 0.64-inches thick. For comparision the MacBook Air is 0.62-inches thick.

The minimalistic look of the Series 9, the black finish and chrome borders make it quite appealing. I’ve had the opportunity to play with the Samsung Series 9 on a couple of occassions and have to say that it’s easy on the eyes. This is a machine that I wouldn’t hesitate to own as my “ultra-portable” of choice.

Apple MacBook Pro and Apple MacBook Air

It’s hard not to like the Apple line of laptops. The aluminum finish and the unibody design are hard to resist. They’ve easily been the king of looks for several years now, but PC makers are catching up. I think any all the machines above offer similar good looks to the MacBook line of laptops.

My favorite has to be the MacBook Air secondary to it’s size. It’s so thin.

While IV rooms remain a high risk area they tend to fall off the radar of many hospital administrators when it comes to implementing technology capable of reducing risk. USP <797> tends to get all the glory even though much of the guidelines proposed in this USP chapter have yet to be shown any more effective than diligent hand washing and impeccable technique.

Improving patient safety inside the cleanroom environment

Bar-code verification – BCMA continues to provide a simple solution to enhance patient safety at the beside. What’s often overlooked is the benefits of utilizing bar-code scanning inside the acute care pharmacy, especially in the IV room. Not only does bar-code scanning provide a secondary layer of safety, it can help pharmacies manage and track inventory as well as create audit trails for later use.

Systems that utilize bar-code technology in the IV room include DoseEdge from Baxa and i.v.SOFT from Health Robotics. I’ve talked about DoseEdge before, but only recently discovered i.v.SOFT. Both solutions offer several excellent features to assist in making the IV room a safer place.

Robotics – The pharmacy world has been quietly making robotic advances in the IV room. While robotics appears to be more popular in the non-IV areas of a pharmacy, my favorite area of pharmacy robotics has to be in the preparation of intravenous medications. It’s a hot topic of discussion and appears to be advancing faster than most other areas in pharmacy automation and technology at the moment.

Health Robotics has been quite prominent in the area of IV room automation with i.v.STATION for non-hazardous compounding and CytoCare for hazardous compounding. The company recently released the results of their i.v.STATION beta-test. The results appear promising.

RIVA by Intelligent Hospital Systems is another fully contained automated IV preparation system. Secondary to i.v.STATION, RIVA is probably the most often cited IV room robot.

IntelliFill I.V by ForHealth Technologies, Inc is another automated IV solution that’s slightly different than i.v.STATION and RIVA as it specializes in preparation of small-volume IV medications. It’s hard to tell where IntelliFill I.V. fits because I rarely hear the system mentioned when talking about IV room automation. According to Baxa “the IntelliFill i.v. from Baxa is the market leader for pharmacy automation — with more than 29 million safe doses processed to date. Recently named as one of the 12 Advances in Medical Robotics by Information Week IntelliFill i.v. has more active user sites than all of its competitors combined.”

Carousel dispensing technology (CDT) – I’ve talked briefly about CDT before, but was unaware that the technology can be used inside a cleanroom environment as well as in the general pharmacy.

CleanRoom Connect from SencorpWhite “is an advanced AS/RS system for moving and securely storing inventory as it goes into and out of a clean room environment. CleanRoom Connect provides an ideal clean room gateway in a wide range of applications from pharmaceutical compounding in hospitals to clean rooms in medical device manufacturing.” I have to admit that I think it’s a pretty slick piece of hardware.

More information on CleanRoom Connect can be found here (PDF) and here (PDF)

Another video from a company called Perceptive Pixel that does some really interesting stuff with touchscreen technology. Check out their website for more information and some great demonstration videos.

And there’s Microsoft Surface and this Surface demo at CES 2011. Gorilla Glass…cool. I have no idea what I would do with it, but I really think I need one. If you’ve ever been to the Hard Rock Café on the strip in Las Vegas or on Hollywood Blvd in Hollywood, CA then you’ve seen how cool this stuff can be.

Successful entertainment game designs draw on a well-understood set of features, such as a narrative setting that motivates goals, systems of feedback, points, levels, competition, teamwork, trading, and often, self-representation using an avatar. The extent to which a game is engaging (and useful for health objectives) depends on the skill with which these are implemented as a package for a particular audience.”

I encourage everyone to go to the JAMA website and read the rest of the commentary, it’s quite interesting. I think video games have their place in society along with every other piece of technology we’ve developed over the past 20 years. I can attest to the fact that video games can be used to sharpen your reflexes, dexterity and your ability to make some pretty quick decisions. In addition games can be used to simulate complex situations in which different decisions lead to significantly different outcomes. I find value in that. Unfortunately they can also be used to simply kill time and lay waste to ambition and imagination. I don’t find value in that.

How can this all be applied to healthcare? I don’t know. No one knows for sure. One thing I think video game technology is good for is advancing computer software and hardware technology, which in turn trickles down into healthcare; eventually. And that’s certainly a good thing.