Evaluating my travel technology

My typical travel gear includes:

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.

Coolest looking laptops on the market

I have a thing for laptops and tablets, no question about it. Doesn’t matter who the manufacturer is, as long as it looks cool I’m drawn to it. It’s a good thing I don’t have unlimited funds or I’d have stacks of machines all over the house. While I’m not prejudiced against any particular laptop maker I am drawn to a certain style. For example, I like smaller laptops with screens typically less than or equal to 14-inch, and the thinner the better.
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Cleanrooms – the forgotten realm of acute care pharmacy

Cleanroom environments, a.k.a. IV rooms, inside acute care pharmacies compound some of the most complex and dangerous medications used inside a hospital. Unfortunately this area is often overlooked when implementing safety features such as bar-code verification, identification of high-alert medications, advanced training and competency and so on. I was reminded of the dangers of intravenous products by a recent story coming out of Alabama where the death of 9 patients was linked to TPN (total parenteral nutrition) contaminated with Serratia marcenscens.

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.
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Playing video games is serious business

JAMA: “The efficacy and mechanism of action of games targeting health outcomes are not well defined. Time spent playing entertainment games can enhance psychomotor skills, judgment, and high-level social skills such as leadership and collaboration.3 However, evidence also exists for the negative influence such media exposure can have on the health of children, particularly those exposed to themes of violence and aggression.

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.

Where will automation and technology make the biggest impact in pharmacy?

I was planning on writing a rant this morning about lack of motivation, leadership and dumbasses – hey, I was in a fould mood when I got up – but then I opened an email from a friend. He asked me “How can retail pharmacists get involved in this [pharmacy informatics] industry?”. My first thought was to say that retail pharmacy would be the death of our profession and that they have no business getting involved in pharmacy informatics. Harsh I know, but I told you I was in a foul mood.

Then I did something I rarely do, I thought about the question a bit more before answering. After some time I came to the conclusion that retail, or more generally outpatient, pharmacy is exactly where more automation and technology is needed. I follow a few retail pharmacists on Twitter and one generalization I can make from reading their Tweets is that they all pretty much hate their jobs. Why? Because they spend precious little time working as pharmacists, instead spending most of their time physically filling prescriptions, chasing insurance claims, etc.

What retail pharmacy needs is a super-sized dose of pharmacy automation, technology and greater pharmacy technician involvement. Nowhere in pharmacy is there a greater need for automation and technology than outpatient services. Much of what’s done in the outpatient pharmacy setting does not require a pharmacist. This echoes the words by Chad Hardy last week on the RxInformatics website. Chad states “The longer we rely on pharmacists to run the entire supply chain, the higher our risk of obsolescence.” He’s absolutely right, although the article he references insinuates that pharmacists will become obsolete secondary to technology. Nay, I say. Technology in the outpatient arena can offer pharmacists the opportunity to break away from the mundane and do a little more hands on patient care. In addition, the drive to implement automation and technology in the retail setting creates the perfect job opportunity for pharmacists interested in informatics.

Of course we’ll have to prove to the retail boys upstairs that they can save money by using pharmacists in a more clinical role, but that’s what business cases are for. Unfortunately I couldn’t write a business case to save my life. In fact, a colleague of mine told me that pharmacists are terrible at creating business cases. I suppose that’s true as most of us didn’t become pharmacists to practice business. Instead we became pharmacists to provide patient care. Go figure.

First Impressions – Lenovo T410s Laptop

There’s a new Lenovo T410s laptop in the house. It’s technically not mine because it has a giant company asset tag on it, but it’s mine for the duration of my employment and it’s one incredible machine.

The configuration is as follows:

  • Windows 7 Professional (64-bit)
  • Intel Core i5-M560 Processor
  • 160GB Intel Solid State Drive
  • 8GB RAM
  • 14.1-inch WXGA touchscreen…yes, that’s right, it is a touchscreen
  • 6 Cell Li-ion battery
  • 3-cell ultrabay battery that fits in the DVD slot when I need additional battery
  • And all the typical stuff that goes with most laptops, i.e. camera, Bluetooth, wireless (no 3G), etc
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Time to accept pharmacy robotics as our friend and ally

As the word “robot” passes its 90th birthday1 – introduced by Karel Capek in his play R.U.R. (Tossums’s Universal Robots) in January 1921 – it’s become obvious that robotics has not only captured the imagination of geeks everywhere, but has become a point of interest in many industries including healthcare.

Late last year ASHP began pushing the idea of a new pharmacy practice model, PPMI. The movement was a hot topic for a while, but seems to have lost a lot of steam recently – “Hence the name: movement. It moves a certain distance, then it stops, you see? A revolution gets its name by always coming back around in your face” (Tommy Lee Jones in Under Siege 1992) – Anyway, when the PPMI movement was still going strong many important people in the pharmacy world struggled with the best way to approach a new pharmacy practice model. Many believe, and rightly so, that the best way for pharmacists to reinvent themselves is to become the cornerstone of a more robust patient care model. After careful consideration I believe the best hope for developing such as model will be to rely heavily on pharmacy robotics to handle much of the repetitive dispensing duties now handled by pharmacist on a day to day bases. You know, free up the pharmacists. It’s not a new concept, but one that seems to escape us.

Obviously it will take some time to develop robotics to the point where it will be effective in such a system, and it certainly won’t be cheap, and pharmacists will have to fight with state boards of  pharmacy to accept it, and pharmacy administrators will have to work closely with their hospitals to develop such a systems, and someone’s going to have to be brave enough to step up to the plate and get stated, and so on and so forth. In other words it’s going to be hard and it won’t happen overnight.

Who’s up for a little project? For now let’s just take a quick look at some of the things that lead me to believe robotics is worth another look as a potential solution.

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Who’s to blame for the lack of advancement in pharmacy automation and technology?

Without question there is a lack of advanced automation and technology in the acute care pharmacy setting. Spend some time in several acute care pharmacies if you don’t believe me. There’s clearly a need for it, but it’s just not being used.

I am a fan of automation and technology in any setting, but especially in the acute care pharmacy. I believe that the continued use, development and advancement of pharmacy technology should be a key component of any plan to change the current pharmacy practice model. Unfortunately, the situation is problematic because current pharmacy technology is either poorly designed for the needs of the pharmacy or the pharmacy in which it is used has a poorly designed workflow that doesn’t take advantage of it. Why is that? Who’s to blame; someone, anyone, no one? Valid questions.
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Beyond the idea of a medical-alert bracelet with the use of text messaging

I stumbled across an article in The Wall Street Journal that discusses the use of advancing technologies to improve first responder access to important patient information. Anyone that has a severe allergy or that requires special treatment for a rare or life threatening medical condition is probably aware of medical alert bracelets. Order forms for these trinkets are prevalent in pharmacies across the country. Well it seems that the idea of medical alert bracelets is starting to take on a more technologically advanced edge like everything else in healthcare these days.

One of the things that caught my eye in the article was the mention of a program called Invisible Bracelet (iB) that utilizes text messaging to retrieve pertinent medical information about a patient, while at the same time notifying the patient’s emergency contact(s). And since I was just talking about using text messaging as a way to improve patient compliance with medications I thought it was worth a closer look.

“The program, a partnership between Docvia LLC of Tulsa, Okla., and the American Ambulance Association, a trade association, allows members for $10 a year to upload personal medical data to a secure website and receive a personal identification number. Members get cards to place behind their driver’s license, key fobs and stickers that can be put on, say, a bike helmet that show their identification number and the website address.

The program is currently available in a dozen markets and is expected to expand. Docvia trains ambulance medics to use the system. The website also allows medics to automatically generate text or email messages to designated family members notifying them where the patient is being taken by ambulance.”

Neat concept.