Medication packaging that expires: the Self Expiring concept

Medgadget: “Designers Kanupriya Goel and Gautam Goel propose a new design for pill blister packs that will display a message not to take the drugs once enough time passes. The material would consist of two layers, with the top containing the original drug’s info label and a bottom layer with ink that slowly seeps into the top. After enough time passes, the warning message will become clear and the patient will immediately know to get a fresh refill.  The Self Expiring, as the design concept is called, won a 2013 red dot design award.”

SelfExpiring

From the reddot design award site: “Self Expiring is a packaging material for medicinal products that visually ‘self expires’ over a fixed period of time. This packaging will graphically display a ‘not fit for consumption’ message using universally accepted danger signs in regional languages. This solution will prevent illegal sales of expired medicines and fatalities arising from their consumption.”

Great concept. It would be cool if they could take it one step further and have the package analyze the medication inside and “expire” it when the potency goes below a pre-defined percentage. Expiration dates are good, but they don’t always tell the whole story.

Cool i.v. room technology – Drugcam Assist

[Update 12/22/2013: I received an email from one of the inventors/developers of Drugcam software informing me of a new website that contains more information about the system. The site is eurekam.fr, which contains pages describing both Drugcam Assist and Drugcam Control. It’s still not a great amount of information, but at least it’s more than I had.]

I’ve talked about technology for the i.v. room extensively on this weblog. It’s no secret that I think the i.v. room is the next frontier for pharmacy technology. The reason I think this is simple, the i.v. room is dangerous, and precious few healthcare systems are using technology to its fullest in that environment.

I’m not the only one that thinks the i.v. room is important. As of December of 2012 I knew of basically four i.v. room workflow management systems: DoseEdg DoseEdge by Baxa, Pharm-Q In The Hood by Envision Telepharmacy, SP Central Telepharmacy System by ScriptPro, and Phocus Rx by Grifols.

Joining the fray are at least two more systems that I saw at the ASHP Summer Meeting just last week: Cato software, which is now owned by DB, and Drugcam Assist by Getinge. Unfortunately you won’t find much about Drugcam Assist online, which is really too bad because it’s an amazing system. The website offers more information and a video demonstration for those that are willing to fill out a form and register. I was not willing.

Drugcam Assist
Continue reading Cool i.v. room technology – Drugcam Assist

Every amateur mechanics dream – AR-media 3D tracker app

Check out the video below from AR-Media using augmented reality (AR) and digital technology blended with real world scenarios to create an app to help would-be mechanics work on their cars. What a great, and practical use for AR. Reading instruction manuals for toy assembly at 2:00 AM on Christmas morning just went right out the window; been there.

Now pair that same technology with Google Glass, develop an application that blends AR with medication identification technology and, BOOM, something really cool.

Thoughts on the Xbox One announcement

I’ve had an Xbox system in one form or another for a long time. I currently have an Xbox 360 in my home, and there’s a Kinect attached to it. We use the system for games and movies. Typical stuff.

Microsoft’s newest Xbox, dubbed Xbox One, is taking things to a whole new level. I sat with my wife the other night and watched the announcement as it replayed on my Xbox.

Some things that caught my attention during the announcement:

  1. Three operating systems. One based on the Windows NT kernel for apps like Netflix, Skype, YouTube, Twitter, etc.  The second is dedicated to games.  The third allows the other two to communicate with each. All this is designed to provide instant switching between apps. The demo was impressive.
  2. New Kinect. People in healthcare have been experimenting with Kinect for a while. After all Microsoft offers an SDK for anyone that’s ready, willing and able. Several groups have taken advantage of the technology. It’s surprising to me that no one in pharmacy has done anything with Kinect technology inside the IV hood. I fully expected to see something this year, but nothing has materialized. Why is that? Do you think any schools of pharmacy are looking at this type of technology? Don’t some schools claim to have strong “pharmacy informatics” programs? What do they do?
  3. The improved dashboard. This goes hand and hand with item #1 above. The instant switching, the ability to snap items and multi-task is pretty cool. I’ve been in pharmacy for a long time, and I can say without hesitation that all the pharmacy information systems I’ve used are nothing short of craptacular. Xbox One is an entertainments system that will most certainly cost less than $999; likely half that. It’s connected to the cloud and offers the ability for millions of people to be connected at the same time; as I look up from my laptop I can see that there are 87,043 people online playing COD Black Ops II at this very moment. That’s one game at 10:30PM PST.
  4. Voice and gesture control. Self-explanatory and awesome. Pharmacy systems should be voice and gesture controlled; packagers, carousels, robots, etc. The idea of using a keyboard and mouse on these systems just seems silly to me.

Xbox One could be an interesting foundation upon which to build some pretty cool pharmacy functionality. The new HD-capable Kinect with Skype is an out of the box telepharmacy system. The system could also be used to bring educational videos and games (gamification) right into the living room of patients. How about using the SDK to build medication adherence applications that tie into things like the AdhereTech smart bottle? And as mentioned above in item #2, Kinect offers up some interesting ideas for gesture control/recognition for certain pharmacy operations.

It’s exciting and disappointing to think of the potential for an entertainment system such as Xbox One. Exciting because the technology is staggeringly cool. Disappointing because healthcare continues to wallow in failure when it comes to technology. Crud, we still can’t figure out how to keep electronic records. My Xbox Live account knows more about me and certainly has more accurate information about me than my GP.

A view of pharmacy through Google Glass [simulated]

I haven’t been this excited about a technology in quite some time. Google Glass makes hands-free operation a reality in the pharmacy. I don’t think it’s a long term fix as I believe that robotics will likely take over the distribution process someday, but not today. Today robotics remains expensive and clumsy.

Unfortunately Google Glass is hard to come by. And there’s little chance I’ll get my hands on any (one?) in the foreseeable future. I did however stumble across a website that allows one to create a reasonable facsimile of what the view through Google Glass might be like.

So I took a minute and did a quick mock-up of what a pharmacy technician might see if they were directed to pull a medication from a static shelf while wearing Google Glass. Click on the image below to get the full effect. A little information along with a little augmented reality (red box and arrow) would be cool.

GGPick

 

I think technology like this would be a great addition to any product that utilizes barcode scanning or requires photos. “Ok, glass, take photo”. Products like DoseEdge or Pharm-Q In The Hood that utilize cameras to document the compounding process could benefit from being able to snap a quick hands-free photo with only a voice command. Crud, you’re already looking at the product, which means Glass is too.

ResolutionMD diagnostic imaging for Android clears FDA

MobiHealthNews: “Calgary Scientific announced this week that the US Food and Drug Administration had cleared its ResolutionMD software for diagnostic medical imaging on Android devices, including the Samsung Galaxy.

Calgary Scientific claims that its ResolutionMD software, which now has six FDA clearances is the first diagnostic imaging app cleared for use on mobile devices, according to the company.

In 2012 a study at the Mayo Clinic in Phoenix found that radiologists using ResolutionMD Mobile versus a traditional PACS workstation were able to access CT scans of stroke victims 24 percent faster, according to the company. Calgary Scientific says the study found its software saved an average of 11 minutes per patient. This data appears to be new as our report at the time focused on the accuracy of the diagnoses instead of the specific time to diagnosis.”

This is cools stuff. It’s also good timing. I was talking to a colleague today about where I think Android in heading in healthcare. What I see is similar to what I saw in the early days of iOS when it was just starting to gain traction in the healthcare arena.

I’ll be at the Mayo Clinic in Phoenix in a couple weeks, maybe they’ll let me check it out.

Center for the study of pharmacy automation and technology [idea]

MadScientistEarlier this week I put up a post about a Prezi created by Dr. Robert Hoyt called Evidence Based Health Informatics: Replacing Hype with Science. It was a great presentation about a lot of the technology that healthcare has adopted over the years without any real evidence to back it up. I wish you could all see it, but it appears that someone has pulled it down. The link I have for the Prezi is dead. Bummer

Anyway, the Prezi got me thinking about how we have many technologies in pharmacy that have precious little, or no data to support their use. We use carousels, high-speed packagers, tabletop packagers, robotic medication distribution, robotic IV preparation along with other IV room technologies, smart IV pumps, automated storage cabinets, and so on. The data we do have for these items is typically provided by the manufacturer’s themselves, which makes it biased in the best of situations and completely worthless in the worst cases.

Pharmacy is in desperate need of an academic center for the study of pharmacy automation and technology. The center would study the use of pharmacy technology in different use cases, collect data, and provide the pharmacy community with the information. Look at robotics versus carousels for distribution. Analyze cross contamination in high-speed packagers versus tabletop models. Perform time-motion studies on cart fill vs. automated dispensing cabinets for medication distribution, and compare the safety of one over the other. Analyze pharmacy inventory costs of one technology over the other. And so on, ad infinitum.  Conclusions wouldn’t be necessary as simply presenting the information in an easy to understand format would suffice. Let the end users draw their own conclusions. Every practice setting is slightly different, and what may work for one may not work for another. But understanding how a piece of technology or automation fits into a particular practice model might be a significant benefit to many.

The center would tear the automation and technology apart, both figuratively and literally to unveil all there is to know about each and every piece.

Such a place would have to exist at a well respected academic research center as it is the only way to ensure some semblance of impartiality.

How would it be funded? Ah, there’s the rub. Getting funding for such an endeavor would be difficult at best. A lot of this equipment is expensive. Of course the best place to troll for money would be the pharmacy technology vendors themselves. After all, they have all the equipment that would be needed to perform the research. Unfortunately this is unlikely to happen as most companies will not be willing to drop resources into a project that they have no control over. What if the outcome of such research reflected poorly on their products? That would not only be embarrassing, but could potentially hit them in the pocketbook. No, they couldn’t risk it. How about the federal government? Perhaps, but that might be like getting blood out of a turnip these days.

Getting the equipment and funds would definitely be the hardest part. There’d be no shortage of pharmacists interested in doing that type of work. What pharmacist could resist playing with giant toys all day long?

Time to get out my crayons and start drafting a proposal….

Cool Pharmacy Technology – AdhereTech “smart pill bottle”

AdhereTechI came across this today, the AdhereTech “smart pill bottle”. Not sure exactly how it works as the information on the website is a bit vague, but it appears to utilize sensors inside the bottle to measure content. What’s cool about it is that the bottle will provide information on both oral solids as well as liquids. That’s unique in the products that I’ve seen in the past.

Our bottles measure the exact amount of pills or liquid in the bottle in real-time, wirelessly send this HIPAA-compliant data into the cloud, and remind patients to take their medication via automated phone call or text message.”

Medication adherence is a hot topic in healthcare these days, and AdhereTech is obviously trying to take advantage of it. Their blog is full of articles related to the topic.

I would like to have provided more information on the AdhereTech bottle, but information on the product is scarce. I couldn’t find a single video explaining the product in detail.

According to Josh Stein, the co-founder and CEO the company is preparing for several pilot projects to test the efficacy of their bottles compared to standard medication vials. The tests are scheduled to start in Q2 of 2013 at Walter Reed Army Medical Center and The University of Pennsylvania.

One other cool thing about AdhereTech is that they have an open API. “AdhereTech can integrate with all existing apps, programs, and adherence solutions.”

I’ll be keeping an eye out for updates on this product. It’s an interesting concept. I hope to see it in the wild very soon.

Xenex device uses UV light to kill infectious organisms

I thought this was pretty cool. Simple, yet effective.

Syracuse.com: “St. Joseph’s Hospital Health Center has stepped up its war against potentially deadly patient infections by unleashing killer robots. The hospital is using two robots, that resemble R2D2 from Star Wars, to kill germs in patient rooms with powerful blasts of ultraviolet light. After trying out the device last summer, St. Joe’s quickly saw a more than 50 percent decrease in its rate of Clostridium difficile – C. diff for short – infections. That highly contagious bug is rampant in hospitals and nursing homes. It can make patients very sick and sometimes kill them.” – That’s a big deal, especially when you’re talking about something as problematic as C. diff.
Continue reading Xenex device uses UV light to kill infectious organisms

fMRI study uncovers mechanism for drug cravings

This article at Medical Xpress caught my interest because I’ve been reading Physics of the Future: How Science Will Shape Human Destiny and Our Daily Lives by the Year 2100 by Michio Kaku, which spends a fair amount of time talking about fMRI.

“An fMRI machine uses “echoes” created by radio waves to peer inside living tissue. This allows us to pinpoint the location of the various signals, giving us spectacular 3-D images of inside the brain…

The fMRI scans allows scientists to locate the presence of oxygen contained within hemoglobin in the blood. Since oxygenated hemoglobin contains the energy that fuels cell activity, detecting the flow of this oxygen allows one to trace the flow of thoughts in the brain.

…fMRI scans can even detect the motion of thoughts in the living brain to a resolution of .1 millimeter, or smaller than the head of a pin, which corresponds to perhaps a few thousand neurons. An fMRI can thus give three-dimensional pictures of the energy flow inside the thinking brain to astonishing accuracy…”

According to the Medical Xpress article:

“Cues such as the sight of drugs can induce cravings and lead to drug-seeking behaviors and drug use. But cravings are also influenced by other factors, such as drug availability and self-control. To investigate the neural mechanisms involved in cue-induced cravings the researchers studied the brain activity of a group of 10 smokers, following exposure to cigarette cues under two different conditions of cigarette availability. In one experiment cigarettes were available immediately and in the other they were not. The researchers combined a technique called transcranial magnetic stimulation (TMS) with functional magnetic resonance imaging (fMRI).

The results demonstrate that in smokers the orbitofrontal cortex (OFC) tracks the level of craving while the dorsolateral prefrontal cortex (DPFC) is responsible for integrating drug cues and drug availability. Moreover, the DPFC has the ability to suppress activity in the OFC when the cigarette is unavailable. When the DPFC was inactivated using TMS, both craving and craving-related signals in the OFC became independent of drug availability.”

Cool stuff.

Article referenced: Takuya Hayashi, Ji Hyun Ko, Antonio P. Strafella, Alain Dagher; “Dorsolateral prefrontal and orbitofrontal cortex interactions during self-control of cigarette craving.” PNAS, January 2013, DOI:10.1073/pnas.1212185110