Our facility is running a trial of DynaMed, “an evidence based medicine point-of-care” database. It reminds me of UpToDate.
From the DynaMed site:
• According to the National Academy Press (2001) 44-98,000 American deaths per year occur due to preventable medical errors; medical errors are estimated to cost the U.S. $17 to $29 billion annually
• Using the “best available evidence” for clinical decision-making improves health outcomes and reduces health care costs
• Busy clinicians use “fast and easy” resources expected to answer most of their questions instead of resources designed to provide the best current evidence
• Clinicians sometimes turn to textbooks and online resources with substantial breadth, but these resources do not use the best available evidence
• Physicians and other health care professionals need a resource where they can reliably answer most questions quickly and accurately (i.e., with the best available evidence)
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The National Library of Medicine has a website know as Pillbox beta that allows anyone to use various identifiers on a tablet or capsule, i.e. imprint, shape, color, size and/or scoring, to quickly identify a medication. I’ve used systems like this many times for the emergency department when a patient would roll in the door with ten different medications all thrown together in a plastic baggie. The nurse would bring them to the pharmacy and say “I need you to tell me what these are”. I tried holding the baggie to my head like the Great Carnac on Carson, but most of the time I had to use other references to help me out.
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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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2009 brought many new and exciting changes not only in my personal life, but in the world of pharmacy and technology as well. I’ve learned many new things, gained some skills previously absent from my armamentarium, met some great new people, discovered the “real” internet for the first time, traveled more than ever before, discovered I don’t know diddly squat about a great many things, and am more excited about the next year than I can remember in recent history.
Below is a list of opinions about a great many things that I have seen and done over the past year. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.
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Recently I was fortunate enough to be a beta tester for the new Android version of Lexi-Comp’s suite of medical information software. I was very excited for the opportunity as I’ve been using what I would consider inferior drug information resources since purchasing my Droid about a month ago. The installation was a problem initially as the databases wouldn’t install directly to the microSD card on the Droid. As you can imagine, the databases are large and immediately filled up the physical memory on the device. Within a couple of weeks of reporting the problem to Lexi-Comp they had corrected the issue and sent me a new build that installed seamlessly.
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I finally had an opportunity to roam around the exhibit hall at the ASHP Midyear today. Of course I had to sacrifice a session to attend, but it was worth it. If you’ve never been in the exhibit hall at one of these events you owe it to yourself to check it out.
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The Annals of Pharmacotherpy (Vol. 43, No. 11, pp. 1912-1913): “Approximately 80% of pharmacists use the Internet to obtain drug information.1 Wikipedia, often found at the top of Internet search results, is a free-access, collaborative, online encyclopedia that can be edited by anyone.2 Incidents of vandalism have occurred, since the site allows anyone to contribute. For example, an incident occurred in which a fake biography was created as a joke to implicate prominent writer and journalist John Seigenthaler for the assassination of John F Kennedy. It took about 4 months until the fake biography was detected and deleted by Wikipedia.3 Although Wikipedia does have an internal quality review, the ability of internal editors to find and correct erroneous information may not be timely. As reported by Clauson et al.,4 the information found on Wikipedia may not be complete and accurate, especially in regard to drug information. Published data regarding pharmacists’ use of Wikipedia to obtain drug information is lacking. Therefore, the objective of this study was to measure pharmacists’ use and perception of Wikipedia for obtaining drug information.” – This letter to the editor discusses the results of a questionnaire given to pharmacists regarding the use of Wikipedia for drug information. I was disturbed to read that 28% of respondents reported using Wikipedia for drug information. Strange that it doesn’t appear on any of my drug information resources lists, and never will. I expect better from pharmacists.
Below is a list of drug information resources for both mobile devices and online access. I’ve used most, but not all, of these resources and have found the mobile versions to be a valuable resource when you’re on the go. While it is possible to access the online versions of these resources via a smartphone, the mobile applications are designed with the smaller screen in mind and therefore, in my opinion, work better then the online versions when using a mobile device.
Let me know if I missed any. Also feel free to comment on your favorite.
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I found an interesting article at EHR Bloggers that talks about the possibility of easy access to information via the internet resulting in difficult-to-treat patients and higher healthcare costs.
The concern raised in the NPR article describes the effect of information dissemination without context or interpretation – it happens anyway, with direct-to-consumer advertising in all forms of media, and it happens even faster with the Internet. And when patients, armed with these “facts” and the questions they raise, come to their physicians – the physician is often hard-pressed to put things into perspective. The result? Often, very-low-yield tests (or even unnecessary tests that raise the risk of harm through adverse events) and unnecessarily expensive treatments are agreed-to, simply because it’s the path of least resistance.
The problem isn’t with informed patients; it’s the model we’ve developed in our current healthcare system. The article speaks about limited time for physicians secondary to fee-for-service care. This is similar to what retail pharmacies have done with much of outpatient pharmacy services. Most retail pharmacists will tell you they spend more time fighting with insurance companies then they do talking with patients about their medications. One of the most enjoyable times of my pharmacy career was a short stint I spent working for a small independent pharmacy in San Jose. The owner/pharmacist that I worked with had a genuine interest in his patients, knew them by name and offered sound therapeutic advice. His patients appreciated his time and knowledge and were better informed to make important decision because of it.
The article goes on to offer some thought provoking ideas for closing the gap between our current healthcare model and well informed patients. It’s interesting stuff. If you have a moment I recommend you read the entire thing.
Earlier today Lexi-comp offered a sneak peak of their new drug information software for the Palm Pre. That’s exciting news for all you Palm Pre owners out there. Lexi-comp offers one of the most comprehensive drug information packages available and is certainly a favorite among pharmacists.
The Palm Pre is a great device to use as a peripheral brain for pharmacists because it allows you to keep several applications open at once. That’s a nice feature to have when you need to access something quickly.
The one thing I would ask Palm to do to improve the Pre is offer a form of the device in the image of the HTC HD2 with its massive screen. The screen on the current Pre is just a tad bit small for my taste. Even better would be if Palm would offer the device without 3G service like the iPod Touch. It’s just a thought.
