In this case it’s ASHP’s Interactive Handbook on Injectable Drugs: IV Decision Support by Lawrence A. Trissel. Every pharmacist working in a hospital pharmacy knows about this reference. And if they don’t then they have a big problem because it’s only one of the most definitive reference sources for IV compatibility. Over the course of my career it’s simply been know as “the Trissel’s”. (kind of like “the Talyst”…just sayin’ – private joke people)

There’s a link in the ASHP web store leading to a “getting started video”, but I couldn’t get the video to run. Little bit of a fail. Perhaps ASHP’s never heard of YouTube. Who knows.

The Author of the article, Pat Moorhead connected a BlackBerry PlayBook to a Samsung 21.5” LED Display, Apple Wireless Keyboard and Acer Ferrari Bluetooth mouse. You can see the setup here.

Overall Pat had some good things to say about the PlayBook as a modular device, but it appears that we have a long way to go before tablets like the PlayBook, iPad and Xoom can function as a real productivity tool. “I was not nearly as productive as I could have been on my notebook or desktop computer. Not even close. The biggest productivity sucker for me was the difficulty in tabbing back and forth between web tabs followed by the lack of responsiveness on web sites followed by the waste of white space on the large display followed by the lack of an integrated mail and calendar solution. If I compare this experience with the other modularity experiments I have done, theAtrix Lapdock still comes out on top and that wasn’t even very productive. I am not going to ditch my laptop or desktop any time soon.” Although I suppose it depends on your definition of productivity, but for me productivity goes beyond surfing the internet, playing on Twitter and reading my email. Basically I feel the same way as the author. I no longer use an iPad because it simply didn’t meet my needs. 

With that said I believe that we’re headed for an environment where the new model for tablets will eventually take the place of desktops, laptops and netbooks for most of our computing needs. As Pat says “I can envision a future where we carry around a personal module and when we get close to any display, we can easily interact with our content.” That would be something. Simply walk into an area with monitor, keyboard and mouse, pair them to your tablet, sit down and go to work.

This model fits nicely with my vision for cloud computing, however we need a few things to happen first.

1. We need to find a way to always be connected. I know that wireless connectivity is becoming more ubiquitous by the day, but we really haven’t reached the point where you can give up desktop storage. I’m not sure I want to ever completely give up the desktop storage model, but we certainly need continuous connectivity to enjoy the full potential of mobility. To that end, companies like AT&T, Verizon, etc need to stop charging folks for multiple data plans when one will do. People should be allowed to tether their devices without fear of the data police coming down on them. You can read more about my thoughts on the subject here if you like.
2. Better native browser on tablets. The iPad has a really crappy browsing experience. The Xoom isn’t much better. I’ve only played with the PlayBook briefly, but found it to be better than the others, but still not perfect. According to Pat Moorhead “the BlackBerry PlayBook has the best native web experience in a tablet.” As we move away from the old fashioned desktop model browsers will become increasingly important.
3. Universal office suite. Like millions of other people I use Microsoft Office for nearly all my document, spreadsheet and presentation needs; right or wrong makes no difference. Devices like the iPad, Xoom and PlayBook still have difficulty handling these file types. The inability to easily move presentations to the iPad was the primary reason I decided it wasn’t for me. It was possible, but it required a lot of work. Why would I go through the trouble of “forcing” a presentation onto a tablet when I could simply deliver it from a laptop or netbook? Here’s what Moorhead had to say about the PlayBook: “Of all the tablets I have used, including iPad 1, iPad 2, Xoom, Galaxy Tab, Archos 5 IT, the BlackBerry PlayBook most properly read MS Office documents. It wasn’t perfect, but it was closer to the “real deal” than any other device.” We’re getting closer, but still not there.

Ultimately devices like the PlayBook, iPad, iPad2, Xoom, Galaxy tablet, etc were not designed to replace desktops, laptops and netbooks, but it’s the natural progression of things. As we continue down the path of mobility and modularity we may actually see the vision of the tablet preached by Bill Gates back in 2001 – “The real value of the Tablet is that it makes it possible for knowledge workers to bring the power of the PC into more places than ever, and they can do it right away, with the same software they use on their office PC or laptop today.” Maybe not exactly the same software, but certainly the same productivity. All we need now is a little imagination and some good old fashioned innovation.

Anyway, I found his responses fascinating. He said that he uses his iPad in the cockpit of his aircraft to replace an “entire bag full of papers and books”. He was using an application to file his flight plan, check the weather, handle some flight calculations and review his “alternate” landing sites. In addition he was reading the New York Times and checking his email all while enjoying breakfast.

We talked a bit about the features of the iPad and how he liked it. He indicated that he used to have an iPhone and thought it was similar enough that he didn’t have much of a learning curve.  Before leaving he finished up the conversation by saying “it lets me keep everything in one place” before turning back to finish his meal.

The short conversation got me thinking about the often overlooked value of the new generation of tablet design. In this case it was an iPad, but it could have been an Android device, BlackBerry PlayBook, or HP TouchPad. Three things struck me:

First – The importance of the tablet form factor. Everything the gentleman was doing on his iPad could have easily been done on any computer. However, during our conversation he said that he used to use a laptop in the cockpit, but found that it was awkward. He liked the form factor of the iPad much better. Slate tablets are lighter, smaller and have better battery life. It’s hard to beat that combination of features for quickly viewing information.

Second - Standardized user interface and user experience. The fact that his learning curve for the iPad was improved by his previous use of an iPhone didn’t escape my attention. Android smartphone and tablet manufacturers should make note of this. The current trend with Android tablets is to create a customized user interface that overlays the “stock” Android UI. As cool as I think the aftermarket user interfaces are, they have the potential to create a bit of a dilemma for the end user. Keep it standard across the board boys and girls. From what I’ve seen of the TouchPad it looks like HP is trying to keep the experience similar across its line of devices.

Finally – Availability of key pieces of software and applications. Consuming information on a mobile device certainly took center stage for this gentleman as he was using his iPad to take the place of more than one item that he previously carried in his bag. It’s hard to say if all tablet manufacturers will have enough software and applications to make their devices as compelling as the iPad. Only time will tell.

When our conversation was over and the gentleman had finished his cereal he simply picked up his coffee cup in one hand, his iPad in the other and walked out the door. I suppose that just about sums up the value of utilizing technology in a mobile form factor.

Below is a list of opinions I’ve gathered over the past 12 months. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.

And here we go…

Best idea for healthcare – An integrated healthcare solution; easier said than done

Worst idea for healthcare – An integrated healthcare solution. The current infrastructure won’t support it.

Biggest healthcare story of the year – Meaningful use and electronic health records (EHR)m

Biggest pharma story of the year - Withdrawal of propoxyphene from US market. Good riddance.

Biggest story in acute care pharmacy operations – Recalls and drug shortages; 2010 was the worst year in recent memory.

Best idea for new pharmacy practice model – PPMI from ASHP

Biggest disappointment in pharmacy practice – PPMI from ASHP

Biggest disappointment from a pharmacy organization – California Society of Health-System Pharmacists (CSHP). I reached out to CSHP regarding tech-check-tech in California and they blew me off. I received a generic response to my first email, then nothing from my follow up email back to them. It’s ok if your opinion is different than mine, but at least have an opinion. #Fail

Best idea in pharmacy that has yet to mature – Clinical Decision Support (CDS) and RFID

Best drug information resource, hardcopy – Lexi-Comp Drug Information Handbook

Best drug information resource, handheld/electronic – Lexi-Comp Lexi-Drugs

Best pharmacokinetics calculator, handheld/electronic – RxCalc for the iPhone, of course

Best medical reference, electronic/web based – UpToDate (includes access to Lexi-Drugs, online version)

Best customer support – Talyst – Disclaimer: I’ve been working for Talyst since the beginning of December 2010, but had this opinion log before then. That’s part of the reason I decided to go to work for them. I’m just sayin’.

Worst customer support – Integrated Informatics, makers of POMS

Best bar code scanner used this year – Code Reader 3500. Still my favorite.

Best article on bar-code technology – “Effect of Bar-Code Technology on the Safety of Medication Administration” NEJM 2010; 362: 1698-1707

Biggest bar coding challenge for me this year – Actually I had two challenges this year: 1) keeping up with bar-code changes from the manufacturers and 2) acting on analytics collected from out BCMA system.

Most valuable data collected – Data from our MAK (BCMA) system

Least useful data collected – Pharmacist intervention data. I just don’t see the value in continuing to collect data to justify our existence when no one does anything with it.

Best automated dispensing cabinet technology – Omnicell. While Pyxis is still king of the hill, Omnicell is chipping away with better R&D.

Best tablet that never was – Notion Adam Ink. The tablet looks great on video, and you can pre-order it, but I’ll believe it when I see it. You wonder why Apple is winning the tablet market; look no further than companies like Notion Ink and their year long tease.

Best eReader – Barnes & Noble Nook. Say what you will about the Kindle, but my daughter has a Nook and it’s a very nice, easy to use device.

Best eReader that no one is talking about – Barnes & Noble Nook Color. The Nook Color is an Android driven eReader with 7-inch LCD screen with touch interface, and it’s a great device.

Best information collection tool I used this year – Evernote. I couldn’t live without it. SpringPad is nice, but Evernote is still the big dog in this category.

Best file sync tool I used this year – Dropbox is simply awesome. SugarSync deserves mention. Microsoft has all the pieces in place, but has yet to deliver a coherent solution. Maybe next year boys.

Best screen capture utility – FastStone Capture. It’s light weight, easy to use and performs admirably. I use it all the time.

Best new desktop application I used this year – Skype

Best new smartphone application I used this year – Google Voice

Best convertible tablet PC I used this year –Lenovo X201 tablet PC, hands down.

Worst convertible tablet PC I used this year – Dell Latitude XT2 tablet PC. I used this tablet PC for about a year and always thought it was ok. That was until I purchased a Lenovo X201 tablet PC. Now I consider the Dell as an overpriced piece of junk.

Best slate tablet PC I used this year – Motion Computing J3400. The J3500 is the updated version of the J3400 rugged slate tablet. As far as Windows based slates go, I don’t think you’ll find a better device in the current crop of tablets.

Coolest new concept for a tablet PC – The Dell Inspiron Duo. I would love to see more tablet PC manufacturers use this design concept.

Worst marketing campaign for a tablet PC – The HP Slate 500. No wonder tablet PCs have such a hard time catching on.

Best not-a-tablet-not-an-ereader device – The Kno. Great concept, I hope it makes it.

Most popular “tablet” – Apple iPad

Most overhyped device – Apple iPad

Mobile device with the biggest impact on healthcare – Apple iPad

Biggest status symbol for physicians and executives in healthcare – Apple iPad

Most underrated “tablet” of 2010 – Samsung Galaxy Tab

Best tablet PC software – Microsoft OneNote. I use it all the time and love it.

Best PDF annotation software – PDF Annotator

Best tablet pc blogger on the ‘net – Warner Crocker (@WarnerCrocker) of GottaBeMobile.com.

Best UMPC blogger on the ‘net – Steve ‘Chippy’ Paine (@chippy) of UMPCPortal.com.

Most interesting blogger on the ‘net – Louis Gray. He blogs about things that interest me, and he appears to be less biased than most. I can appreciate that.

Best everything mobile site on the ‘net – GottaBeMobile

Best gadget site on the ‘net – Engadget

Coolest gaming gadget of the year – Kinect for Xbox. Bought one for my nephew for Christmas. Man, what a blast. And that doesn’t even include what you can do with it once it’s been hacked.

Best new smartphone – Samsung Galaxy S and the iPhone 4. Bought my daughter a Samsung Fascinate for Christmas and let me just say that it is one phenomenal smartphone.

Biggest surprise in the smartphone market – Windows Phone 7. I spent some time playing with one at the Microsoft Retail Store and it was really nice.

Biggest tragedy in smartphones – Basically the webOS died in 2010. I hope I’m wrong because the user interface is really something.

Most functional smartphone – Android smartphones. Take your pick.

Most exciting developments in an operating system – Android. It’s only just begun.

Best smartphone user interface – iPhone 4. HTC gets honorable mention here.

Most exciting non-hardware smartphone development – HTCSense.com. The website is a series of connected services for security, backup and remote control of your HTC device. I’m surprised Google hasn’t done something like this already. The potential is off the charts.

Best meeting/conference attended – ASHP Midyear 2010

Best advice I received in 2010 – Change jobs

Best presentation attended – There were two presentations I attended at this year that really caught my attention: 1) Alternatives to Barcoding: RFID and RTLS at the unSUMMIT and 2) Better Patient Care and Safer Staff with IV Compounding Automation at ASHP Midyear

Best presentation I gave this year – Hard to say really, but the presentation I did for Nova Southeastern University titled “Pharmacy informatics – One pharmacist’s perspective” had some pretty good informational content.

Best webinar attended – Barcoding End-to-End Solutions: From Pharmacy to Bedside. This webinar featured Dr. David W. Bates and Dr. Eric Poon from the NEJM article mentioned above.

Best vendor I worked with this year – Talyst

Worst vendor I worked with this year – Siemens

Best RSS Reader – Google Reader

Best email client – GMail

Best online collaboration tool – Google Docs

Best new thing that people won’t use – Google Buzz

Best search engine – Bing is gaining, but Google still rules.

Best browser for Windows machine – Google Chrome has now overtaken Firefox as my browser of choice.

Best extensions for Google Chrome
1. Chromed Bird
2. Clip to Evernote
3. Session Buddy
4. iReader
5. Docs PDF/PoserPoint Viewer (by Google)
6. Awesome Screenshot

Best consumer cloud provider – No brainer, Google

Most impressive push into the cloud – Microsoft with Window Azure

Best Twitter client for Android – Seesmic

Best Twitter client for the iPhone – TweetDeck

Best Twitter client for the desktop – Don’t know. I no longer use a desktop client for Twitter. I now use a combination of the Twitter website and the Chromed Bird extension for Google Chrome.

Best desktop operating system – Windows 7. I don’t care what anyone says, I like it.

Most exciting new development in a desktop operating system – Google Chrome OS. I’ve only seen glimpses of it, but I’m excited about its potential.

Most frustrating computer upgrade – Mac OS X Snow Leopard. I was forced to upgrade my 21-inch iMac  secondary to the purchase of an iPad. Following the upgrade it became slow and unresponsive, basically turning it into a very expensive paperweight.

Number of movies my wife, Lori and I saw at the theater this year – 47

Best movie that I saw in the theater- This is tough for me. I think I’m going to go with:
1. Iron Man 2
2. Red
3. How to Train Your Dragon

Most overhyped movies that I saw in the theater
1. The Other Guys
2. Harry Potter and the Deathly Hallows (Part I)

Worst movie that I saw in the theater- The American with George Clooney. The Wolfman was a close second.

Worst trend in movies – 3D. Someone please knock some sense into these people. I don’t know anyone that actually likes 3D.

Biggest grossing movie of 2010 – Toy Story 3. It did over $400 Million at the box office. Avatar actually grossed more domestically in 2010, but it was released on December 18, 2009.

Most overused word of 2010 – Meaningful use. I still don’t fully understand what it means.

Most valuable lesson learned in 2010 – Don’t wait so long to make a move and let people know what you want.

Best thing I did for myself – Changed jobs

Biggest surprise about my new job – The laptop assigned to me is older and in worse shape than the one I used to complain about when I worked in the hospital. Doh!

Best thing about the new job – The people and the projects.

Worst thing about the new job – Having to wear a “jacket and tie” when visiting “customers”.

Coolest commercials on TV – Geico (Therapist Sarge and Woodchucks) and E-trade (Solitary)

Worst advertising campaign – Visa and their Never Miss a Super Bowl commercials. Meet Larry “I’ve missed weddings. I have missed babies being born. But I have no intention of ever missing a Super Bowl, ever.” Makes me want to turn off the TV and spend a little time with the family. I assume that wasn’t Visa’s intent.

Best YouTube video of 2010 – iPhone4 vs HTC Evo. If you’ve ever met an Apple cultist, errr, I mean fanboy then you know they can’t be reasoned with because their minds are sealed off from rational thought. Baa-baa!

Biggest surprise in professional football – The Kansas City Chiefs. Well done.

Biggest disappointment in professional football – The Arizona Cardinals. What a difference a year and the loss of Kurt Warner makes.

Gutsiest coaching decision in professional football – The New Orleans Saints decision to open the second half of Super Bowl XLIV with an onside kick. Wow.

Best catch in the NFL 2010 – Randy Moss one-handed TD catch against the Jets. Crazy.

Biggest what-the-heck moment in pro sports – Jets assistant coach Sal Alosi tripping a Miami Dolphins player during kick coverage

Biggest disappointment in college football – Boise state losing a game and not going undefeated

Worst system in the universe to determine a sports champion – The BCS. Unfortunately it seems to work out year after year as teams like Boise shoot themselves in the foot.

Worst professional sport to watch on TV or in person – Major League Baseball

Best professional sport to watch on TV or in person – The NFL of course.

Most visited post on this website in 2010 – Best iPhne/iPod Touch Applications for Pharmacists originally posted September 14, 2009

Biggest blogging disappointment this year – My former employer censoring my blogging by whipping out a “social media” policy. Nice!

Here’s to a New Year full of new and wondrous things.

Is this the future of mobile computing?

Here’s a great photo of an Apple iPad on a stand with a keyboard on the desk. Is this the future of mobile computing? Will we all end up using thin slate tablet computers that are held up on stands? While we’re sitting on a desk, we may use the keyboard. When it’s time to go, we grab the slate and we run off. No keyboard needed since we’re probably going to be computing on-the-go.

The image from Dr. Kim’s post reminded me a similar setup I’ve seen in a pharmacy before. The image to the right is a J3400 tablet PC attached to the Motion FlexDock. The FlexDock offers support for an external monitor, RJ45 nectwork connectivity and multiple USB ports for keyboard, mouse and printer. In addition the FlexDock includes a charging bay with room for an additional battery.

Would it surprise you to learn that the setup to the right was introduced more than a year ago (early 2009), and that the J3400 is an “older” model tablet PC that was recently replaced by the J3500? I find that interesting.

Anyway, the presentation is below. There is an embedded video near the end that didn’t pull into SlideShare. It’s about a 30 second look at how we use Citrix on the iPad to access various clinical applications. I attempted to upload in to YouTube, but kept getting an error. I’ll try again later. If you want to see the elongated version of the videos simply go to YouTube and type in “Kaweah Delata iPad“, or something similar, and several options will pop up.

My brother and I were talking about doing something like this on the iPhone a couple of years ago. An electronic prescription pad on the iPhone makes perfect sense as the iPhone is so prevalent among healthcare professionals. Even though ScriptPad is promoted for both the iPhone and iPad I’m convinced the iPhone is a better option. Most people carry their iPhones with them at all times. I don’t think you can say that about most iPad users.

SciptPad is looking for beta testers. Check the website for more information.

ScriptPad e-Prescribing Demo from ScriptPad on Vimeo.

Consumer technology is clearly ahead of healthcare with the exception of scanning devices like MRIs, which are pretty cool when you stop to think about what they do. However, some of the most recently vaunted consumer technologies are devices aimed at information consumption like the iPad or devices designed to access data and social media while on the go, i.e. the new crop of smartphones. It’s not really new technology per se, but rather a new application of already available technology.

The iPad experiment was cool, but is basically over for me. Android phones are cool, but I’m waiting to see what will happen over the next six months. Smartphones are improving at breakneck speed, but the improvements are tied to the user experience at this point. The iPhone 4 is cool, but it’s just a shiny representation of already available technology. The original iPhone was truly revolutionary as it changed the smartphone platform forever, but the newer devices are a rehash of the same idea. The simple fact that people can compare the new line of Android devices to the iPhone 4 is proof enough that it is not revolutionary. Of course the Apple zealots will call me a complete idiot for saying that, but it’s true. One can now make a conscious choice of smartphone platform and carrier without feeling like they’re missing out. If you want to go with Google and enjoy the freedom of the cloud and choice to do things a little different, then feel free to use the Android platform. If you like the ease of use and solid integration that Apple offers with their desktop and iTunes, then by all means feel free to do so. The choice is yours, and neither is wrong.

The introduction of Android tablets is a little exciting, but their appearance on the consumer market is late. I can’t wait to get my hands on one, but most people I talk to have little interest. To them the iPad is the perfect consumer device, and at the moment it’s impossible to argue otherwise. Microsoft has the power to compete, but they appear to be in complete disarray regarding the consumer tablet market. Microsoft has a desktop presence rivaled by none, and they are still king of the desktop and tablet platform for now. They continue to react slowly to market changes and have let the tablet PC platform become stale, which is a shame because the potential is great. Microsoft is also increasing their cloud presence, and while their offerings are cool, they feel disjointed. They’re teetering on greatness, but only time will tell which direction they’ll fall. This is in complete contrast to Google who has a great cloud presence, but offers nothing on the desktop to compliment it. The perfect union might be between Microsoft and Google, but I doubt that will ever happen because they approach things from completely different directions.

HP opened some eyes with their acquisition of Palm, and I think the WebOS has the potential to be the greatest slate OS on the market, but only time will tell. HP needs to get something in the hands of the consumer quickly if they have any hope of becoming more than water cooler conversation.

With that said, technology in the consumer market is light years ahead of technology in healthcare, especially when it comes to pharmacy. I’ve only been an informatics pharmacist for about three years and have seen little change in pharmacy automation and technology in that time. Sure there has been plenty of conversation, but little action. Groups have been formed, articles written and chests pounded, but no one has bothered to get down and dirty and make something happen. Where is pharmacy automation and technology headed? No one can say. ASHP appears to be leading the pharmacy informatics charge, but their efforts are in their infancy. It will be several years before pharmacists see the results of the work being done now. We’re five to ten years behind the technology curve, and we need young aggressive pharmacists to get involved now if we hope to change the future. Where are the pharmacy schools in all this? Where are all the academics and researchers? The line between UX professionals, biomedical engineers, software engineers and clinical informatics is blurry. There’s opportunity there for those schools willing to jump in to the fray.

Some of the technologies that I’ve had the pleasure of working on over the past three years:

1. Alaris smartpumps – This was one of the first projects I was involved with when I came to work for Kaweah Delta. I love the concept and think the technology is great. However, nothing has changed since implementing the pumps in early 2008. At the time of implementation integration with bar-coding systems was “close”. Well, here we are more than two years later and we still don’t have our smartpumps integrated with our BPOC system. I know that it is possible as I’ve attended two presentations on the subject; one at ASHP Midyear 2009 and the other at the unSUMMIT earlier this year. However, there is no official word from Care Fusion.
2. Siemens Pharmacy Information System (PhIS) – One of the things I wanted to do when I got to Kaweah was get the pharmacy system up to date. We were a few versions behind. With great effort we pushed out two significant upgrades, including a platform change, and several minor patches. Now we’re using the latest version of Siemens PhIS. My honest opinion is that the upgrade had significant changes in the user interface, but did little to advance the functionality. The clinical decision support needs some work as does the ability to log interventions. Siemens could take a lesion from Pharmacy OneSource when it comes to clinical surveillance. Throw in Siemens process for requesting changes and their ho-hum customer support and you can quickly see why I’m pessimistic about the future. Here’s the best part, Siemens is considered one of the better PhIS platforms in the industry. What does that say about the rest of the systems?
3. Talyst automation – This was my first really big project at Kaweah Delta. We implemented several pieces of Talyst automation throughout February, March and April of 2008. The equipment is solid and unlike most of the software in healthcare, our AutoPharm software has the look and feel of something designed in this decade. The functionality is better than most of the products we use. They’ve been a pleasure to work with and their customer support is the best I’ve seen to date. Period. With that said, there have been no real advancements since our implementation in early 2008. Minor upgrades here and there, but nothing earth shattering. Our facility has been fortunate to be involved with beta testing new Talyst products, but they’re simply minor changes to an existing model. We don’t even use two of their more advanced pieces of technology: AutoCool and InSiteRx. The former didn’t fit our immediate needs and the latter is designed for long term care.
4. Pyxis – The world of automated dispensing cabinets is interesting. These devices have become a standard of practice in most hospitals across America. And while the concept is solid, the technology has become stale. Omnicell appears to be advancing faster than Pyxis at the moment, but even that hasn’t changed the way we practice. Remember, the current practice model in pharmacy is a couple of decades old. Nothing should go that long without a major overhaul. I would like to see changes to the dispensing cabinets that allow less open access and greater flexibility in dispensing. I mentioned this in June 2009 when I spoke about using a modified unit-dose packager on nursing units in lieu of an open drawer configuration. Think of it as using an ATM machine to get money instead of a cash register. JVM offers a product called the JV-60C30 that might fit the bill with some modification. Just a thought.
5. BPOC system, a.k.a. MAK – The bedside scanning system from Siemens isn’t half bad. The software is a little clunky, i.e. it looks just like our pharmacy system, but it works. I’m a true believer in bar-coding and think Siemens is on the right track. There is certainly room for improvement, but it does the job for now. I would like to see better integration between the Siemens clinical nursing system, their PhIS and MAK. I’m really not a fan of the jigsaw puzzle method for building a HIT system in a hospital. It gets messy. I’ve had several opportunities to speak with Siemens representatives from programmers to consultants, and when pressed on the issue of creating a better integrated system they have no answers.
6. Clinical Decision Support (CDS) – This is one of the most underutilized technologies on the market today. A well designed CDS system can offer so much yet we rarely speak of it. Implementation of CDS has been on my “IT” budget for two years running, and two year straight it got axed in the first round. It has received no serious consideration in our healthcare system.
7. Mobile technology – The use of mobile technology in healthcare is more prominent with nurses and physicians than it is with pharmacists. I have no explanation for this, but it’s immediately obvious when walking around the hospital. Our pharmacists have been using tablet PCs on the floor for a couple of years, but interest in their use remains minimal. Interest increased with the introduction of the iPad, but as I initially suspected opinions for their use in clinical work has been lukewarm. Our facility has become thick with iPads, mostly carried by executives to meetings. Whether they increase productivity or not I cannot say. I see most individuals using them to check email and their calendars; not for notes or file access. Some secretaries have brought their “department iPads” to meetings for note taking only to pull out a stand and keyboard. Not sure if that offers any advantage over a laptop or not. The perfect device for clinical pharmacists has yet to be invented. The device will be a hybrid of the desktop and the current tablet offerings. Regardless, we’ve done a poor job of investigating this technology as it offers pharmacists freedom from the desktop to practice at the bedside.

This isn’t the first time I’ve pondered the future of technology in pharmacy, and it certainly won’t be the last. I don’t think pharmacy technology will be driven by hospitals because most hospital pharmacists are more interested in advancing clinical practice than advancing technology, which is unfortunate because doing one leads to the other. The bigger issue is the lack of both financial and labor resources to do the job right (another blog post all on its own).

Pharmacy schools needs to form relationships with vendors and begin researching new technologies that will unchain the pharmacists from the physical pharmacy and drive true clinical practice. RFID, improved robotics, remote monitoring, advanced CDS, automated order verification, voice recognition, expanded system interoperability, improved allergy reporting and identification systems, alternate operating systems to drive system integration, i.e. Mac OS, Android OS, etc, better use of the cloud, and so on ad infinitum. The possibilities are endless.

I’m looking for the next revolutionary technology and certainly hope to see it soon. I’m just sayin’.