- Valentine’s Day was #1 at the box office last weekend. That seems appropriate somehow, considering that Valentine’s Day was Sunday. Oh by the way, Avatar is now the #1 grossing movies of all time in the United States. Cool!

- San Francisco Business Times: “[Keenan & Associates] employees can call board-certified doctors at Dallas-based TelaDoc’s national network at all hours — weekends, evenings, holidays — and get recommendations and short-term prescriptions for some kinds of ailments. Henry Loubet, Keenan’s Oakland-based senior vice president of strategic planning, says the service should reduce the volume of unnecessary doctor and ER visits, especially in Northern California, which has far fewer urgent care centers than Los Angeles and Southern California.” – Telemedicine is growing. With advances in technology and the ever increasing demands placed on physicians time it’s inevitable that telemedicine will become the norm rather than the exception.

- RxInformatics.com: “Here is a fantastic pharmacist practice model for the future that is here and now at UMass Memorial Medical Center. I have the honor and privilege of knowing these folks. Their impact goes way beyond ventilator management. Nice job!” – John is speaking about an article that appears in The Annals of Pharmacotherapy. The article reports on the impact of a tele-ICU pharmacist on the management of sedation in critically ill patients on vents. Good stuff if you’re a pharmacist. How long do you think it will be before all acute care pharmacies offer video as an option for nursing-pharmacist communication? I’m betting it won’t be long. For more information on telemedicine visit the American Telemedicine Association (ATA).

- AJHP News : “Shearer said CoachRx evolved from Cigna’s “gaps in care” medication adherence programs. Data from the insurer indicate measureable improvements in patient care, including an 11-percentage-point increase in adherence to dyslipidemia therapy that prevents 262 heart attacks each year, saving an estimated $6.6 million in annual medical costs.” – CoachRx is a web based tool that gives individuals with chronic medical conditions access to a clinical pharmacist. The benefits of using a pharmacist to help patients continue to add up. I’m just sayin’.

[Just a quick thought about the term ‘clinical pharmacist’. I’ve never been a fan of the term because I believe it infers that pharmacists that don’t carry the title are less than clinical. Nothing could be further from the truth. Every pharmacist that is actively practicing performs “clinical” functions each and every time they look at a patients medication information, medication history, allergy information, etc.]

- Medscape Today : “British scientists have found a cheap and simple way of keeping vaccines stable, even at tropical temperatures, which they say could transform immunization campaigns in the developing world. The team’s method uses a patented system from Nova called HydRIS and involves mixing the vaccine with the sugars trehalose and sucrose and leaving it to dry out on a filter or membrane.” – Who said sugar was bad for you?

- Google Buzz appeared on my GMail page even though I didn’t ask for it. Now what the heck am I supposed to do with it? For those of you that don’t care to give Buzz a try, you can always opt out.

- iMedical Apps has a nice list of “Top 10 Free iPhone Medical Apps for Health care Professionals.” It’s a great list and the price is right.

- The Wall Street Journal has an interesting article on the status of iPad rivals from Microsoft , Dell and HP. I hope these devices hit the market soon, real soon.

- Check out the demo of the new Wired tablet running Adobe AIR; impressive. I have to ask myself why all these publishers and vendors have waited so long to get their tablets on the market. The appearance of the iPad before their device could mean it’s over before it starts. I think it will be hard to develop market share after the fact.

- jkOnTheRun: “Sketching the molecular composition of a compound is easy enough on a display, but getting the computer to recognize and identify the sketch is the challenge. MIT’s software does just that however, and once the sketch is identified, accessing related data is simple. How does the recognition work? The solution combines what was drawn along with how it was drawn — it’s not difficult to determine if a stroke was made from left to right or up to down, for example. Those two data sets further break down into individual elements of the sketch and all of the information is compared to a database for recognition.” – This has the potential to be incredibly useful. Take a look at the video below and be prepared to be amazed.

Original article at MITnews.

- RxDoc.org: “[from PointOfCareForum]“Lesson Four: Workarounds are not an argument against bar coding at points of care any more than an erring priest is an argument against bar coding at points of sale.”
[John Poikonen] – Huh? Of course it is. If there is a high rate of overrides, which studies have shown, there is something seriously wrong with the process.” – I had an opportunity to spend some time with John Poikonen at the ASHP Midyear in Vegas. He has a brilliant mind and truck loads of experience to go with it. Too bad I don’t have a year to spend following him around; I could learn something. It’s no secret that he is also very outspoken about the lack of literature based evidence to support BCMA. He doesn’t think it should be abandoned; he just wants someone to prove the value of BCMA before the healthcare industry crowns it king of patient safety. Anyway, John makes some interesting points in his post, but this is one that I don’t necessarily agree with (sorry, John). I agree with Neuenschwader’s comment that “workarounds are not an argument against bar coding at points of care”. Let’s face it, as long as there are humans involved in any process there will be workarounds.

- Check out the new line of Wacom Pen Displays. I love Wacom tablets.

- EHR Bloggers has a nice piece on clinical decision support (CDS). According to the post “in fact [meaningful use] specifically requests that a “meaningful user” implement 5 “clinical decision support rules (in addition to drug-drug and drug-allergy contraindication checking) according to specialty or clinical priorities that use demographic data, specific patient diagnoses, conditions, diagnostic test results and/or patient medication list.” – I’m a big fan of CDS technology and think the healthcare industry should devote significantly more resources to its development. The subject of the 5 clinical decision support rules is discussed beginning at 38 minutes 50 seconds in this podcast at RxInformatics.com.

- KevinMD:” So, there you are. Cell-phones, blessing and curse. But one thing is certain; no matter how much they may make physicians and nurses crazy, they aren’t going away. So we’ll all have to adapt.” – That about sums up what KevinMD has to say throughout the post; it’s both sad and funny at the same time. I find my smartphone to be an incredibly valuable tool.

- I don’t usually put items from my personal life on this blog page, but I’m going to make an exception today. Last weekend both my daughters competed in the USA All-star Cheer Nationals in Aneheim, CA. My youngest daughters team took first, which is terribly exciting and quite an accomplishment. She was absolutely beside herself. My oldest daughter’s team took second. This is still quite an accomplishment, but try telling that to a competitive athlete like my daughter. Most impressive was what my oldest girl managed to do over the weekend. She landed funny on her first tumbling pass of the weekend and twisted her knee and back. She managed to finish the routine before limping off the floor. Lots of ice and several ibuprofen later she managed to pick herself up and perform a second time the next days in the finals; all her decision. I am proud of both girls not only for their accomplishment, but for all the hard work and determination they put into the season up to this point. Congratulations girls!

Have a great weekend everyone.

- Avatar continues to rake in the money as it remained in the top spot at the box office again last weekend. It has quickly risen to #3 on the list of top grossing movies of all time. Cool.

- CCHIT plans to reopen testing against the initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology. Testing will reopen by February 12, 2010. More information is available here.

- LG has created the world’s largest flexible ePaper display. It’s 19” wide and it’s pretty slick. I wonder how I can get my hands on a couple of sheets. Hmm….

- GIGAOM: “Who Exactly Owns Your Data in the Cloud? – Between Gmail, Google Docs, Zoho, Facebook, Basecamp, Flickr, Twitter and countless other applications, much of our data now sits in the cloud. But few people ever stop to think about where that data is stored or how it might be accessed or used. So who exactly does own your data and who has access to it? And how much privacy can you expect?” – The post raises some interesting questions that I don’t think have any easy answers.

- besttabletreview: “There’s a lot of potential in tablets — no one can deny that. The main debate is if any company will be able to unlock that potential and offer it to consumers at a reasonable cost. A lot of people think that will happen next week when the Apple Tablet or iPad or iSlate or iDontCareWhatItsCalledIWillBuyItRegardless is announced. While we’re not convinced of that, Apple will certainly provide the kick in the pants to validate tablets and boost them into the mainstream.” – I think this is a fair statement. Look what the iPhone did for the smartphone industry.

- The WSJ has an article about Apple just in time for the speculated release of their new tablet.

- 9to5Mac: “Today, I was presented with two simulations of what Apple’s futuristic OS could look like working with medical and engineering applications. The simulations were done on an iMac and I think that you’ll find them to be absolutely fascinating. As long as you know that they’re simulations and not secret tests that I’ve discovered.” – The video below shows some pretty wicked-cool stuff. There is more information and an additional video at the 9to5Mac site.

- A colleague of mine told me last year that “if you only attend one technology conference next year, make it HIMSS.” That was my plan until I was informed late last week that my trip was canceled secondary to budget cuts at the hospital. HIMSS10 will be held in Atlanta at the Georgia World Congress Center March 1-4. The Pharmacy IT Symposium will be held on Sunday, February 28. Perhaps I’ll see you there next year.

- Healthcare Informatics: “In addition to kiosks, tablets are another touch-screen device that patients can use independently. At Adventist, Snyder is using them as a kiosk alternative that can also take credit card swipes and can be used anywhere in the hospital. “You can push the same content to the tablet or the kiosk,” says Snyder. At Adventist, patients waiting for morning surgeries are handed tablets in the waiting room. “If there is a co-pay due, we process that, and it allows one registration clerk to handle four or five patients at a time,” he says. “We’ve been an early adopter as to how much we’ve leveraged this in our revenue cycle.” – Interesting use of tablet PCs don’t you think?

- I’ve developed a bit of an interest in telemedicine in the past couple of weeks. Here are a few links I found helpful: Telemedicine and Telehealth Articles, an Introduction to Telehealth at Digital Telehealth incorporated, and a TeleHealth stream at the Healthcare Informatics Forum. The concept of Telehealth has much broader application than I once thought. This could be a very interesting and dynamic field in the very near future.

- A friend of mine, @poikonen, recently turned me on to using Posterous (http://posterous.com/). The same friend pointed me to an interesting article on Posterous vs. Tumblr, both popular mini-blogging services. The article is very thorough and interesting.

- Thanks to @carlacorkern for Tweeting a link to ASHP’s Pharmaicsts’ Letter on Stability of Refrigerated and Frozen Drugs. References like this are a good thing to keep tucked away just in case.  Here’s another handy references for Light-Sensitive Oral Prescription Drugs from the December issue of Hospital Pharmacy. You always seem to need references like these at the worst possible moment, and you can never find them; murphy’s law.

- Speaking of Hospital Pharmacy, the journal can no longer be found at the Facts & Comparisons website. The journal now resides with Thomas Land.

- Earlier this week I tweeted that I was thinking about going back to school and asked for recommendations on what field to pursue. Out of the entire Twitter universe I only received three responses: one to get an MBA, one to pursue software engineering and one person thought I should become a belly dancer. Hmm, I wonder what I would look like in a belly dancing outfit. On second thought don’t, that image could cause someone irreparable harm.

- I do a little per diem work at Children’s Hospital Central California (CHCC) in Madera, CA a couple of days a month. It helps me keep my pediatric pharmacist skills current. One thing odd about the place is the inability to connect to the outside world while inside the hospital; no 3G, no cell signal, no wireless, etc. In addition, the hospital IT department has the internet locked down so tight that you can’t do anything online. I worked at CHCC yesterday and felt very isolated from the rest of the world for the 11 hours I was there. It was strange, but I felt relieved whey my DROID went crazy with all my new Tweets, emails, and text messages when I was about half-way to my truck in the parking lot. Weird.

- GottaBeMobile has been hammering Dell about the Dell Latitude XT and N-Trig drivers. I use a Dell Latitude XT2 and have a copy of Windows 7 Ultimate sitting at home on my shelf, but haven’t installed it because of what I’ve been reading at GottaBeMobile. I haven’t been impressed with the XT2 and am already looking for a replacement.

- Evernote has a new release for Windows.

- mobihealthnews has an interesting read on the use of technology and medication adherence.

- PEPID is now available for the Palm Pre.

- Engadget: “While we can’t say for sure that videogames, as your grandmother insists, do indeed rot your brain, thanks to research conducted at a variety of Universities around the States we know that better gamers tend to have more gray matter than others — at least in certain areas.” – Very interesting.

- The NFL Title Games are this weekend. I went 2-2 last weekend, bringing my playoff record to a respectable 4-2 overall. One of my loses last week was handed to me by way of the Saints kicking the crud out of my Cardinals. Oh well, there’s always next year. My picks for this weekend are: Vikings and Colts to win.

Have a great weekend everyone.

While the idea is sound, the implementation has something to be desired. The overwhelming attention to the definition of “meaningful use” and the looming 2011 timeline has created some unwanted side effects to the ARRA. Hospitals have started throwing project plans in reverse for significant revision or throwing them out the window and starting over all together. Projects that may have been in the pipeline for months, or years, are now taking a back seat to the ARRA requirements. Project development and timelines are involved processes that are designed to work around several variables such as capital budgets, current software and hardware specs, and available human resources.

Many healthcare systems have yet to develop a plan to implement many of the requirements necessary to meet the ARRA “meaningful use” criteria. If a healthcare systems wasn’t ready to begin the process at any time over the past several years what makes the US government think they’ll be ready just because they say so? Is the infrastructure in place? Do they have the resources to not only implement, but support the new systems as well? These are all questions that people should be asking. I for one am disappointed in our facility as we have decided to immediately move forward with projects that weren’t slated for another 18-24 months. To make this happen other projects have been placed lower in the priority queue, creating a lack of resources that risk jeopardizing the quality of both implementations.

Healthcare systems should not be directed down a path that they feel unprepared to face. Doing so will only invite failure.

As I wrap up my time here at Innovations ’09 a few thoughts come to mind:

I should have stayed an extra day or two. There are two hospitals near here that I would love to visit: Pinnacle Health in Harrisburg and Main Line Health. When I grow up, I want to be like them.

Overall Innovations was a good experience, but I am looking forward to the ASHP Midyear in December of this year. I hope to see you all there.

iHealthBeat: “Thirty-five percent of hospital CIOs surveyed said it would take their facilities three years to achieve 100% adoption of computerized physician order entry, according to a new survey from the College of Healthcare Information Management Executives. Twenty-seven percent of CIOs surveyed said it would take their hospitals two years to achieve 100% CPOE adoption, while 17% of respondents said complete CPOE adoption would take four years and 13% estimated a five-year time frame to achieve 100% adoption. Only 9% of CIOs surveyed said full CPOE adoption could be achieved in one year.”  - Remember that the “adoption year” timeframe is 18 months away (2011) with a 2012 start date qualifying you for the full incentive potential. This means you could actually wait as late as 2013 for full adoption and still qualify for funding. I realize CPOE is a major project; we’re struggling with it right now. Bu I still think hospitals have enough time to do this right and still get 100% usage. As the saying goes, “nothing worth having comes easy”.