Don’t miniaturize your application, redesign it instead

Anyone that’s read this blog knows that I am a fan of mobile devices and touchscreen technology; from the smartphone to tablet PCs and the iPad. My love affair with mobile technology actually began with the HP 200LX palmtop computer when I was in Pharmacy School. I couldn’t believe that something so small could have so much power; funny now, but a marvel at the time. Now fast forward to early 2000 when I purchased a TRGpro, my first Palm OS device, and never looked back.
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Has interest in technology come and gone for pharmacsits?

I spent some time yesterday talking with some good people over at Pharmacy OneSource about pharmacy technology, clinical decision support, data mining, and a whole bunch of other interesting items. During one point of a conversations the history of Pharmacy OneSource came up. Part of that history includes the merger of Pharmacy OneSource with HealthProLink (HPL) sometime in late 2005.

The mention of HealthProLink (HPL) brought back fond memories of a time when pharmacy informatics was really starting to take off and I was infatuated with the Palm Pilot <insert flashback sequence here>. HPL was a set of software tools for collecting and quantifying pharmacist intervention data as well as ADR/ADE information. In addition, the application offered access to several clinical calculators and a fairly robust reporting system. I was part of the implementation team for HPL when I worked at Community Medical Centers – Fresno and used it daily for a couple of years.

This was also a time when Palm Pilots were all the rage and every pharmacist I knew carried one in their lab coat pocket. The Palm OS was a stroke of genius because of its minimalistic approach to the user interface. Anyone could pick up a device using the Palm OS and figure out how to use it in a matter of minutes. They were a model of simplicity and functionality. In addition, several development environments were available for application development as well as several “readers” and database applications. This led to the development of hundreds of medical references, medical calculators, free and commercial peripheral brains and countless ways to track patients, labs, and medications available for devices running the Palm OS. It is the only time in my career as a pharmacist that the entire profession embraced a new technology and used it to their advantage. The literature was full of “studies” using handheld devices for documenting clinical interventions1-4, carrying individually created documents and “peripheral brains”5,6 performing pharmacokinetic calculations, accessing drug information and performing drug interaction checking.7-12 The entire handheld movement was quite impressive to watch.
Continue reading Has interest in technology come and gone for pharmacsits?

“What’d I miss?” – Week of January 17th

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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Conceptual design for electronic communication in the outpatient setting

From Implementation Science 2009 Sep 25;4:62:


BACKGROUND: Health information technology and electronic medical records (EMRs) are potentially powerful systems-based interventions to facilitate diagnosis and treatment because they ensure the delivery of key new findings and other health related information to the practitioner. However, effective communication involves more than just information transfer; despite a state of the art EMR system, communication breakdowns can still occur. 123 In this project, we will adapt a model developed by the Systems Engineering Initiative for Patient Safety (SEIPS) to understand and improve the relationship between work systems and processes of care involved with electronic communication in EMRs. We plan to study three communication activities in the Veterans Health Administration’s (VA) EMR: electronic communication of abnormal imaging and laboratory test results via automated notifications (i.e., alerts); electronic referral requests; and provider-to-pharmacy communication via computerized provider order entry (CPOE). AIM: Our specific aim is to propose a protocol to evaluate the systems and processes affecting outcomes of electronic communication in the computerized patient record system (related to diagnostic test results, electronic referral requests, and CPOE prescriptions) using a human factors engineering approach, and hence guide the development of interventions for work system redesign. DESIGN: This research will consist of multiple qualitative methods of task analysis to identify potential sources of error related to diagnostic test result alerts, electronic referral requests, and CPOE; this will be followed by a series of focus groups to identify barriers, facilitators, and suggestions for improving the electronic communication system. Transcripts from all task analyses and focus groups will be analyzed using methods adapted from grounded theory and content analysis.

Although the information in the article is only a design concept, it is still worth reading. Concepts like these could be useful for many outpatient as well as many inpatient alerts; labs that are outside normal parameters, results from blood tests, incorrect antibiotic choice following culture results, etc. With the advances in mobile technology, especially mobile communication devices, this is worth serious consideration.

The digital peripheral brain

The Palmdoc Chronicles:” I’ve had a Palm Pre for about 2 months now and I can declare that the device has seen tremendous improvement with firmware updates (pushed OTA) and a steadily increasing amount of useful applications in the Palm App Catalog and the unofficial Homebrew scene.

How usable is it as an smartphone for doctors? Well I can say it pretty much does replace your old PalmOS device as it is. One of the cool features of the old Palm PDAs is the ability to keep snippets of information in the Memos (Notes) in various categories for instant recall. These notes may be protocols, clinical pearls or practically any bits of information which you want to look up while rounding for instance.

WebOS’ builtin “post-it” type Memos is ok if you are keeping about 10-20 notes but pretty useless if you are talking about 300-500 notes or more. There are several solutions at hand which overcome this limitation.”

The blog goes on to describe a few applications that can be used to create a peripheral brain out of the Palm Pre smartphone. One of these applications is the ever popular Evernote, which I use daily on my tablet PC as well as my Droid.

The information presented at the Palmdoc Chronicles isn’t restricted to the Palm WebOS. The iPhone, Motorola DROID, RIM BlackBerry devices, and a host of other smartphones are capable of storing memos, notes, PDFs and numerous other forms of information documentation.

The idea of using a PDA as a peripheral brain isn’t new. Felkey and Fox 1 were talking about it back in 2002 when the precursor to the Palm WebOS was popular among healthcare professionals. It’s interesting how the idea is as good today as it was nearly a decade ago.

1. Felkey BG, Fox BI. PDA interface: Creating the Digital Peripheral Brain. Hosp Pharm. 2002; 37:1222-1224

“What’d I miss?” – Week of January 3rd

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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“What’d I miss?” – Week of November 29th

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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Verizon, you gotta love ’em

eWeek: “Not only did it recently experience a win over disgruntled competitor AT&T, in being allowed to continue airing some cheeky ads, and then enjoy a jump in consumer opinion, but in a Dec. 1 statement, Consumer Reports revealed that Verizon was named the preferred carrier by the people it surveyed in 26 cities for its cell-phone-focused January issue.” – T-Mobile was second, while Sprint and AT&T tied for third. This is consistent with what I’ve heard around the hospital. I was previously assigned a Verizon mobile broadband card. Unfortunately our facility decided to move away from Verizon a couple of weeks ago and go with AT&T and Sprint. I am now using a Sprint 598U Wireless USB Plug and the performance and connectivity are terrible. While in Vegas last week I was unable to connect to the hospital VPN secondary to poor coverage and lack of speed. I couldn’t even check my email. I ended up using the browser on my Droid. My Verizon card never gave me any problems, ever. I spoke with a nurse today in our IT department who was assigned an AT&T mobile broadband card after previously using one from Verizon. Her story was similar to mine; bummer. It looks like I really need to set up my Droid to tether.

“What’d I miss?” – Week of November 22nd

Turkey_cartoonWelcome to the Thanksgiving edition of “What’d I Miss?”. Thanksgiving is a wonderful time that marks the beginning of my favorite time of the year. It’s just a hop, skip, and a jump until the New Year.  Squeeze Christmas in there and you have the best 6 week span of the year. Good times, good times.

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.
Continue reading “What’d I miss?” – Week of November 22nd

Lexi-Comp running on the Android OS

I just saw a Tweet from Lexi-Comp announcing that they have a demonstration video of their ON-HAND software running on the Android platform. And because I’m using a Motorola Droid as my mobile device of choice, this is very exciting news. See the video below. Additional information is also available at the Lexi-Comp website.