The Palm OS was a leap forward in technology secondary to the genius of simplicity and user interface (UI) design, something that Apple has taken to new heights with its current line of products. Too often you see companies try to take their desktop application and miniaturize it to a mobile device. That’s not an effective way to design a handheld user interface, just ask Microsoft. My first Windows mobile device was a HP Jornada in early 2002. It ran on Windows CE, and had great potential, but even I became frustrated with the number of clicks and menus one had to go through to get something done. Microsoft had broken the first rule of putting an operating system on a handheld device: don’t try to copy the desktop. Compared to the Palm OS, Windows CE was a terrible user experience. I believe Windows CE could still be a great mobile platform given the right amount of TLC, but we will probably never know.

Looking at today’s newer mobile platforms it appears that almost everyone has finally gotten the point. Palm provided the template nearly a decade ago by simplifying the UI and making the user experience priority number one. Even though Apple has nearly perfected the idea I believe that the webOS, the most recent iteration of the Palm OS, may actually provide a better platform for mobile devices. The Card View design has a lot of potential for applications in healthcare.

The tablet PC is an example of potential for a great user experience that was never realized. It’s great having the complete functionality of a desktop computer, but rarely is it necessary. To compound the problem Windows was never completely redesigned to be a friendly touch environment. Software designers understand this as there are several vendors like Thinix developing UI’s that lie over the top of the Windows environment making the operating system easier to use on a tablet PC.

I carry my tablet all over the place, but most of the time its use revolves around the Microsoft Office Suite for taking notes and managing documents, PDF annotation software and accessing the internet. I dare say that I don’t use nor need 80% of what the machine is capable of. I would love to see a stripped down version of Windows on a tablet that was built around their Office line of products and was well integrated with Windows Live, including Office Live, SkyDrive and Live Sync. Often times I think vendors simply try to cram too much functionality into mobile software or try to create an exact replica of the desktop. In my opinion it would be better to take the most frequently used functions, make it brain-dead simple to use and scrap the rest.

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 interventions^1-4, 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.

In fact, the technology remained popular with pharmacists up until just a couple of years ago. The facility I work for now was still using Compaq iPAQ Pocket PCs as a mobile drug reference during rounds when I came on board in November of 2008. I had to pry them from the pharmacist’s hands when I introduced them to tablet PCs less than a year later. They would have preferred to keep the Pocket PC devices, but they were old, slow, wouldn’t hold a charge any longer, had limited wireless connectivity and memory, and were getting harder and harder to support.

The tablet PCs have not been accepted with similar enthusiasm. While they are more powerful than their predecessors and offer greater access to information, they are larger, more cumbersome, more fragile, have less battery life and present challenges not previously predicted. I still believe they offer several advantages over previous handheld devices, but some  pharmacists would take the latter given the choice.

The trend of embracing emerging mobile technology has not transitioned to the more advanced platforms in use today. Of course I’m speaking of technologies like the iPhone, the Motorola DROID and a host of other popular smartphones. Several pharmacists I know carry smartphones, but they do not use them in a similar fashion to the Palm handhelds of the past. An impromptu survey of my department revealed that of the five iPhones in use by pharmacists, none were used as a drug information resource. Half of those did not have any type of medical reference material installed at all. Only one pharmacist in the department expressed interest in using a smartphone or similar device on rounds and he doesn’t currently own a device capable of doing it.

Is pharmacy technology more advanced than it was eight years ago? Of course it is. We have advanced rules engines, clinical decision support software, unprecedented access to data, BCMA, CPOE, improved ADCs, automated carousels, automated packaging, automated IV preparation robots, smart infusion pumps, and so on and so forth. In addition to the advancing technology we have a growing interest in pharmacy informatics from a great many pharmacists throughout the country. This is a good thing. However, what we don’t have is interest in this advancing technology from the masses. This isn’t true with other healthcare professionals such as physicians. Physicians have embraced the mobile frontier that sprang from the early days of the Palm Pilot. Many physicians carry smartphones and use them as a valuable part of their practice. These devices save physicians time while giving them better and faster access to patient information. Nursing appears to be adopting this technology at a faster rate than pharmacy, but they outnumber pharmacists >30:1 in the hospital so it is difficult to gage the real impact of handheld devices on nursing practice.

Why haven’t pharmacists embraced the successor to the Palm Pilot? It is hard to say, but I believe the greatest interest in technology among practicing pharmacists may have passed us by.

1. Bosinski T, Campbell L, Schwartz S. Using a personal digital assistant to document pharmacotherapuetic interventions. Am J Health Syst Pharm. 2004;61(9):921-934.

2. Clark J, Klauck J. Recording pharmacists’ interventions with a personal digital assistant. Am J Health Syst Pharm. 2003;60(17):1772-4.

3. Ford S, Illich S, Smith L, Franklin A. Implementing personal digital assistant documentation of pharmacist interventions in a military treatment facility. J Am Pharm Assoc. 2006;46(5):589-593.

4. Fox BI, Felkey BG, Bruce A Berger, Krueger KP, Rainer RK. Use of personal digital assistants for documentation of pharmacists’ interventions: A literature review. Am J Health Syst Pharm. 2007;64(14):1516-1525.

5. Felkey BG, Fox BI. Pharmacist PDA document managment considerations. Hosp Pharm. 2008;43(6):518-519.

6. Felkey BG, Fox BI. Creating the digital peripheral brain. Hosp Pharm. 2002;37(11):1222-1224.

7. Honeybourne C, Sutton S, Ward L. Knowledge in the Palm of your hands: PDAs in the clinical setting. Health Info Libr J. 2006;23(1):51-9.

8. Galt K, Rule A, Houghton B, Young D, Remington G. Personal digital assistant-based drug information sources: potential to improve medication safety. J Med Libr Assoc. 2005;93(2):229-36.

9. Clauson K, Seamon M, Clauson A, Van T. Evaluation of drug information databases for personal digital assistants. Am J Health Syst Pharm. 2004;61(10):1015-24.

10. Perkins N, Murphy J, Malone D, Armstrong E. Performance of drug-drug interaction software for personal digital assistants. Ann Pharmacother. 2006;40(5):850-855.

11. Robinson RL, Burk MS. Identification of drug-drug interactions with personal digital assistant-based software. Am J Med. 2004;116(5):357-8.

12. Barrons R. Evaluation of personal digital assistant software for drug interactions. Am J Health Syst Pharm. 2004;61(4):380-5.

- 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.

Abstract:

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 Palmdoc Chronicles

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

- Avatar was #1 at the box office again last weekend. According to Movieweb.com Avatar has made approximately $380,000,000 at the boxoffice, making it the 10th highest grossing move of all time; to date.

- The January 2010 issue of The Annals of Pharmacotherapy has some great articles in it that are a must read. The issue is full of articles exploring the impact of pharmacists on various healthcare services.

- The Annals of Internal Medicine (January 5, 2010 vol. 152, No. 1: 66-67):  Researchers at Cornell University asked participants to measure 5 mL of medication into different sized spoons. Participants were confident in their ability to measure the medication, but the study found that the participants “underdosed by 8.4% when using the medium-sized spoon and overdosed by 11.6% when using the larger spoon.” A similar article appeared in The Journal of Family Practice back in August of 2000. I recommend getting a pediatric oral dosing syringe for measuring medication. Don’t use a kitchen spoon.

- In the same issue of the Annals of Internal Medicine there is an article about the use of low-dose aspirin following GI bleed (Continuation of Low-Dose Aspirin Therapy in Peptic Ulcer Bleeding). Whether or not to continue aspirin for prophylaxis is a very common question from patients that have experience some type of GI problem. The authors of the article conclude that “Among low-dose aspirin recipients who had peptic ulcer bleeding, continuous aspirin therapy may increase the risk for recurrent bleeding but potentially reduces mortality rates. Larger trials are needed to confirm these findings.” In other words it’s a risk versus benefit decision between you and your physician.

- Mobihealthnews: “On December 11 Kaiser Permanente officially rolled out its SMS appointment reminder service, powered by mobileStorm. mobileStorm’s SMS platform enabled Kaiser to create and facilitate appointment reminders, treatment reminders as well as alerts that lab results have returned.” This is a very interesting concept and one that is a little overdue in my opinion. Read more about it here.

- Medscape: “The feasibility of contracting for medication therapy management (MTM) services in a physician’s office was studied.” And the conclusion: “Over a six-month time period, pharmacists in a family medicine practice were unable to receive compensation by Medicare for providing MTM services.” This has been a long standing problem with pharmacist providing services. When is it ever going to change?

- Medical News Today: “Scientists at the University of Maryland, Baltimore have successfully used near-infrared spectroscopy (NIR) — a method already used to test farm product quality — to predict how quickly pills dissolve in the body.” – Very cool stuff.

- The Nexus One was officially announced this week. What a great looking device. According to reports, Verizon should have the phone sometime in the spring of this year. Just enough time for me to convince my wife I need one.

- The consumer electronics show (CES) is being held in Las Vegas this week. If you’re into gadgets this would be the place to be. The stream of information coming from CES this week has been intense and interesting. One of my goals before I die is to attend the CES. Now all I have to do is figure out how. Unfortunately “consumers” aren’t allowed to attend. Go figure.

- If you are interested in reading more about the CES show in Vegas I would recommend visiting the following websites: Gizmodo, Endgadget, GottaBeMobile, TechCrunch, jkOnTheRun and Mobileread. That should keep you busy for a while.

- With the release of the meaningful use guidelines, I’ve noticed a significant number of acronyms flying around the internet. If you have a need to decipher one check out the list at Health IT.

- Check out the Ford Work Solutions Truck at GottaBeMobile. Who says technology can’t be fun?

- Pixel Qi finally made an appearance on a device. I’ve been looking forward to these LCD screens for quite some time. They offer readability in direct sunlight, but more importantly can significantly increase your work time between charges by extending your battery life.

- Congratulations to Alabama for winning the national title. What would have happened if Colt McCoy wouldn’t have been injured? We’ll never know.

- The NFL playoffs start today; I’m ready. I’m taking the Jets, Cowboys, Ravens and Cardinals. Wish me luck.

Have a great weekend everyone.

- The Twilight Saga: New Moon was #1 at the box office for the second weekend in a row. Last weekend my family and I took in the Blind Side, which came in just behind New Moon at the box office. The Blind Side was a very good movie, but I would encourage anyone  interesting in seeing it to read the book The Blind Side: Evolution of a Game first. There are some important things from the book that didn’t make it to the big screen.

- Check out the Annual Ink Blog Awards posted by Warner Crocker. There are some great links to tech blogs.

- If you want to see a great list of Tablet PCs, Netbooks, Laptops and other gadgets to buy the geek in your life for Christmas, be sure to check out  Tablet PC2’s Annual Santa’s List.

- Just in case you missed it, the CrunchPad is dead. I’ve been reading about how wonderful the CruchPad was going to be for well over a year now. Am I disappointed? I don’t think so. It’s hard to miss something that never really existed. I’m still waiting on the Apple Tablet to arrive on the scene. On a positive note, here’s a cool concept for a Sports Illustrated tablet.

- The Spoof: “I’m only as good as my suppliers,” Santa explained. “What am I supposed to tell all the good little girls and boys, and the good BIG boys and girls, who wanted a Nook for Christmas?” Shaking his head from side to side, he said, “As usual, I’m left holding the bag.” – This in response to the Nook from Barnes & Noble being sold out and not available until sometime in early 2010. Oops, there goes someones Christmas gift. If you’re interested in getting a better look at the Nook Engadget has some photos from an anonymous user.

- The Forrester Blog: “2009 has been a breakout year for eReaders and eBooks–device sales will have more than tripled by the end of this year, and content sales are up 176% for the year–but 2010 will be anything but boring.” – The blog goes on to list 10 eBook predictions for 2010. The two predictions that I am most hopeful to come true are: “eTextbooks will become more accessible” and “Magazine and newspaper publishers will launch their own apps and devices”. Are you listening ASHP? I would love to have a dedicated pharmacy, medical, and scientific journal e-reader.

- The EBook: “The world’s first electronic textbook!” The PocketBook 901 offers a 9.7-inch screen and should go on sale sometime in the first quarter of 2010. It’s a nice looking device. The site is in Russian, but the translated page is here.

- Healthcare Technology Online: “The application of RFID technologies in hospitals has been modest, however, primarily due to cost issues. Like most electronic technologies, RFID unit costs have fallen dramatically within the past few years, but have not yet reached the “tipping point” of economic rationality for cash-conscious hospitals. In the 2008 Annual HIMSS Leadership Survey, 15 percent of respondents said their organization uses RFID and 43 percent anticipated using it within two years. To date, RFID in healthcare has been limited primarily to asset management and supply chain applications.” – I continue to believe that RFID is an underutilized technology just waiting for a home in hospital pharmacy.

- Information on using Google Wave in Healthcare: 1)  Healthcare Informatics Forum and 2) Archetypical. There are a group of pharmacists experimenting with Google Wave as a way to interact at ASHP MCM. If you’re interested in checking it out just type “with:public ashp” in the Wave search field.

- Archives of Internal Med. 2009;169(21):1996-2002: “A physician and pharmacist collaborative intervention achieved significantly better mean BP and overall BP control rates compared with a control group. Additional research should be conducted to evaluate efficient strategies to implement team-based chronic disease management.” – One thing to make note of in the article is the 96.2 percent acceptance rate of pharmacist’s recommendations. This is a very high number. Well, certainly higher than the physician acceptance rate for my recommendations anyway.

- Military Medical/CBRN Technology: “Automation at military pharmacies has streamlined and improved delivery methods in recent years to bring them into the 21st century, helping save pharmacists from counting individual pills, save pharmacies from suffering product loss because of inexact inventory procedures that lead to drug expiration, and sometimes even save the lives of patients, who might in the past have received the wrong prescription as a result of human error.” – The article is a rather simplistic view of things, but interesting nonetheless. The best part was the concluding paragraph: “it’s about the diagnosis, and the prescriptions and what interactions the medications are going to have—and here they come out of pharmacy school, and they go into a pharmacy and they spend all of their time doing manual work, running around trying to find out where the pills are,” Mullenger said. “It’s not the right work for them to spend their time on.” - Exactly.

- Healthcare IT News: “The Department of Veterans Affairs and Kaiser Permanente are launching a pilot program to exchange electronic health record information using the Nationwide Health Information Network (NHIN) created by the Department of Health and Human Services. The pilot program slated to begin mid-December 2009, will connect Kaiser Permanente HealthConnect and the VA’s electronic health record system, VistA, two of the largest EHR systems in the country.” – This will be something to keep an eye on as it will become a model of how large healthcare systems can link information.

- Medhaps: “ Doctors Told to Ignore Facebook Come-ons – Medical Defense Union (MDU), a non-profit organization that seeks to “defend the professional reputations of our members when their clinical performance is called into question,” warns physicians that they should not respond to advances by patients on social networking sites–not even to politely say “no.” “– Very interesting. This kind of goes against the whole social media trend. Doesn’t it?

- Florence dot com: “A decade of studying what actually makes high-consequence industries reliable has sent healthcare stakeholders back to some foundational behavior-based learning. It turns out that things like speaking clearly, repeating words to be certain they have been understood; taking turns; using “inside” voices; and getting plenty of rest matter when individuals rely on complex processes to deliver intended outcomes.” – Imagine that, it’s not all about the technology.

- PLoS Computational Biology: “Here, we present a high-throughput approach to the exploration of such parameter sets, leveraging recent advances in stream processing hardware (high-end NVIDIA graphic cards and the PlayStation 3′s IBM Cell Processor). In analogy to high-throughput screening approaches in molecular biology and genetics, we explored thousands of potential network architectures and parameter instantiations, screening those that show promising object recognition performance for further analysis. We show that this approach can yield significant, reproducible gains in performance across an array of basic object recognition tasks, consistently outperforming a variety of state-of-the-art purpose-built vision systems from the literature.” – In other words, these scientists from Harvard and MIT are working to reverse engineer the brain’s ability to make something usable out of visual data. Now that’s pretty neat stuff. Check out the video below.

Finding a better way for computers to “see” from Cox Lab @ Rowland Institute on Vimeo.

- The most popular searchengine searchpharases that brought people to my site this week: “new lcd technology“, “droid lexi comp“, “lexi comp droid“, “siemens pharmacy program short cuts“,  “shareable ink“, “lexi comp for droid“. Take note of the number of lexi-comp references in the top six phrases, i.e. three times. I’m hoping to get my hands on a newer beta version soon.

- Epocrates is looking for beta testers for WebOS. This is exciting news for Palm Pre owners.

- I will be in Las Vegas again next week attending the 2009 ASHP MCM. I’m very excited about the trip as I plan to connect with several people and attend several interesting education sessions. I’ll be sure to keep everyone up to date.

Have a great weekend everyone.

Welcome 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.

- The Twilight Saga: New Moon was #1 at the box office last weekend. No surprise there, my daughters have already seen it twice. While in Las Vegas this week my family and I took the time to go see Disney’s A Christmas Carol. I was pleasantly surprised by how good it was.

- Life in the Fast Lane has a great blog on Social Media and Healthcare. It’s interesting to me how popular social networking has become among healthcare providers. I believe it will continue to evolve into something we have yet to consider, especially as more and more hospitals like mine find new ways to deprive people access to these incredbly valuable tools.

- Would you like to learn CPR from your iPhone? Well, now you can with PocketCPR. “PocketCPR for iPhone ™ provides REAL-TIME feedback and instructions on CPR that empowers ANYONE to learn and practice CPR.” Watch the demo, it’s interesting.

- Microsoft continues to develop their presence in the healthcare industry with Health Tech Today, their monthly onlince video series. It’s kind of neat.

- I saw a post today on how to have a Vegan Thanskgiving. I believe that classifies as blasphenmy.

- I’ve been looking for a new, small slate model tablet with an 8-10 inch screen. There are several to chose from and the Cool Rui X9 with Windows 7 is definitely on my list of possibles. The X9 offers a 10.2” touch screen, 1GB or RAM, a 160GB hard drive and an Intel Atom N270 processor.

- Amazon announced an update for their Kindle e-reader that offers native PDF support and extends battery life.

- I continue to play with Google Wave as I think it may provide a practical platform for pharmacists across the country to collaborate on various projects. My brother and I spent some time after Thanksgiving luch discussing Wave and his general disinterest in the application. He doesn’t see a use for it. I had difficulty arguing my case as I haven’t spent much time using it. For those of you interested in the possible uses for Wave, I encourage you to read  “5 Impressive Real-Life Google Wave Use Cases” at Mashable.

- Have you seen the new AT&T commercial that says you can surf the web and talk on their network at the same time, but not on Verizon’s? Well, that’s a complete load of crap. I can’t testify to what AT&T and the iPhone can do, but yesterday I had two phone calls going at once on my Droid, one active and one on hold, while I was checking Google Maps for the closest Starbucks; all at the same time. It just makes me hate AT&T all the more.

- The Annals of Pharmacotherapy (Vol. 43, No. 12, pp. 1964-1971): “Propylene Glycol Accumulation in Critically Ill Patients Receiving Continuous Intravenous Lorazepam Infusions – The continuous infusion rate and cumulative 24-hour lorazepam dose are strongly associated with and independently predict propylene glycol concentrations. Despite the absence of confirmed propylene glycol–associated adverse effects, clinicians should be aware that propylene glycol accumulation may occur with continuous-infusion lorazepam.” – Lorazepam infusions are very common in the ICU setting and are a very effecting method of sedation. The important thing to take away from the article is the lack of adverse effects associated with propylene glycol levels. In other words, it’s not time to change your clinical practice just yet.

- The Baltimore Sun: “As things stand now, the pharmaceutical companies that make those prescription drugs are also looking over the doctor’s shoulder, keeping track of how many prescriptions for whose drugs the individual physician is writing. And that data on the prescribing habits of thousands of doctors has become a powerful sales and marketing tool for the pharmaceutical industry, but also a source of growing concern among some elected officials, healthcare advocates and legal authorities” – It’s an interesting article, you should read it.

- The Android OS is gaining popularity for use on smartbooks/netbooks. I’d like to spend some time with one.

- Lexi-Comp is beta testing their comprehensive drug databases for the Android OS. I was fortunate enough to be selected as one of the beta testers, which was quite exciting. On the downside, I quickly found that their beta version won’t store information to my microSD card making it virtually useless. The Lexi-Comp databases are rather large and quickly overtook the internal memory on my Droid. Lexi-Comp hopes to have the issue resolved shortly. I’ll keep you posted.

- Top searchphrases that brought people to my sight this week: “new lcd technology”,” ipod apps pharmacist”, “wireless medication tracking”, “pharmacy apps for itouch”, “siemens pharmacy short cuts”.

Have a great weekend everyone.