- Paranormal Activity was #1 at the box office last weekend.

- ModernHealthcare.com has released a list of best places to work in healthcare. Alas, my current employer isn’t on the list, but several hospitals are.

- HER Bloggers: “One of the biggest challenges for linking together different health information systems is the inconsistency in referring to a given individual – be that a physician, a patient, or whomever. One system, for example a lab system, may refer to “Patient x” one way (using their own arbitrary internal patient identifier number), while a different system (for example, a hospital) may use a completely different identifier. Between ambulatory EHRs, each one will also likely refer to a given patient with different, internal methods. Cross-linking these systems so that a unified dashboard can be created that displays all the information from all these systems is made much more difficult as a result.” – Exactly! See my post on a similar issue from yesterday here.

- DeepDyve is a search engine for scientific papers where you can “rent” the article for 99 cents per day. Of course they offer frequent flier plans for people who like to read a lot more; $9.99 for 20 articles per month or unlimited for $19.99 a month. It’s a nice service if you don’t have your very own medical librarian at your fingertips.

- The October 2009 issue of Laptop magazine has a review of Twitter applications for your mobile phone. The top Twitter clients were:

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- How about a dual screen netbook? I’m not sure about you, but in my opinion the size of the thing kind of defeats the purpose of a netbook; not to mention that it’s just ugly.

- TEDMED2009 took place in San Diego this week. “TEDMED celebrates conversations that demonstrate the intersection and connections between all things medical and healthcare related: from personal health to public health, devices to design and Hollywood to the hospital.” You can find some third party information on the event at medGadget or by simply searching Twitter for TEDMED.

- The Bay Bridge closed earlier this week following a piece of the cantilever section snapping and falling onto the upper deck. More than 280,000 cars travel across that bridge each day. Wow, I can’t imagine the problems that has caused in the bay area.

- Google rolled out “Google Music Search”. Is there anything these guys can’t do?

- The BlackBerry Storm2 is now available at Verizon Wireless. I haven’t had a chance to play with one yet, but I’m reading good things.

- Check out the new Dell Latitude XT2 XFR rugged convertible tablet PC in the video below. It has a 12.1” LED capacitive multi-touch display and can be had for the low, low price of $3599. The video shows the XT2 XFR taking some serious abuse. Cool

- Here is an interesting interview with Edwin Webb, PharmD on Medscape Today. “Healthcare Reform Has Potential to Improve Pharmacist-Patient Relations: The bill that came out of the Senate Health, Education, Labor and Pensions committee and the bill that is currently under consideration by all 3 committees of the House of Representatives both have provisions that would support the concept of pharmacists’ clinical services in the medical home model, a big element of healthcare reform that has received a lot of attention. One of the Senate bills would initiate a grant program to establish community health teams, including access to pharmacist-delivered medication-management services. Another section of that bill would provide funding for grant programs to implement medication-management services as collaborative interprofessional services in a team-based approach to managing chronic diseases for targeted individuals. Those are 2 provisions that are consistent with the efforts we’ve been making for many years to reform the Medicare Part B payment rules that provide for payment for physician and nurse practitioner services. We would like pharmacist services to be recognized under that provision.”

- “Update on Antibiotics for Infection Control in Cystic Fibrosis”. Cystic Fibrosis (CF) is a devastating genetic disease that typically causes severe chronic respiratory tract infections that often lead to an early death. From a strictly pharmacologic standpoint, CF is an interesting disease because of the affect it has antibiotic kinetics. When I was a pharmacy student at UCSF we had several CF patients on our medicine service, and I can tell you it pulls at your heart strings.

- Annals of Pharmacotherpy (Vol. 43, No. 11, pp. 1781-1786): “A pharmacist-run osteoporosis service significantly improved short-term compliance with guidelines, including appropriate DEXA scan frequency, pharmacotherapy, calcium and vitamin D supplementation, and nonpharmacologic education.” – Pharmacists strike again.

- TechCrunch: “Ever since Twitter announced it is working on a new Lists feature a month ago, users and developers have been awaiting its broad rollout. Over the past few weeks, Twitter has been expanding the number of people in the Lists beta, but now it appears that a full rollout is under way.”- I have access to lists, but really haven’t figured out how to use them. I guess I’m just not tech-savvy enough.

- medGadget: “The modular TransHospital system allows for the creation of a clinical facility from six beds up to just about any size imaginable. Each unit can be setup within four hours by a six man crew and can then function autonomously for 72 hours. Add a source of power and water and setup a supply line, and you’ve got yourself a real hospital during emergency situations.” – Reminds me of the old TV series, M.A.S.H. I loved that show.

- GigaOM: “Microsoft once again is touting its speech-recognition technology, predicting on its site this week that “talking to a computer may soon be as natural as using a mouse.” But while voice is a natural fit for mobile phones and some other platforms, when it comes to traditional computing — using a laptop, desktop or even a netbook — the use-case scenarios for speech recognition are more limited. It will take quite an effort to convince users to talk to their laptops instead of typing on them.”- I disagree, I think there are some practical uses for speech-recognition. Like any new technology it must be modeled into something you want. My thoughts on subject can be found here.

- Check out this video by Bill Koslosky of  the Wireless Doc in which he demonstrates using Google Voice on an HTC Hero smartphone to perform a medical search. It’s really quite impressive.

- The Barnes & Noble Nook e-reader has been getting quite a bit of press lately. It’s a nice looking device and offers 3G, Wi-Fi, 2GB of storage and access to over 1 milliion electronic book. I’m impressed enough with it that I’m going to pre-order one. As long as the Nook doesn’t befall some catastrophic failure I think it will give the Amazon Kindle a run for its money.

- Top search phrases that brought people to my sight this week: jerry fahrni (hey, imagine that), xcelodose, dell xt2 keyboard, jaansun capsule machine, where is tony north of talyst (this is my favorite), d&d surface table, pharmacokinetics iphone, talyst autopack supplies, talyst users group, pyxis parx system.

- Please stop the agony that is the Major League Baseball season. For those of you that don’t know, we’re still playing the World Series and it will be November before it’s over. It’s football season!

Have a great weekend everyone.

- Zobieland was #1 at the box office last weekend. Great movie.

- I’ve been thinking about facial recognition a lot lately. My brother works for a company that applies analytics to their video systems to identify people and other objects, even license plates. We’ve discussed the possibility of applying this technology to tablet identification. I also think there’s a place for facial recognition in healthcare. Facial recognition is simply another biometic ID. We use fingerprint scanning on our Pyxis stations now, why not facial recognition. The technology appears to be maturing. A research team from the School of Computing Sciences at UEA found that computers could outperform human lip-readers by a large margin. We also know that the Faces feature in Apple’s iPhoto ‘09 and Picasa from Google offer facial recognition tagging for photos. Just a thought.

- PTR: “These tools [Web 2.0] provide you with a unique approach to forming better ties to your customers. Blogging is a great way to start. You could blog about seasonal allergies and what you recommend for your LOCAL ENVIRONMENT. You could feature biographies on your (willing) staff and create a common place for customer comments and interaction. Interaction is the key. It’s a social medium that enables you to reach out to your customers as creatively as you want.” – That’s really the crux of the matter. Blog about things that interest you and make connections with people of similar mind. It really works. Todd has more information on the subject, in the form of a 7 page document, here.

- Medscape performed a survey on which EMR systems users felt was the best. Amazing Charts received the highest marks while Cerner received the lowest. Interesting.

- The New England Journal of Medicine (N Engl J Med 2009;361:1448-1458,1502-1504) is reporting that doxycycline is effective against infection with Mansonella perstans, a filarial parasite. M. perstans is found primarily in sub-Saharan Africa and is refractory to standard antifilarial therapies. Doxycycline is a great drug that still carries significant value and is sadly underutilized.

- A study in the Journal of Pain (J Pain. 2009;10:944–952) found that “Self-medication of pain with alcohol is most common among younger nonHispanic white males and associated with pain frequency, depression, and use of pain medications. Alcohol use for pain needs to be assessed so that health care providers can make appropriate referrals and adjustments to treatment.” Not good.

- Medscape lists 19 drugs that the FDA is keeping an eye on for safety risks. All drugs come with some inherent risk, some are just worse than others.

- IT World: “Market research firm NPD put out a study earlier this week about the market penetration of various PC brands, which was full of all sorts of interesting information, but the one that was most interesting to me was that almost 85 percent of households with Macs also have at least one Windows PC. (And no, the reverse is not also true.)” – I guess I’m normal. I have 4 Macs, 3 desktops and 1 MacBook, two Windows laptops and a Windows tablet PC. People continue to move toward Macs for various reasons, but will always be tied to Windows secondary to it being the standard in many industries. With that said, it’s quite simple and easy to run Windows on Mac desktops and laptops. That’s something I think Microsoft should embrace. After all, they don’t sell hardware, they sell software.

- Someone finally decided that the Apple MacBook Air should be copied. The Sony Vaio X is an 11.1-inche notbook that is a whopping 0.55 inches thick and weighs 1.6 pounds. That’s thin and light. Oh yeah, it also boasts a 14 hour battery life with the extended battery pack. Now if I could only convince Sony to add a Pixel Qi LCD screen and make it a convertible laptop it would be perfect.

- We’ve got some hot new cell phones hitting the market soon. The HTC HD2 is a great looking smartphone running a modified version of Windows mobile. The touchscreen is huge with a 4.3 inch surface. Check out the video here. The Palm Pixi is also headed for a mobile provider near you. I like what the Pixi has to offer, WebOS, tactile keyboard, multi-touch screen, etc., but I don’t like the footprint or the screen size. Check out the Palm Pixi Artist Series, I like the skull.

- Powermat Home & Office Mat: ” Wirelessly charges up to 3 Powermat-enabled devices simultaneously (plus one USB power port). Works with all Powermat receivers. Universal Powercube with 8 tips is included to enable you to charge hundreds of different devices.” – Available for $99 at Best Buy. I want one.

- The Angry Pharmacist: “What kills my soul (which a lot of things do, this being one of them), is when patients have a tiny-yet-dangerous bit of medical knowledge gained through the internet or one nursing class 15 years ago. Then the bullshit they spout actually sounds like it really did come from the doctor or pharmacist even though its completely wrong.” – There’s a some truth in that statement. Sometimes a little information found via the internet can be a dangerous thing in the wrong hands. That’s why it’s important to discuss this information with your healthcare provider while keeping an open mind.

- President Barack Obama won the Nobel Peace Prize. Hmm, that’s great for the United States and Washington D.C., but I have to wonder what body of work the decision was based on. I  believe the last US President to win this award was Jimmy Carter in 2002, long after he left office, for his “decades of untiring effort to find peaceful solutions to international conflicts, to advance democracy and human rights, and to promote economic and social development.” Note the keyword “decades”.

- How cool is this, NASA crashed a rocket into the moon in search of hidden ice. It’s kind of like what my brothers and I do on the 4th of July, only on a much larger scale. You can see video of the crash here, but it’s not much to look at.

- The top five search engine phrases used by people to arrive at my site this week: 1. “iphone apps for pharmacists”, 2. “pharmacists curriculum vitae”, 3. “dell xt2”, 4. “arra cope”, 5. “pyxis dispensing system pros and cons”.

- Would someone please put professional baseball out of its misery. We have professional football, college football, the United Football League, professional basketball and professional hockey to watch this time of year. We don’t need baseball playoffs in snowy Colorado. Shorten the season and finish up in September for crying out loud.

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Have a great weekend everyone.

Why pharmacists need to consider the tablet PC.
Let’s face it, pharmacists spend a lot of time collecting and analyzing data to provide safe and effective medication use for patients. They dig up information in all sorts of places, such as online drug information resources, medication records, laboratory systems and various nursing “flow sheets”. Unfortunately, pharmacists often have to go to several different systems to collect all this data. Creating further complexity is the lack of a standardized collection method among pharmacists. The combination of multiple systems and collection methods results in redundancy and decreased efficiency. Opportunity for errors also exits as many of these systems are manual, including good old pen and paper. As technology advances, it becomes important for us as a profession to move away from inefficient, error prone practices and evaluate newer options for accessing and collecting data. Electronic medical records (EMR), computerized provider order entry (CPOE) systems, computer based monitoring and decision support systems are becoming more and more common place in hospitals across the globe. While not every hospital uses each of these systems, a recent ASHP survey showed that a majority of hospitals are using at least some of these technologies.¹ In addition to these information systems, pharmacists can frequently be found using various software programs to perform pharmacokinetic calculations and track clinical interventions.

The increasing reliance on technology in healthcare, not surprisingly, equates to pharmacists spending much of their time accessing information via computer. Incorporation of computers into the pharmacists’ daily routine is commonplace. Walk into nearly any hospital pharmacy today, and you’ll see a host of desktop computers (desktop PCs) lining the countertops. While desktop PCs work well in a centralized pharmacy model, they present several challenges for pharmacists at the patient’s bedside.

Lack of access to desktop PCs at the point-of-care coupled with the growing need for real time access to information has led to the introduction and rapid growth of small, portable devices such as “personal digital assistants” (PDAs), and to a lesser degree mobile phones, in pharmacy practice. The popularity of mobile devices is evident by the volume of information in the medical literature supporting their use. Widespread use has led to significant advances in mobile computing within healthcare as well as acceptance into mainstream pharmacy practice.

Common uses for PDAs and mobile phones include documenting clinical interventions^2-5, carrying individually created documents and “peripheral brains”^6,7, performing pharmacokinetic calculations, accessing drug information and performing drug interaction checking.^8-13 PDAs and mobile phones offer this functionality in a surprisingly small form factor for easy use at the bed side. However, the portability of these devices comes with a price. Today’s PDAs and mobile phones do not posses the processing power or the screen real estate necessary to manage complex pharmacy software. Systems such as the Apple iPhone have made tremendous strides in handling graphics and providing real time access to many web based drug information and decision support resources, but screen size remains problematic. PDA and mobile phone screens are often times several orders of magnitude smaller than that of a full size desktop PC.

The complexities of pharmacy systems and information resources have not made PDAs and mobile phones obsolete per se, in fact their use in healthcare continues to grow. There is, however a void between these mobile devices and desktop PCs. While it is true that desktop PCs lack portability, they offer significantly more processing power, memory, screen size, improved back-up solutions for data integrity, improved views of complex healthcare records, better integration with hospital systems and limitless access to drug information. Despite their lack of mobility, desktop PCs have been shown preference over PDAs in certain clinical situations¹⁴ and mobile drug information databases have never been shown to be superior to their online counterpart.¹⁵ While tremendous advances in technology have been made over the past several years, there remains a gap between the lack of mobility from desktop PCs and the limitations of a PDA or mobile phone. Anecdotal information is available for possible solutions for this gap, but the literature within healthcare and pharmacy in particular, is lacking. What we need is a device small enough to be portable, but powerful enough to handle the needs of today’s technologically advanced pharmacy; I present to you the tablet PC.