Update ASHP #Midyear2009

Today was a good day for informatics at ASHP Midyear.

Pharmacy 2.0: How the Web is Changing How We Practice
This was a great session moderated by John Poikonen (@poikonen), PharmD or RxInformatics.com. John defined Pharmacy 2.0 as the combination of ASHP’s practice model, participatory medicine, health reform, and self-reform, i.e. changing the way you work. In an interesting move Poikonen asked the audience how many of them were familiar with the term “hashtag” and mentioned the use of #Midyear2009 as a way to follow the meeting on Twitter. Unfortunately very few pharmacists raised their hand to acknowledge the term. I wish we had a way to quantify the number, but it was only 10-20 in a crowd of a couple hundred. It’s obvious that the crowd had an interest in the subject by their presence, but as I already suspected pharmacy has a long way to go before we can be considered tech savvy.

Todd Eury (@toddeury) of Pharmacy Technology Resources and Pharmacy Web 2.0 presented on “Healthcare System Communications Evolution: Pharmacy and Web 2.0”. In his presentation he introduced many of the most commonly used social media available today; specifically LinkedIn, Twitter and Facebook. He did an excellent job of defining their role in pharmacy practice and communicating not only their benefits, but pitfalls as well. One thing of particular interest in Eury’s presentation was the need to monitor your online reputation and occasionally “Google yourself”. Try it; you’ll be surprised at what you find.

Kevin Clauson (@kevinclauson), PharmD of Nova Southeastern University College of Pharmacy presented “A Pharmacist’s Web 2.0 Toolkit for Information Management.” He covered the use of RSS Readers, like Google Reader, PeRSSonalized, and Clinical Reader, as well as Twitter and Evernote as a way for pharmacists to keep up with the ever changing world of information that we have to digest and assimilate. I consider myself pretty well versed in the ways of the web, but Kevin offered up some great pearls of wisdom that I can immediately put into practice.

The final segment of the Pharmacy 2.0 session was a video presentation by Dr. Daniel Sands (@drdannysands) in which he spoke about physician’s use of social media and the web to communicate with his patients. He also covered ways that patients can get involved in their own healthcare through the use of online societies specific to their condition. Dr. Sands spent several minutes in the video interviewing physicians in his own practice about their views on social media and its impact on their relationship with patients. Not surprising some physicians spoke positively about the technology, while others were not so flattering.

Pharmacy Informatics Education Networking Session
This session offered up some of the most interactive discussion that I’ve been involved with during my time here at Midyear. The discussion centered on what informatics education standards should be for pharmacy students and how that should translate into a “qualified informatics pharmacist”. It was interesting to see the difference in opinions from pharmacist to pharmacist. While I won’t go into exactly what was covered I think everyone in that room needs to remember that pharmacists are highly educated clinicians that deserve to practice informatics at that same level. A <insert title here; clinical informaticist, Informatics pharmacist, pharmacy informaticist, clinical informatics pharmacist, medication management informaticist> should not be the guy sitting in a cubicle writing reports day in and day out, or the guy that has to edit each line item in the pharmacy information system because “G” should be “GM”. The <insert title here> should be the individual involved in making sure that systems are designed to include pharmacy workflow, that the reports being written provide the necessary information to be clinically relavent, that current clinical standards are adhered to during implementation of new systems, be the representative at the table during discussions of integration and interoperability of hospital systems, etc. Pharmacy informatics is a young discipline and a step in the wrong direction can harm the profession for years to come.

Informatics Bytes 2009: Pearls of Informatics
This session, which is still going on, has a little bit of everything when it comes to pharmacy informatics and patient safety. They announced that the session would be recorded. Maybe they’ll even create a podcast out of it; one can only hope.

Exhibit Hall ASHP #Midyear2009

I finally had an opportunity to roam around the exhibit hall at the ASHP Midyear today. Of course I had to sacrifice a session to attend, but it was worth it. If you’ve never been in the exhibit hall at one of these events you owe it to yourself to check it out.
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ASHP Midyear 2009 – “The Plan”

I’m sitting in the airport waiting for my plane to board and getting my agenda together. Below is my plan of attack for my time in Vegas. Of course it’s all just speculation at this point as I have an affinity to stray from my plans based on what I find interesting.  I also need to find some time for the exhibit hall, where I will undoubtedly waste countless hours wondering around checking out all the cool technology.

– Talyst User Group, 2:00 – 5:00 PM

– IV Sedation in the Intensive Care Unit: Applying Pharmacoeconomic Principles, 6:15-7:45 AM
– Opening Session, 9:00-10:30 AM
– Integrating Tech to Improve Medication-Use and Patient Safety, 11:30AM – 1:30 PM
– Does the Shoe Fit? Selecting Robotic IV Technology for Pediatric Sites, 2:00-5:00 PM
– Section Advisory Group on Ambulatory Care Informatics Networking Session, 5:15-6:15 PM
– Pharmacy OneSource Happy Hour, 5:30-7:00 PM

– BCMA: Inpatient & Outpatient Trends, Metrics, and Innovations, 8:00-9:30 AM
– On the Bleeding Edge of Technology: Overcoming Implementation Challenges with Informatics, 10:00-11:00 AM
– Section Advisory Group on Pharmacy Operations Automation Networking Session, 11:15 AM – 12:30 PM

Here’s where it get fuzzy. There are 4 sessions in the 2:00-5:00PM slot that I want to attend; not sure what I’m going to do just yet.

– Redefining the Practice Model: Where Have We Been, Where Do We Go? 2:00-5:00PM
– Rule of Thumb: A Look at Positive ID, Secondary Authentication, and Health IT Regulation, 2:00-4:00 PM
– Powerful Impact of Human Factors Engineering on Medication Safety, 2:30-4:00 PM
– More Than a Vending Machine: Effectively Planning and Implementing Carousel/Packager Technology, 4:00-5:00 PM

– Pharmacy 2.0: How the Web is Changing How We Practice, 8:00-9:45 AM
– Section Advisory Group on Pharmacy Informatics Education Networking Sessions, 11:15 AM – 12:30 PM
– Informatics Bytes 2009: Pearls of Informatics, 2:00-5:00 PM

Unfortunately I return home on Wednesday night, which means I will miss the following sessions that I would like to attend, especially the first one listed.

– Does Current Technology/Automation Need to Change to Advance Pharmacy Technician Dispensing? 9:30 AM -12 NOON
– Strategies for Successfully Implementing ADMs and CPOE into the Medication Management System, 2:00-4:00 PM

“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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Cool Technology for Pharmacy

Entering and making pediatric drips for pharmacists working in an adult hospital can be a real sphincter tightener. Pharmacists that aren’t accustomed to working with pediatric patients feel a little bit uneasy when an order shows up for a customized dopamine, dobutamine, etc. I remember working in a pediatric facility where we did this kind of thing all the time and no one gave it a second thought. We used a combination of two standardized concentrations, hi and low, for each commonly ordered drip. For code blue situations we often used the “Rule of 6’s”, which is now discouraged by the Joint Commission.
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Use of pharmacy informatics resources in hospital pharmacies

ajhpI read an interesting article today in the November 1, 2009 issue of the American Journal of Health-System Pharmacy (AJHP). In the article the authors report the results of survey sent to 200 hospitals in the US developed to assess the use of various informatics resources by pharmacy departments. The survey consisted of two-sections with a total of 20 questions. Only hospitals with at least 100 beds were included, and of the 200 surveys mailed only 114 were returned More information on the specifics of the survey can be found at the AJHP website here.
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Thinking about Clinical Decision Support (CDS)

I attended at webinar today on “Achieving Meaningful Use – The Importance of Clinical Decision Support”. Overall the information was pretty good. It wasn’t exactly new information, but it never hurts to hear something again. The webinar got me thinking about Clinical Decision Support (CDS).
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Getting pharmacists to lay down their 3×5 cards

The decentralized pharmacy model brings with it the opportunity for pharmacists to be an integral part of the medical team. This includes following teams of healthcare provides, physicians, nurses, respiratory therapists, etc, on morning rounds. And like all good little pharmacists we like to be prepared with as much information as possible about the patient. Several methods for collecting data have been developed over the years, including the all time favorite; the 3×5 index card. The problem with this system is obvious; it’s prone to human error. Taking information from one source and transcribing it somewhere else simply increases the chance for error. In addition, the information may be inaccurate as things can change rapidly with hospitalized patients, especially in areas like the ICU.
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The Future of the IT Industry

John Suffolk: “Following on from recent blogs, publications and presentation on the Government’s IT strategy I have been asked a number of times what my thoughts are on how this will play out in the IT industry over the next ten years…I think we are all in for a shock, a big shock because IT and service provision will be dramatically different and I’m not convinced the IT industry is facing up to the new reality. Consider a world where:

– The concept of desktop disappears as a predominant model…
– Things like ERP become a sequence of transactions….
– The number of data centres will be dramatically reduced….
– Public and private clouds will be pervasive….
– The combined cloud model and the application store opens up the IT market….

So those operating on the IT world will need to decide what their true competences will be.  Where can they shine and get recognition for being outstanding.

The blog is quite insightful and I believe an accurate look at where IT is headed. In addition I think the healthcare industry will see more outsourced IT support as we move toward a cloud model. Hospitals will be tied less to software and hardware support, instead providing informatics experts responsible for developing workflow and effective use of purchased services. Some hospitals have begun adopting this model already, and expect to see greater adoption in the future.