unSUMMIT 2011 Presentation (#unSUM11)

I uploaded the presentation I gave Thursday at the unSUMMIT in Louisville, Kentucky. You can see it below, although some of the slides came out a little rough when I uploaded it to slideshare. It looks like it may have something to do with the font I used. If I find time I’ll correct it later.

The presentation focused on the often overlooked things that need to be done following implementation of something like BCMA. Healthcare systems have a bad habit of not providing enough resources, both labor and monetary, to maintain and optimize technology once implemented. I simply suggested five things that healthcare systems could do post-implementation to make sure their BCMA implementation didn’t crumble right before their eyes.

And now that the unSUMMIT presentation has been delivered I am officially retiring from the role of presenter. Unlike some people I know, it takes me a concerted effort and a fair amount of time to put one of these things together, and I just don’t feel like doing it again. Enjoy.

I think it’s time for a new mobile connectivity model

I fought this one for a while, but I think I’ve experienced the need enough lately to change my tune. It’s becoming increasingly common for new devices – tablets, netbooks, laptops, etc – to be offered with cellular antennas build in. These can be activated through various carriers to provide continuous connection to the world around us.

I originally found the idea silly. I’m not sure why, but I just felt that there wasn’t really a need for such device specific connectivity. After all, I have a USB access point through Verizon. With that said, it’s become increasingly obvious to me that that isn’t the answer. I find it cumbersome to use at times as it sticks out the side of my laptop like some unwanted extra appendage. Add to that the fact that I can’t use it on my wife’s iPad secondary to a lack of USB ports and my frustration only grows. Oh sure, I could purchase a MiFi-like device, and that would solve some of the issues like lack of USB port, but it doesn’t help me if my wife has the MiFi-like device in Florida and I’m in Kentucky. Get my drift?

The problem with purchasing devices with cellular specific access is the cost of activating all those data plans. Can you imagine paying for data plans on several devices that only occasionally get used? I can’t. If my wife and I were to purchase separate data plans for each device in our armamentarium of electronics we’d certainly go broke trying to pay for them all.

With the nature of connectivity changing, and the way the world has begun using mobile devices, I believe it’s time for companies like AT&T, Verizon, T-Mobile, Sprint, etc. to evaluate personalized data plans that follow the user around. Think of it as applying the idea of data in the cloud to your cellular service. Regardless of device, simply log into your cellular account and the antenna in the device would use your phone number to access service. Would that really be that hard to do? How about extending the idea further to include a family based data plan with similar features, i.e. a group of numbers assigned to individual family members that follow them around based on device. I know I’d be willing to pay a little extra for such a plan. Just sayin’.

Preparing for the unSUMMIT (#unSUM11)

I’m sitting in a hotel bar in Louisville, Kentucky having a salad as I prepare to register for the unSUMMIT. This is the second year in a row I’ve made the trek to the unSUMMIT. I felt that the experience I had last year was definitely worth a second look.

From the unSUMMIT website:

Conventional summits deliver a something-for-everyone survey of the landscape with little or no depth on any given topic. This warp-speed flight provides only a 30,000-foot view of the terrain below. Nurses, pharmacists, and IT professionals return to the trenches of their own hospitals no better equipped to dig in and implement change.

The unSUMMIT is different. It delivers a steadfast focus on barcode point-of-care technology. Attendees are outfitted with practical tools, insight, and inspiration for leading their institutions to carefully select, implement, and harness the quality-improvement power of BPOC systems.

Truly an unconventional convention, The unSUMMIT is designed to get you out of the clouds and into the weeds, where the union of technology and practice can be more easily realized through the shared expertise of your experienced colleagues.

I think most people believe that the unSUMMIT is nothing more than a bunch of people sitting around talking about BCMA, but it actually goes beyond that. Last year I heard presentations on not only bar-coding medications, but integrations of smartpumps into eMARs, the use of RFID tags, how to conduct observational studies and so on.

This year looks to provide a similarly broad scope of information. While reviewing the list of presentations I saw topics on mobile technology, accountability, technology roadmapping, workflow design and of course a lot of stuff on bar-coding medications.

The unSUMMIT begins officially tomorrow morning. I will be presenting on Thursday, April 28 at 2:00pm. I haven’t decided if I’m going to post the presentation here or not. I’ll let you know.

If you’d like to know what’s going on during the conference you can follow the Twitter stream at #unSUM11.

 

Do larger hospitals have an edge? Maybe

I’ve worked in several hospitals over the course of my career, ranging in size from 25 acute care beds to nearly 600 (584 beds to be exact). While 600 beds isn’t a large hospital, it certainly isn’t small. Regardless of the size of the hospital I’ve worked in, the operations inside the walls of the pharmacy are strikingly similar, including from the way pharmacists process orders to the way technicians handle distribution. There are differences to be sure, but the basics are the same. Differences to note include clinical services and use of automation and technology.
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The tail wagging the dog

WSJ: “The Food and Drug Administration said Tuesday that it will require some painkiller manufacturers to produce new educational tools in an effort to quell prescription-drug abuse.

The requirements will affect makers of long-acting and extended-release opioids, which include oxycodone, morphine and methadone.

Letters have been sent to manufacturers of the drugs describing the medication guides and tools for physician training that are now required, FDA Commissioner Margaret Hamburg said. The FDA will approve the materials, which will also be accredited by professional physician-education providers, she said, a step meant to combat bias in the materials.”

Oh. My. Gosh. Let me see if I can wrap my brain around this. The FDA is going to require that manufacturers of certain “painkillers” tell physicians how to properly use the drugs instead of requiring physicians to read the literature and do exactly what they’re trained and paid to do. Crud, it’s nothing a good pharmacist couldn’t fix. Why doesn’t the FDA simply require physicians to run these same prescriptions through a pharmacist for approval or give pharmacist prescriptive authority instead. It makes a lot more sense than putting the manufacturers in charge of the asylum. I would be utterly embarrassed if a drug manufacturer had to tell me how to properly use a drug because I couldn’t get it right. I think the healthcare system has officially reached a new low. Unfortunately this ain’t no limbo contest.

Revisiting the idea of Shareable Ink

EMR and HIPAA: “The interesting thing about Shareable Ink is that they provide such an interesting middle ground between a technical solution and continuation of paper. I remember about 5 years ago when I heard someone describe the perfect clinical documentation system. It was completely flexible. Required little to no training. Supported every possible documentation style. etc etc etc. Then, they acknowledged that what was being described was the paper chart. It was then that I recognized that while EMR can provide some benefits that paper charts can’t provide, paper charts also had some advantages that would be difficult to provide using an EMR.

I think this background is why I found the Shareable Ink approach to documentation so fascinating. I really see it as an interesting way to try and capture the benefits of granular data elements and electronic capture of the data while still enjoying the benefits of paper.

My simplified explanation of the Shareable Ink technology is as follows. You print out a form that you want to use for the patient visit. Each page that’s printed out has a unique background (although it just looks like a colored page to the naked eye). When you use the Shareable Ink pen to write on the printed out page, the pen uses a camera to record what you wrote on that page and where you wrote it. Then, once you sync the pen it recreates the document you wrote on in the system.”
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Taking a look at the new Lenovo X220t Tablet PC

I purchased a Lenovo x201t Tablet PC back in November 2010. It’s been a great machine.

The new x220t is every bit as impressive as the x201t, but has a slightly larger 12.5-inch Gorilla Glass touchscreen. In addition it has a new ThinkPad battery pack that should provide the user some serious portability without the need to continuously be tethered to a plug. I get about 5-6 hours of continuous use  on a single charge with my x201t extended battery pack. I expect the new x220t will get at least that. Throw in the new batter slice and users could potentially get up to 16 hours on a single charge. You simply can’t ask for more than that.
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Cool Pharmacy Technology – Codonics SLS Safe Label System

Labeling syringes has always been difficult for anesthesiologists in the OR. It must be because they never seem to get it right. If you don’t believe me, just look at the image below. These drugs were found during routine inspection of an OR suite. Well that’s all changed now with the Codonics SLS Safe Label System.
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Coolest looking laptops on the market

I have a thing for laptops and tablets, no question about it. Doesn’t matter who the manufacturer is, as long as it looks cool I’m drawn to it. It’s a good thing I don’t have unlimited funds or I’d have stacks of machines all over the house. While I’m not prejudiced against any particular laptop maker I am drawn to a certain style. For example, I like smaller laptops with screens typically less than or equal to 14-inch, and the thinner the better.
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Cleanrooms – the forgotten realm of acute care pharmacy

Cleanroom environments, a.k.a. IV rooms, inside acute care pharmacies compound some of the most complex and dangerous medications used inside a hospital. Unfortunately this area is often overlooked when implementing safety features such as bar-code verification, identification of high-alert medications, advanced training and competency and so on. I was reminded of the dangers of intravenous products by a recent story coming out of Alabama where the death of 9 patients was linked to TPN (total parenteral nutrition) contaminated with Serratia marcenscens.

While IV rooms remain a high risk area they tend to fall off the radar of many hospital administrators when it comes to implementing technology capable of reducing risk. USP <797> tends to get all the glory even though much of the guidelines proposed in this USP chapter have yet to be shown any more effective than diligent hand washing and impeccable technique.
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