Saturday morning coffee [March 30 2013]

MUG_MPSo much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug to the right comes straight from Moonstone Pottery in Los Osos, California. It’s a pretty cool mug. It was a gift from my brother, Robert. Thanks bro.

The Croods was #1 at the box office last weekend to the tune of nearly $44 Million. I didn’t see that one coming. I knew that the movie was out, but had no interest in seeing it. My family chose instead to see Olympus Has Fallen. It was terribly predictable and a bit corny, but I liked it. It was full of lots of gratuitous violence and gun play, which makes it my kind of movie. Just for the record, Jack the Giant Slayer has officially flopped at the box office.
Continue reading Saturday morning coffee [March 30 2013]

The loss of Google Reader will be tough and here’s why

The news that Google Reader is going to be sunset in July of this year has created somewhat of a panic among many, including myself.  The internet has been abuzz with articles on potential replacements. I’m sure people will look at many of these and find something to meet their needs, but what I’ve found thus far has been disappointing. I assume that’s because Google Reader was truly more than just a RSS aggregation tool for me.  A lot of the functionality that I used was the result of many third party developers that wrote plugins and scripts to do everything from rearranging the information on the page to removing ads. Google Reader was popular and mature, and it showed.

ReaderSTATS

 

Continue reading The loss of Google Reader will be tough and here’s why

Saturday morning coffee [March 16 2013]

MUG_ASHPSM2011So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug to the right was presented to me as a gift from ASHP for winning the 2011 ASHP Summer Meeting Twitter Contest. Not to be confused with the one I put up last August for the 2010 ASHP Midyear Twitter contest. The mug was accompanied by a $50 Best Buy gift card; very nice. The meeting was held in Denver, CO and was the first ASHP Summer Meeting I ever attended. The Summer Meeting is quite a bit different from the Midyear Meeting held in December each year. Midyear is much larger and has a much wider variety of educational sessions. Midyear also has a bigger exhibitor area. With all that said I found the Summer Meeting quite enjoyable as it had several informatics related sessions that I was able to attend. It was the last pharmacy conference that I was able to enjoy as an attendee.
Continue reading Saturday morning coffee [March 16 2013]

Center for the study of pharmacy automation and technology [idea]

MadScientistEarlier this week I put up a post about a Prezi created by Dr. Robert Hoyt called Evidence Based Health Informatics: Replacing Hype with Science. It was a great presentation about a lot of the technology that healthcare has adopted over the years without any real evidence to back it up. I wish you could all see it, but it appears that someone has pulled it down. The link I have for the Prezi is dead. Bummer

Anyway, the Prezi got me thinking about how we have many technologies in pharmacy that have precious little, or no data to support their use. We use carousels, high-speed packagers, tabletop packagers, robotic medication distribution, robotic IV preparation along with other IV room technologies, smart IV pumps, automated storage cabinets, and so on. The data we do have for these items is typically provided by the manufacturer’s themselves, which makes it biased in the best of situations and completely worthless in the worst cases.

Pharmacy is in desperate need of an academic center for the study of pharmacy automation and technology. The center would study the use of pharmacy technology in different use cases, collect data, and provide the pharmacy community with the information. Look at robotics versus carousels for distribution. Analyze cross contamination in high-speed packagers versus tabletop models. Perform time-motion studies on cart fill vs. automated dispensing cabinets for medication distribution, and compare the safety of one over the other. Analyze pharmacy inventory costs of one technology over the other. And so on, ad infinitum.  Conclusions wouldn’t be necessary as simply presenting the information in an easy to understand format would suffice. Let the end users draw their own conclusions. Every practice setting is slightly different, and what may work for one may not work for another. But understanding how a piece of technology or automation fits into a particular practice model might be a significant benefit to many.

The center would tear the automation and technology apart, both figuratively and literally to unveil all there is to know about each and every piece.

Such a place would have to exist at a well respected academic research center as it is the only way to ensure some semblance of impartiality.

How would it be funded? Ah, there’s the rub. Getting funding for such an endeavor would be difficult at best. A lot of this equipment is expensive. Of course the best place to troll for money would be the pharmacy technology vendors themselves. After all, they have all the equipment that would be needed to perform the research. Unfortunately this is unlikely to happen as most companies will not be willing to drop resources into a project that they have no control over. What if the outcome of such research reflected poorly on their products? That would not only be embarrassing, but could potentially hit them in the pocketbook. No, they couldn’t risk it. How about the federal government? Perhaps, but that might be like getting blood out of a turnip these days.

Getting the equipment and funds would definitely be the hardest part. There’d be no shortage of pharmacists interested in doing that type of work. What pharmacist could resist playing with giant toys all day long?

Time to get out my crayons and start drafting a proposal….

Visualizing data – Tableau Software

I spent the day in San Francisco attending the Tableau 8 Roadshow event.

Tableau is an amazing piece of software that helps you link to data in various forms – SQL databases, Excel spreadsheets, Google analytics, and many, many more – and use that information to create stunning visualizations. It’s insanely easy to use, and quite frankly is one of the most impressive pieces of software I’ve ever used to present data in an easy to understand manner.

Tableau
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Great Prezi on Evidence Based Health Informatics

Thanks to Tim Cook over at Google+ for the lead on this one.

I’m familiar with Prezi’s, but have never created one. I played around with the technology once, quickly became frustrated, and gave up. Anyway, the Prezi below from Dr. Robert Hoyt - Evidence Based Health Informatics » Replacing Hype with Science – has a lot of great information in it.

Update 3/13/2013: Looks like the presentation was pulled down. Not sure why, but the link is dead. Unfortunate as it was a great presentation.

Update 8/21/2013: The presentation is back! Dr Hoyt left a comment on this post letting me know that the presentation is up with new and improved content.

You can see the full presentation here or view it below.

Saturday morning coffee [March 9 2013]

MUG_genericSo much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug to the right isn’t one of my personal mugs. Instead it’s the kind of generic mug you get in cheesy hotel restaurants. And that’s because I’m not at home. I’m in Las Vegas for my daughter’s volleyball tournament. In lieu of that, and the fact that I had to crawl off into a “quiet” corner to open my laptop, I’m going to make this quick.

Jack the Giant Slayer was #1 at the box office last weekend. Not a big surprise as again there was little in the way of competition at the box office for a second week in a row. Jack brought in a measly $27 Million on its opening weekend. Not too bad, but when you consider the $195 Million production budget that makes it a flop. Yikes! My family and I saw Jack over the weekend. We enjoyed it. Identity Thief continues to do well as it came in second place for weekend box office totals.
Continue reading Saturday morning coffee [March 9 2013]

CPOE reduces likelihood of error by nearly 50% [article]? I’m skeptical

There’s quite a bit of talk floating around the internet about a recent article in JAMIA that looks at reduction of medication errors in hospitals secondary to CPOE adoption (J Am Med Inform Assoc doi:10.1136/amiajnl-2012-001241). The article is available for free so I read through it last weekend. By the end I was looking at something that wasn’t all that impressive. The authors use a lot of sleight of hand, i.e. statistical models to tell a story about how CPOE “decreases the likelihood of error on that order by 48%”, which ultimately could potentially lead to a reduction in medication errors by approximately 12.5%”. That would be great, except that the entire thing is based on statistical models, assumptions, survey data and a great big meta-analysis.

ChiefStatistian
Continue reading CPOE reduces likelihood of error by nearly 50% [article]? I’m skeptical

#1 thing to consider when buying pharmacy automation and/or technology…

There are a ton of things to consider when you’re thinking about putting new technology in the pharmacy. You have to consider the cost, the impact on your operations, the reputation of the company that you’re buying from, what type of technology you’re going to buy, and so on and so forth ad infinitum.

However, the number one thing you must consider before taking the plunge is whether or not the technology fits your dispensing model. Do you still do a cart fill? Are you completely decentralized? Are you using a just-in-time dispensing model? Will the technology that I’m looking at fit what I hope to accomplish? You need to think about that long and hard before making a decision.

It’s like buying a new vehicle. You certainly don’t buy a Toyota Prius if you need to pull a 24 foot Centurion Enzo SV244 – a really nice boat – to the lake on weekends. No, instead you buy a new Ford Super Duty truck. I know that makes perfect sense to you, yet I hear people frequently say “it doesn’t fit the way we work” when talking about pharmacy automation and technology. When they say that, the first thing that pops into my mind is “then why did you buy it?”. It’s a question that needs serious consideration because some of this stuff is expensive.

I experienced this firsthand in my previous role as an IT pharmacist. We installed new technology that didn’t really fit our distribution model all that well. We tried to cram the technology into an manual process. Didn’t work. I fought it for a few months until the light bulb finally went off. Once we got out act together we redesigned the process around the technology. We took advantage of the automation and filled in the gaps where necessary. It fundamentally changed the way we did things, and in the process improved the overall distribution process.

So before you go and buy a robot, or a carousel, or a high-speed packager, or a compounding machine, make sure you ask yourself how you’re going to use it.  This stuff isn’t top secret. Do a quick Google search. Watch some videos. Talk with hospitals that do the same things as you.

In a nutshell do your homework before taking the plunge because once you take the plunge and decide you’ve made a mistake you can only do one of two things: 1) change automation, or 2) change the way you work.

MedFolio, more medication compliance technology

Seems like everyone has some piece of technology designed to help patients with medication adherence and/or compliance.

What’s interesting to me is the number of different approaches there are out there to solve the problem. MedFolio looks similar to the old style medication organizers. It’s probably the most labor intensive solution I’ve seen, but then again it may be the most useful. Hard to say. From the videos I found on YouTube it looks like it’s been around for a while.
Continue reading MedFolio, more medication compliance technology