Jerry Fahrni

Author: Jerry Fahrni

  • Thoughts on the Xbox One announcement

    I’ve had an Xbox system in one form or another for a long time. I currently have an Xbox 360 in my home, and there’s a Kinect attached to it. We use the system for games and movies. Typical stuff.

    Microsoft’s newest Xbox, dubbed Xbox One, is taking things to a whole new level. I sat with my wife the other night and watched the announcement as it replayed on my Xbox.

    Some things that caught my attention during the announcement:

    1. Three operating systems. One based on the Windows NT kernel for apps like Netflix, Skype, YouTube, Twitter, etc.  The second is dedicated to games.  The third allows the other two to communicate with each. All this is designed to provide instant switching between apps. The demo was impressive.
    2. New Kinect. People in healthcare have been experimenting with Kinect for a while. After all Microsoft offers an SDK for anyone that’s ready, willing and able. Several groups have taken advantage of the technology. It’s surprising to me that no one in pharmacy has done anything with Kinect technology inside the IV hood. I fully expected to see something this year, but nothing has materialized. Why is that? Do you think any schools of pharmacy are looking at this type of technology? Don’t some schools claim to have strong “pharmacy informatics” programs? What do they do?
    3. The improved dashboard. This goes hand and hand with item #1 above. The instant switching, the ability to snap items and multi-task is pretty cool. I’ve been in pharmacy for a long time, and I can say without hesitation that all the pharmacy information systems I’ve used are nothing short of craptacular. Xbox One is an entertainments system that will most certainly cost less than $999; likely half that. It’s connected to the cloud and offers the ability for millions of people to be connected at the same time; as I look up from my laptop I can see that there are 87,043 people online playing COD Black Ops II at this very moment. That’s one game at 10:30PM PST.
    4. Voice and gesture control. Self-explanatory and awesome. Pharmacy systems should be voice and gesture controlled; packagers, carousels, robots, etc. The idea of using a keyboard and mouse on these systems just seems silly to me.

    Xbox One could be an interesting foundation upon which to build some pretty cool pharmacy functionality. The new HD-capable Kinect with Skype is an out of the box telepharmacy system. The system could also be used to bring educational videos and games (gamification) right into the living room of patients. How about using the SDK to build medication adherence applications that tie into things like the AdhereTech smart bottle? And as mentioned above in item #2, Kinect offers up some interesting ideas for gesture control/recognition for certain pharmacy operations.

    It’s exciting and disappointing to think of the potential for an entertainment system such as Xbox One. Exciting because the technology is staggeringly cool. Disappointing because healthcare continues to wallow in failure when it comes to technology. Crud, we still can’t figure out how to keep electronic records. My Xbox Live account knows more about me and certainly has more accurate information about me than my GP.

  • Saturday morning coffee [May 18 2013]

    So 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 below was a gift that I received from the unSUMMIT U for giving a barcoding webinar back in January. For those of you that don’t know, the unSUMMIT is all about barcoding, of which I have a fair amount of experience/expertise.  The unSUMMIT U is an extension of the unSUMMIT that offers webinars about barcoding throughout the year. I’ve attended a couple.

    IMG_6298
    (more…)

  • A view of pharmacy through Google Glass [simulated]

    I haven’t been this excited about a technology in quite some time. Google Glass makes hands-free operation a reality in the pharmacy. I don’t think it’s a long term fix as I believe that robotics will likely take over the distribution process someday, but not today. Today robotics remains expensive and clumsy.

    Unfortunately Google Glass is hard to come by. And there’s little chance I’ll get my hands on any (one?) in the foreseeable future. I did however stumble across a website that allows one to create a reasonable facsimile of what the view through Google Glass might be like.

    So I took a minute and did a quick mock-up of what a pharmacy technician might see if they were directed to pull a medication from a static shelf while wearing Google Glass. Click on the image below to get the full effect. A little information along with a little augmented reality (red box and arrow) would be cool.

    GGPick

     

    I think technology like this would be a great addition to any product that utilizes barcode scanning or requires photos. “Ok, glass, take photo”. Products like DoseEdge or Pharm-Q In The Hood that utilize cameras to document the compounding process could benefit from being able to snap a quick hands-free photo with only a voice command. Crud, you’re already looking at the product, which means Glass is too.

  • Medication therapy management at TEDxUniversity [video]

    Thanks to Megan Hartranft (@MeganPharmD) and John Poikonen (@poikonen) for tweeting this. It’s nothing earth shattering, but it sums up why pharmacists should be more involved. Tim Ulbrich does a really nice job.

    Pharmacy schools should show this short video to all their pharmacy students before turning them loose on the world. I talked about some of this in my presentation at the HIMSS Southern California Annual Clinical Informatics Summit a couple of weeks ago.

    There was a time when I thought that the best place to engage patients was in the hospital, but I’m starting to rethink that position. If you think about it, engaging patients in the hospital is a bit of a reactive approach. We need to engage patients before they’re hospitalized to get the most bang for our buck.

  • Saturday morning coffee [May 11 2013]

    MUG_Talyst3So 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 is from the company I work for. Strange little story to go along with how I ended up working there, but that’s probably better saved for another time. I ended up with a mug from the company long before I came on board. It was part of a swag bag at one of the past user group meetings that I attended as a customer. I believe it was my first ASHP Summer meeting way back in June of 2009; can’t be sure though.

    Iron Man 3 was #1 at the box office last weekend raking in a cool $174 million. No surprise there as Iron Man 3 was expected to be a blockbuster. I wasn’t able to see it over the weekend, but did manage to catch it Monday night. Was it good? Absolutely, it was a very good move. However, I was a bit disappointed. There was a lot going on in the movie, and some of it felt “off”. I’d still see it again. It’s a bummer that this is likely the end of the Iron Man franchise. Oh, just in case you were wondering Pain and Gain was a close second with $7.5 million in weekend gross; a mere 23 fold difference.
    (more…)

  • Info packets instead of a pharmacist used in attempt to improve medication adherence

    angry_monkeyI came across an article today in The Baltimore Sun that caught my attention.

    According to the article: “In a test of services geared toward making sure patients took their prescribed medications after leaving the emergency room, none made a difference, a large new study suggests.

    Based on the experiment involving nearly 4,000 ER patients, researchers found that information packets, personal assistance and even access to an on-call medical librarian to answer questions about the drugs did not lead patients to fill more prescriptions or to take them as directed when they left the hospital.”

    The best line from the article has to be that patients were given “access to an on-call medical librarian to answer questions about the drugs [they were prescribed]” This has to get the head-scratcher of the year award. The lunacy of healthcare never ceases to amaze me. Why, oh why would you give patients access to a medical librarian to answer drug questions. I have great respect for medical librarians, but that’s not their domain.

    And as a surprise to no one, “One week after ER discharge, 88 percent of patients had filled their prescription, according to pharmacy records, and in a phone interview 48 percent reported taking the medication as prescribed. Those percentages did not differ between the participating groups.”

    No kidding. Medication adherence is an incredibly complex problem with many different reasons why patients choose not to get their prescriptions filled or fail to take them consistently and accurately.

    Depending on the study you read, medication adherence costs the United States anywhere from $100 billion to $290 billion annually, including increased morbidity, lost time from work, readmissions, etc. Pharmacists have been shown to help. Handing out pamphlets has not.

    Honestly, I’m surprised that the Annals of Emergency Medicine would publish such crap. My cats leave equivalent work in the yard all the time, but at least they try to cover it up.

    The article – Does Providing Prescription Information or Services Improve Medication Adherence Among Patients Discharged From the Emergency Department? A Randomized Controlled Trial – can be found here.

    Morons.

  • SharePractice – a collaborative clinical reference for physicians

    Here’s an interesting concept.

    SharePractice is an application that uses the idea of crowdsourcing other physicians to rank treatments for various disease states.

    “Good doctors make bad decisions because knowledge sources are incomplete and static. Medical reference tools are biased by business interests and take too long to update. Reading research papers is an antiquated process that most busy doctors just don’t have time to read.

    It is challenging for doctors to remain aware of new or effective treatments because there are no easy ways for us to communicate, evaluate and share clinical insights. So we call, text, email, use forums and go to conferences. But this data is not collected and it is lost.

    Share Practice gives doctors power to collaborate on treatments and rate clinical efficacy.  Our next generation medical reference gives every doctor the ability to ‘publish’ findings, get feedback from the community, review conventional therapies and incorporate new and integrative medicines into the collective knowledge-base.

    Share Practice is the most current source of medical information, contributed to and maintained by doctors around the world. Beautifully simple, mobile and freely available, Share Practice is built for doctors; by doctors.”

    Check the video below to get a better idea of what SharePractice is.

  • Smartphone medication adherence apps [Article]

    JPhA_article_header

    Not sure how I missed this one, but there’s an article in the March-April 2013 issue of the Journal of the American Pharmacist Association that covers smartphone applications for medication adherence.

    Smartphone medication adherence apps: Potential benefits to patients and providers (J Am Pharm Assoc. 2013;53:172-181)

    From the abstract: “160 adherence apps were identified and ranked. These apps were most prevalent for the Android OS. Adherence apps with advanced functionality were more prevalent on the Apple iPhone OS. Among all apps, MyMedSchedule, MyMeds, and RxmindMe rated the highest because of their basic medication reminder features coupled with their enhanced levels of functionality.”

    There’s a lot of good information in the article, especially the bibliography. To top it off, the article is available in its entirety for free so go get it. Actually, the entire March-April issue is worth reading.

  • Evolution of [Pharmacy] Practice in an Age of Information [Presentation]

    Yesterday I was at Children’s Hospital of Orange County in Orange, CA. for the HIMSS Southern California Chapter 5th Annual Clinical Informatics Summit: Adventures in Clinical Informatics. I was there to give a presentation about pharmacy. It’s the first public presentation I’ve given since retiring from the presentation game just over two years ago. Now that it’s over I’m heading back into presenter retirement.

    The presentation in its entirety has been uploaded to Slideshare and is embedded below. Some of the slides didn’t show up at the time of upload. I tried a couple of different things to get them to show up, but at last view they still weren’t there.

  • Saturday morning coffee [April 20 2013]

    MUG_IndianapolisSo 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 Indianapolis. I was there for work as part of a multi-city five hospital rampage through that section of the country. It was pretty nice for the most part, but trying to get home turned out to be a bit of a nightmare. Indianapolis was hit by severe thunderstorms the day I was supposed to leave – high winds, lightning, hail, and so on – which caused all sorts of chaos and delays at the airport. The delays made me miss my connection in Denver, which just happened to be the last flight out to Fresno on the night in question. I got lucky as the last flight to Los Angeles from Denver had been delayed by an hour so I grabbed an available seat and headed for the city of Angels. I landed at LAX about 1:00AM Friday morning, rented a car, got a hotel room, stole a few hours of sleep and finally drove the short four hours home. Total travel time from Indianapolis airport to my front door: approximately 20 hours. Not how I planned it. When I talk to the sales guys they tell me this is “no big deal”. If you were to talk to me I’d tell you it sucks.
    (more…)