I’m always on the lookout for a new tablet, and never more so then I am at this moment. My trusty Lenovo X201T is getting old. At more than a year, it’s downright ancient in computer technology years. It’s a dilemma to be sure.
Fortunately for me there’s no shortage of tablets on the market: Windows OS, Android OS, iOS. Crud, based on reports from CES 2012 I’ll have a much bigger selection within another 6 months or so.
If you know me then you know that I’m a proponent of expanding the role of pharmacy technicians in the acute care pharmacy setting. I believe pharmacy technicians are underutilized and are capable of doing many functions within a healthcare system to improve patient care, both directly and indirectly, as well as free up pharmacists to do the things they should be doing.
I had an interesting conversation with a colleague earlier today. We were talking about a feature set for a new product that we have due out later this year. Some of the language being used to describe a certain feature, and how it would be used, was causing quite a bit of confusion for me. So I tried to clarify things a bit. After a brief email exchange it turned out that I knew exactly what he was talking about; healthcare and especially pharmacy simply use different words to describe the process.
I recommended that we use the pharmacy specific lingo, but I was told no because it wasn’t the industry standard. I found that quite interesting because we build products for pharmacy, i.e. that is the industry we’re in. However, the terminology used for this particular process is different outside the pharmacy world. Still with me? Good.
So, the question becomes does one conform to the terminology in the market segment you’re in, i.e. pharmacy, or do you ignore the pharmacy terminology and go with the “standardâ€? My gut reaction would be to go with the standard – after all I preach standardization all the time – however, if one does that you end up talking to pharmacy people that have no idea what you mean. You know, everyone has that deer in the headlights look with everyone standing around wondering what the heck is going on. And to top it off, no one asks for clarification because they’re afraid it might make them look stupid. We’ve all been there. I know I have.
So, based on what I just said above I think you have to conform to the industry you’re in. In other words, use the pharmacy terminology, standard or not.
MedPage Today: “Robotic prostatectomy has spread all over the U.S., despite the fact that we don’t have clinical trial data to show that it’s better than traditional open surgery.Â
The company marketing the robotic surgery systems boasts on its website about news coverage from ABC’s “Good Morning America” and from CNN’s Dr. Sanjay Gupta. And, under a picture of a couple dancing, the manufacturer claims:
“Studies show patients who undergo a da Vinci Prostatectomy may experience a faster return of urinary continence following surgery … Several studies also show that patients who are potent prior to surgery have experienced a high level of recovery of sexual function (defined as an erection for intercourse) within a year following da Vinci Surgery.â€
But a paper published by the Journal of Clinical Oncology concludes that:
Risks of problems with continence and sexual function are high after both (robotic and open prostatectomy). Medicare-age men should not expect fewer adverse effects following robotic prostatectomy.â€
The article gives examples of complications following open (“normalâ€) surgery versus robotic surgery using Medicare claims data from 406 men that had robotic surgery and 220 that had open surgery. The data from the two groups looks surprisingly similar. In fact, the open surgery group had a larger percentage of respondents reporting no complications than did the robotic surgery group; although the difference may not be significant.
Ultimately the authors of the Journal of Clinical Oncology suggest that the reason for the popularity of robotic surgery may be “gizmo idolatry†is at play. The authors go one step further by calling out Medicare’s reimbursement for robotic prostatectomy, “The apparent lack of better outcomes associated with (robotic prostatectomy) also calls into question whether Medicare should pay more for this procedure until prospective large-scale outcome studies from the typical sites performing these procedures demonstrate better results in terms of side effects and cancer control.â€
It makes one wonder where the line for reimbursement should be drawn. Should reimbursement be tied to evidence based outcomes? It’s a good question when you think about all the treatments we use everyday that may not have sufficient data to back them up. Does that mean we should only use evidence based treatment? No, that would limit our ability to try new therapies when others fail. Interesting debate nonetheless.
Anyone that’s ever worked in an acute care pharmacy knows about med trays, code trays, transport boxes, intubation kits, etc. They’re a bit of a headache because all the medications inside each kit has to be manually manipulated and tracked, including the dreaded lot number and expiration date of everything in the trays.
Well, KitCheck is a system that uses RFID technology to track the medications found in all those different med trays, code boxes, etc. I thought it was pretty cool. It’s a great idea. Wish I would have thought of it.
Seems like a reasonable platform for clinical pharmacy services.
Interesting video that talks about the use of telepharmacy for Medication Therapy Management (MTM).
Have you ever had something on your plate that just won’t go away because someone is “thinking about it†or trying to “justify it� Sure you have. I know I have. I always wonder what the person is thinking about when it takes months to make a decision. Doesn’t the information you have to make the decision become outdated when you wait that long? I for one, can’t think about anything that long because it gives me a headache. And sometimes you simply can’t justify something; it’s a leap of faith.
One thing is for certain, if you’re waiting for the right moment, the moment will never come. Decisions don’t need to be right or wrong, they simply need to be made. Heaven forbid you make a bad call on something. I seriously doubt anyone has gone through life mistake free. If you never make a mistake you’re not trying hard enough in my opinion. Heck, I’d go as far as to say that some of the most valuable lessons I’ve learned have been from my failures. Sure, the failures sting a little, but that’s what helps one learn from the process.
I believe fear is the cornerstone of indecisiveness; fear of making the wrong decision. Choosing to not make a decision is, in itself, a decision. Unfortunately it’s a decision that people repeat time and time again without learning from the mistake of not choosing. The only way to learn to make good decisions is through the experience gained from making bad decisions. Kind of a circular argument, I know. Go figure.
According to Albert Camus “life is the sum of all your choices.†So what does that say about your life if you don’t make any decisions? Not much.
As Staff Sergeant Nantz so eloquently put it in the movie Battle Los Angeles, “You can go right. You can go left. I don’t give a damn. Just make a decisionâ€.
The definition of telemedicine is “the use of telecommunication technologies to deliver medical information and services to locations at a distance from the care giver or educator.†So what’s the definition of telepharmacy? I’m not quite sure, but replacing “medical information and services†with “pharmacy information and services†seems reasonable.
I saw a lot of interest in telepharmacy at the ASHP Midyear meeting in New Orleans last month. Based on all the activity one might think it’s a new concept. Au contraire, telemedicine has been around since at least the 1960’s, when NASA built this technology into spacecraft and astronauts’ suits to monitor physiological parameters. Crud, one could argue that the concept has been around much longer than that (see image to the right from April 1924).
The ZiuZ Inspector – or is it the Foresee Inspector – is an interesting system designed to inspect the contents of unit dose packages produced by high-speed unit dose packagers. I don’t think there’s much need for this in most acute care pharmacy operations here in the U.S. because we don’t unit dose enough tablets and/or capsules to make it worth while, but I do think it may have potential in some long-term care pharmacies using a central dispensing model. Who knows, that’s not really my area of expertise.
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