Jerry Fahrni

Author: Jerry Fahrni

  • We need a better system for medication reconciliation

    Medication reconciliation is defined by JCAHO as “the process of comparing a patient’s medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.” The process should be fairly straight forward, but it is actually very difficult and time consuming.
    (more…)

  • Impact of Handheld Technology on Hospital Practice

    The Impact of Mobile Handheld Technology on Hospital Physicians’ Work Practices and Patient Care: A Systematic Review1

    The Journal of the American Medical Informatics Association
    Mirela Prgomet, Andrew Georgiou, Johanna I Westbrook

    Abstract

    The substantial growth in mobile handheld technologies has heralded the opportunity to provide physicians with access to information, resources, and people at the right time and place. But is this technology delivering the benefits to workflow and patient care promised by increased mobility? The authors conducted a systematic review to examine evidence regarding the impact of mobile handheld technology on hospital physicians’ work practices and patient care, focusing on quantification of the espoused virtues of mobile technologies. The authors identified thirteen studies that demonstrated the ability of personal digital assistants (PDAs) to positively impact on areas of rapid response, error prevention, and data management and accessibility. The use of PDAs demonstrates the greatest benefits in contexts where time is a critical factor and a rapid response crucial. However, the extent to which these devices improved outcomes and workflow efficiencies because of their mobility was largely absent from the literature. The paucity of evidence calls for much needed future research that asks explicit questions about the impact the mobility of devices has on work practices and outcomes.

    (more…)

  • Sad, but all too common experiences with healthcare

    I read Warner Crocker’s musings at GottaBeMobile as well as his Tweets via the @LPH/tablet-pc-enthusiasts list on Twitter. Warner also has a second blog called Life On the Wicked Stage: Act 2, which I do not read with any regularity. I was, however, driven toward his personal blog secondary to a Twitter post. The post, titled Rush and My Mom: Two Different Care Experiences, talks a little about his experiences with his mothers medical care. She is apparently very ill with lung cancer. I sympathize with Warner as my mother-in-law, Mary Lou, succumbed to lung cancer in December of 2008. I also understand much of what he is talking about as my wife and I experienced similar problems during Mary Lou’s chemotherapy, pain management and surgeries.
    (more…)

  • “What’d I miss?” – Week of December 27th

    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.
    (more…)

  • MedEx: a medication information extraction system for clinical narratives

    The practice of informatics: Application of information technology: MedEx: a medication information extraction system for clinical narratives

    Hua Xu, Shane P Stenner, Son Doan, Kevin B Johnson, Lemuel R Waitman, Joshua C Denny

    Abstract

    Medication information is one of the most important types of clinical data in electronic medical records. It is critical for healthcare safety and quality, as well as for clinical research that uses electronic medical record data. However, medication data are often recorded in clinical notes as free-text. As such, they are not accessible to other computerized applications that rely on coded data. We describe a new natural language processing system (MedEx), which extracts medication information from clinical notes. MedEx was initially developed using discharge summaries. An evaluation using a data set of 50 discharge summaries showed it performed well on identifying not only drug names (F-measure 93.2%), but also signature information, such as strength, route, and frequency, with F-measures of 94.5%, 93.9%, and 96.0% respectively. We then applied MedEx unchanged to outpatient clinic visit notes. It performed similarly with F-measures over 90% on a set of 25 clinic visit notes.

    Xu H, Stenner SP, Doan S, et al. MedEx: a medication information extraction system for clinical narratives. Journal of the American Medical Informatics Association. 2010;17(1):19-24.

  • New medical tablet from Sanwell offers RFID, barcode scanner

    Samwell has introduced a tablet PC designed specifically for the medical industry. The tablet is dubbed the MCA9 and offers a 1.6GHz Atom processor, a two megapixel camera, a RFID reader and optional bar code scanner, and an 8.9-inch TFT-LCD touch screen that is readable in sunlight.

    According to Samwell: “designed for medical application, the ability for data capture, record and transmission is highly valued. The built-in 2-megapixel camera is centrally mounted on the backside. The 1D/2D Barcode Scanner and 13.56 RFID reader support electronic medication administration records, reliable patient identification, and medical tracking.”

    I’m skeptical of tablets with built in bar code scanners designed for “medical application”. The Motion Computing C5 tablet has a similar design. Our facility trialed a C5 tablet earlier this year and nurses found it difficult to use and too heavy to carry for extended periods. The two megapixel camera and small screen may also present a problem for documentation and viewing patient data.

  • Cool Technology for Pharmacy

    This weeks cool technology comes by way of a comment left at RxInformatics.com in response to a recent post I wrote on smartphones and pharmacy practice.

    The author of the comment, @pillguy, is an iPhone fanboy and pharmacy technology guru.

    @pillguy:  “The iPhone certainly has some promising applications related to EHRs. Airstrip is one of the coolest I have seen.

    The smartphone takes PDAs to the next level with access to realtime information. I can see a TheraDoc, Pharmacy OneSource, or Zynx type clinical monitoring/alerting app fit in with the Airstrip suite nicely.”
    (more…)

  • The 10,000-hour rule to becoming an expert

    Non-Clinical Medical Jobs: “According to this article on TheLadders.com: “It takes 10,000 hours of dedicated effort to become an expert performer in any field.”

    Dan Coughlin from The Coughlin Company attributes the conclusion above to the best-selling books “Outliers” by Malcolm Gladwell and “Talent is Overrated” by Geoff Colvin as well as the new hit TV comedy series, Modern Family. Dan writes about his personal experiences as a consultant for 12 years and he says: “From these sources as well as my own 12 years of consulting work, I have found that the key to great performance can be summarized in three words: thought-filled practice. That comprises executing a simulation of the actual performance while consciously observing the outcome.” Dan outlines the following “six steps of thought-filled practice:”

    • Select a role for which you have passion and strengths.
    • Identify the five critical aspects of that role.
    • Create simulations of the actual performance that let you focus on improving one or more of the role’s critical aspects.
    • Gain relevant, timely feedback on the simulated performance from a skilled observer .
    • Consider the feedback and make adjustments.
    • Repeat steps three to five for 10,000 hours.”

    Bummer, I’m about 8,000 hours shy of becoming an expert in my field. Guess I have some work to do.

  • Year end thoughts for 2009

    2009 brought many new and exciting changes not only in my personal life, but in the world of pharmacy and technology as well. I’ve learned many new things, gained some skills previously absent from my armamentarium, met some great new people, discovered the “real” internet for the first time, traveled more than ever before, discovered I don’t know diddly squat about a great many things, and am more excited about the next year than I can remember in recent history.

    Below is a list of opinions about a great many things that I have seen and done over the past year. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.
    (more…)

  • Are smartphones a viable platform for pharmacy practice?

    It’s no secret that I’m a big fan of tablet PCs. In fact, I can’t imagine life without one. The reason why acute care pharmacists haven’t adopted the tablet PC platform escapes me. My complete opinion on the matter can be found here.

    With the growing need for real-time access to patient data it no longer makes sense to be anchored to a desktop PC at the point-of-care. Couple this with the rapid growth of portable technology and you have a rare opportunity to develop a mobile pharmacy practice in the acute care setting. Whether that model will utilize tablet PCs, UMPCs, WebStations, netbooks or other mobile device remains to be seen.
    (more…)