Jerry Fahrni

Category: None of the above

  • The illusion of multitasking

    Yesterday I went through the drive-thru of a local fast food chain. The young lady manning the register asked for my order, so I started giving it to her. She asked me to pause for a second, and when she resumed she repeated the first part of my order back to me. She had it completely wrong. This happens to me all the time in the drive-thru, which is why I typically avoid them at all cost. Yesterday I made an exception and instantly regretted it.

    People working drive-thru windows at fast food joints typically try to multitask, i.e. take an order from one person while trying to put an order together for another, and so on. In my experience this usually results in what happened to me yesterday. Frequently I have to repeat part, if not all, of my order. I find it quite irritating.

    Multitasking is a myth, plain and simple. People do not have the mental capacity to concentrate on more than one thing at a time. Don’t take my word for it. There’s plenty of evidence to back up my claim.

    Christopher Chabris, PhD is a professor, research psychologist, and coauthor of the best-selling book The Invisible Gorilla. His research focuses on two main areas: how people differ from one another in mental abilities and patterns of behavior, and how cognitive illusions affect our decisions. He has published papers on a diverse array of topics, including human intelligence, beauty and the brain, face recognition, the Mozart effect, group performance, and visual cognition. He was also the keynote speaker at the unSUMMIT that I attended last week. The presentation was fantastic.

    According to Dr. Chabris everyone thinks they can multitask, but very few can. His research estimates that a mere 2.5% of people can “do ok as a multitasker”. Unfortunately his research has demonstrated that everyone thinks they can multitask, and those that consider themselves true multitaskers tend to do the worst in experiments that require one’s attention.

    Everything that Dr. Chabris spoke about applies to pharmacy, but I found two things particularly interesting:

    • Post completion errors – this is when someone forgets to complete the last step of a process. Examples include leaving an original paper on a copy machine, or in healthcare, when someone leaves the guide wire from a PICC insertion in place. Even when people are told they forgot the final step they often can’t figure out what went wrong. Dr. Chabris refers to this as “satisfaction of search”, i.e. you see what you expect to see. This type of thing happens all the time in pharmacy practice, especially during the distribution process and the IV room.
    • “Illusion of attention” – this is when people think they can pay attention to multiple things at once. He refers to this as an “everyday illusion”, of which multitasking is a prime example. These misconceptions are hard to overcome and systematically wrong. How many times have you witnessed a pharmacist or pharmacy technician trying to do more than one thing at a time – talk on the phone while filling a script, retrieve tablets from a “Baker cell” while on the phone, etc? Happens all the time.

    Overall the presentation was solid and the information valuable. I recommend taking a look at Dr. Chabris’ work. The concepts can be applied both directly and indirectly to errors that occur in the pharmacy.

  • I used a telemedicine service for the first time and loved it

    My daughter woke the other morning with the following complaints:

    • itchy eye
    • watery eye
    • “feels like there’s sand in my eye”
    • and from my observation, redness in the “white” of her eye

    Hmm, I’ve seen this before. My initial thought was conjunctivitis, a.k.a. “Pink eye”.  I called our family pediatrician looking for something to hold us over the weekend until we could be seen on Monday. Basically I was saying it looks like Pink eye, so let’s  treat it like Pink eye for the rest of the weekend and I’ll follow up with you on Monday. Unfortunately I got the nurse practitioner on call. She wasn’t very cooperative. She wanted me to take my daughter to the urgent care to rule out periorbital cellulitis. Really? You jump from itchy, red eye with a slight watery discharge to periorbital cellulitis? I thought that was rather ridiculous, so I ignored her and hung up the phone.

    Sounded like a good time to try a telemedicine service. My insurance company, Anthem Blue Cross, offers a a service called LiveHealth Online. I followed the link provided by my insurance company, downloaded the app, and by 7:30 am on Sunday morning my daughter and I were sitting on the couch in our living room speaking with a Family Practice physician about her eye.

    I let my daughter do all the talking. I was simply there to make sure things went smoothly. The physician asked several questions about how my daughter was feeling, about her eye, who she’d been in contact with, and what she had been doing over the past several days. The physician had my daughter hold her eye up to the front facing camera on her Galaxy S5 from several different angles to better view of the eye. Conclusion? Conjunctivitis, probably viral. The physician decided to treat with some anti-bacterial eye drops “just in case”. A prescription was electronically sent to our pharmacy and that was it. From beginning to end the entire visit took less than 15 minutes.

    It’s been about 36 hours since we started treatment and her eye has improved significantly. Overall I have to say that my first experience with telemedicine was fantastic. A trip to the urgent care would have taken several hours and been quite inconvenient. I have to say, I believe now more than ever that telemedicine has a place in healthcare, especially for things like this.

    Periorbital cellulitis my rear.

  • Desire to see more collaboration between pharmacies and local universities

    Bitwise Industries in Fresno is an interesting place. It’s basically a tech hub pulled together by some great local minds. Located in a nice little area in downtown Fresno, BitWise has tasked itself with taking “a burgeoning tech industry that was growing in silos in California’s heartland, add places that inspire community, collaboration, and growth, create accessible education that equips and empowers a homegrown army of technologists, deploy talent to execute technology success stories”. I visited the facility with my brother, Robert when it first opened. Impressive and inspiring.

    But this post is not about BitWise. It’s about something I’ve been thinking about for a couple of years. BitWise was simply a catalyst to remind me to revisit my idea.
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  • Moving from the Motorola Moto X to the Samsung Galaxy S5

    s5_blackA short time ago I was an unwilling participant in my Moto X being dropped on a concrete floor.

    Over the past year or so I’ve been working with a colleague on a book about the state of automation and technology in pharmacy IV rooms. During this time I’ve made several site visits to acute care pharmacies to look at the technology, workflow, etc in their IV rooms. As part of the data collection process I not only take a lot of notes, but snap lots of photos and record video of technicians working with the technology. I find the photos and video invaluable when reviewing my notes.

    Prior to entering the cleanroom at one large hospital back east, the pharmacist in charge insisted that he wipe down my Moto X with alcohol. I wasn’t thrilled with the idea, but it was either let him do it or not take it in. I opted to let him wipe it down. During the process he dropped my Moto X. It hit the concrete floor pretty hard and bounced. The back popped halfway off. Not good. Since that time my Moto X has been acting weird, freezing up, not taking voice commands, and so on. I finally decided to replace it through the insurance I carry on the device.
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  • Access to information and learning

    “Intellectual growth should commence at birth and cease only at death.” ― Albert Einstein

    I’ve recently returned from the ASHP Summer Meeting. I learned some new things, which serves as a reminder to me of the importance of continuous learning and access to information in our profession.

    As a pharmacist I’ve been involved in a lot of systems over the years designed to keep me up to date. All have been successful in their own way, but obviously some were better than others.
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  • Slingshot, getting clean water from just about anywhere

    I was sitting in a movie theater in Las Vegas waiting for X-Men Days of Future Past to start when I saw an interesting video about a product called the Slingshot, invented by Paul Lazarus.

  • On the job, six months as an independent

    Through an interesting series of events over the past several months I’ve slowly transformed myself from an employee to an independent contractor, so to speak. I suppose I’ve officially become a consultant of sorts, but I’m not thrilled with the term “consultant”. My dislike for the term comes from my experience with consultants over the years. I’ve worked with many, but found few that were actually helpful. It’s obviously not fair to lump them all into the same basket, but those are the breaks.

    Immediately after losing my job in July 2013 I tried to jump back into pharmacy, quickly realizing that it wasn’t going to happen. Fortunately I was able to piece together “full-time work” by combining some per diem hours at a local hospital and some ad hoc product management work for a small company working on a new pharmacy application. The hospital work was good, but limited to 10-20 hours per week for about three months. As luck would have it as the hospital job was coming to an end another small company building pharmacy software reached out and just like that I had a second job as an ad hoc product manager. Then a few hours helping a group with strategic planning, then a few hours on a marketing campaign, then some time analyzing state specific pharmacy laws, and so on.

    I’ve had a fair number of inquiries from various companies covering a host of projects. Some turned into work, while others were nothing more than discussions. I’ve had to turn down two jobs due to various circumstances. Hopefully those circumstances will clear up later this year, which means I’ll be able to open myself up to another group of potential opportunities.

    Truth be told I’ve entered the world of consulting completely by accident, and it turns out that I like it. I like it a lot. My schedule is flexible and within my control, and the variety of work prevents me from getting bored. I’ve also discovered that the companies that engage me have a desire to do good work. They’re looking for a fresh perspective and aren’t afraid to hear a different opinion. They’re motivated to build some really great products. I’ve been impressed with all the groups I’ve had the privilege to work with. They make rapid, decisive choices and move swiftly to make things happen. I respect that.

    It’s not all rainbows and unicorns. There are new things to worry about like paying my own taxes and getting health insurance for me and my family, but the positives clearly outweigh the negatives. Overall I’m enjoying the ride.

  • Application for Wacom’s new WILL technology in healthcare

    PC World: “Wacom has grand designs for a new graphical language…WILL, short for Wacom Ink Layer Language, will store pen strokes in a Stroke File Format and allow them to be streamed using its Stroke Messaging Format. The file formats capture not only coordinates and pressure, but also who made an ink stroke, and when…One of the more far-fetched usage scenarios Wang proposed for WILL involved digitally signing documents using a pen that would certify who had manipulated it thanks to a built-in DNA sampling device.”

    Like it or not the human race still loves to communicate via pen and paper.1 It’s a process that’s been ingrained in us for a very long time. It’s natural, and it’s going to be quite some time before we’re able to move to a completely different medium for communication. We’re well on our way to a digital world, but that won’t replace our need to use pen and paper for a great many things for quite some time to come.
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  • 5 Shady Ways Big Pharma May Be Influencing Your Doctor

    AlterNet: “When it comes to acknowledging the influence of gifts and money on behavior, doctors, like everyone else, suffer from self-delusion. Most say they believe it affects the other guy, not them, and many become offended at the idea that they are “for sale.”

    Trips to resorts and strip clubs will likely continue to diminish under the Physician Payments Sunshine Act, but there are many other ways, often sneaky, that Pharma can entice doctors to prescribe its expensive, patent drugs.”

    Physicians, just like everyone else, are subject to bias. I rarely come across a physician that’s been practicing for more than 10 years that relies on up to date scientific data and/or guidelines to drive their prescribing habits. I can’t tell you the number of times I’ve had a physician say “because the drug rep told me” in response to my question regarding their use of a specific drug over another. That answer doesn’t instill confidence. 

    Here are the 5 methods of influencing prescribing habits as listed in the article:

    1. Spying on Prescribing – “By selling the names, office addresses and practice types of almost every doctor in the US to marketing firms the AMA netted almost $50 million a year“
    2. Continuing Medical Education Courses – “…these classes are often “taught” for free by Pharma-funded specialists, sparing doctors from having to pay for them but providing the objectivity of a time-share presentation.“
    3. Ghostwriting – “Being published in medical journals is essential to academic doctors but researching, writing and reworking papers is a formidable job. Luckily for doctors, Pharma is willing to help—as long as they write what Pharma wants.”
    4. Speakers Bureaus – “Few things combine the ego stroking and fast cash of being paid to speak—and Pharma has no trouble finding takers at $750, $1000 and more per pop.”
    5. Clinical Trials – “Pharma-funded clinical trials can be paydirt to doctors, yielding as much as $10,000 per patient in some cases.”

  • Merry Christmas 2013

    Wishing all of you a very Merry Christmas!

    And there were shepherds living out in the fields nearby, keeping watch of their flocks at night. An angel of the Lord appeared to them, and the glory of the Lord shone around them, and they were terrified. But the angel said to them, “Do not be afraid. I bring you good news of great joy that will for all the people. Today in the town of David a Savior has been born to you; he is Christ the Lord.

    Luke 2:8-11