The Annals of Pharmacotherpy (Vol. 43, No. 11, pp. 1912-1913): “Approximately 80% of pharmacists use the Internet to obtain drug information.1 Wikipedia, often found at the top of Internet search results, is a free-access, collaborative, online encyclopedia that can be edited by anyone.2 Incidents of vandalism have occurred, since the site allows anyone to contribute. For example, an incident occurred in which a fake biography was created as a joke to implicate prominent writer and journalist John Seigenthaler for the assassination of John F Kennedy. It took about 4 months until the fake biography was detected and deleted by Wikipedia.3 Although Wikipedia does have an internal quality review, the ability of internal editors to find and correct erroneous information may not be timely. As reported by Clauson et al.,4 the information found on Wikipedia may not be complete and accurate, especially in regard to drug information. Published data regarding pharmacists’ use of Wikipedia to obtain drug information is lacking. Therefore, the objective of this study was to measure pharmacists’ use and perception of Wikipedia for obtaining drug information.†– This letter to the editor discusses the results of a questionnaire given to pharmacists regarding the use of Wikipedia for drug information. I was disturbed to read that 28% of respondents reported using Wikipedia for drug information. Strange that it doesn’t appear on any of my drug information resources lists, and never will. I expect better from pharmacists.
Category: Pharmacy Informatics
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Pharmacist perception of Wikipedia as a drug information resource
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Dealing with the shortcomings of healthcare information systems
This week has kept me busy dealing with issues surrounding our various clinical systems and how they fit, or don’t fit, into various processes. If you’ve been reading this blog then you are probably a little too familiar with one of the problems; the dreaded allergy issues which I’ve discussed here and here. The issue runs much deeper then I’m willing to go into here, but suffice it to say that it’s been a real pain in the rear. The other significant issue has to do with bar code medication administration and “things we can’t do†with our current system.
Anyway, I’ve been in meeting after meeting this week listening to people argue over things that I consider outside of our control and basically spending a lot of time talking about what our systems can’t do. As you can imagine the discussions can become quite energetic. During one particularly heated discussion I asked a key player to forget about what we couldn’t change and asked them to focus on the issues that could be controlled. The end result was a general consensus that we could control and correct approximately 60% of the problem by working within the confines of the systems and deal with the remaining 40% through education and accountability. The arguing took 60 minutes, the ultimate solution took 15.
Believe me, I am painfully aware of the shortcomings of our various clinical systems, but I really don’t see the need to dwell on things that are outside of my control; a lesson I learned from my wife. Oh sure, I get frustrated and vent every now and then, but the bottom line is that I have to work within the limitations of the systems put in front of me. You see engineers do it all the time; focus on how to make it better not on what can’t be done. I think healthcare professionals could learn a lot from engineers. Just a thought.
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Drug information resources
Below is a list of drug information resources for both mobile devices and online access. I’ve used most, but not all, of these resources and have found the mobile versions to be a valuable resource when you’re on the go. While it is possible to access the online versions of these resources via a smartphone, the mobile applications are designed with the smaller screen in mind and therefore, in my opinion, work better then the online versions when using a mobile device.
Let me know if I missed any. Also feel free to comment on your favorite.
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Why my Firefox browser is more advanced than our hospital’s HIS
Each day I roll into work ready for another exciting day of pharmacy technology. I’m usually bright-eyed and ready for a new challenge because I’ve spent the previous night scouring the web and reading about all the incredible technology being put into place all over the world; tablet pcs, electronic paper and ink, advanced nanoparticles, automated dispensing devices, mobile phones, advances in social networking, and so on ad infinitum. Then there are days like today when I have something land in my lap that just makes me shake my head and wonder if healthcare will ever catch up to the rest of the world.
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Thinking about Clinical Decision Support (CDS)
I attended at webinar today on “Achieving Meaningful Use – The Importance of Clinical Decision Supportâ€. Overall the information was pretty good. It wasn’t exactly new information, but it never hurts to hear something again. The webinar got me thinking about Clinical Decision Support (CDS).
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Non-traditional roles for pharmacists
The increased chatter surrounding healthcare has piqued my interests in job opportunities for pharmacists outside the traditional roles, i.e. retail, hospital, IT, long-term care, etc. Physicians have been filling many of these roles for quite some time. For more information on physicians in non-traditional roles I recommend visiting Non-Clinical Medical Jobs, Careers, and Opportunities by Dr. Joseph Kim. It was Dr. Kim’s site that put my mind into overdrive.
Much of my interest in these non-traditional pharmacy jobs stemmed from various internet articles on advances in healthcare technology from companies like Microsoft, Google, and GE among others. These companies are developing some very interesting technology and have jobs posted that require a pharmacy degree.
Over the past several months I’ve applied for positions at several of these companies, but haven’t heard so much as a peep from most of them. Microsoft gets some brownie points because they were kind enough to send me a nicely worded rejection notice in the form of an email.
Anyway, pharmacists have a unique perspective when it comes to process design in healthcare and several of the “movers and shakers†in the industry have started to take notice. For those of you interested in something other than a traditional role in pharmacy know that there are positions out there that may interest you. All you have to do is look.
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Using technology to advance pharmacy practice through education
I found an interesting article in the October issue of the American Journal of Health-System Pharmacy. The article, titled Informatics in clinical instruction (Am J Health Syst Pharm. 2009 Oct 1;66(19):1694, 1699), gives a description of a software system designed by the authors that “allows students at one site to receive online and teleconference instruction from preceptors at multiple sites through remote, interactive discussion. It also allows “blogging” based on assigned videotapes, simulation modules, live patient cases, discussion questions, and primary literature review. In addition, the system facilitates clinical encounter documentation, including interviewing patients, taking physical assessments (e.g., blood pressure), taking medication histories, assessing for adverse effects (e.g., abnormal involuntary movements), and addressing potential or actual medication-related problems(MRPs).â€
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The American Recovery and Reinvestment Act is not without risk
The American Recovery and Reinvestment Act (ARRA) has created quite a flutter of activity in healthcare during the past several months. I can’t remember a time when something was such a popular topic. Everywhere you look, Twitter, Facebook, personal blogs, professional blogs, and so on are talking about how to demonstrate “meaningful use†and get their hot little hands on some cash.
While the idea is sound, the implementation has something to be desired. The overwhelming attention to the definition of “meaningful use†and the looming 2011 timeline has created some unwanted side effects to the ARRA. Hospitals have started throwing project plans in reverse for significant revision or throwing them out the window and starting over all together. Projects that may have been in the pipeline for months, or years, are now taking a back seat to the ARRA requirements. Project development and timelines are involved processes that are designed to work around several variables such as capital budgets, current software and hardware specs, and available human resources.
Many healthcare systems have yet to develop a plan to implement many of the requirements necessary to meet the ARRA “meaningful use†criteria. If a healthcare systems wasn’t ready to begin the process at any time over the past several years what makes the US government think they’ll be ready just because they say so? Is the infrastructure in place? Do they have the resources to not only implement, but support the new systems as well? These are all questions that people should be asking. I for one am disappointed in our facility as we have decided to immediately move forward with projects that weren’t slated for another 18-24 months. To make this happen other projects have been placed lower in the priority queue, creating a lack of resources that risk jeopardizing the quality of both implementations.
Healthcare systems should not be directed down a path that they feel unprepared to face. Doing so will only invite failure.
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Wikipedia as a drug reference….bad idea.
Medicine 2.0 Congress blogspot : “Readability of the Top 50 Prescribed Drugs in Wikipedia – Devin explained that a sample of 50 most prescribed drug in United State were selected and the content related to those prescribed drugs in Wikipedia were indentified and saved as HTML files for evaluation. Each Wikipedia entry was analyzed independently by two investigators using Flesch-Kincaid Grade Level. A Health information readability analyzer was also used to integrate dimensions that other readability tools lacked such as : lexical, the most easy to read; semantic, the most difficult to read; cohesion and syntactic. Eventually, descriptive statistics was used to analyze the scores generated by these tools. Devin concluded by stating that the reading level of the 50 prescribed drug entries in Wikipedia are higher that the reading level of consumers. Therefore, there is a potential barrier of health and drug information for some Wikipedia users. To improve the Wikipedia, the vocabulary can be simplified; and in order to improve the consumers’ comprehension, the lexical and syntactic constructs need to be enhanced without compromising cohesion and structure.†– Similar to information provided by drug reps, Wikipedia is not a credible drug reference and should never be used as such. While interesting, Wikipedia may contain opinions and information presented in a biased manner. The fact that there is a study on the usability of drug information in Wikipedia is disturbing. When looking for drug information, healthcare professionals should always use credible references like Lexi-Comp, UpToDate, MD Consult, or something similar. If detailed information is needed, consult the primary literature. Consumers should consult their local pharmacist for credible drug information.
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View on technology-enabled practice from ASHP
The September issue of the American Journal of Health-System Pharmacy contains a vision statement written by the ASHP Section of Pharmacy Informatics and Technology. The statement represents their thoughts on the current state of pharmacy practice and contains a healthy dose of ideas on how technology can help support and improve pharmacy practice.
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