I found this interesting video (below) showing some of the things BlackBerry is doing at the University of Pittsburgh Medical Center (UPMC). The name BlackBerry really doesn’t come to mind when you think of healthcare. Maybe the new BlackBerry PlayBook will help change all that. It’s a compelling device for anyone already using a BlackBerry smartphone.
There’s a great review of the BlackBerry PlayBook at CrackBerry.com if you’re interested in learning more about the device.
So IBW’s Watson recently competed and won ‘Jeopardy!â€. Well, ‘Jeopardy!’ is a lot harder than verifying many medication orders routinely seen by pharmacists in the acute care setting.
According to a recent article at Network World: “Watson’s ability to analyze the meaning and context of human language, and quickly process information to find precise answers, can assist decision makers such as physicians and nurses, unlock important knowledge and facts buried within huge volumes of information, and offer answers they may not have considered to help validate their own ideas or hypotheses, IBM stated.
From IBM: “… a doctor considering a patient’s diagnosis could use Watson’s analytics technology, in conjunction with Nuance’s voice and clinical language understanding solutions, to rapidly consider all the related texts, reference materials, prior cases, and latest knowledge in journals and medical literature to gain evidence from many more potential sources than previously possible. This could help medical professionals confidently determine the most likely diagnosis and treatment options.””
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Over the weekend I read a tweet from a friend and colleague @kevinclauson. The tweet shared a link to an article titled “Young Adults’ Credibility Assessment of Wikipediaâ€. I don’t have a problem with the article. On the contrary, it just reinforces my dislike of Wikipedia as a healthcare reference source.
From the abstract: “This paper found that a few students demonstrated in-depth knowledge of the Wikipedia editing process, while most had some understanding of how the site functions and a few lacked even such basic knowledge as the fact that anyone can edit the site. Although many study participants had been advised by their instructors not to cite Wikipedia articles in their schoolwork, students nonetheless often use it in their everyday lives.†Kevin also links to the pre-print version of the article here (PDF).
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I spent some time this week in Las Vegas attending some NCPDP work groups on standards, e-prescribing and pedigree/track and trace. Because I’m relatively naïve in these areas I learned a lot. The NCPDP is an interesting organization that appears to be doing a lot of the right things in driving standards and improving e-prescribing in the outpatient setting. Unfortunately acute care hasn’t been as aggressive in adopting these standards or implementing e-prescribing. That’s for another blog post.
Following the scheduled meetings I found myself sitting in on a few impromptu after hours sessions where I got my first glimpse of the political side of the pharmacy underbelly. Let’s just say that there are a lot of special interest groups involved in the process and much of what they want has little to do with better healthcare or improved patient care. Instead it’s a what’s-in-it-for-me mentality. It was disturbing to see the good work that NCPDP was doing overshadowed by groups looking to make a buck or make sure that their competitors didn’t get the upper hand.
Even though I was enlightened by the work done by NCPDP, I was troubled by the behavior of “industry leaders†and large healthcare providers. I believe we have forgotten the reason we’re in healthcare in the first place. I’m just sayin’.
When my brother, Rob and I get together it often brings our wives to tears with boredom as we often get deeply engrossed in long conversations about computers, software and technology in general. Super Bowl weekend was no different. Rob and I started talking about strategies for connecting various pharmacy systems to other hospital systems and the issue of a lack of standardized information in healthcare came up. I mean we have standards, right? Of course we do. There’s SNOMED-CT, RxNorm, ICD-9, ICD-10, LOINC, GLNs, GTINs, NDC, bar-code “standardsâ€, HL7, NCPDP SCRIPT standards and so on and so forth ad infinitum. I realize the list above includes a hodge-podge of standards that don’t really belong in the same category, but I did it to illustrate my point. And that point is that we have too many stinking standards. Trying to figure out which standard to use is an exercise in futility. Standards typically make sense to the people that invent them or study them, few others. And someone always has an idea for a better standard, hence the plethora of standards.
As healthcare inches forward interoperability of systems will hold a key role in the success of the government’s plan for electronic health records. So as Rob and I discussed how to integrate various services and products we pondered how one goes about creating a standard that everyone can live with. Well, how does one create a standard that everyone will use? Heck if I know, but we decided that there are basically two approaches. The first is to create a standard and try to cram that standard down everyone’s throat. Microsoft has been fairly successful with this approach. With that said, few people have the resources that Microsoft has to throw at a problem. The second approach is to offer the standard as part of a free solution that comes with your product; this way people can use your product and use your free, open-source solution to tie the systems together. I assume this is the smart approach for companies that have limited resources; kind of a grassroots approach. Of course it would be wise to build this free, open-source solution on top of an existing standard that’s prominent in the market, otherwise you’re trying to re-invent the wheel. And we all know what happens when someone re-invents the wheel. Uh, you get a wheel. We don’t really need any more of those. Both approaches have pros and cons.
Now the question becomes which standard makes sense as you design your solution. If only I had a crystal ball. We’re at least a decade away from having a truly inter-operable healthcare system; optimistic, I know.  Ultimately, the standard of choice won’t be driven by what makes sense, but rather will be driven by adoption rates. Things often become a standard without even trying.
RxInformatics: “The following was a list serv question from Monica Puebla, PharmD, MBA, BCPS for a HIS course. Here is my response to the Question. I would add State Boards of Pharmacy to the list of those to present this as well.
“If you were given the opportunity to present to your DOP, VP and CFO a project that you deem would have the greatest impact on the pharmacy department as well as the health-system in general from any point of view, clinical, financial, operational, without regards to costs, what would it be?””
John’s response was to “Study under what circumstances pharmacist order review (perfection) could be taken over by automated clinical decision support while increasing quality and safety” in addition to including a nice list of references related to ‘perfection’ (listed at the bottom of this post). I highly recommend looking at the references John provides because they’re informative and enlightening. You can also read more about the ‘perfection’ idea at one of John’s older posts here. It’s amazing that this discussion has been going on for well over a year and to the best of my knowledge has yet to make much headway.
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Every time I turn around someone is talking about the need for change in pharmacy practice. That’s a good thing. In fact, it’s a great thing. I’ve discussed my thoughts in detail on this site before so I don’t feel the need to rehash everything I’ve said. Suffice it to say there is a buzz in the air.
I read an interesting article this morning at the ASHP Intersections website about the expanding role of technicians in pharmacy practice. While the article focuses a bit too heavily on the need for providing better education for technicians to fill this new role, it does make one thing perfectly clear: “As Pharmacists expand their roles and carve out new niches in an era of health care reform, they are counting more and more on highly skilled pharmacy technicians to take on added responsibility.†Well said.
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Here I sit in the airport on my way home as another great ASHP Midyear has come to a close. This feels strangely familiar.  Anyway, the end of the Midyear meeting is always bittersweet. I’ve taken in about all the information my brain can possibly handle, but each day at Midyear brings something new and exciting, which I will miss. Many attendees departed prior to the final sessions today so it was a virtual ghost town compared to the previous days of the event. The exhibit hall was closed, the small stands for food and drink were gone, the line for coffee was non-existent and session attendance was clearly affected. With all that said, it was still worth hanging around for the final session. Huh, I had to, I was presenting at it; more on that later.
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Ah yes, another day of ASHP Midyear is in the books and it just keeps getting better with each passing day. Today was probably the busiest day I’ve had since arriving on Saturday, and it went something like this:
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Today was a great day to be at ASHP Midyear 2010. Things really got going as the sessions were kicked into high gear and the exhibit hall officially opened.
I spent the day tracking down pharmacy automation and technology. Did you really expect me to do anything else? I don’t ever recall being as excited as a clinician as I am being an informatics pharmacist. Anyway, here are some things I found interesting:
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