TheStreet.com: “Apple (AAPL Quote) will have a tablet computer in time for the holidays, but the company is still mulling how to sell it. The device, designed as a larger version of the iPod Touch, will have a 9-inch to 10-inch touchscreen and possibly a keyboard, as analysts, industry sources and news reports have outlined. An initial version of the long-anticipated Apple tablet will be subsidized by Verizon (VZ Quote), but Apple and Verizon “won’t be as tightly integrated” as Apple’s iPhone exclusivity deal with AT&T (T Quote), says one source familiar with the companies, who asked not to be named.” – I continue to be a huge proponent of the tablet form factor for computers. Their utility is infinite and I believe Apple can certainly bring something special to the table.  Apple has an uncanny knack for creating wildly popular and inventive devices long after other vendors have gone stale. Let’s face facts; the iPhone has revolutionized the smart phone industry. My credit card hasn’t been out of my wallet in quite some time and it’s overdue for the purchase of a new toy. C’mon Apple, don’t let me down.
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Hospital wanted….
WANTED: Immediate opening for a full-time hospital on the cutting edge of technology. Must be willing to implement technology necessary to provide advanced patient care while increasing safety and efficiency, regardless of cost. Able to effectively implement open-source software as well as explore “cloud computing†and other advanced, less main stream solutions. Must be willing to use operating systems other than “Windowsâ€. Willingness to utilize Apple computers with Mac OS X a plus. Use of tablet PCs and smart phones to extend the reach of healthcare professionals preferred. Must have great personality and be open to exploring desires of IT pharmacist to blaze a new trail through healthcare, no matter how bizarre the ideas. Desire to implement barcode technology in the pharmacy and at the bedside. Must be willing to implement smart pumps, computerized provider order entry (CPOE), advanced database design and reporting, online and electronic documentation. The ideal hospital will possess strong leadership qualities and be willing to lead the way. Hospitals that do not meet the requirements above need not apply. Interested hospitals should leave resume below.
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Length of time to implement CPOE
Ok, I’ve taken a little heat since claiming that a “meaningful use” goal of 10% CPOE was weak, so I did a little digging. While collecting ammunition for my defense I came across a little blurb addressing this very issue.
iHealthBeat: “Thirty-five percent of hospital CIOs surveyed said it would take their facilities three years to achieve 100% adoption of computerized physician order entry, according to a new survey from the College of Healthcare Information Management Executives. Twenty-seven percent of CIOs surveyed said it would take their hospitals two years to achieve 100% CPOE adoption, while 17% of respondents said complete CPOE adoption would take four years and 13% estimated a five-year time frame to achieve 100% adoption. Only 9% of CIOs surveyed said full CPOE adoption could be achieved in one year.”  – Remember that the “adoption year” timeframe is 18 months away (2011) with a 2012 start date qualifying you for the full incentive potential. This means you could actually wait as late as 2013 for full adoption and still qualify for funding. I realize CPOE is a major project; we’re struggling with it right now. Bu I still think hospitals have enough time to do this right and still get 100% usage. As the saying goes, “nothing worth having comes easy”.
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The use of speed bumps in healthcare
One day last week I was driving home and happened by a school that doubles as a community swimming pool in the summer. The street had several large speed bumps, forcing me to move rather slowly. I’m usually irritated by speed bumps because they slow me down. This day, however, I was happy they were there because a little boy darted out in front of me. I drive a ¾ ton Ford f250 crew cab pick-up. It’s big and heavy. I have serious doubts that a child would stand much of a chance if they went head-to-head with my truck. Fortunately I was coasting along at a safe 10 MPH secondary to the speed bumps and easily came to a stop at a comfortable distance away. At that moment I was thankful for the safety feature built into the pavement on the road, i.e. the speed bumps. -
Is patient safety recession-proof?
AMNews: “Protecting patients from harm is medicine’s bedrock goal, but the resources required to do so have never come cheaply. With the recession taking its toll on the health sector, doctors and other medical professionals who have tackled problems ranging from hospital-acquired infections to patient falls find their efforts increasingly scrutinized on dollars-and-cents grounds. Ninety percent of hospital CEOs have cut administrative expenses, staff and services amid the recession, according to a survey of more than 1,000 chief executives released in April by the American Hospital Assn. More than three-quarters said they cut capital spending and nearly half scaled back ongoing projects.” – Healthcare administrators don’t want to admit it, but it is clear that you can put a price on patient safety. As I mentioned in a previous post, projects that directly affect patient care are being cut secondary to a lack of funding. The only real question is how much patient safety is worth. I had projects cut that ranged in cost from $10,000 to well over $100,000. What’s the ROI on reduced adverse patient outcomes? Arguments can be made for cost savings associated with several patient safety measures, but hospital administration will argue that this cost saving is “soft money” and simply can’t be tallied in a column. While this is true, we must continue to advance technology, and with it, patient safety. It’s just going to be a little tricky, that’s all.
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My personal vacation technology
I spent most of last week at the beach with my family enjoying some much needed time off. Because I’m a little bit of a gadget geek and enjoy playing with all sorts of electronic toys, I thought I would give you a quick glimpse of the technology that went on vacation with me. All the little gadgets were designed for pleasure, not work. Hey, I was on vacation after all.
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“Ten percent” rule for meaningful use on CPOE is weak!
Idon’t usually feel compelled to comment on healthcare policy, but something I read recently has me a little miffed. The Meaningful Use Work Group of the ONC’s HIT Policy Committee recommended that 10 percent of orders be entered via CPOE to meet criteria for funding in 2011. Since when is ten percent considered successful. I’ve been through many years of schooling; I’m a veteran pharmacist of more than ten years “in the trenches” and have now been involved with many technology projects in my relatively new role as an IT pharmacist. Never has ten percent of anything been considered acceptable. Try telling your boss you’re only going to give ten percent. Note the reaction on his/her face.
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“What’d I miss?” – Week of July 13
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.
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Best Hospitals 2009-2010
US News and World Report: “America’s Best Hospitals, an annual ranking of the country’s elite medical centers, is a tool for patients who need medical sophistication most facilities cannot offer. Unlike other rankings and ratings that grade hospitals on how well they execute routine procedures like outpatient hernia repair or manage common conditions like low-grade heart failure, the U.S. News approach looks at how well a hospital handles complex and demanding situations—replacing an 85-year-old man’s heart valve, diagnosing and treating a spinal tumor, and dealing with inflammatory bowel disease, to name three examples. High-stakes medicine…..In 12 of the 16 specialties, those in which quality of care can spell life or death, hospitals were scored on reputation, death rate, patient safety, and care-related factors such as nursing and patient services; the 50 highest scorers were ranked. Scores and complete data for unranked hospitals are available as well. In the other four specialties—ophthalmology, psychiatry, rehabilitation, and rheumatology—hospitals were ranked on reputation alone, because so few patients die that mortality data don’t mean much. Here are a few of the details: Reputation, which counted as 32.5 percent of the score, was based on three years of specialist surveys—a total of almost 10,000 physicians were asked to name five hospitals they consider among the best in their specialty for difficult cases, without taking into account cost or location. A mortality index, also 32.5 percent of the score, indicates a hospital’s ability to keep patients with serious problems alive. Patient safety, new this year, made up 5 percent of the score; it indicates how well a hospital minimizes harm to patients. And a group of other care-related factors, such as nurse staffing and available technology, accounted for the remaining 30 percent.”
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Cool Technology for Pharmacy
Advantech MICA-101
The Advantech MICA-101 is The MICA-101 is a medical tablet PC based on the Intel Mobile Clinical Assistant (MCA) reference architecture. The device reminds me a lot of the Motion C5. The MCA tablet provides clinicians access to patient care records at the point of care and allows for real time documentation.
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