Opened my spam folder today and found an email announcing the availability of Medscape for Android. While it’s not my favorite drug information resource, it’s decent and it’s free. The application can be downloaded here.
Medscape Mobile is also available for the iPhone, iPad and BlackBerry, just in case you don’t have an Android device.
I spent some time recently speaking with the director of pharmacy (DOP) from a large acute care facility about operations and various dispensing models. In this particular instance, the hospital utilizes a cartfill model, decentralized pharmacists in satellites to handle first doses, batched IV’s and automated dispensing cabinets for pain meds and other “PRN†medications.
At one point the conversation drifted toward a discussion of using a cartless dispensing model. The DOP wasn’t a fan. The reason cited was a fear that utilizing automated dispensing cabinets in a cartless model would create a workflow logjam in the pharmacy as the entire day would be dedicated to “massive ADC [automated dispensing cabinet] fillsâ€. I understand the thought process, but have found through experience that this simply isn’t true. In a well-constructed workflow a cartless model is quite efficient.
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I’ve been conversing with several pharmacists about the future of pharmacy practice, specifically about the PPMI developed earlier this year by ASHP. This is a sharp group of people, but what I continually hear is the same thing I’ve heard for a number of years. While I’m not as experienced as many of my esteemed colleagues due to a late start to my career, I have worked in several acute care facilities. I’m not sure who said it, but Einstein gets credit for defining insanity as doing the same thing over and over again and expecting different results.
The literature presented in support of a new practice model is, in reality, based on current practice. It’s all looking at how best to apply the pharmacist’s current knowledge and resources to the current practice model. Economic outcomes improved by a pharmacist; great, but not new. Improved patient outcomes with a pharmacist in a team approach; awesome, but not new. Use a pharmacist as a prescriber; cool idea, but not new. These models are easily ten years old and we’re still talking about them as if they were new ideas. See a trend here? I think this is exactly what Einstein had in mind when he defined insanity.
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It’s been a good week in the world of non-pharmacy. ASHP Midyear 2010 is behind us, but the work generated from that meeting has just begun. And 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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Without question there is a lack of advanced automation and technology in the acute care pharmacy setting. Spend some time in several acute care pharmacies if you don’t believe me. There’s clearly a need for it, but it’s just not being used.
I am a fan of automation and technology in any setting, but especially in the acute care pharmacy. I believe that the continued use, development and advancement of pharmacy technology should be a key component of any plan to change the current pharmacy practice model. Unfortunately, the situation is problematic because current pharmacy technology is either poorly designed for the needs of the pharmacy or the pharmacy in which it is used has a poorly designed workflow that doesn’t take advantage of it. Why is that? Who’s to blame; someone, anyone, no one? Valid questions.
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I read an interesting discussion about pharmacovigilance (PV) software a few weeks ago on one of the pharmacy listservs I belong to. The conversation struck me as odd because much of it sounded an awful lot like a discussion on clinical decision support (CDS). This led me to wonder whether or not PV and CDS are the same thing, completely different or subsets of one another. I am not familiar with the term PV myself, so I set out to gather some information. And here’s what I found.
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I’ve been on a mission, however small it may be, to get pharmacy technicians more involved in the operational aspect of acute care pharmacy. And by more involved I mean using a tech-check-tech model to free pharmacists up for more patient related clinical activities. I’ve posted my thoughts on the use of tech-check-tech before.
The reason for rehashing the issue is due to a conversation I had with a colleague last week. This particular colleague and I were having a light hearted discussion over the possibility of using a tech-check-tech model with automated packagers like those I described in a post earlier this week.
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The Spiroscout Inhaler Tracker by Asthmapolis is a small device that attaches to the top of an inhaler. The unit is GPS capable so that each time the inhaler is used, the GPS unit records the time the medication was taken and the patients location.
What a great tool to not only help asthmatics control their disease, but provide physicians with great real-time data. I suppose the next step would be to integrate devices like this into the electronic health record similar to what has been done with me blood glucose and blood pressure monitoring devices.
The Spiroscout Inhaler Tracker is used in conjunction with the Asthmapolis mobile diary to help patients map and track their asthma symptoms, triggers and use of medications.
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Hospitals make a lot of intravenous (IV) preparations. That makes sense when you consider that most people admitted to the hospital are there because their acute illness requires more care than can be administered at home; not always, but in most cases. This is especially true for patients in the intensive care unit, i.e. the ICU.
A fair number of the medications used in the ICU are prepared on demand for a host of reasons including stability, differences in concentration, difficulty in scheduling secondary to rate variability, etc. Any pharmacist or nurse reading this will understand what I’m talking about. Example medications that fall into this category include drips like norepinephrine, epinephrine, phenylephrine, amiodarone and nitroprusside.
Last year I mused about using devices on the nursing stations designed to package oral solids on demand at the point of care. I still like the idea for several reasons, all of which can be found in the original post. Â Based on currently available technology the same concept could be applied to preparation of IV products at the bedside. Robotic IV preparation has come a long way and these devices could be used at the point of care to make a nurses, and patient’s, life a whole lot easier. The use of robotic IV preparation at the bedside could reduce wait times for nurses and lesson the workload on pharmacy.
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Recently I’ve been in bit of a blogging slump. The world of technology suddenly appears a little less exciting. In fact, I find myself thinking of current technology as boring. I read lots of blog posts and articles that refer to new technologies as “revolutionaryâ€, but I haven’t seen much revolutionary technology lately. In fact, most of the new technology is simply an iteration of the same theme; or worse, recycling of an old theme.
Consumer technology is clearly ahead of healthcare with the exception of scanning devices like MRIs, which are pretty cool when you stop to think about what they do. However, some of the most recently vaunted consumer technologies are devices aimed at information consumption like the iPad or devices designed to access data and social media while on the go, i.e. the new crop of smartphones. It’s not really new technology per se, but rather a new application of already available technology.
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