Pharmacy Informatics

FOUR NEW VIDEOS FROM TEDMED2011 DEAN KAMEN How is a chainsaw safer than a bionic arm? The Segway inventor tells of his funny-but-not adventures in trying to get his company’s new DARPA Luke prosthetic arm approved by the FDA. View Video ALEXANDER TSIARAS Thevisualmd.com, which Tsiaras created with partner Deepak Chopra, uses videos and stunning, detailed art to give us a virtual peek inside our body -- in wellness, in disease and as it reacts to how we treat it. View Video JOHN WYNN How much of your will to succeed comes from the knowledge that you will, someday, die? A provocative talk by psychiatrist Wynn, who suggests that status-seeking might ultimately be a waste of time. View Video ANDREW DAWSON At age 19, Ian Waterman lost all sense of his physical orientation below his neck. Choreographer Dawson portrays the experience of moving through the world when all sense of movement is lost. V

PRINT| E-MAIL| RESPOND| REPRINTS| SHARE COMMENTARY Observations on the state of medical practice and medical life SEE ARCHIVES New York City's Health and Hospitals Corp., the nation's largest municipal hospital system, is going paperless. In doing so it is going with the flow. The electronic medical record is touted as a cure for all that ails the paper record: illegibility, inaccuracy, inaccessibility and incompleteness. Beyond that it offers decision-support systems and facilitates population medicine via its databases. It has become an essential technology. Yet as a primary care physician in one of HHC's largest facilities, I have serious misgivings. So do many of my colleagues. See related content The EMR has become an essential technology for health care and can be an immensely valuable tool, but going paperless is crossing the Rubicon, a critical boundary, a line which may be that of diminishing returns. The problems have to do with the limitations of how data can be enter...

Why T-Sheets Work Disclosure: I have no financial interest in T-System, Inc. There is nothing particularly high-tech about a T-Sheet. A T-Sheet (designed by T-System, Inc.) is a particular design for a double-sided, single-page printed paper form used to chart patient visits. T-Sheets are extremely popular and have been widely adopted by emergency department and urgent care physicians. Why do many physicians prefer using T-sheets to the more technologically advanced EHR solutions that they are increasingly being required to adopt? There are of course many reasons. One is so basic — and is such a defining property of the paper form in general — that we tend not to even notice it: T-Sheets assign each category of data to a box of fixed size and fixed location on the page. A second reason T-Sheets are popular is that each presenting problem (chest pain, abdominal pain, headache, and so forth) has its own customized T-Sheet template. But regardless of the specific problem and the specific...

Futuristic Clinical Decision Support Tool Catches On IndiGO healthcare software, which predicts which patients will develop chronic conditions and the best interventions to head off disease, signs users. 5 Key Elements For Clinical Decision Support Systems (click image for larger view and for slideshow) After being tested successfully at Kaiser Permanente, a futuristic decision support tool from San Francisco-based Archimedes is beginning to build traction elsewhere. Archimedes' application, known as IndiGO, applies algorithms to clinical databases to predict the chances of patients developing a serious chronic condition. It also shows patients and doctors which interventions have the best chance of heading off a heart attack, a stroke, or another adverse health event. The MyAccess Health Network in Tulsa, Okla., one of the 17 Beacon Communities that have received health IT grants from the Department of Health and Human Services, last week agreed to use IndiGO. Physicians could...

AHRQ Pharmacy Health Literacy Center This site provides pharmacists with recently released health literacy tools and other resources from the Agency for Healthcare Research and Quality (AHRQ). These include Four health literacy tools for pharmacy. Curricular modules for pharmacy faculty. Resources for pharmacists interested in understanding more about health literacy. What is Pharmacy Health Literacy? Pharmacy health literacy is the degree to which individuals are able to obtain, process, and understand basic health and medication information and pharmacy services needed to make appropriate health decisions. Only 12% of adults have proficient health literacy (e.g., can interpret the prescription label correctly). Medication errors are likely higher with patients with limited health literacy, as they are more likely to misinterpret the prescription label information and auxiliary labels. Studies document an association between low lit...

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More answers from 9,000 Physicians Sign Up! Already a member? Log in Overview Jobs Our Interns Medical Expert Network Smile Join us! We're growing and looking to expand our exceptional team. This is a great time to join us. We're driven by the common goal of helping improve peoples' lives, and you should be too. As a tight-knit group, we're looking for experienced candidates who are eager to work in a growing start up environment, and who are ready to hit the ground running. If you're driven by helping people, a passionate about and what you do, and you do it very, very well, let us know! View current openings What it takes We're looking for more of the "best and brightest" to help us change the world. We are looking for you if you're a talented doer who's also truly passionate about improving people's lives. If you are capable, positive, creative, driven, efficient, and a team player, and you also resonate with our culture and values, let's connect today. View current openi...

Monday, February 06, 2012 Meaningful Use in Year Two and Beyond: Informing the Efforts of RECs by Christopher Harle and Nir Menachemi Physicians and other eligible health care professionals have shown broad interest in the meaningful use incentive program. As we enter year two of the program, it is informative to look back at first-year participation to inform efforts aimed at increasing electronic health record adoption in future years. According to CMS, in 2011, 29,344 eligible professionals received a total of $570,350,910 in incentive payments through either the Medicare or Medicaid incentive programs. Participation ramped up at the end of the year, with 50% of all eligible professionals receiving their payments in November and December of 2011. Of note in the CMS statistics is that nearly 173,000 providers registered for the program, indicating far more interest than actual participation thus far. This is not necessarily surprising given the many known obstacles to s...

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February 4, 2012 Advice for the Ill, and Points for the Doctors By RANDALL STROSS EVERY sphere of life, it seems, can be turned into a game — including the way physicians offer medical advice and build a public reputation. HealthTap, a start-up based in Palo Alto, Calif., has brought the vocabulary and mechanics of games to medicine. At the company’s Web site, users post questions and doctors post brief answers. The service is free, and the doctors aren’t paid. Instead, they engage in gamelike competitions, earning points and climbing numbered levels. They can also receive nonmonetary awards — many of them whimsically named, like the “It’s Not Brain Surgery” prize, earned for answering 21 questions at the site. Fellow physicians can show that they concur with the advice offered by clicking “Agree,” and users can show their appreciation with a “Thank” button. These clicks bring recognition to the contributors, too. Receiving 25 thanks gives a doctor a “Doogie Howser Award”; ...

Schools are on a short list of organizations that have been notoriously slow to adopt emerging tech. But within the last few years, as social media becomes more integral to students’ lives, educational institutions are finally catching on, and catching up. When it comes to higher ed, there are not only opportunities for digital learning, but digital marketing too. Some schools have taken the reigns on both sides, with mixed results. SEE ALSO: 5 Free Homework Management Tools for the Digital Student The infographic below takes a look at how schools have fared with social media over the last few years — what platforms are best, where they’ve succeeded, and the challenges that lay ahead. Does your alma mater use social media effectively in the classroom and in the recruitment office? Share your social ed story in the comments. Infographic by onlineuniversities.com. Image courtesy of iStockphoto, YinYang

I had performed this procedure dozens of times before. It was routine. I stand under the bright lights, I take a deep breath, I wait for my hands to stop shaking, and then, I begin. This time was different, though. The lights were blinding, there were lots of people watching, and there were TV cameras. Oh, and the guy performing before me was a Grammy winner. This was one of many talks I’ve given, but this was different because it was my first TEDx talk. TEDx is a spin-off of the popular TED talks series. Both provide a stage for anyone with a good story and a good voice. We doctors have a great story, and I was honored to tell it. Medicine has changed enormously in the last decade. Knowledge that previously only we had is now freely available to anyone. Technologies that enabled us to be successful diagnosticians are now rendering us redundant. Minimally skilled health care workers use simple tests to diagnose diseases that once only skilled physicians would get correct. Newly...

HIMSS12 HIE Symposium Reflects on Recent Success and Plots the Future of HIE Sustainability HIE: The Year of Implementation, Collaboration & Beyond, will be held at HIMSS12 in Las Vegas on Monday, Feb. 20, as part of the pre-conference symposia lineup. The symposia will focus on implementation, collaboration and ways of leveraging innovation to advance HIE organizations at the local, state and regional levels. The HIE landscape is in transition as state and regional HIE organizations seek innovative sustainability, enterprise HIE organizations advance and ACO models develop across the country. Now is the time for these organizations to build a solid foundation for a sustainable business platform, look to their stakeholders for collaboration opportunities and explore new innovations that will propel them forward. These successes will support HIE organizations to truly become the core enabler that facilitates effective and efficient quality patient care delivery. This Symposium focuses...

STUDY: E-PRESCRIBING SHOWN TO IMPROVE OUTCOMES AND SAVE U.S. HEALTHCARE SYSTEM BILLIONS OF DOLLARS Study Quantifies Relationship between E-Prescribing and Medication Adherence, With Potential Savings of $140 Billion over the Next 10 Years ARLINGTON, Va. - Feb. 1, 2012 - Surescripts, the nation's e-prescription network, today announced study findings from de-identified data that link e-prescribing to a significant increase in first-fill medication adherence. Poor adherence to medication therapy is a large and costly problem in the U.S. The World Health Organization estimates that as many as 50 percent of patients do not adhere fully to their medication treatment[1], leading to 125,000 premature deaths and billions in preventable health care costs[2]. The Surescripts analysis suggests that the increase in first-fill medication adherence combined with other e-prescribing benefits could, over the next 10 years, lead to between $140 billion and $240 billion in health care savings and...

Imagine having the assistance of a pharmacist when shopping for over-the-counter meds. Scandinavian Outcomes AB, a Swedish consulting firm, has released the Medicinera.se app for iOS and Android that promises to ease drug shopping through the help of a ‘virtual pharmacist’. Currently it is only available in Swedish and works with European drugs and drug names. But, if you’ve got hemorrojder and are visiting Sweden, you might just have a way to buy the right cream without having to explain yourself to a real person behind the counter that may not speak your language. The Virtual pharmacist service is integrated in the app Medicinera.se and consists of a robot with artificial intelligence specialized in pharmacy. The service supports consumers in chosing the right over-the-counter drug for more than a hundred of everyday ailments that can be self treated. The Virtual pharmacist answers users questions in Swedish in real time, and provides answers that are up-todate, impartial and...

Dr. Farzad Mostashari, the national health IT coordinator, expects health information exchange to ramp up significantly in 2012 because the necessary elements of interoperability will be in place. The health information exchange strategy means finally bringing together the standards, identity authentication certificates, governance for rules of the road, and the availability of directories or digital provider phone books. [Commentary: 3 reasons to let customers define HIE services.] These will enable providers to exchange information whether through a simple transaction for a referral or sharing a test with another provider or a more complex query for patient data. More work will need to be done, “but I think we really do have the pieces coming together for a big win on interoperability in exchange in 2012,” he told the Feb. 1 meeting of the advisory Health IT Policy Committee. Health information exchange will be a critical part of the meaningful use of electronic health records...

See sections 36 and 37 on CPOE and HIE Whereas, The deferred operation of this act would tend to defeat its purposes, which is to expand forthwith access to health care for residents of the commonwealth, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public health. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same as follows: SECTION 1. Subsection (d) of section 38C of chapter 3 of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by striking out the third sentence and inserting in place thereof the following sentence:- The division shall enter into interagency agreements as necessary with the office of Medicaid, the group insurance commission, the department of public health, the division of insurance, the health care quality and cost council, and other state agencies holding utilization, cost or claims data relevant to the...

May 05, 2010 HIT incentives in Massachusetts: Less carrot, more stick Health care providers all over the country are all worked up because they say that the federales' regulations on meaningful use of certified EHRs go too far, too fast. They should be glad they're not in Massachusetts, where EHR use will soon be required as a condition of licensure of physicians, hospitals and community health centers. The word got out, thanks to Secretary of Health and Human Services JudyAnn Bigby, who spoke at last week's HIT conference hosted by Governor Deval Patrick and the MA Health Data Consortium. This seemed to be news to some folks out there, but these requirements are deep in the heart of Part II of the Massachusetts health reform law (Chapter 305 of the Acts of 2008). Much of the coverage in August 2008 didn't mention the EHR-for-licensure provisions, but the HealthBlawg post at the time highlighted the EHR requirement as a condition of licensure as one of the important bits enacted in...

Abstract and Introduction Abstract Background Rashes are a frequent conundrum in clinical practice as they may be reactive, drug induced or disease specific. Identification of the culprit drug is important as re-exposure may be harmful or even life-threatening and unnecessary avoidance of 'innocent' drugs leads to limitations of treatment options. Objective To objectify the cause of suspected cutaneous drug reactions in a large patient population. Method Over 5 years (2006–10), 612 patients with suspected cutaneous drug reactions were evaluated. Histology was assessed. About 200 patients were invited for complete work-up with skin tests (prick/intracutaneous testing and scratch/patch as indicated) and, if necessary, lymphocyte transformation tests (LTT). In special cases, drug provocation tests were conducted. Results A total numb...

This week: A new model for heading off disease before it starts; the mindset one needs to conquer a grueling endurance challenge; the team approach to ending maternal mortality, and the debut of TEDMED’s very own theme song. Enjoy - and be sure to join the discussion on Facebook and Twitter (@TEDMED). FOUR NEW VIDEOS FROM TEDMED2011 DAVID AGUS Agus, author of the new book The End of Illness, talks about how preventive and personalized medicine, spurred by genetic testing, can help individuals ward off disease altogether. Is this medicine’s blueprint for the future? View Video DIANA NYAD “Do you have it?” Nyad asked herself as she set out to swim from Cuba to Florida. What did it take to try such a feat? And for what? Hint: It had little to do with setting a record. See what determination looks like. View Video MICHAEL ROSENBLATT During the few minutes Merck’s CMO spoke, about 20 women died in childbirth – largely preventable tragedies, and with far-rangi...

Improving Patient and Health System Outcomes through Advanced Pharmacy Practice A Report to the US Surgeon General, 2011 Click Image to View the Report / Letter This comprehensive Report to the U.S. Surgeon General Dr. Regina Benjamin on current pharmacy practice has been reviewed and discussed collaboratively between U.S. Public Health Service (PHS) Pharmacy leadership, the Office of the Surgeon General, and Dr. Benjamin throughout the past year. For the first time in our history, the U.S. Surgeon General was presented with a comprehensive evidence-based report on pharmacy practice. After reviewing the Report, Dr. Benjamin issued a signed letter of support. The Report utilizes objective data to advance the discussion of how models of innovative care involving pharmacists can ultimately help alleviate demands on the health care system (acce...

PharmMD Applauds Report From The Office Of The Chief Pharmacist, U.S. Public Health Service By: PharmMD via Business Wire News Releases Posted on January 12, 2012 at 10:27 AM EST PharmMD, the nation’s leader in quality Medication Therapy Management (MTM) services, applauds the January 9th report, Improving Patient and Health System Outcomes through Advanced Pharmacy Practice, from the Office of the Chief Pharmacist, U.S. Public Health Service. With an official endorsement letter from Regina Benjamin, MD, MBA, U.S. Surgeon General, this report outlines four focus points that confirm the value and present the roadmap for integration of pharmacists more fully into the patient care process. “On behalf of PharmMD and our pharmacist network, we are thankful to the U.S. Surgeon General’s letter and bringing this report to policy makers’ attention. As a pharmacist w...

This Is How Apple Changes Education, Forever Apple ’s plan to bring iPad textbooks to schools across America and around the world via iBooks 2 and iBooks Author is nothing short of a revolution. It could mean the end of giant, overused dog-eared volumes jammed into bulging backpacks balanced atop the over-burdened backs of America’s youth. It might also mean I’ll never have to explain to my daughter again where the rest of chapter 16 went. A couple of months ago, my 13-year-old junior high-school-attending daughter was diligently plowing through piles of homework. Part of it involved reading a chapter in her Social Studies text book and then answering questions on a worksheet about what she read. However, when I looked over at my daughter, she had her head of curls in her hands. “What’s the matter?” I asked her. “I can’t finish my homework,” she said without looking at me. “Why not?” “Here.” She shoved her text...

I admittedly snorted out loud when I read a New York Times article recently regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day. There is no question that electronic devices distract physicians as the article pointed out. But that’s like complaining about a leaky faucet when there’s a flooded basement and a hole in the roof. The bigger problem that should be mentioned is hospital bureaucracy which probably creates just as much if not more unintended distractions for physicians and nurses. What many patients and lay public may not realize is that there is a ton of paperwork that goes into the care of a patient. Regulatory bodies like the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) that accredits hospitals have made it mandatory in many cases though I suspect hospital administration often...

How U.S. Lost Out on iPhone Work Donald Chan/Reuters People flooded Foxconn Technology with résumés at a 2010 job fair in Henan Province, China. By CHARLES DUHIGG and KEITH BRADSHER Published: January 21, 2012 When Barack Obama joined Silicon Valley’s top luminaries for dinner in California last February, each guest was asked to come with a question for the president. But as Steven P. Jobs of Apple spoke, President Obama interrupted with an inquiry of his own: what would it take to make iPhones in the United States? Not long ago, Apple boasted that its products were made in America. Today, few are. Almost all of the 70 million iPhones, 30 million iPads and 59 million other products Apple sold last year were manufactured overseas. Why can’t that work come home? Mr. Obama asked. Mr. Jobs’s reply was unambiguous. “Those jobs aren’t coming back,” he said, according to ano...

TOP STORIES ECRI to hospitals: If you’re not Tweeting, you’re bleeding (opportunities) More than 1,000 hospitals have embraced online social networking. It’s as much for them as for the 4,700 or so that have avoided the resource that ECRI Institute has released a new risk analysis, "Social Media in Healthcare," and made it available for free downloading. The implication: Adopters need to be aware of the risks they face while abstainers should consider the benefits they’re missing out on. ECRI, the care-improvement nonprofit based in Plymouth Meeting, Pa., said in a news release that it has been closely following hospitals’ increasing use of social media over the past five years. The research identified 1,068 Facebook pages and 814 Twitter accounts tied to hospitals. The organization said that, in usin...