DocuSys, a proprietary anesthesia information management system !!

DataCaptor as a translator.

DocuSys is a proprietary anesthesia information management system (AIMS) to facilitate an electronic version of the anesthesia record and chart entries such as drug doses and case narratives. One of the advantage of  DocuSys is that it provides clear and easily readable anesthesia record which leads to patient safety since it is collected electronically from clinical monitors, laboratory computers and other monitoring devices. In addition , there are many other benefits associated with the AIMS that include expedited transfer of the anesthesia case record to any existing electronic hospital record system, controlled substance tracking, improved cost management of hospital supplies. 

Anesthesia work station including DocuSys.

During the implementation, there were several concerns associated with DocuSys that include how to edit incorrect data and times and, timing of the entries. In addition, they fell short of expectations in several areas during mock implementation; the areas included the narcotic tracking and wastage, user log on, image quality of the printed electronic record, accuracy of the surgery scheduling interface, difficulties with wireless units, incomplete allergy data from the pharmacy database. However, all issues were solved except the incomplete allergy data from the pharmacy database before DocuSys was implemented fully.

Overall, I believe that this is also one of the good addition to the healthcare system. Feel free to share your comments and thoughts about this system. The article can be accessed through the following link:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119212/?tool=pubmed

Use of Twitter to monitor the Influenza A Pandemic !!

I am really amazed after reading this article that twitter can be this good use of social network in healthcare. Twitter is just like blogging but more specifically it is a micro-blogging that enables their users to send and reach each other's short 140 character messages called tweets. What I find interesting in this article is that twitter is used for monitoring actual disease activity and public concern about health related events. By using twitter's new streaming application programmer's interface (API), we can collect large amount of tweets  in order to monitor specific disease related activity as they collected for influenza activity over the US.  In addition, the use of monitoring public's interest and concerns related to any disease like H1N1 influenza  by twitter was faster than the current practice. 

The data you would receive over twitter wouldn't be as suitable as you would receive by visiting emergency departments at national level  but twitter data can be very easily collected and processed in real time. Moreover, it can be used for more than just monitoring disease activity since it provides more relative information than just search queries.  For instance, in this article, they had actually observed the perceptions of people taking influenza vaccine in pregnancy where they saw that pregnant woman might avoid the new H1N1 vaccine due to pregnancy-related concerns so this makes public health professional to be aware of such concerns. In short, twitter can be a great tool for healthcare system if it is used wisely and effectively. In order to know how twitter can be used effectively for healthcare purposes, check out the following link:
http://philbaumann.com/2009/01/16/140-health-care-uses-for-twitter/

The article can be accessed through the following link:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087759/pdf/pone.0019467.pdf

Use of Electronic Prescribing in Healthcare !!

How E-Prescribing Works.

After reading this article, I found it very interesting that how many US physicians have started to use electronic prescribing over past few years. However, a lot of physicians are still using the hand written prescriptions. Prescription drugs are very common treatment in primary health care. The American Recovery and Reinvestment Act of 2009 has developed a program that promotes the “meaningful use” of electronic health record systems (EHR). E- prescribing helps prescriber to send electronically, error- free and understandable prescription directly to the pharmacy. There were some following challenges exist in adopting the e-prescribing for primary care that has slowed the adoption of e-prescribing:

·        unrealistic expectations among users

·        inadequate technical support

·        poor functioning of the technical infrastructure for e-prescribing. 

         
Although these challenges do exist, some e-prescribers has still developed their e-prescribing successfully and transformed into their practice extensively. In addition, I also think that the growth of adopting e-prescribing by physicians will increase in next couple of years because there are so many great advantages associated with e-prescribing such as medication safety via automated alerts delivery, less call backs due to poor handwriting, reduce costs via using generic drugs and lower cost medications. Furthermore, it is another way of helping prescribers and patients in order to reduce healthcare cost and therefore, patients adherence may increase due to reduced patients' cost. However, in order to apprehend all these means of e-prescribing, better health information exchange is required for e-prescribing so I believe that improvements can still be made to overcome some of these challenges.

The article can be accessed through the following link:

http://www.annfammed.org/content/9/5/392.full.pdf+htm

A Telemedicine System for monitoring abnormal tremor in patients with Parkinson's disease !!

I came across this article today and thought that it is really interesting since it focuses on a new telemedicine instrument that is used for remote evaluation of tremor.  Rest tremor is the most common symptom of Parkinson's disease but the severity of tremors can vary during the day and so it is not reliable for patients to self assess the severity of this symptom at home. In this article, they have developed a wireless tremor monitoring system that consists of personal digital assistant and wireless communication technology for home monitoring of patients with Parkinson's disease.

  

This telemedicine primarily consists of the mobile unit and the hospital unit. The mobile unit (PDA) is located around the patient in order to obtain patient's tremor data as well as to collect medical recommendations whereas the hospital unit is set up for the medical team to monitor the patient's state and to send medical recommendations. The transmission between mobile unit and hospital unit is simply done by using TCP/IP protocol and if the central PC and the mobile unit are in the same room then the communication can be simply accomplished by connecting a USB cable between the central PC and the mobile unit. 

From my perspective, this is really a good addition to healthcare system since it can be used for home monitoring of patients with Parkinson's disease. In addition, treatment for other diseases like multiple sclerosis, stroke, traumatic brain injury can be benefited by home tremor monitoring solutions. 

For more details, the article can be accessed through the following link:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042428/pdf/1475-925X-10-14.pdf

Dispensing errors are not only costing lives but also costing healthcare !!

Dispensing errors has been one of the leading causes of death in United States for years now and surprisingly, it accounts for almost 21% of all medications errors that occurs in healthcare system. Many dispensing errors made in community pharmacy include either dispensing the wrong drug, dose and quantity or inappropriate labeling, packaging, storage and directions for use. More often than not, these all dispensing medication errors has harmed the patient and increased the hospitalization of patients, and as a result, it has increased the healthcare cost. According to National observational study of prescription dispensing accuracy and safety in 50 pharmacies,  "dispensing errors occur at a rate of 4 per day in a pharmacy filling 250 prescriptions daily, which amounts to an estimated 51.5 million errors out of 3 billion prescriptions filled annually nationwide".  The main cause of these dispensing error is the faulty system so the key to reduce dispensing errors  is to implement the appropriate system. 

The appropriate system should include the followings in order to minimize the dispensing errors.

1.     Ensure correct entry of the prescription which should omit transcription errors.

2.     Confirm that the prescription is correct and complete which should omit illegible, ambiguous, call-in prescriptions.

3.     Beware of look-alike, soundalike drugs; specially for unfamiliar drug.

4.     Be careful with zeros and abbreviations; specially for drugs with narrow therapeutic windows.

5.     Organize the workplace.

6.     Reduce distraction when possible; specially avoid multitasking.

7.     Focus on reducing stress and balancing heavy workloads.

8.     Take the time to store drugs properly.

9.     Thoroughly check all prescriptions.

10.  Always provide thorough patient counseling.

(more details about these followings can be accessed through this article link: http://www.pharmacytimes.com/media/pdf/P2PdispensingErrors.pdf )

Since, a lot of part of dispensing is done by pharmacy technicians, I believe that pharmacists needs to be more alert and responsive in order to prevent these dispensing errors from occurring because pharmacy technicians almost don't have any knowledge about drugs which they are dispensing. Therefore, the pharmacists has to put more efforts in comprehensive checking prescriptions. In addition, we have a lot of medication error reporting systems (ISMP, MedWatch, MedMarx) in place to report medication errors which help alert healthcare professional to prevent from making the same medication errors that has happened in the past.  Therefore, every individual should take part in reporting a medication error to these institutes.  At last, we need to realize the seriousness of the dispensing errors and we should not blame individuals but the dispensing system, and take precautionary measures to prevent these all dispensing errors from occurs.  

Use of Social Media in Healthcare: good or bad ??

Before we answer this question, we need to know what kind of social media we are talking about here. I think that this article provides an excellent explanation of how social media can be used in healthcare; you can access this article via following link: http://onlinelibrary.wiley.com/doi/10.1002/chp.20129/pdf. As we have learned in the class, there are several social media available for healthcare professionals such as Facebook, YouTube, Twitter, Blogs, LinkedIn, RSS Readers,  etc. Health Professionals can streamline the news they receive every day through RSS reader to keep everybody updated with the latest trends in the field. We all know about YouTube; it is one of the best social media available for everyone including healthcare professional in the world. Twitter is certainly useful to alert everyone for recent doings and it can also be used to track real-time information about health issues. LinkedIn is a great professional networking site that allows health professionals and colleagues to build connections with each other. Now, I believe that we all are familiar with blogs; blogs can be used to share your opinions and interpretations of health information publicly. 

However, there are plenty of issues with the use of social media in healthcare. For instance "Should a healthcare professional accept a patient's friend request on facebook"  because patient privacy can be violated by using some of these networking tools according to Health Insurance Portability and Accountability Act (HIPPA). In addition, twitter can also create privacy and professional issues. 

So all in all, more guidelines and better education may be needed for health professionals before they engage in social media so that they can make the most use of these social media effectively and responsibly to protect the patient's privacy. Use of social media tools should not be ignored or minimized by the health professional since its advantages far outweigh its disadvantages.

Smartphone: A Prime addition to Health Care

The innovation of Smartphone seems to be one of the biggest contributions to the healthcare as yet and it is rapidly changing the face of health care and, I also believe that in near future, it might change the approach of healthcare provided by professionals to consumers. According to California Healthcare Foundation, 6000 healthcare related applications were available within the Apple AppStore as of February 2010 and of these, 73% were intended for use by consumer or patient end- users, while 27% were targeted to health care professionals. There is a full PDF document available online; you can view on http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HowSmartphonesChangingHealthCare.pdf. I found this PDF file very interesting because it has mentioned some of excellent Smartphone's applications that can be used for healthcare.

According to A PRICEWATERHOUSECOOPERS survey, half of the US health population would like to receive consultations over the phone because the Smartphone can deliver any kind of laboratory results over the phone as soon as they are completed and this will help in quick follow up instructions if the need of seeing a physician is urgent.

Apple has demonstrated 2 new applications of blood pressure and blood glucose monitoring on iPhone-3 operating system to collect and send these data automatically to a doctor at regular intervals. In addition,  QxMD ECG(electrocardiogram) app to interpret ECG results, pregnancy wheel software, a gastroenterology tool, use of Vigilance app to track patients' vital signs by physicians, use of AirStrip Obstetrics iphone apps to access fetal heart tracings, Catra system for an early diagnosis of cataract, i-stethoscopes, remote physician consultation are the best examples of the healthcare applications available for the Smartphone users. RxCalc, MedCalc, Lexi-comp, Epocrates Rx, Skyscape are some of other applications which I have used on my smartphone as a pharmacy student.

The application of i-Stethoscope uses sensors in the phone to monitor patient’s heartbeat which is available on the following video: http://www.bbc.co.uk/news/technology-11144994

The characteristics of the smartphones mentioned above must say that the growth of Smartphones will increase in next couple of years and there will be so many consumers who would rather want to be in touch with their doctors by text, chat and email communication than by in person.