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April 29 Job Change...On Monday, May 1st, I'll be transitioning to a new position within my company. I'll be developing customized solutions (I hate that word) for our existing hospital customers on a contractual basis. It's a lot different than what I'm used to: developing prototypes and doing usability reviews. As much as I'll miss it, and that great group of co-workers, I'll get to do the same thing in my new job, hopefully.
What's this have to do with Healthcare and Technology? I'm hoping that this branch of software development will really, Really let me see what hospitals need (or at least what they think they need). It is very interesting to know that a lot of "canned" EMR / CPOE / etc. systems don't meet all of a hospitals needs. It's not unexpected, but it's interesting to see all of the time and money being invested in our product not being 100%. I think that's good, though..
WHY? It means that my company's solution doesn't necessarily try to pigeon-hole hospitals into OUR way of thinking, our workflow. It means our clients are still maintaining their own processes to do the job in which they shine. We don't mandate a hospital conform to us: we're willing to conform to our clients. Who wouldn't want our product?!
April 28 Scanning Medications....Good evening, all. I told you all I'd write more on some med scanning workflow I saw at the hospital my little guy was born in. I should note that nothing went wrong at all. All rights were met.
 My wife got some pills from the nurse, who scanned them prior to giving them to my wife. The thing I thought was odd was that the bar code scanner was completely separate from the laptop cart, where the nurse documented her meds. The laptop was outside of the room, away from my wife or the baby. The was a simple beep when the med was scanned.
If the nurse scanned the wrong med, how would she have known?
My most optimistic answer is that the barcode scanner would have beeped differently. Not good if you're deaf. My pessimistic answer is that nothing would have happened. Ugh.
So what should have happened to ensure safety and document it?
How about something like a PocketPC with a scanning device built in? The scanning device could have scanned the medication, provided a .jpg / .bmp / .png file to show what the pill should look like and a big solid red X should have displayed over it if it was incorrect, and a green translucent checkbox should have been over it, if the med was correct. Touch the screen once the med is given, "checking" the checkbox. More than one med? Have the original list have a smaller shots of each pill due to be given and expand the med once its scanned. Once done, shrink it back, still with the red X or green checkmark. Audible cues could also be given.
It provides the nurse with pictures of what s/he is supposed to be giving. The audio cue helps as well. It provides a quick check as to all of the meds s/he has given in this encounter. No more "Did I already give the Lasix?". The nurse doesn't have to lug the laptop / roller cart into the patient's room. And lastly, you can have up-to-date knowledge of what has been given, what is pending, and what is wrong.
Workflow, workflow, workflow... April 26 A Quick Update - News and ThoughtsJust a quick update. Seems like I've slacked off. Well, I have.. But it's only because a) It's my birthday and b) I've an awesome baby to take care of. Regardless, I had some more random comments.
Dr. Crouse is continuing to encourage doctors to adopt an EMR. A good idea, by any stretch, but in none of his articles does he address how to pay for it. With Tablets costing around $1,000, Servers costing $2,000 at least for a semi-decent one, Networking, training, etc.., payment must be addressed. The Internal Med guys I know are looking to technology to help cut costs, but can't easily afford everything needed. Maybe by pooling resources? Merging practices? Not sure.
Cerner is teaching providing software for University of Maryland Nursing Students. What a great idea! I wish I had an EMR program to use when I was in Nursing School. People who want to learn will be learning on Cerner's product, most likely influencing purchasing decisions when they evolve into Nursing Informaticists. Unless, of course, they leave shortly thereafter. (2002 link)
Speaking of Cerner, what's up with their Stock? Or what's *NOT* up with their stock. Despite a great earnings report, they're down. I still don't understand the free market. It's why I'm not an economist.
Oh well. Hope to write more later. Saw something interesting when Little Nat was born. Meds were given after being scanned in with a bar code scanner. Nothing very major, bar code scanners have been around for years. But, the workflow behind it kinda scared me. I'll comment more later. April 21 Most Powerful People in HealthcareLooks like Modern Healthcare is having their annual survey of their most powerful people. Not sure what "Powerful" means? Doesn't really matter, since they don't ask what powerful means. You can nominate people here. If you want to vote by CIO Salary, check out Mr. HISTalk. April 19 How dirty is *your* keyboard?Anyone ever wonder what cultures would grow from a swap of their keyboard? Me too. With antibiotic resistance now a major issue with many infections, you gotta realize that technology is a chink in our armor. Universal Precautions are great, but what about our gadgets?
Well, I saw for sale a neat (albeit pricey) possible solution for this: A keyboard that is laser projected onto a desktop. That's right: you turn it on, it projects the keys to a flat surface, you type what you need to, and then turn it off, if you so choose. When you want to clean it, you simply disinfect the surface as you normally would. No dirty in-between keys, none of it.
It comes at a steep price, though. 179.99 from ThinkGeek.Com Plus, it's bluetooth as well, so you may have to add a bluetooth dongle on your computers, so throw in another 30 or 40 bucks.
I wonder if anyone else has thought of using this in healthcare yet. Anyone actually doing it?
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