Pharmacists

Google Health: A View From the Inside

Google Health launched on Monday, which sent the world’s Google-watchers into a tizzy. I serve on Google Health's Advisory Council – which met all day Tuesday – and so here’s a bit of inside dish, along with my impressions of the site and the company.FYI, my work on the Council is covered by a Non-Disclosure Agreement, so I won’t reveal anything that isn’t publicly known regarding Google’s products or intentions. Also, in the interest of full disclosure, you should know that I am compensated for my Google service. (No stock options, darn it.) With that as background, here’s the scoop. Google began working on its version of the personal health record a couple of years ago, after the company realized that a remarkably high percentage of searches were for health information (I know, if that’s going to be how priorities are set, you’re wondering if Google Sex is next). Google…

The “Technology Hype Cycle”: Why Bad Things Happen to Good Technologies

Fresh on the heels of my recent bar coding epiphany comes another “unintended consequences” article. It turns out that the whipsawing that accompanies the adoption of new technologies is completely foreseeable, the “why doesn’t this thing work right?” phase as predictable as the seasons.Thanks to Dr. Mark Wheeler, Director of Clinical Informatics of PeaceHealth, for introducing me last week to the “Technology Hype Cycle” concept. The Cycle, originally described by the IT consulting firm Gartner, is comprised of an all-but-inevitable series of phases that technologies tend to traverse after they are introduced. The five phases are:"Technology Trigger" – the initial launch; a new technology reaches public or press attention."Peak of Inflated Expectations" – A few successful applications of the technology (often by highly selected individuals or organizations) help catalyze unrealistic expectations, often aided and abetted by hype driven by word of mouth, the blogosphere, or vendor spin. "Trough of Disillusionment"…

Should Hospitals Install Bar Coding or CPOE First? Why I’ve Changed My Tune

This is one of the most commonly asked questions in IT World, and my answer has always been “CPOE first” – largely because that has always been David Bates’s (the world’s leading IT/safety researcher) answer. But I’ve changed my mind. Here’s why.Before I start, I promised that I’d let you know if I ever blogged on a topic in which I have a financial conflict of interest. On this, I do: I serve as a paid member of the Scientific Advisory Board of IntelliDOT, a company that makes a stand-alone bar coding system. If that freaks you out, stop reading. But recognize that if you had asked me the “bar coding or computerized provider order entry?” question last week, I would have answered “CPOE”.That’s because the evidence supporting CPOE is substantially stronger than the evidence for bar coding. For example, a search of “CPOE” on AHRQ Patient Safety Network (AHRQ…

A Nordstrom To-Do List: Tie, Slacks, a Little V. Tach?

Great quote by USC cardiologist Leslie Saxon (a reporter reached her on her cell phone as Leslie was shopping) on this week’s NEJM study on delayed defibrillation: “You’re better off having your arrest [here] at Nordstrom [than in a hospital]… because there are 15 people around me.”You’ve probably seen the study, a detailed analysis of cardiopulmonary resuscitation results of nearly 7,000 patients who coded with “shockable” rhythms (ventricular tachycardia or fibrillation) at 369 hospitals participating in a large CPR registry. The study found that the overall hospital survival rate for these patients was one-in-three. Note that this rate is substantially higher than the usually-quoted hospital CPR survival rate of about 15% because of the exclusion of patients with “non-shockable” rhythms like asystole. [I can’t resist a little riff on estimated CPR survival rates: Several years ago, Pittsburgh and Duke investigators asked real people to estimate the CPR survival rate in…

Dennis Quaid’s Kids: Are VIPs Safer?

The Entertainment Blogosphere was atwitter yesterday with the story of actor Dennis Quaid’s twin newborns, who reportedly received a 1000-fold heparin overdose at Cedars-Sinai Medical Center in La La Land. Cedars’ Chief Medical Officer Michael Langberg may win this year’s Oscar for fastest public apology – having learned the lesson from the 2003 Duke transplant error, where the hospital stonewalled for a week or so, adding chum to the media feeding frenzy.The error came during heparin line flushes, when a 10,000 units/ml solution of heparin was mistakenly substituted for the intended 10 units/ml solution. Although the cases required pharmacologic reversal of the anticoagulant effect, thankfully there were no bleeding complications.These cases come on the heels of last week’s report out of Dallas that the state-supported UT-Southwestern kept an “A-list” of potential donors and assorted bigwigs. Apparently, when these folks come to the hospital or clinic, they may get a personal…
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