John Poikonen, Pharm.D.
Medical Informaticist and Pharmacist
http://RxInformatics.com and http://RxDoc.org
John Poikonen, PharmD mail:jp@rxdoc.org
It seems that this is the year of usability in medical applications. There are lots of studies and examples of how better usability impacts patient care and workflow. A couple of years ago Allen Flynn from the Univ of Michigan Hospitals and pharmacy informatics extraordinaire, presented this concept of a pharmacy profile, a la iTunes. This is awesome and a classic. Thanks to Allen Flynn for allowing to share his brilliant ideas. A image of the entire iTunes pharmacy profile is attached.
Fifty Usability Ideas for Pharmacy inspired by iTunes
1. Pharmacy Department’s on-screen message box
2. Patient selection via Venue -> Unit -> Name
3. Updating counts of orders to be verified in parenthesis (y)
4. Drug information summary box updated for current drug
5. Contextual hyperlinks to drug info databases as buttons
6. On-screen clock
7. Large name panel with age, sex, weight, CrCL
8. Name panel scrolls on command to show current visit details
8. Active, discontinued and home medications toggle
9. Dynamic search capability
10. Pharmaco-surveillance provided as patient-specific alert buttons
11. System status signal with double-click for detailed information
12. Active orders count
13. Note management functions include Add, Edit and Remove
14. Pause function
15. Expandable window
16. Drug list with column sort, columns add, column arrangement
17. Window-shade order detail view without dialog boxes
18. Step-wise order verification using dynamic evaluation panes
19. Order risk ranking based on drug, order and patient information
20. Order provenance information for ordering clinician and process
21. IV push guidelines directly integrated into verification workflow
22. Rule-based forcing functions for verification steps
23. Metadata Dosing Evaluator with statistical indicators
24. Metadata Characteristic Selectors control the metadata used
25. Metadata Frequency Evaluator based on previous orders
26. Supply chain analysis pane with ADM and inventory information
27. Related home medications by generic name and therapeutic class
28. Previous orders for same order item listing
29. Allergy review pane with allergy data collection forcing function
30. Related findings pane with lab, vital signs and physiologic data
31. Alerts and responses pane shows clinicians’ CDS responses
32. Ordering clinicians’ names with hyperlinks to paging system
33. Order level notes function
34. Patient level notes function
35. Hover over PRN column to see detail of prn reasons
36. Hover over Dose and Frequency column to see scheduled times
37. ADM product availability column updated by ADM system
38. Verified order check-box
39. PRN assessment pane
40. Add customized verification panes to the verification process
41. Active ingredient by active ingredient verification
42. Switch all oral dosage forms from solids to liquids and vice-versa
43. Change all appropriate IVPB diluents from D5 to NS or vice-versa
44. Calculated CrCL on screen has selectable equation options
45. Body surface area onscreen
46. User’s recently verified medication list (not shown)
47. Patient’s individualized IV compatibility chart (not shown)
48. Last 24 hours and cumulative lifetime dose (not shown) columns
49. Infusion titration history graph pane (not shown)
50. Unused PRN indicator
While we disagree on the value and integrity of ASHP, I agree with everything in this speech. He is an unbelievable pioneer and innovator in pharmacy informatics. Congratulations to Dennis!
We hope this 90 second trailer gets you even more excited to see the full and final product. We hope you enjoy it!
On behalf of The Pharmacist Cast & Crew, Happy Thanksgiving!
Since this hypocrisy has to do with informatics, it is posted here. Other professional society craziness can be found on Google Plus in the links below.
The Am Society of Health System Pharmacists (ASHP) CEO report has a number of hypocritical and delusional aspects. Part I <LINK> addresses ASHP’s patient safety policy and handling of the State of Ohio’s “lynching” of a pharmacist. This one addresses ASHP's claim to being at the right table when policy is made. Subsequent posts will deal with the financial management and leadership aspects in the 2011 CEO report. Part III on taking unpopular positions is here <LINK>. Under the heading of “Being at the right table” the ASHP CEO pounds his chest about being at the right table on health care policy and information technology issues. He notes the Pharmacy HIT Collaborative as an example. In the HIT and health reform land grab ASHP was no where near the table and are struggling to nibble on crumbs. There is not even a mention of pharmaicsts in any of the HITECH, ARRA or any health reform legislation. They seem to be coming to the table for scraps after everyone else has had a feast. These legislative initiatives were the equivalent of the Oklahoma land give away, GI bill and moon shot for health information technology. Pharmacists, the most connected health professionals, should have been at least part of the HITECH act to be “eligible providers” around electronic prescriptions and CPOE. As it stands there is not even a requirement to receive eRx’s and CPOE orders electronically. So claiming to be at the right table is, well, hypocritical. It borders on delusion. The Pharmacy HIT Collaborative is generally a very positive strategic initiative. It desires some thoughtful consideration. Please take a look at those efforts. Even at its best, this initiative does not put ASHP at the table at all. At its worst that it puts pharmacy farther down the hall by taking a counter productive approach to EHR involvement. The specific tactics of the collaborative are a bit confusing that I will address in a separate post. What say you? 2011 Report of the Executive Vice President and Chief Executive Officer: ASHP: Continually in pursuit of truth (right)This is Part III on the hypocrisy in the American Society of Health System Pharmacists (ASHP) ASHP CEO 2011 report that he entitled Continually in the Pursuit of the Truth. Here are links to Part I and Part II on other hypocrisy's in the report. At least a couple more items are in the works.
https://plus.google.com/u/0/107878174927164666208/posts/7iKCyimcCnn
https://plus.google.com/u/0/107878174927164666208/posts/TqbAaGXw9A1
In talking about pharmacists as leaders the CEO boasts about taking positions that are not popular. He cites telling the truth about the contributions of pharmacists in light of some negative AMA statements. How is this not popular? This does not seem all that brave to me. Standing up to physicians is what he is bragging about? Oh my, I see pharmacists and nurses do this every day in the course of their job. Doing this directly and in the heat of patient care takes a lot more courage than writing an opinion piece and throwing it over the wall. Of course he must defend the role of the pharmacist, that is his job. That was not exactly going out on a limb for the truth or taking a unpopular position. A true leader should be able to do better than that. I have the pleasure and honor see pharmacy leaders working with and challenging physicians at the academic medical center where I work all of the time.
There is a really good sequence in a movie Ratatouille. It is a commentary on critics. In many ways the work of a critic is easy. I do not pretend to be better or even know how to run a professional organization. However, like the famous quote about pornography “you know it when you see it”, I know incompetence and arrogance when I see it. I see it in ASHP all of the time in representing their members and the way they approach professional issues. Part IV and V of ASHP’s continual pursuit of hypocrisy to come.
In criticizing the ASHP, I am sensitive that this might start to be perceived as the ramblings of a disgruntled member. But, as a member of ASHP for 30+ years and a former elected official in the organization, I care deeply about the organization and its impact on the pharmacy profession. Their stewardship of this organization, with its actions and arrogant aristocratic airs, has reached a point that I must speak out. It is my sincere hope that the leadership take this criticism in a constructive manner.Edit
John Poikonen, Pharm.D.
Medical Informaticist and Pharmacist
http://RxInformatics.com and http://RxDoc.org
John Poikonen, Pharm.D.
Medical Informaticist and Pharmacist
http://RxInformatics.com and http://RxDoc.org
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