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  • http://www.goldstandard.com/pages/CPMobile-Devices-Browsers.pdf
  • Blackberry 4.x and earlier – data connection required
  • Droid Incrediblehttp://www.androphones.com/available-android-phones.php
  • http://www.engadget.com/2010/02/15/windows-phone-7-series-is-official-and-microsoft-is-playing-to/
  • http://www.bloomberg.com/apps/news?pid=20601082&sid=aEmb1KZUMvZg
  • http://metrics.admob.com/wp-content/uploads/2010/04/AdMob-Mobile-Metrics-Mar-10.pdf
  • http://cell-phones.toptenreviews.com/smartphones/
  • http://www.billshrink.com/blog/6015/total-cost-of-ownership-motorola-droid-versus-iphone-3gs-versus-palm-pre/
  • Slide 1

    1. 1. Supporting Your Practice with Portable Information Technologies Brent I. Fox, PharmD, PhD Assistant Professor Department of Pharmacy Care Systems Auburn University Harrison School of Pharmacy
    2. 2. Objectives 1. Describe the need for portable information technologies to support pharmacy practice 2. Describe evidence surrounding the use of software to support pharmacists’ decision-making 3. Describe the selection factors to consider when adopting a portable information device 4. Describe the array of portable information technologies available for pharmacists 5. Identify 3 portable information device accessories for purchase consideration 6. Develop a personal plan for device and software adoption 2
    3. 3. 3  Institute of Medicine (IOM)  To Err is Human: Building A Safer Health System (11/99)  Crossing the Quality Chasm: A New Health System for the 21st Century (3/01)  Health Professions Education: A Bridge to Quality (4/03)  Preventing Medication Errors (7/06) Awareness: The Focus is on Safety
    4. 4. Core Knowledge 4Schiff AJHP 2002
    5. 5. (Leape, 1995) Systems Failures and Attributed Errors • 1-7: 78% of errors • Limited information access • Information should be available to physicians, nurses, & pharmacists when and how it is needed
    6. 6. Evidence-based Medicine Sackett et al. define evidence-based medicine as: "The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients; EBM de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research." Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72. 6
    7. 7. Why Practice EBM? 1. New types of evidence are now being generated which, when we know and understand them, create frequent, major changes in the way we care for patients. 2. Although we need new information daily, we usually fail to get it. 3. Our up-to-date knowledge and clinical performance deteriorate over time. 4. Traditional CE does not work. 5. A different approach has been shown to be more effective. David Nash, Wisconsin Quality and Safety Forum, 10/08 7
    8. 8. EBM: Challenges 8  There were 6000+ new articles published globally in the biomedical literature in 1992.  There are limits to our human memory, and we humans have a limited ability to incorporate information into our decision-making.  We have opinions, but these opinions may be based on conjecture.  David Eddy takes the position that, "The complexity of modern American medicine is exceeding the capacity of the unaided human mind." Evidence-based Health Care program presented at the University of California, San Diego, June 2002. Davidoff F, Haynes B, Sackett D, Smith R. Evidence based medicine. BMJ. 1995;310:1085-1086.
    9. 9. OUR COMMODITY Any content Any device Any network Any time 9
    10. 10. Software Types  iPhone only  2010 10 California Healthcare Foundation. How smartphones are changing health care for consumers and providers. http://www.chcf.org/~/media/Files/PDF/H/HowSmartphonesChangingHealthCare.pdf
    11. 11. Software Types: Medical Reference  iPhone only  2010 11 California Healthcare Foundation. How smartphones are changing health care for consumers and providers. http://www.chcf.org/~/media/Files/PDF/H/HowSmartphonesChangingHealthCare.pdf
    12. 12. Software Considerations: General  Updating  Download or Web-based  Free/trial version  UI/functionality  *Features  Pricing (multi-year)  Linking across applications  Space requirements  Memory card support  Electronic version of paper reference?  A word about installation  Data plan costs  Drug interaction checking  Severity scale  Number  Pharma or other support?  Target users  Charts & tables  Notes  Training and support  All apps for all platforms?  Tablets?  Nonrenewal = stop? 12
    13. 13. Software Considerations: Features  Search  Brand/generic  Indication, ADR/SE  NDC  Drug class  Other  Patient education  Images  Pricing  Calculators  information  Formulary integration  IV compatibility  International products  Storage  Administration  Dosage forms and strengths  Dosing (special populations)  Other monograph content desired 13
    14. 14. Epocrates  Epocrates Rx  Epocrates Essentials  iPhone  BlackBerry  Palm WebOS  Android  Windows Mobile 14
    15. 15. Clinical Pharmacology  Website  iPhone  BlackBerry  Windows Mobile 6  Android 15
    16. 16. Facts and Comparisons  A to Z Drug Facts  Unbound Medicine  Silver  Medications and updates  Gold  + Drug Interaction Facts  Platinum  + Review of Natural Products  Android  BlackBerry  Windows Mobile  Palm OS  A to Z Drug Facts  Skyscape  iFacts  Android  BlackBerry  iPhone  Palm OS  Symbian 16
    17. 17. mobile Micromedex  Revamped Jan 2010  Wireless access via browser  Includes  DrugDex  DiseaseDex Emergency Med  DiseaseDex General Med  AltMedDex  Drug-Reax  IV Index  IdentiDex  Lab Avisor  Complimentary  Data plan required  iPhone  BlackBerry 17
    18. 18. Lexi-Comp  Individual databases (20+)  Packages  Handheld (+ Online)  Updates  Palm OS  Windows Mobile  BlackBerry*  iPhone  Palm WebOS*  Android 18
    19. 19. Lexi Complete Suite 1. Lexi-Drugs 2. Lexi-Interact 3. Lexi-Natural Products 4. Pediatric Lexi-Drugs 5. Lexi Poisoning and Toxicology 6. Lexi-Lab and Diagnostic Procedures 7. Lexi-Infectious Diseases 8. Lexi-Pharmacogenomics 9. Lexi-Calc 10. Dental Lexi-Drugs 11. Nursing Lexi-Drugs 12. Lexi-PALS 13. Nuclear, Biological, and Chemical Agent Exposures 14. Lexi-Companion Guides 15. Perioperative Nursing Lexi-Drugs 16. Lexi-I.V. Compatibility 17. Medical Abbreviations 18. Griffith’s 5 Minute Clinical Consult 19. Stedman’s Medical Dictionary 20. Pharmacotherapy Handbook (from McGraw Hill) ++ 19
    20. 20. 20
    21. 21. Computer Hardware Array (large to small) 1. Mainframes 2. Minicomputers 3. Micro-Computers a. IBM and Clones b. Apples c. Desktops 1. Towers 2. Mini-Towers 3. Integrated 4. Notebooks 1. Tablets a. Convertibles b. COWs 5. Air Panels 6. Sub-notebooks 7. UMPC 8. Palmtop PDAs 9. SmartPhones 21
    22. 22. Personal Digital Assistants (PDAs)  Shirt Pocket  OS Options  Screen Size  Connectivity  Storage  Swappable Batteries  Data Entry 22
    23. 23. Pure PDAs… 23
    24. 24. Smartphones  Cellular Carrier  Data Plans  OS Options  Data Input  Storage  Swappable Batteries  Added Features 24
    25. 25. Palm WebOS (and Palm OS)  Legacy devices (T|X)  WebOS  Pre Plus  Pixi Plus  Elevation Partners  Sprint, Verizon, AT&T*  >2000 apps 25
    26. 26. iPhone and iPod Touch 26  Apple  Revolutionized smartphone market  Integration with other Apple products  AT&T  185K apps
    27. 27. 27
    28. 28. Android 28  Open OS  Google  Many hardware manufacturers  T-Mobile, Verizon, Sprint  >50K apps
    29. 29. Windows Phone 7*  Coming 4th qtr?  Completely new  Xbox LIVE and Zune integration  Tiles (vs Start)  Many hardware manufacturers  AT&T, Sprint, Verizon, T-Mobile  Apps? 29
    30. 30. BlackBerry  BlackBerry 6 (3rd qtr)  Trackball  Enterprise integration  Data plan  AT&T, Sprint, Verizon, T-Mobile  Apps? (>2000) 30
    31. 31. Mobile OS Comparison 31
    32. 32. Features Comparison http://cell-phones.toptenreviews.com/smartphones/ 32
    33. 33. Types of Connections Connection Types Functional Aspects Applications Wi-Fi Commonplace wireless broadband Email and Internet @ home and work Bluetooth Personal radio frequency up to 30’ Wireless device connections 802.15 (WPAN) Broadband for personal devices like PDAs and home entertainment Based on Bluetooth, higher transfer rates BPL Uses the existing utility power grid for broadband Broadband to anyone with electricity EV-DO Broadband for mobile phones (CDMA) Email, Internet, clinical uses anywhere EDGE Broadband for mobile phones (GSM) Email, Internet, clinical uses anywhere WiMAX High bandwidth over long distances (3 – 30 miles) Wireless broadband over the “last mile” UWB (Digital Pulse Wireless) Digital transmission of voice and data over short distances at high speeds Huge voice/data transfers, low power, through media 33
    34. 34. Selection Criteria  Do you want 1 device or are you OK carrying 2?  If 2, get a PDA from eBay or an iPod Touch  If 1, read on….  Status of current cellular contract  If you can not get out, select among your carrier’s devices (next slide)  If you can get out, next slide 34
    35. 35. Selection Criteria  If staying with your current provider, start with what you can afford  Device  Plan (voice and data)  If switching carriers, consider coverage and price 35
    36. 36. Selection Criteria: Features  Interaction  Touch screen vs Keyboard (Real/Virtual ) vs Both  Wireless  High speed data vs WiFi  Camera  Quality  Flash  GPS 36
    37. 37. Selection Criteria: Features  Bluetooth  Apps  Music/video  Memory  Battery life  Form factor = test drive  Verizon 37
    38. 38. Cost of Ownership Caveat: 10/28/09 38
    39. 39. 39
    40. 40. Accessories 40
    41. 41. ADDITIONAL TOPICS 41
    42. 42. Patient Education 42
    43. 43. Google Translate (34 languages) 43
    44. 44. Innovation in Wireless Products is Accelerating!  Apple iPhone, 3 Skype Phone, Amazon Kindle, Google….  91% of mobile users keep phone within 1 meter reach 24x7  15-25% of mobiles have GPS, 50% within 5 years Morgan Stanley – Web Trends 2007 – http://www.slideshare.net/misteroo/web2-139178?src=related_normal&rel=5944 California Healthcare Foundation. How smartphones are changing health care for consumers and providers. http://www.chcf.org/~/media/Files/PDF/H/HowSmartphonesChangingHealthCare.pdf 44
    45. 45. Where are Patients are Tuning In? 45 California Healthcare Foundation. How smartphones are changing health care for consumers and providers. http://www.chcf.org/~/media/Files/PDF/H/HowSmartphonesChangingHealthCare.pdf
    46. 46. Connecting with Your Patients in the Future Web 2.0 Health 2.0 PHR EMR/EHR National Records 46 California Healthcare Foundation. How smartphones are changing health care for consumers and providers. http://www.chcf.org/~/media/Files/PDF/H/HowSmartphonesChangingHealthCare.pdf EHR Pharmacy PBM Payer Electronic Medical Record Personal Health Record Hospital Information System Managed Care Information System Pharmacy Physician Practice Patient Hospital Or IDN Pharmacy Management System Lab Clinical Lab Information System Inpatient EMR Clinical Data Repository Payer EMR Member Clinical Summary Rx Claims History Patient Lab History Blood Donor Repository Genetic Profiles Imaging Image Management System PACS Archive Diagnostic Image Repository Prescription History PHR Clipboard PMR: Current Meds Ambulatory EMR
    47. 47. Questions Brent I. Fox, PharmD, PhD Assistant Professor Department of Pharmacy Care Systems Auburn University Harrison School of Pharmacy

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