infatuated with the device. At least two medical schools are requiring iPads for incoming students
(Stanford and UCI). To my knowledge and a Google search has revealed
that no pharmacy school requires an iPad (yet). Now this interesting post by KevinMD, a noted physician blogger, with
this editorial with lots of comments. The comments are the best part, btw.
An iPad should be mandatory in medical school
http://www.kevinmd.com/blog/2010/04/ipad-mandatory-medical-school.html
The summary of their code of conduct:
Sabine is actively collecting the feedbacks and responses about the code of conduct.
What do you think?
Wondering if these rules also make sense for conduct on online activities when speaking “about” your employer in general? Reposted from http://scienceroll.com/2010/08/18/roche-social-media-code-of-conduct-pharma-2…
Another gem from Kevin! Great use of pictures and ARS! Death by Powerpoint is up next for review.
Health IT to Be Part of Specialist Certification
By John Gever, Senior Editor, MedPage Today
Published: August 10, 2010
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Familiarity with healthcare information technology (HIT) and electronic records systems may soon be part of the specialist board certification process, the American Board of Medical Specialties (ABMS) announced.
The group said it was considering development of two self-assessment modules covering health IT to be included in maintenance-of-certification programs for its 24 member specialty boards.
“It’s readily apparent that building meaningful use of HIT into maintenance of certification will benefit patients,” Kevin B. Weiss, MD, ABMS president and CEO, said in a statement.
“Aligning maintenance of certification and meaningful use of health IT will help to facilitate physicians’ knowledge, skill, and use of health IT, and in turn can improve physician performance and patient outcomes.”
One proposed module would test knowledge of IT systems that incorporate evidence-based medicine into physician practices. The other would evaluate knowledge of systems for promoting patient safety through computerized order entry, coordination of care, and medication reconciliation.
Initial products will be developed for the ABMS’s three member boards covering primary care: the American Board of Family Medicine, the American Board of Internal Medicine, and the American Board of Pediatrics. About half of the 750,000 U.S. physicians with specialist board certifications obtained them through these three bodies.
The ABMS’s announcement noted that “meaningful use” of health IT, as defined in the federal government’s current push to encourage physician uptake of the technology, “overlap[s] with the six core competencies that are continually measured through the ABMS maintenance of certification.”
These are patient care, medical knowledge, practice-based learning and improvement, interpersonal and communications skills, professionalism, and systems-based practice.
The ABMS is also considering additional ways to cover health IT in its certification processes:
- Patient scenarios that would be included in the modules to demonstrate functionality of electronic records systems, which would serve as training for physicians
- Data exchange utilities that would streamline submissions to the Physician Reporting Quality Initiative and the meaningful-use evaluations required by the Centers for Medicare and Medicaid Services
- Web-based practice improvement modules to help physicians collect data from medical charts and patient surveys, which could be combined with other data for comprehensive practice-performance assessments in specific clinical areas.
Lori Heim, MD, president of the American Academy of Family Physicians, told MedPage Today in a phone interview that the initiative was welcome, so long as it’s voluntary for physicians.
“Our concern is, I don’t think it’s ready to be a requirement,” she said. “We’re waiting to see how they roll it out.”
She said some aspects of health IT had been demonstrated to be beneficial, but for some others, “the jury is still out.”
“A lot of people have electronic records [systems] that have questionable benefits for their practices and for their patients,” Heim said.
But the ABMS initiative could be useful in helping physicians choose better systems and use the ones they have more effectively, she said.
“Anything that helps physicians to use health IT in a meaningful way to improve patient care, that’s a good thing,” Heim said.
She added that members of the AAFP’s executive board would be meeting soon with their counterparts at the American Board of Family Medicine. “I’m sure [the initiative] will be a topic of conversation,” she said.
The ABMS is the governing body for physician specialty certification, coordinating 24 individual boards for specialties ranging from allergy and immunology to urology.
Just curious if HIT is part of the new Ambulatory Pharmacy Certification?
1365-2923/asset/cover.gif?v=1&s=2d16fd6dd08600b22b3f7040f57234b7629e2324)
Medical Education 2010: 44: 805–813
Objectives This study aimed to examine the nature and extent of use of the social networking service Facebook by young medical graduates, and their utilisation of privacy options.
Methods We carried out a cross-sectional survey of the use of Facebook by recent medical graduates, accessing material potentially available to a wider public. Data were then categorised and analysed. Survey subjects were 338 doctors who had graduated from the University of Otago in 2006 and 2007 and were registered with the Medical Council of New Zealand. Main outcome measures were Facebook membership, utilisation of privacy options, and the nature and extent of the material revealed.
Results A total of 220 (65%) graduates had Facebook accounts; 138 (63%) of these had activated their privacy options, restricting their information to ‘Friends’. Of the remaining 82 accounts that were more publicly available, 30 (37%) revealed users’ sexual orientation, 13 (16%) revealed their religious views, 35 (43%) indicated their relationship status, 38 (46%) showed photographs of the users drinking alcohol, eight (10%) showed images of the users intoxicated and 37 (45%) showed photographs of the users engaged in healthy behaviours. A total of 54 (66%) members had used their accounts within the last week, indicating active use.
Conclusions Young doctors are active members of Facebook. A quarter of the doctors in our survey sample did not use the privacy options, rendering the information they revealed readily available to a wider public. This information, although it included some healthy behaviours, also revealed personal information that might cause distress to patients or alter the professional boundary between patient and practitioner, as well as information that could bring the profession into disrepute (e.g. belonging to groups like ‘Perverts united’). Educators and regulators need to consider how best to advise students and doctors on societal changes in the concepts of what is public and what is private.
ASHP Election thoughts for 2010
August 18th is the deadline for voting in the Am Society of Health System Pharmacists (ASHP) elections. Please vote. Some have asked me who I am voting for. I have given this more thought than normal this year. This is partly because of my disagreements with my professional association and belief that a significant change is needed. Here are my recommendations for the General and Section for Pharmacy Informatics and Technology.
As a way to gear each candidates thinking and views, I emailed each candidate their thoughts on the following:
- I have struggled on the role of our professional society in injustices. Can you provide your views on the Eric Cropp case?
- What is ASHP's role in defending a Just Culture beyond policy statements?
- What should the role of ASHP be in defending pharmacists that are prosecuted for errors in the course of practice?
I will summarize the responses and explain why I believe this is a good surrogate marker for a leader. Since the emails where personal communication, I will not share the exact content, but will give my impressions. First, I have been a bit obsessed with the professional tragedy of Eric Cropp. It has perplexed me at times. It is just that I have been in and seen too many identical circumstances that mirror what happen to Mr. Cropp. For him to go to jail of doing his job is the greatest injustice in health system pharmacy history. Therefore, how candidates view this case and the role of ASHP is a reasonable marker for their thinking and views on member services and defending just culture; two important roles for the organization.
A leader should be able to analyse a situation objectively and arrive at a conclusion that is based on his/her core believes, based on the facts presented. Having a clear and decisive view is better than burying ones head in the sand, which was the response from ASHP in the Cropp case. I have more respect for people that have a clear response and position, even though I may disagree, than people that hide behind facts not in evidence or are non committal. Reminds me of this from Dante’s Inferno "The hottest place in hell is reserved for those who in time of crisis preferred to remain neutral." It seems to me that pharmacists going to jail in the course of practice is a crisis.
One more qualification. None of the candidates encouraged me to do anything. They are specifically asked not to do this and have not done so. This is completely and solely on my own initiative.
Candidates for President
Both candidates where kind enough to respond to the above questions.
Should a membership organization support members? The response by nursing organization to individual cases of injustice have been strikingly different. They have come to the aid with statements, support and legal aid. While I would not necessarily expect legal aid for individuals from a professional organization, some level of support in in the form of press releases, offer of testimony and resolutions would be reasonable in my mind.
It seems that commenting on an individual TV show but not individual members, is a role of ASHP. I find this repulsive and a lack of leadership from current ASHP officials. Luckily it looks like we have some outstanding new leaders in the wings.
Kathryn Schultz
She believes that ASHP’s role is in policy development. Individual members be dammed, was my interpretation of her response. Even in the case of a gross injustice, lots of luck, she clearly believes you are on your own and there is no role in a membership organization in helping individual members. Her speech on the ASHP site was a bit of bla bla bla, as well.
Stan Kent
My nod goes to Stan Kent because of his understanding and focus on informatics and leadership development. Leadership is something the organization clearly needs. While he supports help to members, he was silent during the Eric Cropp case and hid a bit behind not knowing all of the facts or not choosing to find them. Since actions speak louder than words, I have some reservations, but believe his is a good man deserving of the job.
Candidates for Board of Directors
These choices are much clearer. Candidates for the three year term (vote for two)
Ernest Anderson
His understanding and support of a just culture for members is impressive. He provided some terrific material on the subject. He has a series of lectures on leadership that are stellar. Similar to Stan, Ernie seemed a bit reluctant to stick his neck out during the Cropp crisis, so he needs to stand up and be counted in his Board role. Being from Massachusetts, I have run into him from time to time and he has an impeccable reputation. He deserves your vote.
Larry Clark
His email was wrong in the election bulletin. I called him and he sent me the correct one. He chose not to respond to the questions posed. I would choose not to vote for him.
Thomas Johnson
A terrific and eloquent response to my questions was received. He supports members and deserves your support and vote.
Mary Ann Kiethermes
Did not hear a peep. I would not vote for someone that ignores members.
Candidate for two year term (vote for one)
Eric Hola
This gentleman had a heartfelt and eloquent response to my questions. He would be an asset to members and the organization. I had the pleasure to see Eric in action at regional delegate and House of Delegate meetings. Eric is one of the most thoughtful leaders in health system pharmacy. He should run for President and you should vote for him.
Randy Kuiper
Email was wrong in the bulletin and a follow up phone call was unanswered. As with Ms. Keithermes, I would not vote for someone that ignores members.
Section of Pharmacy Informatics and Technology
I have less of a philosophical issue here, and did not pose an acid test to these folks. It comes down to who I know and respect from personal experience.
Chair
My vote goes to Allen Flynn, hand down. I have had the honor and privilege to co-chair the clinical information system group with him. Allen is one of the top informatic thinkers I have ever met. No disrespect to Ron Burnette, as I simply do not know him as well.
Director-at-Large
Stan Pestotnik is the man. Since he has cashed out on TheraDoc, it is our win to have him represent informatics and the organization. Stan is a treasure in pharmacy informatics. Please give him your support. Again there is no disrespect to Sylvia Thomley.
Connie (bleeping) Chung?
- New owners of an WNBA Franchise?
- Candidates for SNL spoofs?
- Victims of a Jon Stewart lashing?
- Keynotes for a clinical pharmacy meeting?
Wah, Huh– What was that last one?
Keep in mind that the title of the meeting is the Midyear CLINICAL Meeting. So the proposed keynotes, in the choices above, are tied to pharmacy and clinical in what way? I have been to 30+ Midyear Clinical Meetings and never have I seen such irrelevant choices. Penn & Teller have a Showtime series called "Bullshit", that exposes fraud. Perhaps they might be good speakers to expose those who think that ASHP leadership is stellar. Nah, that would be too easy. What are they thinking? What are you thinking?
Allergy Fun Fact
A quick Google search reveals: "Females were also 2.6 times more likely than males to report multiple drug allergies," There have also been previous reports of studies that found female sex to be a risk factor for adverse drug reactions in general." SOURCE: Annals of Allergy, Asthma, and Immunology, July 2007. [I am leaving this one alone]
CCHIT Crazy Criteria
In discussing the CCHIT criteria with a vendor friend of mind some real “head scratchers” came up. These examples point out the problem with certification or perhaps the lack of clinical skills at CCHIT.
The first was Inpatient script # 1.47 “in order entry, “Search for drug by therapeutic class catecholamines.”
- First who orders by therapeutic class? Dah. Second who would search for catecholamines? Double Dah. Thirdly, catecholomines is a chemical class not a therapeutic class.
- How about searching for an antibiotic class that have sensitivity to the patient’s infection, is on the formulary and is recommended for antibiotic rotation? Opps that is way too hard for most EMRs.
Second, Inpatient script # 1.39 “System identifies that multiple medications from the same therapeutic class (ibuprofen and acetaminophen) have been ordered and informs the user”
- While it is true that both acetaminophen and ibuprofen are both analgesics, it is a bad choice to be alerted and would contribute to alert fatigue. It is not uncommon that these are given together for pain relief and presents no likely danger to a patient. It is even good therapy to decrease the total dose of ibuprofen for kidney exposure and acetaminophen for liver toxicity in patients that are getting pain relief from these, instead of narcotics.
- How about taking into account some patient parameters before alerting to duplicate therapy? Opps, some EMRs do this but not many.
- Therapeutic duplications alerts are some of the more ‘dumb’ alerts produced by the drug knowledge base vendors and contribute to alert fatigue.
So now the vendor has to dumb down the drug knowledge base and system to pass these ridiculous scenarios. While I over shoot the bar on my suggestions, there are many better examples CCHIT could use rather than these bizarre ones.
How does one get these things changed?
Cliff Note Version of Meaningful Use
