Blogs

When the AI is wrong

By Dennis Tribble posted 2 days ago
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Today (6/15/2023) I read an article in Beckers regarding a case in which a nurse felt compelled to draw blood on a leukemic patient because the AI came to the conclusion that the patient might be septic even though they disagreed. The nurse felt that the AI did not understand the impact leukemia might have on a patient’s presentation or on the risk of drawing blood. The blood was drawn, that patient was not septic, and, thankfully, the patient did not acquire an infection. The article goes on to note a couple of other things: Although the organization indicated that the ultimate decision belongs to the physician and the nurse, caregivers may feel ...
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Technology that will not die

By Dennis Tribble posted 10-31-2023
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I read two interesting articles today: one about why healthcare information exchanges (HIE’s) are failing (it blames fax machine use) and another on ubiquity of pagers within the healthcare system. As I read through them, I was reminded of a presentation that I once saw (I think it was at a HIMSS meeting but am uncertain) about a project to replace a white board in an ED with a shiny new large-screen display. It failed to a large degree for the same reasons faxes and pagers persist, which appears to be because the infrastructure (both physical and operational) that supports these newer technologies is not sufficiently organized or robust to completely ...
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Pharmaceutical Acuity

By Dennis Tribble posted 09-30-2023
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I recently received an email from the European Association of Hospital Pharmacists (EAHP) describing a project supported by EAHP to define a definition of pharmaceutical acuity which has apparently been published. Sadly, I seem to be unable to obtain a copy; I hope to yet get one. This made me think about some of the early efforts along this path that have occurred historically. These efforts resulted in models that attempted to look at acuity in terms of the cost of pharmacy services (including the costs of drugs involved) that arose because current general patient acuity models treat disease states with very different use of pharmaceutical services as ...
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ASHP Policy Week: An Extern’s Perspective

By Gabrielle DeGagne posted 09-29-2023
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As a fourth year pharmacy student on an APPE rotation with ASHP, I had the distinct pleasure of attending ASHP Policy Week. For those who may not know, policy week is an annual event where appointed members of ASHP Councils and Commissions gather in Bethesda, Maryland to discuss key issues and important topics that are impacting the profession of pharmacy. The appointed members in attendance serve on the Commission on Affiliate Relations or one of five councils which include Education and Workforce Development, Pharmacy Practice, Pharmacy Management, Public Policy, and Therapeutics. The councils use this week to collaborate and develop recommendations to guide ...
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Uncovering the potential of pharmacy in the virtual world

By Rigoberto Segovia posted 09-06-2023
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Authors Rigo Segovia, PharmD, Annie Vo, PharmD, BCPS, Emily Gamroth, PharmD, Priyan Lad, PharmD, Chad Compagner, PharmD Introduction The metaverse is a broad term that describes an integrated and shared virtual space. A singular metaverse that is fully networked and immersive has yet to be developed, but platforms using virtual reality ( VR ), augmented reality ( AR ), or mixed reality ( MR ) are numerous. Applications focused on taking users to a different space tend to favor VR, where the environment is entirely virtual. Conversely, usage focused on providing additional information or multitasking favor AR or mixed reality, where virtual elements ...
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The jobs we put off - are we putting ourselves at risk?

By Dennis Tribble posted 08-31-2023
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I read an interesting article in Beckers today regarding a hospital that suffered a data breach because an unauthorized person stole patient records from an old, unused facility in which they were being stored in bins awaiting shredding. The building was apparently scheduled for demolition but still contained bins of records awaiting destruction. One wonders how long they had been there. I won’t pretend to know why they had put those records there or what their plans were for the ultimate destruction of those records. But it made me think about old reports, returned medication containers, and other detritus that sometimes accumulates in our pharmacies because ...
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Saddened at the death of a friend

By Dennis Tribble posted 08-28-2023
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While reading a recent ISMP publication, I learned today of the death of someone I came to know as a friend and colleague, Larry Trissel . I first met Larry at M D Anderson during my first tour of duty at Baxa when I met with him to ask about an idea for a new product (I really don’t remember now what it was). What I remember was the speed and acuity with which he dove to the fundamental weaknesses in the concept without making me feel like the village idiot. We subsequently continued what was mostly a correspondence relationship, with occasional meetings at national conferences. I came to be more and more ...
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Reimagining the Healthcare User Interface

By Dennis Tribble posted 07-31-2023
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I had a chance to read a compelling discussion regarding the need for a significant change in the way that electronic medical records (EMR) products interact with physicians. While a lot of this discussion centered around removing regulatory and administrative tasks from the clinician interaction with the patient, it also talked about changes in design, configuration, and implementation of these EMR products. This reminded me of a concern I have had for some time that our healthcare products in general seem to heavily rely on user interface technologies that were designed for use in business applications which are both less information intense and less time-sensitive ...
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Limits to Telehealth

By Dennis Tribble posted 07-20-2023
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Today (7/13/2023) I read an article in Beckers regarding some research that telehealth only reduces cost for certain types of diseases. Specifically, the researchers noted that telehealth did not reduce costs or the probability of future office visits for patients with circulatory, respiratory, or infectious diseases. They found telehealth to be effective at reducing costs for behavioral health conditions, metabolic disorders, dermatologic disorders, and musculoskeletal disorders, though they did not quantify those benefits individually. When I finally got to the actual abstract , there were some numbers that were interesting: · On average, ...
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Babies Training Babies

By Rachel Bishop posted 07-05-2023
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As the profession of pharmacy has progressed, the roles of technicians are changing, the emergence of a worldwide pandemic, and now with the extreme shortage of technicians, it seems like the training of technicians has fallen by the wayside. Now, we see new technicians who have only worked for a few weeks training the new hires themselves. When did we lose our focus on the training of our technicians and how do we correct it? As the pandemic swept the world, healthcare workers took the brunt of the workload. If you were not infected with the virus, you likely were filling in for those that were, as well as working your shifts. As the pandemic slowed, healthcare ...
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Predicting physician turnover with AI

By Dennis Tribble posted 07-01-2023
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I read an interesting review article in Becker’s talking about an algorithm developed at Yale for predicting physician departures. The spoiler alert is that it was 97% accurate. I was sufficiently intrigued by the notion that I followed the link to the original article and dug into the details. It comes as no surprise that physician age is a determinant. Nor should we be surprised that physicians over 65 years old were a significant part of that metric. What was surprising to me was that physicians between the ages of 35 and 44 years old were the dominant age group. Other factors included: Tenure – the length of time ...
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Leveraging Technology to Address Health System Pharmacy Staffing Shortages

By Samuel Ubanyionwu posted 06-12-2023
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Authors: Samuel Ubanyionwu, PharmD, BCPS; Stacy Carson, PharmD, BCPS, FISMP; Chris Urbanski, BSPharm, MS, FASHP; Madeline Camejo, PharmD, MS; Devlin Smith, PharmD, MS SAG: Operations & Automation; Workgroup: Get IT Done Pharmacy technicians are critical members within a health system pharmacy team. They perform many functions that support the medication-use process and overall patient care such as medication inventory management, compounding sterile products, fulfillment of medication orders, billing, patient medication history reviews, and the performance of many other clinical and administrative functions. 1 ...
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Generative AI

By Dennis Tribble posted 06-01-2023
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In reading an article regarding what some consider 10 trends to watch in healthcare, I encountered a term I was unfamiliar with, the #1 item, Generative AI. According to Technopedia , Generative AI “is a broad label that's used to describe any type of artificial intelligence (AI) that can be used to create new text, images, video, audio, code or synthetic data” where synthetic data is “data input that is generated mathematically from a statistical model. Synthetic data plays an important role in finance, healthcare, and artificial intelligence (AI) when it is used to protect personally identifiable information (PII) in raw data and fabricate ...
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Mental Health In Community Pharmacy: It's Time To Talk

By Brianna Nelson posted 05-24-2023
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Background Mental Health is described as the emotional, psychological, and social well-being that affects all aspects of our life. It influences how we think, feel, and act.(3) Mental health also has a vast contribution to our health, increasing the risk of many chronic disease states like diabetes, heart disease, and stroke. With 1 in 5 US adults living with mental illnesses, it is one of the most common health conditions.(1) Mental Health First Aid (MHFA) is a course that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders.(2) The training guides you through an essential step-by-step action ...
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Women (Men Invited) SM Networking Session

By Sara White posted 05-17-2023
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ASHP Summer Meeting Women (Men Invited) Pharmacy Leadership Networking Session 0 Recommend Sara White Posted one second ago Reply Options Dropdown I would like to invite you to participate and possibly moderated a networking table Saturday, June 10 4;30-5:30 Baltimore Convention Center. There will be some questions to stimulate the discussion but the roundtables are intended to allow you to voice your questions and benefit from others experiences. Please let me know if you are willing to moderate a table. Thanks a bunch Sara ------------------------------ ...
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Data Quality

By Dennis Tribble posted 05-01-2023
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Another pearl from Intelligent Medical Objects with thoughts I would like to share. In my work analyzing data across organizations, one of the things that I constantly stumble on is the lack of data quality both within and between various health systems. The short story seems to be that the process of gathering our healthcare data focuses mostly on getting data into our systems in any way possible, and rarely on ensuring that the data is usable when we try to get it back out. I make this assertion without prejudice; most of us in healthcare professions do not see ourselves as data gatherers or data stewards. The generation of data is a secondary ...
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Channeling Brene' Brown by Being Vulnerable with Learners

By Kristin Watson posted 04-30-2023
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Being vulnerable can be scary or uncomfortable for many of us. However, stepping outside our comfort zone can lead to remarkable things. Dr. Brené Brown got the world talking about shame and vulnerability after her TEDxHouston Talk that took the world by storm in 2010. (Brown 2010) Since then, Dr. Brown has become a New York Times best-selling author and has changed the mindset of so many. How does her research impact what we do as pharmacy educators? Vulnerability is defined as “open to attack or damage; capable of being physically or emotionally wounded”. (Merrian-Webster 2023) Students in the classroom must confront vulnerability when deciding to ...
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A Week in the Life: ASHP Extern Week 4

By Madison Collins posted 04-22-2023
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Friday, April 21 marks the end of my fourth week at ASHP. As much of a cliché as it is; “time flies when you’re having fun” truly applies to my experience. This rotation has been challenging my brain in different ways every week. Talking to staff and members of ASHP with different backgrounds, compiling and analyzing information, and using my creative side to come up with topics for a pharmacy technician podcast are just a few of the things I’ve worked on! One of the biggest differences between this rotation and a traditional clinical pharmacy rotation, is this rotation’s independence. This may be in part due to the mentoring/precepting ...
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A Week in the Life: ASHP Extern Week 3

By Madison Collins posted 04-17-2023
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This week at ASHP was momentous for multiple reasons. It not only marks the halfway point for my rotation, but the ASHP Strategic Planning Retreat also took place this week, and I have 3 weeks left until graduation! The ASHP Strategic Planning Retreat is an annual meeting that lasts a day and a half where ASHP staff, ASHP Section and Forum Chairs, and members of the ASHP Board of Directors come together to discuss ASHP’s future strategic plans. This meant that pharmacists and technicians from across the country met at ASHP headquarters to discuss the future of pharmacy and I was able to attend! The retreat was a mixture of ...
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A Week in the Life: ASHP Extern Week 2

By Madison Collins posted 04-10-2023
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Week 2, as an ASHP student extern, has been a whirlwind of meeting new people, setting up meetings, and managing projects. This rotation is challenging my skills in different ways than any clinical pharmacy rotation has before. While most of my clinical rotations have had a structured daily schedule including pre-rounds, rounds, medication reconciliation, topic discussions, etc., I have much more freedom in setting the pace and activities of my daily schedule. Between setting up meetings with different ASHP staff members and working on different assigned projects, it requires a different level of mindfulness to get the most out of this rotation. ...
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