FACEBOOK: Social or Professional...OR Can it be Both?

The other day I was working at HIPPE with the slowest computer EVER!!! This computer would only let me type a single word ever five minutes.  So I decided to take out my iPod and visit the infamous Facebook.  After several minutes of catching up on the world I once knew before school started, I remembered a news report I had heard several weeks ago.  The news discussed how doctors were using Facebook to connect with patients.  You may be thinking how great this is, doctors and patients connecting on a personal level… But is this great? Does it abide by HIPPA? And is anyone documenting what they’re saying to each other back and forth????  These are just some of my questions.

Personally, I have learned NOT to use a social network to connect with people in my profession who really aren’t my friends because it can backfire.   When is a patient considered a friend and no longer a client?  Doctors are not only using Facebook as a way to connect on a more personal level with their patients, but they’re also using it to distribute medical information.  Personally, I find that splendid that a doctor would take his/her time to update patients on information.  Some doctors take distribution of general medical information a step farther.  By this, I mean that some doctors actually hold Q & A’s on their profile and talk about common questions their patients ask about during visits.  There is a thin boundary between distributing general medical information and personal information. 

What were to happen if a doctor saw a female patient with herpes, and right after she left his office he goes on his Facebook profile and posts a status update about reminding people to be cautious of sexually transmitted infections (STIs).  As this women walks out of his office, another patient in the waiting room sees the update and automatically believes Dr. Social is talking about her.  Using Facebook in a professional matter may not be the best idea for any career.  Medical professionals need to be very cautious on what they say about medical cases because it is easy to slip and violate HIPPA. 

Although Facebook can be used as a professional network, it is still looked at as a social network.  Ironically, socializing about medical issues can help deliver a cure even without a doctor.  For instance, last year during finals I was sitting in my room studying while going crazy and itching EVERYWHERE!  I thought stress was tarring me apart as I broke out into the itchiest rash I have ever had.  As I procrastinated, I went on my Facebook account and typed something along the lines “I CAN’T STOP ITCHING” on my profile.  This may not have been the smartest idea after viewing many of the horrific comments I received from ‘friends.’  BUT, one comment from a close friend said “me two!”  It was then we both realized why we were both ridiculously itchy.  It had nothing at all to do with stress.  The past week, it was Thanksgiving, so we decided to give ‘thanks’ by help cleaning out a park.  The park decided to give ‘thanks’ back by giving us the gift of allergic dermatitis from the plants we touched.  We both ended up receiving a steroidal cream and an antihistamine to take care of the problem.  If I had not posted this status on Facebook, the problem would have persisted longer because the doctor I visited proscribed me a medication for scabies….AND IT WAS NOTHING LIKE SCABIES!!!

In the end, it is really up to the patient whether they are ‘ok’ with their personal information being shared.  Doctors need to be cautious what they post and need to continue to abide by professional regulations.  Just remember, if you think you may be revealing too much personal information, you probably are, SO DON’T POST IT!

ISMP

Novolin/Novolog…Ephedrine/Epinephrine…Zyprexa/Zyrtec

How often do you read something and assume a word is something else?

            This may not happen to you, but it happens to me all of the time!  For example, on many tests, I will read correct instead of incorrect.  Doing this really upsets me because I miss the answer unless I notice it when I go through the test a second time.  I now try to CIRCLE those words that I easily misread when I catch them so I know to look back and see if what I read was correct.

            In the pharmacy, everyday is a test. If you and/or I fail to recognize something as minute as a one or two letter word differences, it could mean the end in a patients life.  Since so many medication names sound and/or look alike, it is beyond easy to grab the wrong one (especially when working at a fast paced).  Sadly, mistakes like this happen all the time and it then becomes the pharmacist job to do that double checking. 

The Institute for Safe Medication Practice (ISMP) tries to enable a safer practice environment for pharmacies.  One of the things they try to implement is proper labeling of medications of the look/sound-alike medications by using TALL man lettering (aka capital letters where the names differ).  Although there are tons of people who are lucky enough to rarely misread information, for the ones who are (like myself), these guidelines make working in the pharmacy so much safer.  It is up to pharmacy to implement the use of those labels that follow the guidelines.  This was my job yesterday.  I was in charge of changing all of the labels that stored oral medication to have matching labels that were easy to read based on ISMP guidelines. 

After a half an hour of typing the labels based off the old ones, I realized there were a lot of spelling errors and brand/generic name was missing.  For some of these medications that I already typed, I started pulling the bottles out of the bins to find the correct information (which not all of them had).  All of the sudden ‘POOF’ I had an epiphany.  I reached into my white coat and pulled out my iPod.  I started plugging in different medications in Epocrates and getting all of the answers I wanted.  (I could view all the brand/generic names, doses, use etc.) With the help of ISMP and Epocrates, I was able to contribute to the safe medical distribution of HIPPE.  Currently, my iPod has come in use for fun, home work, pharmacy knowledge, and now making a safer environment for patients.  It’s crazy to think that a tool that can do all of this fits right into my pocket.  Today’s use of technology in medication will save tomorrow’s patient.

Barium Form

At 8:30 A.M. I walked into HIPPE and started checking expiration dates of medications.

At 9:30 A.M. My preceptor walked in and told me that he needed a form that complied with HIPPA, the Board of Pharmacy, and Florida state laws that would enable a more efficient distribution of a Barium fluid. 

Previously at HIPPE, if a patient were to have an MRI or CT scan, they would need to pick up a barium fluid from the hospital pharmacy a day before the test.  There is no outpatient pharmacy at HIPPE, so the patients typically had to wait an hour to receive the prescription.  My preceptor wanted to allow the Ct scan center in the hospital that gave the tests to also be able to distribute the medication.  If you’ve ever received a medication from a pharmacy, you should have noticed that a paper came along with it.  It is mandatory that all pharmacies distribute this paper with all medications.  The information on it should contain ADRs, drug name, use, and directions.  The CT Scan center of the pharmacy had already been handing out a form with directions on it.  It was now my job to create a form the combined the majority of the previous forms information plus all other required information on ONE PAGE.  

            The pharmacist gave me 6 pages of information and told me he needed it done by 11 A.M. (it was now already 10 A.M.).  I had to determine what information was important out of all the 6 pages.  Just an FYI, but I really don’t know that much about pharmacy law, so I was quite skeptical about leaving out certain information.  By 11 A.M. exactly, I had finished and I quickly rushed it over to the pharmacist where he had already started to have a meeting on it.  I had to cut out a lot of common/minor side effects, simplify the do not take this medication if… section to “Do not use if you have had an allergic reaction to barium and make sure your doctor is aware of the patients medical history prior to all medication use.”  The only real side effect information that was left in there were the ones that a doctor needed to be called about ASAP.  This final form now just consisted of a brief information guide on what to know and really not much more. Now the pharmacist is working on a generic label that can be pre-printed and slapped on by the CT scan staff so it can be distributed to them without walking anywhere near the pharmacy.

            You may be asking yourself, what does this have to do with health informatics? Well…besides the grand idea that this process is now going to make the process more efficient, it will be distributing information to the patient that they must receive/know.   This new form will make the process of the pharmacy less in charged of the barium fluid in just about everyway.  All the pharmacy will need to do is collect the signatures, prescriptions, and carbon copy labels (which will all come after the fact that the barium has left the hospital).  This process allows for optimum distribution of the barium with one great problem, the form doesn’t contain ALL the information.  If you ever got one of those papers from CVS/Walgreens with all the information, you probably never even opened it, BUT, you had the option to review all it.  With this form, only SOME of the information is provided.  I didn’t include when that medication shouldn’t be used because the patient SHOULD have told the physician before hand.  What if the patient didn’t want to disclose information? Before, the patient would have seen not to take it if…., but now, they won’t know unless they actually go to a website and review it.  I can’t tell you if this form is more beneficial or detrimental to the patient, but I can tell you one thing.  By only providing the important information, the patient will probably now actually take the time to look at those few sentences and really take it all in. 

What do you think?  Would you rather be provided ALL the information OR would you rather just get what YOU NEED TO KNOW?

Tappa-Tappa-Tappa

Today’s knowledge is literally at our fingertips!  Everything you’ve ever wondered about is just a single ‘tap’ away.  Like many people, when I was little I didn’t see the point in knowing how to add, subtract, multiply etc. in my head because I could always have a calculator with me.  Not that I found these problems difficult, I just didn’t understand the concept of needing to know how to answer the problem without having it be 100% correct with a calculator.  Today, I feel like I could argue the same thing with just about every subject.

Thanks to technology such as BlackBerry’s, Smart phones, and Macs notorious iPod, information on just about anything and everything we’ve ever wanted to know if just a ‘tap’ away.  Instead of now clicking buttons, we just now tap the screen and ‘poof’, there’s my answer.  Recently, my friend purchased a Mac computer and with their new purchasing deals, she received a free iPod touch.  Since she already had an iPod phone, she sold me the touch for half the price.  I didn’t really care to buy it, I actually spent a month contemplating on whether it was worth it or not (since I knew I would probably drop it in the toilet or smash it on the ground by accident within the next year).  Long story short, I bought the iPod touch, and with the help of my fantastic boyfriend, I added such applications (aka apps) to the device such as MPR (monthly prescribing reference), Epocrates, gFlash, and so much more. With MPR and Epocrates, most of the information about medications that I need to know about are now just a single tap away.

("Med gadget," 2010)

Our world is changing, but something’s will always stay the same.  I could argue ‘what’s the point in me memorizing EVERY DOSE, ADR, MOA, DI, CI, INDICATION, AND NAME OF EVERY SINGLE MEDICATION…. ‘WHY WHY WHY???,’ but in reality, I wont because I know the point.  The point is, ANYONE and EVERYONE has the ability to look up the same information that I do.  So when someone comes to the pharmacy and asks me a particular question about a specific drug, and I need to grab my iPod to answer them, I will be making the entire field of pharmacy look like an overpaid foolish profession.  It is my responsibility to know everything that I can possibly know about all prescribed AND over the counter medications.  Also, there is information gaps within these programs, and as a pharmacist, I need to know why certain ADR (for example) will happen, and not just that ‘they may’ happen.  At some point, I will have to look things up because as the world changes, the information we have on certain medications will change and new medications will be developed.  This is what makes the applications so amazing.  They periodically update themselves!  All I have to do is sit back and tap the button that pops up sporadically when it lets me know it’s ready to add the new version/information.

In my pharmacy lab class at NOVA, we have a final that is open notes.  I asked the teacher about using the computer and he basically told me that wasn’t allowed.  He had asked his supervisor several years ago about using them, and the reason we weren’t allowed to was because not everyone had the ability to use one so it wouldn’t be fair to everyone in the class (considering that there’s only 1 computer for 4 students).  After he explained this to me, I grinned and said ‘well, now just about everyone in the class has one of these (as I pulled out my iPod).  To my surprise, he looked at me and actually agreed and thought that was a great point.  A week later, he announced to the entire class that now during the lab practical we are allowed to use such applications on our iPods, phones etc. but not on the in class test.  When he announced this information, I was kind of disturbed because I felt like I should really know EVERYTHING.  Several minutes later, I then realized that this all made sense.  It’s not fair if a student got the ONE SINGLE medication that they couldn’t remember even though this student knows everything else.  If this happened in the pharmacy, the pharmacist could look it up in a book (just like students did in past practicals).  Yesterdays advantage of having access to such books is today’s weakness because the books are so inefficient compared to using a program such as Epocrates. We are now living in such a fast pace world that we expect the answer in seconds.  People treat the pharmacy like McDonalds as they pull through the drive through, hand me their order and shout at my face “GIVE IT TO ME NOW.” It only makes sense to have a practical like it would actually be like in the REAL WORLD, and in the real world, if you’re not efficient, you can get fired.

Images from:

Med gadget. (2010, February 19). Retrieved from http://medgadget.com/archives/2010/02/2009_medical_weblog_awards_sponsored_by_epocrates_meet_the_winners.html