Transcript Medicine and Computers

Medicine and
Computers
Tom Wesley
NEOUCOP
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Northeastern Ohio Universities College of Pharmacy
Given approval from the Ohio Board of Regents to offer a Doctor
of Pharmacy degree in November, 2005 and has been awarded
Precandidate accreditation status by the Accreditation Council for
Pharmacy Education (ACPE) during their January, 2007 meeting of
the ACPE Board of Directors.
NEOUCOP
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Accepted as of April 10
Requirements
• Laptop
• PDA
Computer uses in a Pharmacy
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Electronic Prescriptions
A typical electronic prescription system, such as ePad from
ePhysician, allows a doctor to • write prescriptions, view information about each patient and
any drug allergies they may have, alert the doctor to
potentially harmful drug interactions by using up to date
databases of medications that are linked to patient records,
and create a list of popular prescriptions.
Another program, called eProcrates is used by over 250,000
physicians. The program allows the doctor to view• information on pricing, dosing, drug interactions,
contradictions, and off-label indications on devices that use a
Palm operating system.
Electronic Prescriptions
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Methods to alert doctor of possible danger vary from system to
system.
One system uses color coded happy faces to allow the doctor to
distinguish between more common prescriptions and prescriptions
that are not usually available at pharmacy's.
If the drug has comparable effects, the physician can prescribe
the more popular one, thus avoiding time delays for the patient.
Also, an alert flashes on the screen if two prescriptions interact
dangerously with each other, or if one prescription conflicts with a
patient's allergies.
Electronic Prescriptions
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The need for electronic prescriptions came about due to the
potential harm caused by incorrect prescriptions.
According to calculations by the Nonprofit Institute for Safe
Medical Practices, (ISPM), medication errors cause more deaths
per year than workplace injuries.
The Institute of Medicine recently released a report stating that
some 7,000 of the 98,000 estimated annual deaths from medical
error resulted from improper medication.
Electronic Prescriptions
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Another major benefit of electronic prescriptions is the
legibility of the prescriptions.
In a 1999 court case in Texas, the jury ordered a doctor,
drugstore, and pharmacist to pay $450,000 to the family of
a man who died after the pharmacist misread the doctor's
handwritten prescription.
"If an accountant makes a mistake, someone loses some
money," explains Barbara Getty, a handwriting expert. "But
with a doctor, it could cost someone their life."
Electronic Prescriptions
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Aside from the possible harm that could occur to patients, there is
also a cost benefit in using e-prescriptions.
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One hospital in the Boston area spent three million dollars as a
result of medication prescribing errors.
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When they switched to an electronic system, they saved over 1.5
million dollars, a 55% reduction in the original cost. One of the
ways in which cost is reduced when switching to an electronic
system is the reduction in payroll costs.
Primary care physicians issue approximately 30 renewals per day
on average, requiring 80% of nurses' time and costing between
five and seven dollars per chart.
When using e-prescriptions, physicians save time, and therefore
save money
Other uses for Computers in
Medicine
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Computers are often used in medicine to communicate with
implantable medical devices.
This can be pacemakers, defibrillators or neurostimulators.
The advantages to this is that changes can be made to the device
parameters (the prescription) without the need for more surgery
or wires (it's done wirelessly using telemetry).
Pacemakers
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When the heart's natural pacemaker has a malfunction, the
heartbeat may become too slow.
A permanent pacemaker — a small device that is implanted under
the skin — is used to start or regulate a slow heartbeat.
At New York-Presbyterian Hospital, the treatment of arrhythmias
uses the latest advancements in pacemaker technology, including
single chamber pacemakers, dual chamber pacemakers, and
combined implantable cardioverter defibrillators/pacemakers, to
treat cardiac arrhythmias.
Pacemaker
Pacemakers
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Keeping the Beat: Artificial Pacemakers
Artificial pacemakers are electronic devices that act in place of
the heart's natural pacemaker (the sinus or sinoatrial node);
that is, they generate electrical impulses that initiate each
heartbeat.
Pacemakers
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An artificial pacemaker is implanted surgically.
After a local anesthetic is used to numb the insertion site, the
wires that connect the pacemaker are usually inserted into a vein
near the collarbone and threaded toward the heart.
Through a small incision, the impulse generator, which is about
the size of a silver dollar, is inserted just under the skin near the
collarbone and connected to the wires.
Pacemakers
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The incision is stitched closed. Usually, the procedure takes about
30 to 60 minutes.
The person may be able to go home shortly afterward or may stay
in the hospital for a few days.
The battery for a pacemaker usually lasts 10 to 15 years.
Nevertheless, the battery should be checked regularly. Battery
replacement is a quick procedure.
Pacemakers
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There are different types of pacemakers.
Some take over the control of the heart rate, overriding the
electrical impulses generated by the heart.
Others, called demand pacemakers, allow the heart to beat
naturally unless it skips a beat or begins to beat at an abnormal
rate.
Still others, called programmable pacemakers, can do either.
Some pacemakers can adjust their rate depending on the wearer's
activity, increasing the heart rate during exercise and decreasing
it during rest.
Defibrillators
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Automated External Defibrillator: Jump-Starting the Heart
Defibrillators
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An automated external defibrillator (AED) is a device that can
detect and correct a specific type of abnormal heart rhythm called
ventricular fibrillation.
Ventricular fibrillation causes cardiac arrest. If cardiac arrest
occurs, an AED, if available, should be used immediately.
An AED is used before calling for help and before attempting
cardiopulmonary resuscitation (CPR) because an AED is more
likely to save lives.
If the AED detects ventricular fibrillation, it provides an electrical
shock (defibrillation) that can restore normal heart rhythm and
start the heart beating again.
If a person remains in cardiac arrest after an AED is used, help
should be called and CPR should be performed.
Defibrillators
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AEDs are easy to use.
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The American Red Cross provides half-day training sessions on the
use of AEDs.
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Different AEDs have somewhat different instructions for use. The
instructions that are written on the AED being used should be
carefully followed.
AEDs are available in many public gathering places, such as
stadiums and concert halls.
People who are told by their doctor that they are likely to develop
ventricular fibrillation may want to purchase an AED for home use
by family members.
Thanks
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http://www.iit.edu/~nandjyo/web/index.htm
http://www.merck.com/mmhe/sec24/ch299/ch299c.html
www.ephysician.com
www.eprocrates.com