Medicine and Computers

1. Medicine and Computers Tom Wesley

2. NEOUCOP • 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.

3. NEOUCOP • Accepted as of April 10 • Requirements • Laptop • PDA

4. Computer uses in a Pharmacy • 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.  

5. Electronic Prescriptions • 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.  

6. Electronic Prescriptions • 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.   

7. Electronic Prescriptions • 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."  

8. Electronic Prescriptions • Aside from the possible harm that could occur to patients, there is also a cost benefit in using e-prescriptions.  • One hospital in the Boston area spent three million dollars as a result of medication prescribing errors.  • 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

9. Other uses for Computers in Medicine • 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).

10. Pacemakers • 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.

11. Pacemaker

12. Pacemakers • 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.

13. Pacemakers • 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.

14. Pacemakers • 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.

15. Pacemakers • 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.

16. Defibrillators • Automated External Defibrillator: Jump-Starting the Heart

17. Defibrillators • 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.

18. Defibrillators • AEDs are easy to use. • The American Red Cross provides half-day training sessions on the use of AEDs. • 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.

19. Thanks • http://www.iit.edu/~nandjyo/web/index.htm • http://www.merck.com/mmhe/sec24/ch299/ch299c.html • www.ephysician.com • www.eprocrates.com