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Friday, March 16, 2018

Alexa? Siri? Anyone?

In the (not-too)-distant phuture, I see the next evolution of healthcare.
Just this week I received the prescription posted that included these lines in the directions: "Instructions to pharmacist. Please clarify directions. They are not clear."
No shit they're not clear. For centuries our job has been to make it clear. Whether to keep patients from harming themselves or their prescribers from killing them, that has been our job.

Later in the week I received a note phrom a pharmacist where an office called asking how to prescribe a medication. They wanted to know how to use (why to prescribe it), how to administer it, and for what duration therapy should continue. When the office staff said she'd "just google how to use it", the pharmacist provided adequate support, but was surprised by the dearth of knowledge. If you do not know HOW to prescribe a medication, why are you prescribing it?

It the (not-too)-distant past, prescribers researched. They went to libraries and called Drug Information Services at hospitals. Now they are calling retail pharmacists about new drugs.
(Carefully, CP walks the line of "we are drug experts so people SHOULD call us" and "this is a new expectation an office staff member has because her prescriber said research it".) Should we know? Many things we do. But even the greatest among us do not know all there is to know about everything, especially when it comes to new, specialty medications. Can I research it for you? Sure. But it is going to take some time.

As phor that not-too-distant phuture prediction?

I see an Amazon Echo in every office and Echo Dots in every room.
Nurse: "Alexa, what's a good blood pressure?"
Dr. Zoffis: "Nurse, I want a Z-Pak. You finish inputting the prescription."
Nurse: "Alexa, What dose should I give? How long do I give a Z-Pak?"
Dr. Zoffis: "Alexa, when I don't know what's wrong, is it ok to just give a Z-Pak and Tamiflu?"
Nurse: "Alexa. . . If I'm out of Vitamin B-12, can I just give a double dose of B-6?"
Nurse: "Alexa, what does asystole sound like?"

Of course this is likely what would happen:
ALEXA: "I don't know. Google it."

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