Paying with your smart phone

An increasing number of apps are offering different ways to pay. They're called digital wallets. Consumer Reports Money Adviser took a look at several to see if you really can leave your wallet at home.

Maryssa Menkin pays for some services using Square Wallet's free application. The digital wallet app links to her chip card, which she finds very convenient.

"I hate carrying a lot of things and, you know, I find that I do always have my phone on me. So it's just very simple," said Menkin.

Starbucks is one of the hundreds of thousands of businesses nationwide that have signed up for Square Wallet.

Square is compatible with a number of iPhone and Android models, and Consumer Reports Money Adviser says it's pretty easy to use. But other digital wallets are not as widely accessible.

"For instance, Google Wallet and Isis aren't available on iPhones and only work with some service providers. They also require a wireless technology that only some stores can use," said Amanda Walker, Consumer Reports.

Some digital wallet apps will only link with a few credit cards. So you may need to link to a prepaid card, which can incur additional fees.

That may also mean you don't have the best protections if you lose your phone or someone breaks into your account.

"Prepaid cards, whether in your hand or on your phone, have no guaranteed protections against unauthorized transactions, so you could lose whatever balance is on the card," said Walker.

Still, if, like Menkin, you like leaving your bulky wallet at home, Consumer Reports says use an app like Square that links to a credit card for the best consumer protections.

The one month mark is Saturday for the year-long initiative that the library does hope to extend should enough funds be raised, and nearly 30,000 people have taken them up on their offer so far.

“As of this morning, we’ve had over 19,000 people renew their library cards and we’ve given out almost 9,000 new cards,” Vicky Varga, associate manager, Circulation and Interlibrary Loans Services, said Thursday. “So this equates to about three times… what we would have seen previous to the free cards.”

Along with signing people up for free cards at branches, there were three pop-up membership drives on March 13 – something that will continue into the fall.

Library staff will be at the Mom, Pop & Tots Fair this weekend, Southgate Mall April 20 and Commerce Place April 30. In May, people will be able to sign up for cards at Century Park and Clareview LRT stations, as well as the Telus building, Bell Tower, Kingsway Mall, City Market Downtown and even the Edmonton International Airport.

By standardizing smart pump settings and better managing alerts, pharmacists at the Cleveland Clinic Health System were able to improve the large-volume pump system that goes across all 10 of its hospitals and its 19 family health and ambulatory surgery centers, according to Silvana Balliu, PharmD, RPh, a smart pump pharmacist at the health system.

Noting that alert alarm management is a key factor in reducing health technology hazards, Dr. Balliu described how Cleveland Clinic pharmacists focused on “decreasing the number of alerts received, to make them clinically significant to our caregivers.”

After reviewing continuous quality improvement (CQI) alarm report data and documenting the number of alerts received, a team at Cleveland Clinic tailored the audio alarm settings for alerts based on care areas and practice settings. The analysis revealed that many alerts received during infusion programming of pressors were caused by caregivers, who, when titrating doses downward ended up administering dosages lower than the lowest soft limits required by the smart pump’s settings. The health system significantly decreased alerts in this area by removing alerts for the lowest soft limits settings.

To reduce the risk for infusion pump programming errors related to high-risk medications, Dr. Balliu said they programmed high-risk medications in the pump to be given as primary, not secondary, infusions. Also, they prohibited secondary medications from being programmed with high-risk medications.

Cleveland Clinic also standardized settings between the smart pump and the electronic medical record (EMR) to provide clinicians with consistent information regarding dosage, duration and concentration, Dr. Balliu noted.

For heparin infusions, the CQI analysis revealed that some alarm alerts were caused by caregivers attempting to enter the volume per hour versus the dosage. The team eliminated this practice by implementing the lowest hard dosage limit for heparin.

Pharmacy works closely with nursing and anesthesia representatives during implementation and maintenance to “provide education and to make the library files transparent to them,” Dr. Balliu added. By making these types of improvements to the smart pumps, the number of alarm alerts decreased 50% from the fourth quarter of 2010 to the fourth quarter of 2011 (figure). Today, Dr. Balliu added, Cleveland Clinic is working toward its goal of having a library compliance rate of 98%.