Saturday morning coffee [February 21 2015]

“An error doesn’t become a mistake until you refuse to correct it.” – Orlando A. Battista

So much happens each and every week, and it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The mug below was sitting next to my laptop filled with chocolate covered espresso beans last Saturday morning, Valentine’s Day. A gift from my lovely wife. Apparently she’s aware of my addiction. It made me smile.

Fifty Shades of Grey was #1 at the box office last weekend, pulling down a cool $94 million on its opening weekend. I have no interest in seeing Fifty Shades. Last weekend my wife and I took in Kingsman: The Secret Service instead; it was my turn to pick in case you were wondering.  It was good. Not great, but good.

I spent most of this week down in the San Diego area visiting with the good people from MEPS Real-Time and visiting a couple of hospitals. I love the technology that MEPS has developed and I will have more to say about it next week.

Speaking of San Diego, the weather was beautiful. One of the colleges that my daughter, Mikaela has applied to is UC San Diego. Is it wrong of me to hope that she picks UCSD just so I can hang out down south more? I’m trying hard not to influence her choice of college, but, but, but….I’m just sayin’.

Mashable: “Perhaps the most surprising part? Coffee not only gets a clean bill of health, but could actively reduce your risk for heart disease and type 2 diabetes. The guidelines say you can drink up to five cups of joe a day without ill effects — if you take it black, that is.” – Coffee, it’s good. Although I’ll need to speak to someone about that five cups a day limit. Who can stop at only five cups?

For those of you keeping track, the FDA has released four new draft guidance documents for sterile product compounding. Sterile compounding is quickly becoming overly complex. Not the actual act of compounding sterile medications, but rather all the regulations around it. It won’t be long until every acute care pharmacies will have a “sterile compounding expert” on staff. And all they’ll do is keep up with new and changing regulations.

Los Angeles Times: “Nearly 180 patients at UCLA’s Ronald Reagan Medical Center may have been exposed to potentially deadly bacteria [carbapenem-resistant Enterobacteriaceae – image below] from contaminated medical scopes, and two deaths have already been linked to the outbreak.” – The scopes in question were used to perform ERCPs (endoscopic retrograde cholangiopancreatography), a procedure my family and I are all too familiar with. This latest tragedy is definitely a black eye for UCLA. Is it negligence or something else? Only time will tell, but early indication is that it wasn’t negligence on the part of the hospital. One thing is for certain, the regulatory jackals will be all over this. [image credit: CDC]

Lenovo really stepped in a pile of poo this week when it was discovered that many of their machines shipped during a specific period were preloaded with Superfish. Superfish alters search results to show targeted ads. That’s bad enough, but in addition the software alters your computer’s security certificates, which could allow unwanted access to your machine. I can’t believe Lenovo let this happen. I’ve been a Lenovo user for years. It’s things like this that will make me look elsewhere. There are things that I can live with from a laptop manufacturer, but this isn’t one of them. Microsoft has updated their Windows Defender to take care of Superfish, and Lenovo has released a Superfish removal tool. Too little, too late for the king of laptops, in my opinion.

I need one of these….

HIT Consultant: “EHR leader Epic Systems is planning to launch its own app store called the “App Exchange”, similar to Apple’s iTunes store that would allow developers to create apps that integrate with Epic’s EHR platform.” – My brother, Robert, has been asking me for years why healthcare companies weren’t doing this. My thought is that most vendors are cowardly and afraid of losing some form of control. Epic is no different. However, Epic can do this now because they dominate the landscape and no one can compete with them. To be frank, Epic scares me. I’ve had an opportunity to use the pharmacy piece of Epic for several weeks now. Not exactly what I’d call user friendly. Actually, I’d call it a UI nightmare. I can’t imagine this being the best we can do. To coin a phrase from the Joker, “the EHR space needs an enema”!

For those of you that don’t think the cost of medication is important, think again. “In the first study to examine the impact of a reduction in glaucoma medication copay on patient adherence, researchers in Michigan have found a potential solution to one of the biggest obstacles facing American ophthalmologists in the fight against glaucoma-related blindness…The researchers found that while medication adherence improved on average among all patients who were switched to generic latanoprost, those who were on name brand PGAs other than branded latanoprost – such as Bimatoprost and Travaprost – experienced a greater improvement.” (source: MNT)

I think Augmented Reality is really cool. The potential applications, even in pharmacy, are endless.

“Fifteen years into use of the da Vinci system, evidence that it trumps other methods is lacking…“The evidence isn’t strong enough to determine whether or not a robot is better than traditional minimally invasive surgery, but the evidence does indicate that it’s better compared to open surgery — more evidence from higher quality studies may change this conclusion,” said Chris Schabowsky, Ph.D., a program manager at ECRI. To justify its price — roughly ten times that of a high-end laparoscope — da Vinci would need to do a lot better overall.” – Technology isn’t always the answer. It’s simply a tool. And if that tool doesn’t work, get rid of it. Way more expensive, no advantage, additional maintenance and upkeep…hmm, what’s not to like. (source: Healthline News)

Columbia Engineering: “A team of researchers, led by Samuel K. Sia, associate professor of biomedical engineering at Columbia Engineering, has developed a low-cost smartphone accessory that can perform a point-of-care test that simultaneously detects three infectious disease markers from a finger prick of blood in just 15 minutes…Specifically, it performs an enzyme-linked immunosorbent assay (ELISA) without requiring any stored energy: all necessary power is drawn from the smartphone. It performs a triplexed immunoassay not currently available in a single test format: HIV antibody, treponemal-specific antibody for syphilis, and non-treponemal antibody for active syphilis infection.” – This is what true mobile healthcare is all about in my opinion, not the ability to check your pulse 15 times a day. I would love to see this technology become available to those that require blood tests to monitor medication therapy, i.e. drug levels, INRs, LFTs, etc.

Good news for Cardinals fans everywhere, Larry Fitzgerald isn’t going anywhere. There were rumors that the Cardinals were going to jettison Fitz at the end of the season. That would have made me sad. He’s the epitome of the Cardinal in my mind. Happy to see he’ll be back. I will continue to covet the #11 Cardinals jersey hanging in my Cardinals shrine, i.e. the closet.

Mobihealthnews: “Walgreens is adding data from PatientsLikeMe to its online health dashboard, giving patients a view of possible medication side effects sourced directly from other patients….The data will be displayed in a graphical sidebar on the health dashboard that will list side effects along with a percent bar that shows how many people reported each side effect from.” – First, I’d like to say that I think crowdsourcing information is good. However, I’m not sure crowdsourcing side effect information is such a good idea. Who screens the information to ensure that ‘toe pain’ isn’t caused from subbing it on the ground versus the medication the individual was taking? Can someone explain that to me. Seriously, I’d like to know. It’s a genuine concern.

iHealthBeat: “Hospitals participating in a national quality improvement initiative were no more likely to improve surgical safety and outcomes than hospitals not participating in the program.” – I have found that “safety initiatives” have little to do with change inside hospitals, especially those that I’ve worked in. Most of the time it’s the underlying culture of the place that matters, and no matter how many posters you hang in the hallway will change that.

New York Times: “The typical order at Chipotle has about 1,070 calories. That’s more than half of the calories that most adults are supposed to eat in an entire day. The recommended range for most adults is between 1,600 and 2,400. The histogram above shows the distribution of calories for all orders. The spike around 1,000 calories represents “standard” burrito orders – a meat burrito with typical additions: cheese, salsa, lettuce, sour cream, rice and beans. If you order a meat burrito at Chipotle with these toppings, it’s very likely to reach 1,000 calories.” – I’ve never been a big Chipotle fan, but many of my family members love it. Follow the link to check out the histogram referred to above, it’s impressive.

Have a great weekend everyone.