Category: Uncategorized

Rethinking Chromebooks

A couple of years ago, I tried switching from a Windows laptop to a Chromebook. It didn’t work. At the time, I was simply too entrenched in my specific needs to make the switch. Things have changed since then. For over a year, I’ve been using an ASUS Chromebook Flip C302 as my primary computing device. Besides having a mouthful of a name, it’s a great little machine. The combination of it plus my Samsung Note 9 has been nearly perfect. I say nearly perfect because I recently ran into an issue where my Chromebook couldn’t cut it. Some will call it an edgecase, but it created a problem nonetheless.

I recently found myself in need of a resume. I have one, sort of. It’s been years since I actually needed a resume, so I haven’t really stayed on top of it. I tried building one from scratch, but quickly realized that it was garbage, so I hired a professional. This particular professional, like many others, uses Microsoft Office, specifically Microsoft Word to create documents. I wasn’t concerned. As a Chromebook user and Microsoft Office 365 subscriber, I assumed everything would be seamless. I mean, I could simply use the web version of Word, right? Yes and no. It turns out that the online version of Word doesn’t play all that well with all desktop versions of Word.

The resume contained a lot of formatting that didn’t translate well from the desktop to the web version. My attempts to make edits and leave comments from within the web version were a disaster. Formating got destroyed, things disappeared from the page, and I quickly became frustrated. Within a day of going back and forth with the author of my new resume, I realized that I had found an instance where a Chromebook simply wouldn’t cut it.

Sooo, what’s a guy to do? I haven’t purchased a Windows laptop for myself in nearly five years. I literally started digging through my computer graveyard, i.e. the closet for one of my old machines. There were plenty to choose from. In the end, I ended up using an old 15.6-inch Sony VAIO to edit and complete the resume. The VAIO is a bit long in the tooth, but it’s a nice big machine to type on. I appreciate the screen real estate for going back and forth between documents, notes, etc. It worked out quite well.

In the end, I received a new resume and went on my merry way. However, it made me realize that as much as I like my Chromebook, the platform still “isn’t there” yet. At least not for me. For Chromebooks to be truly mainstream, this type of thing can’t happen. At least not as long as such a large number of folks continue to use Microsoft Office as their content creation suite of choice. I understand that this is as much Microsoft’s fault as Googles, but when given the option, it seems logical to stick with a Windows machine for the immediate future.

Consider this, I can use Chrome on a Windows machine to seamlessly do everything I can do on a Chromebook. I can’t do the opposite, at least not seamlessly. I’m sure the Chromebook zealots — and Microsoft haters — will disagree, but it doesn’t change the fact that my struggles were real. As PC laptops continue to get better, and Chromebooks continue to become more expensive, a decision that used to simple is much more complicated now. This is especially true now that Microsoft has embraced Chromium in their new Edge browser.

Given that one can purchase a nice Windows laptop from Lenovo, Dell, HP, or Microsoft for around the $1000 price point, it makes spending $800-$1000 on a nice Chromebook a tough sell. I’ll continue to use my Flip for now — as I said above, it’s a great little machine — but I’m currently on the hunt for a new Windows laptop. I’ve narrowed my search down to a select few machines from Microsoft and Lenovo.

Study questions what we consider an ‘adherent’ patient

MedicalXpress: “A study at Universidad Miguel Hernández (UMH) in Elche shows that patients defined automatically as “adherent” by dint of collecting their prescriptions each month are not necessarily any better than their “non-adherent” peers at actually taking their medication…. The main finding, then, was that lack of adherence even among those patients who regularly collected their medication was as high as 32%, based on in-pharmacy physical testing and questionnaires.”

Adherence was best when medications didn’t interfere with daily activities. Surprisingly patients taking five or more different medications were better at following their prescribed treatments. Also surprising was that the study shows that “patients are more likely to stop taking their medication if changes are made to the appearance of either the packaging or the medication, with adherence dropping most significantly when changes were made to the size, shape or colour of the pill itself.” Crazy.

NFC packaging for medications

NFC is good for more than figuring out how much liquor you have.

NFC World: “The two companies [Thinfilm and Jones Packaging] are collaborating to integrate Thinfilm’s NFC OpenSense technology into paperboard pharma packaging and establish key manufacturing processes for production on Jones’ high speed lines.” In addition “the work…will also include the integration of ferrite shield labels with the NFC OpenSense tags. This will enable NFC to function on metalized packaging such as blisters …”

Pretty cool stuff. By using NFC in the packaging, the simple tap of an NFC-enabled phone will allow you to authenticate the product, as well as track individual items. Would be neat to tie this into IV labels somehow.

Saturday morning coffee [August 22 2015]

“Don’t accept that others know you better than yourself. Work joyfully and peacefully, knowing that right thoughts and right efforts will inevitably bring about right results.” – James Allen

The mug below comes from the University of Arizona in Tucson. I was there earlier in the week doing some research on a project. In fact, I’m sitting in a hotel in downtown Phoenix this morning as I write this. I’ll be heading home later today. I saw this mug in a display case in the U of A bookstore. It’s an awesome looking mug. I wanted one, but couldn’t bring myself to purchase it because, well, you know, my daughter is a UCLA cheerleader. Having a U of A mug in the house would be akin to blasphemy. It really is a beautiful mug though.

MUG_UofA
Continue reading Saturday morning coffee [August 22 2015]

Saturday morning coffee [March 14 2015]

“There is nothing in which people more betray their character than in what they laugh at.” – Goethe

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 comes straight from Voodoo Doughnuts in Portland, OR. My wife and youngest daughter were up North last week visiting colleges. They surprised me upon their return with a box of Voodoo Doughnuts and this mug. The doughnuts were delicious.

MUG_VoodooDoughnuts
Continue reading Saturday morning coffee [March 14 2015]

Inhaled Corticosteroid Adherence and Emergency Department Utilization Among Medicaid-enrolled Children with Asthma [article]

J Asthma. 2013 Jun 5. [Epub ahead of print], Rust G, Zhang S, Reynolds J.

Abstract
Objectives: Asthma is the most prevalent chronic disease among children enrolled in Medicaid. This study measured real-world adherence and outcomes after an initial prescription for inhaled corticosteroid therapy in a multi-state Medicaid population.

Methods: We conducted a retrospective study among Medicaid-enrolled children aged 5-12 with asthma in 14 southern states using 2007 Medicaid Analytic Extract (MAX) file claims data to assess adherence and outcomes over the three months following an initial prescription drug claim for inhaled corticosteroids (ICS-Rx). Adherence was measured by the long-term controller to total asthma drug claims ratio.

Results: Only one-third of children (33.4%) with an initial ICS-Rx achieved a controller to total drug ratio greater than 0.5 over the next 90-days. Children for whom long-term control drugs represented less than half of their total asthma drug claims had a 21% higher risk of emergency department visit (AOR 1.21 [95% CI 1.14, 1.27]), and a 70% higher risk of hospital admission (AOR 1.70 [95% CI 1.45, 1.98]) than those with a controller to total asthma drug ratio greater than 0.5.

Conclusion: Real-world adherence to long-term controller medications is quite low in this racially-diverse, low-income segment of the population, despite Medicaid coverage of medications. Adherence to long-term controller therapy had a measurable impact on real-world outcomes. Medicaid programs are a potential surveillance system for both medication adherence and emergency department utilization.

Posted online on June 5, 2013. (doi:10.3109/02770903.2013.799687)

Two things to consider:
Continue reading Inhaled Corticosteroid Adherence and Emergency Department Utilization Among Medicaid-enrolled Children with Asthma [article]

Ideas, Vision, Innovation: Fantasy vs. Reality

Simply put, I think you need an idea and a vision to be innovative. Sounds simple enough.

I’ve read that good ideas are hard to come by, vision even harder and innovation rare. I don’t buy it. I believe innovation is difficult, but probably not for the reasons you might expect. On the other hand I don’t believe that ideas are hard to come by or that vision is rare.

I think ideas are like change in your pocket and you tend to collect more than you think. If you’re like me, and I believe most people are, you probably have several ideas every day about changing how something is done, how to make something better or what the next big thing should be. You know what I mean. All those moments throughout the day when you say something like “what if they…” or “why didn’t they…” or even “wouldn’t it be cool if …”. You know what I’m talking about, like “wouldn’t it be cool if they filled marshmallows with hot fudge”. Yes, yes it would.
Continue reading Ideas, Vision, Innovation: Fantasy vs. Reality

Great response to “Why pharmacy continues to fail”

The Cynical Pharmacist (TCP) dropped by my site and left a great comment in response to my  Why pharmacy continues to fail. I don’t know who TCP is, but I hope to meet him in person some day. I get the impression that we would have some great dinner conversation; some pharmacy related, some not.

You can see more of his musings on Twitter – @TheCynicalRPH

TCP makes some great points in his comment, and in my opinion his thoughts reflects the sentiment of many pharmacists practicing in the real world. I was going to refer you to the comment, but felt it would be better to post the meat of it below:

Continue reading Great response to “Why pharmacy continues to fail”

Quick hit: Confusion over industry terminology

I had an interesting conversation with a colleague earlier today. We were talking about a feature set for a new product that we have due out later this year. Some of the language being used to describe a certain feature, and how it would be used, was causing quite a bit of confusion for me. So I tried to clarify things a bit. After a brief email exchange it turned out that I knew exactly what he was talking about; healthcare and especially pharmacy simply use different words to describe the process.

I recommended that we use the pharmacy specific lingo, but I was told no because it wasn’t the industry standard. I found that quite interesting because we build products for pharmacy, i.e. that is the industry we’re in. However, the terminology used for this particular process is different outside the pharmacy world. Still with me? Good.

So, the question becomes does one conform to the terminology in the market segment you’re in, i.e. pharmacy, or do you ignore the pharmacy terminology and go with the “standard”? My gut reaction would be to go with the standard – after all I preach standardization all the time – however, if one does that you end up talking to pharmacy people that have no idea what you mean. You know, everyone has that deer in the headlights look with everyone standing around wondering what the heck is going on. And to top it off, no one asks for clarification because they’re afraid it might make them look stupid. We’ve all been there. I know I have.

So, based on what I just said above I think you have to conform to the industry you’re in. In other words, use the pharmacy terminology, standard or not.

Quick Hit: The decision to be indecisive

Have you ever had something on your plate that just won’t go away because someone is “thinking about it” or trying to “justify it”? Sure you have. I know I have. I always wonder what the person is thinking about when it takes months to make a decision. Doesn’t the information you have to make the decision become outdated when you wait that long? I for one, can’t think about anything that long because it gives me a headache. And sometimes you simply can’t justify something; it’s a leap of faith.

One thing is for certain, if you’re waiting for the right moment, the moment will never come. Decisions don’t need to be right or wrong, they simply need to be made. Heaven forbid you make a bad call on something. I seriously doubt anyone has gone through life mistake free. If you never make a mistake you’re not trying hard enough in my opinion. Heck, I’d go as far as to say that some of the most valuable lessons I’ve learned have been from my failures. Sure, the failures sting a little, but that’s what helps one learn from the process.

I believe fear is the cornerstone of indecisiveness; fear of making the wrong decision. Choosing to not make a decision is, in itself, a decision. Unfortunately it’s a decision that people repeat time and time again without learning from the mistake of not choosing. The only way to learn to make good decisions is through the experience gained from making bad decisions. Kind of a circular argument, I know. Go figure.

According to Albert  Camus “life is the sum of all your choices.” So what does that say about your life if you don’t make any decisions? Not much.

As Staff Sergeant Nantz so eloquently put it in the movie Battle Los Angeles, “You can go right. You can go left. I don’t give a damn. Just make a decision”.