It’s been a pretty good week, and as usual there were a lot of things that happened during that time. Not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.

• The Vow was #1 at the box office last weekend. I haven’t seen it. Instead my wife and I went to see Safe House, which was pretty good. It’s no threat to the Bourne series, but I’d see it again. 
• I thought this was pretty sticking funny. From Robot Chicken. Pay attention at 0:06 in the video. Quite the conundrum.

• HIIMSS12 is next week in Las Vegas. This is the first year I’ve been able to attend and I’m excited. This is the most excited I’ve been about attending a conference in a long, long time. I can’t wait to get there. I’m looking forward to meeting some folks that I’ve only talked to virtually. In addition I’ll be attending my first ever HIMSS 2012 Tweetup with HP on Tuesday, February 21. Details can be found here. Cool stuff, dude.
• It looks like infant Tylenol oral suspension is on the hook again. More than 500,000 bottles have been recalled. It has to do with the flow restrictor. You can read more about it the ASHP News Site. Infant Tylenol suspension has taken a beating over the years. It begs two questions: 1) why can’t people get this right?, and 2) what do we do in the long run if people can never figure it out? Check the video below for instructions on using Infants Tylenol suspension. It’s not that hard people!

• How far have we really come with smartphone technology? Actually we’ve come a long way, but have you ever gone back and looked at handheld technology over the years? If you have, you’ll know that it’s basically the same. Take a look at this user guide for one of the Sony Clie PDAs (PEG-NZ90). Yes, yes, it’s quite ugly, but look at the manual and evaluate what it can do. Crud, throw in a faster processor, a little more memory and a 4G antenna and I’d use it. The PEG-NZ90 was introduced by Sony in 2003.
• I don’t pay much attention to retail pharmacy, but have you ever seen the ClearRx bottle and labeling system from Target? Brilliant, simply brilliant. Pharmacy bottles have been the same basic design for a long, long time. I applaud Target for doing something different. I still don’t like retail pharmacy, but I think their bottle design is cool.
• I started using the Cloudring service. I use a lot of cloud-based storage solutions and Cloudring helps me keep certain files synched up between them. It also allows me to easily see all my cloud storage solutions at the same time and move files back and forth. So far I’ve experimented with Dropbox, Google Docs, Box and Evernote. It’s very cool.
• The Barcode News: “Imagine, instead of a cashier having to handle every item in your cart, or you having to play spin the bottle with your ketchup at the self-checkout, you simply place your items on a conveyor belt where they are automatically scanned by the time they get to the bagging station. This is possible with 360 scanners. As the name denotes, 360 scanners are capable of scanning a product bar code from 360 degrees.” – Yeah, now instead of thinking of these things in grocery stores, think of using them in healthcare so people don’t have to actively scan things.
• EHR Bloggers: “As part of the treatment plan for a patient who has a critical need to take one or more pills at or very near specified times throughout the day a physician, nurse or perhaps a new kind of specialist will develop a tracking plan.” – Stalker anyone? Just sayin’.
• I read a lot of articles at the sciencebase website. They make reading about science fun and interesting. Even though it’s not from this week, I love the blurb they did on the shape of snowflakes. “Snowflakes have at their heart a minute grain of dust that was once floating in a cloud, this speck of dust is the nucleation centre around which water vapour from the atmosphere can condense and if it is cold enough crystallise as ice. As with any crystallisation process it follows a symmetry intrinsic to the atoms or molecules from which the crystal is formed. In the case of water, the underlying symmetry is hexagonal symmetry.” Be sure to watch the video on the site that shows some great snowflake images. Beautiful stuff.
• How much work goes into movie poster design? Too much. Fast Company has an interesting article on The Psychology Behind Movie Poster Designs. It’s interesting to note that I never see a movie based on the poster design. Do you? I typically watch a movie based on whether or not I think it will entertain me. I don’t see a movie for artistic value, or views on “reality”, or political statements, etc. I go to be entertained. I go to escape reality for a couple of hours.
• Snowboarding at night wearing an LED suite. Quite beautiful.

• AJHP March 1, 2012 vol. 69 no. 5 405-421 “ Projecting future drug expenditures – 2012”: “For 2012, we project a 3–5% increase in total drug expenditures across all settings, a 5–7% increase in expenditures for clinic-administered drugs, and a 0–2% increase in hospital drug expenditures.” – Why is this important? Because acute care pharmacy budgets can run over $100 Million a year, that’s why.
• Scientists have conducted the first successful human test with a drug delivery chip. The article appeared in Science Translational Medicine where the authors describes the successful use of a programmable chip loaded with medication and injected into a person. The chip holds several doses of the drug in place until an electrical current is applied, then the drug is released in the quantity specified. I worked on something like this when I was an undergraduate studying chemistry. Of course it was only in a beaker and not using drugs, but I used polyaniline to carry specific molecular entities and release them when current was applied. In our case, it was all or none, but it was cool. I still have my lab books from the experiments. 
• Picked up a Samsung Galaxy Player 5.0 this week. I love the screen on this thing. Yeah, it’s big, but it’s beautiful. I already synched it with my Google account, which means I instantly had access to all my documents, my music, and of course my email. I also took some time to watch a little Netflix on it and listen to some music via it’s build in FM radio. I plan to take it with me to HIMSS12 along with all my other tech “stuff”. Deciding which of my toys to take on trips is becoming more difficult by the day. 

That’s it folks. I think I’ll keep it short and sweet this week. Enjoy your weekend everyone, and remember “one of the symptoms of an approaching nervous breakdown is the belief that one’s work is terribly important” (Bertrand Russell).

2011 brought many new and exciting changes not only in my personal life, but in the world of pharmacy and technology as well. I’ve learned many new things, gained some new skills, made some new friends, explored the world of pharmacy more deeply, traveled more than ever before and discovered that I once again know nothing. I am excited to see what 2012 has to bring.

Below is a list of opinions I’ve gathered over the past 12 months. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts. If you don’t agree with my opinions that’s fine, but I don’t want to hear about it. On the other hand if you have something useful to add please feel free to leave a comment.

• 2011 was the year I took a hiatus from blogging, got bored, came back
• 2011 was the year my wife and kids bought me a Barnes & Noble Nook Color and I rooted it; makes a great Android tablet.
• 2011 was the year that I learned you have to be a jerk to be successful. I don’t need to be successful that badly. Just sayin’.
• 2011 was the year I completely divorced myself from Apple. I moved my music to the Amazon Music Player first and then to Google Music, and threw my iPod in a drawer. I haven’t missed it.
• 2011 was the year I bought my first suite, and it was about as fun as a prostate exam.
• 2011 was the year the online tech pundits became little more than sounding boards for Apple. Even my favorite tech bloggers in 2010 have become little more than sheep.
  2011 was the year I realized that people basically don’t want to think for themselves anymore.
• 2011 was the year Christina Aguilera screwed up the National Anthem at the Super Bowl. Nothing could have been more disgraceful.

• 2011 was the year that Android took a giant leap forward.
• 2011 was the year of patent trolling.
• 2011 was the year that form overcame function and that’s a real shame.
• 2011 was a year in which mobile became more than a smartphone.
• 2011 was the year of infographics. Still not sure what value they hold, but they’re everywhere, and they’re pretty cool.
• 2011 was the year in which healthcare may have become the most regulated industry in the world. Don’t believe me? Spend some time in a hospital chasing down all the departments, people and forms needed to keep up with all the regulatory garbage.
• 2011 was the year when everyone finally realized a unified EHR wasn’t going to be easy.
• 2011 was the year that my family and I saw 49 50 movies in the theater.
• 2011 was the year that RIM and BlackBerry died (just you wait and see)
• Best idea in healthcare in 2011 – An integrated healthcare solution (same as last year)
• Worst idea for healthcare – Accountable Care Organizations (ACOs)
• Most overused words in healthcare 2011 – mHealth, ACO and meaningful use
• Best pharmacy conference/meeting attended in 2011 – ASHP Conference for Leaders in Health-System Pharmacy in Chicago, Illinois, October 17-18.
• Best ideas in pharmacy that hava yet to mature – Clinical Decision Support (CDS), PPMI and tech-check-tech
• Best drug information resource, hardcopy – Lexi-Comp Drug Information Handbook
• Best drug information resource, handheld/electronic – Lexi-Comp Lexi-Drugs
• Best pharmacokinetics calculator, handheld/electronic – RxCalc for the iPhone, of course
• Best medical reference, electronic/web based – UpToDate (includes access to Lexi-Drugs, online version)
• Best automated dispensing cabinet technology – Omnicell. With that said, Pyxis (CareFusion) appears to have noticed Omnicell’s push and is finally doing some innovative things once again.
• Most active area of pharmacy automation/technology in 2011 – IV room stuff, specifically “IV Workflow Managment”. 
• Best IV Room Workflow Management system – DoseEdge by Baxa
• Biggest story in pharmacy 2011 – Drug shortages. It goes without saying that drug shortages are a real problem that are not only frustrating, but are affecting patient care as well.
• Most underutilized thing in pharmacy in 2011 – Data. Data rules people. We need to learn how collect it, analyze it, group it and use it.
• Healthcare technology in 2011 that’s poised to leap forward – Teleprescence – telepharmacy, telemedicine, etc.
• Most over-utilized thing in pharmacy in 2011 – Warnings/alerts. When is it going to end?
• Technology with most potential for healthcare that absolutely no one is talking about – Near Field Communication (NFC)
• Coolest piece of healthcare technology I saw in 2011 – IV Check by SEA Medical
• Coolest piece of consumer technology I saw in 2011 - ReRFIDgerator. Seriously, someone needs to make one of these for use in healthcare.
• Weakest link in health information technology – Standardization and interoperability (no one wants to play with the other guy and everyone wants to do it “their way”)
• Best “throw away” pharmacy journal/magazine in 2011 – Pharmacy Purchasing & Products. This journal/magazine is the best source for pharmacy technology related information out there at the moment.
• Best pharmacy organization in 2011 – American Society of Health-System Pharmacists (ASHP)
• Best pharmacy automation and technology mind in pharmacy in 2011 – Dennis Tribble
• Best pharmacy IV room mind in pharmacy in 2011 – Eric Kastango
• Best social media mind in pharmacy in 2011 – Kevin Clauson
• Thing I missed most professionally in 2011 – Access to primary medical literature
• Things I should have done more of in 2011 – Blogged. I hope to get back to it in 2012
• “Old” technology that’s finally starting to take off – “Cloud computing”
• Most useful data gathering device in 2011 – Pen and paper, or pencil and paper; the choice is yours. The plethora of tablets hitting the market have yet to replace good old pen and paper for note taking.
• Speaking of pens. The best pen on the market – Uni-ball Jetstream RT pen. I started using these as a pharmacy student and have yet to find anything better.
• Most overused piece of mobile technology – BlueTooth headsets. You people look like morons.
• Funniest commercials I saw in 2011:
  1. GEICO Smartphone, dumb things – “Is the gentleman with the BroStache invited to this party?“
  2. Allstate Mayhem Blind Spot – “You’re good”

• Most over-hyped death of 2011 – Steve Jobs. A man died, and that is tragic and sad, but c’mon, really?
• Worst thing to happen to innovation and advancement in 2011 – Patent trolling.  Companies are doing everything in their power to slow competition via the courts instead of in the market. 
• Dumbest move by a company in 2011 – HP dumped the Touchpad….and eventually the webOS. Fools. What a shame, it was a beautiful operating system with tons of potential. However, I was able to grab a TouchPads in the fire sale, so good for me. I like the tablet hardware and OS, but the lack of applications for it is rough.
• Best movie I saw in 2011 in the theater – This is a tough one for me because we saw so many movies, but I’m going to go with Battle Las Angeles.
• Best movie I saw in 2011 honorable mention – Harry Potter and the Deathly Hallows Part 2. For those of you that know me you know that I am not a Harry Potter fan, but the movie was well done, exciting and most of all it entertained me. I would see it again.
• Worst movie I saw in 2011 in the theater – Season of the Witch. Nick Cage just keeps getting worse.
• Weirdest movie I saw in 2011 in the theater – Drive
• #1 Movie at the box office in 2011 – Harry Potter and the Deathly Hallows Part 2. Interesting that the #1 grossing movie in 2011 made less than the #1 grossing movie in 2010 and 2009. In addition it sold fewer tickets than any of the #1 box office hits in the last decade. What does that tell us? Probably nothing, but it is interesting nonetheless.
• Best online movie service – Still Netflix
• Best place to get a pizza – Pizzeria Uno, Chicago, Illinois. “Real” Chicago pizza according to my friend. It’s nothing like California pizza to be sure. Regardless it’s incredible. Now I know where the phrase “pizza pie” came from.
• Best place to kill time while on the road – Microsoft Retail Store, Bellevue, WA. I enjoy being able to lay my hands on all the different Windows 7 laptops and tablet PCs. It makes me smile :-)
• Best new thing in social media in 2011 - Google+ (pronounced “Google Plus”)
• Worst thing in social media in 2011 – Checking in everywhere you go and applications that post photos like Instagram. Well, I suppose it’s not Instagram itself rather it’s how people use it. Do you really need to post 500 pictures of your cat or dog napping, or the food you’re about ready to consume, or the beer bottles you’ve collected during your drinking binge? Seriously people, get a life. 
• Best social media platform in 2011 – Twitter. Sorry Facebook, but I just don’t like you that much.
• Best desktop Twitter Client – no idea, don’t use one
• Best Web-based Twitter Client – Silver Bird (Google Chrome extension)
• Best Google Chrome extensions, from left to right:

1. Silver Bird – My favorite Twitter Client when working on my laptop(s)
2. Tweet Button – Self explanatory.
3. SGPlus – Allows me to post to Twitter and Facebook from within a Google+ post. It’s not perfect, but it’s the best I’ve found so far.
4. Session Buddy – Saves my current Google Chrome Session so if anything happens I can easily re-open all my previously open tabs
5. Readability Redux – Gets rid of a lot of the fluff on a web page, making it easier to read.
6. Diigo Web Highlighter – Allows me to bookmark a web page, annotate it, highlight it, share it, etc. It’s pretty handy
7. Evernote Web Clipper – The most valuable Chrome extension ever made. Allows me to clip part or all of any web page I’m on, tag it and send it to Evernote.
8. TabCloud – Similar to Session Buddy, but the info is saved in the cloud. I can retrieve my session from any machine. Why even use Session Buddy? I like the UI better and I’ve been using it longer.
9. Awesome Screenshot – Allows me to capture all or part of a webpage and turn it into a JPG, along with some other cool features.
10. ScribeFire – A full-featured blog editor from within Google Chrome. It works with all my existing blog platforms: Windows Live, Tumblr, Posterous, Blogger, etc.
11. XMarks – Cloud-based bookmark extension. I had to find an alternative after Google decided to scrap Google Bookmarks.

• Best mobile Twitter Client for Android – Official Twitter app for Android
• Best email client – GMail
• Best decision(s) by Google this year – Google+ and the Samsung Galaxy Nexus
• Worst decision by Google this year – Getting rid of Google Bookmarks. That really pissed me off.
• Best thing that happened in the NFL in 2011 – They settled the holdout before it impacted the season.
• Worst thing in the NFL in 2011 – The holdout because it makes them all look like greedy bastards, and the new rules. The NFL continues to dilute the game. I can barely recognize the game I played and loved as a boy. It’s more about entertainment now than anything else, and that’s sad.
• Lamest penalty in the NFL – Pass interference. It’s the only penalty in the world that has the potential to be worth the entire length of the field; it’s a spot foul.
• Dumbest penalties in the NFL – The ridiculously stringent rules surrounding hits on quarterbacks and wide receivers. Dear Comissioner Goddell, please consider putting flags on them, it would make things a whole lot less confusing for the rest of us.
• Most amazing play I saw in the NFL in 2011 – Jerome Simpson Front Flip Touchdown against my beloved Arizona Cardinals

• Best rookie in the NFL 2011 – A.J. Green, WR, Cincinnati Bengals. This kid is a game changer. Honorable mention: Andy Dalton, QB, Cincinnati Bengals and DeMarco Murray, RB, Dallas Cowboys. I know, I know, where’s Cam Newton? I’m not talking about fantasy football here. The numbers don’t mean anything to me. It’s all about the “W’s”.
• Most polarizing figure in the NFL in 2011 – Tim Tebow. I will admit here and now that I’ve flopped on Tebow. I didn’t like him in collage. I said he was overrated and would fail miserably in the NFL. I was wrong, and somewhere along the way, despite my best efforts, I started pulling for the guy. Perhaps it’s the fact that “the experts” say he can’t succeed in the NFL because he’s not a prototypical QD. Well, we all know that “the experts” are pretty much a bunch of sheep; they all say the same thing. Maybe it’s time for someone to shake up the NFL.
• Biggest surprise team in the NFL in 2011 – The SF 49ers. Who would have thought a coaching change would have made that big a difference.
• Biggest disappointment in the NFL in 2011 – The Indianapolis Colts. Yikes!
• Biggest scandal in college football in 2011 – Take your pick: Ohio state, Syracuse, University of Miami? With that said the worst thing to hit college football in the history of the sport had to be the Penn State scandal, hands down.
• Worst thing in professional sports 2011 – The NBA lockout.  The NBA already has a bad reputation of catering to a bunch of spoiled, rich thugs. All the lockout did was reinforce that idea. I’m not a big fan of the NBA, and all this did was make me go from a casual fan to no fan at all. I won’t be watching an NBA game anytime soon.
• Biggest surprise in pro sports – The World Series. First time in recent memory that it I felt any interest at all in watching MLB. The sport was almost dead. Perhaps this was enough to resurrect it.
• Best in sports talk radio – The Herd with Colin Cowherd (ESPN). I think Cowherd rambles on at times, but at least he rambles on about sports.
• Worst in sports talk radio – The Dan Patrick Show. Honorable mention Mike and Mike.
• Best new TV series – Suits
• TV series that used to be good, but turned to crap in 2011 – Burn Notice and The Closer. It’s the beginning of the end for both. The storyline for Burn Notice is getting old and I find myself rooting for the bad guys in The Closer because the main character has become such a self-righteous witch.
• Best traveling companion other than my wife and family in 2011 – SiriusXM Satellite Radio. Why? Because the stations are always the same, no matter where I go: 84-ESPN Radio, 85-ESPN Xtra, 86-Mad Dog Radio, 88-SiriusXM NFL Radio.
• Coolest thing I did at work in 2011 – AutoPharm Mobile (it’s my first product)
• Best trip for work – Europe: Amsterdam; Paris, France; Düsseldorf and Cologne Germany
• Worst trip for work – Overnight trip to Las Vegas
• Best thing about being a PM – Visiting “customers”, i.e. getting paid to talk with other pharmacists
• Worst thing about being a PM – Tons of useless paperwork. Honorable mentions: 1) having to prove that an idea can make money before it’s deemed a “good idea”. 2) having to put on a suite and tie.
• Best mobile operating system – Android. Honorable mention, Windows Phone 7 (Mango)
• Best Android Tablet – Asus Transformer. I suspect the Transformer Prime will be better, but I haven’t actually seen one to be sure. The original Transformer tablet is a great device, and the keyboard docking station only makes it that much better.
• Best new Windows 7 Slate – Samsung Series 7 11.6-inch Slate.
• Best new rugged tablet – Panasonic Toughpad. I would really like to get my hands on one of these. I like the idea of being able to use a slate tablet on the road without worrying about pampering it.
• Biggest impact from a new tablet device – The Kindle Fire. It made waves.
• Best new Windows 7 convertible tablet – Nothing here to report. 2011 will go down in history as the year of the slate tablet to be sure. I miss the keyboard revolution. To all you great computer makers – Lenovo, Dell, Samsung, HP – please bring the keyboard back to tablets, whether as a convertible machine or as a docking station similar to the Asus Transformer.
• Best not-exactly-computer-related technology of the year - Wacom Inkling
• Best e-reader – Amazon Kindle DX. E-Ink is still the best screen type for reading.
• Most amazing piece of technology that no one is talking about – Microsoft Kinect for the Xbox 360. Some of the things that have been done with this technology is amazing, but all-in-all you don’t really hear that much about it. 
• Best synching solution across multiple computers – Sugarsync
• Best “cloud” based back up solution – Sugarsync
• Most indispensable piece of software on a tablet PC – Microsoft OneNote
• Best PDF editor – PDF Annotator
• Best screen capture utility – FastStone capture. I believe Version 5 is still freeware and is absolutely indispensable. I use it multiple times everyday
• Best information collection tool I used in 2011 – Evernote. I couldn’t live without it. It’s so valuable, and I use it so often, that I pay for the premium version
• Best application used to temporarily-park-content-you-intend-to-read-later in 2011 –  Read it Later. Read it Later works better on my smartphone than Evernote. I can’t clip an entire webpage to Evernote on my smartphone, but I can send it to Read it Later.
• Best new smartphone – Samsung Galaxy Nexus. I have one. It’s my first new smartphone in almost three years. Suffice it to say that it is simply spectacular.
• Technology I’d like to see manufacturers work on the most in 2012 – Battery technology. The functionality, processors, screen technology, etc has outpaced smartphone batteries. It’s an issue.
• Favorite family trip 2011 – There were two trips that stick out in my mind this year: 1) My family and I drove to Oregon in July to attend my niece’s wedding. We spend five days near Eugene. We had a great time. 2) In early August my family and I spent two weeks running around Washington State. During that time we ventured into Idaho and Montana and took the kids into Northern Washington to visit Forks and La Push (of course we had to do this because of the Twilight books and movies). Both trips were awesome. They each generated enough good memories for a lifetime.
• Favorite family trip 2011 honorable mention – Disney World. My daughter’s competitive cheer team qualified for “Worlds“, a world-wide cheerleading championship, and it was held at Disney World in April 2011. 
• Coolest barcode scanner I used in 2011 – KoamTac KDC300
• Best RSS reader – Google reader. With that said, the idea of an RSS reader is beginning to fade as social media platforms like Twitter and Google+ take shape.
• Best mobile news reader – Google Currents and Pulse. I like Google Currents better on my smartphone and Pulse on my tablet.
• Worst “improvement” to web-based system – What Google did to Google Reader and GMail. I don’t like the “new look”
• Best desktop OS – Windows 7. Looking forward to Windows 8
• Best desktop office suite – Still MS Office
• Best cloud-based office suite – Google Docs
• Best “desktop” browser – Google Chrome. I don’t even have Firefox on my machine anymore
• Best cloud music storage/player – Google Music. Honorable mention goes to Amazon Music Player.
• Favorite technology blog/website 2011 – Engadget
• Favorite medical technology blog/website 2011 – Medgadget. I love this site. 
• Honorable mention for healthcare technology blog/website 2011 – DirkMD – Free CMIO Perspective
• Favorite mobile technology blog/website 2011 – GottaBeMobile
• Favorite medical mobile technology blog/website 2011 – FierceMobileHealthcare
• Favorite website for videos and short presentations about cool stuff 2011 – TED
• Favorite website for great science stuff 2011 – sciencebase. David Bradley has created a great site that I enjoy immensely. I loved chemistry and other science long before I became a pharmacist and this site satisfies my ever present curiosity. 
• Best new pharmacy informatics blog/website 2011 – rxINFORMATICA
• Most interesting pharmacy blog/website 2011 – The Cynical Pharmacist
• Best place to order technology not available in the US – Dynamism.com
• Best online retailer – Amazon.com
• Best airline I used in 2011 – Icelandair. I flew to Europe on Icelandair for work and they were great.
• Worst airline – Oie! That’s a bit more difficult than the best airline. They’re all pretty bad, but I think American takes the cake.
• Worst idea by and airline – In flight advertisement, especially this one.
• Best travel experience in 2011 – Received a free upgrade to first class on two occasions. Both were short flights – Denver to Fresno – but it was really cool.
• Worst travel experience in 2011 – Flight was cancelled and I got stranded at SFO; literally stuck in the airport overnight. The experience was pretty lousy as the airline customer support and our company travel agent were about as helpful as a bag full of rocks to a drowning man.   

2011 was an amazing year. I wonder what 2012 will bring? Only time will tell. Happy New Year everyone.

Luke 2:8-11

Battle: Los Angeles was #1 at the box office last weekend; definitely my kind of movie. My family and I saw it yesterday and I thoroughly enjoyed it. It’s the kind of movie that gets your blood pumping and pulls on the American pride strings a bit. I’d see it again.

I came across an interesting article in the American Journal of Pharmaceutical Education on Selecting a Clinical Intervention Documentation System for an Academic Setting authored by Brent Fox. Brent is a pharmacist and professor at Auburn University Harrison School of Pharmacy. He’s a great guy and a brilliant informatics pharmacist. Anyway, Auburn ended up going with Quantifi by Pharmacy OneSource out of Bellevue, WA. It’s an interesting article.

Drug Topics: “Warehouse retailer Sam’s Club has launched what may be the country’s largest retail preventive health program targeting consumers and small businesses. The Prevention Plan, which costs $99 per year, is an online health screening and primary prevention program similar to plans already being marketed to employer groups. The retailer is also launching free in-store health screening programs that include an individual pharmacy consultation, blood-pressure checks, bone-density scans, BMI assessment, cholesterol and blood-glucose testing, hearing exams, and eye exams.” – Great job by Sam’s Club, and poor job by healthcare systems across the country. It’s a sad day indeed when a retail outlet begins providing better preventative care than local hospitals and clinics.

Engadget: “Soon Japanese drivers will never be far from a place to charge their EV, either. Forking Company, which oversees 1.2 million vending machines across Japan, is going to start working with Panasonic to deploy chargers for electric vehicles along with those machines. It’s a potentially perfect solution, since these stations already having power and, often, connectivity.” – I found this interesting for a couple of reasons. First, I think it would be cool to use this type of vending machine for medication dispensing. Second, isn’t the idea of sitting in your car having something cold to drink while you surf the internet waiting for your car to “charge up” funny? Yeah, I think so too.

Since seeing the UCSF robotics video several days ago I’ve been looking more closely at Swisslog automation. I found the video below on YouTube that does a pretty decent job of showing off the nuts and bolts of the system. And I’m excited to report that I will be going to UCSF for a tour of the pharmacy. Very exciting stuff.

Talyst and Sparton Corporation announced a partnership agreement this week. We all know that Talyst builds pharmacy automation solutions, but what does Sparton do? According to the press release they empower “customers vision as a provider of complex and sophisticated electromechanical devices with capabilities that include concept development, industrial design, design and manufacturing engineering, production, distribution, and field service to technology-driven companies in the medical device, defense & security systems, and electronic manufacturing services markets.” Apparently Sparton was part of the Talyst AutoCool product back in the day.

Mashable: “Adobe has finally released Flash Player 10.2 for Android. Its release marks the availability of Flash for Android 3.0.1 Honeycomb, Google’s OS for tablets. While Flash 10.2 for Android boasts performance enhancements that improve the experience on mobile, the thrust of this update is to bring Flash to tablet devices like the Motorola Xoom.” – I’ve been following the Android tablet market closely for quite some time. Anyone that reads this site knows, I’m a fan of the Android platform. Unfortunately the Android tablet market remains quite immature at the moment. Even though I’m eagerly waiting for an Android tablet worthy of my hard earned mula, I’m starting to think more and more that a Windows slate would make more sense.

I really like what I see out of the Lenovo Hybrid U1. I love the hybrid design with Windows while in the dock and Android when in slate mode. I’ve talked to people about this before, but didn’t think anyone would actually have the foresight to make it happen. Bravo Lenovo. Note to demo guy – practice docking tablet prior to next demo. See video below

Here’s a news flash for you, “Removing menthol from cigarettes would improve public health, according to a report from the FDA’s Tobacco Products Scientific Advisory Committee (TPSAC).” Wow, there’s some insightful information from the FDA.

Fast Company: “CoolPlanet claims that it can develop “carbon-negative fuels” that can replace gasoline found in cars in the road today. The company’s secret sauce is a thermal/mechanical processor that extracts hydrocarbons from biomass, leaving behind excess carbon in solid form. That biochar can be sequestered and used as a soil conditioner or burned as a coal substitute.” – Google just dumped a truck load of money on CoolPlanet to develop their biofuel. Good luck boys, I’m pulling for you.

mobihealthnews : “This week during a panel focused on mobile health apps at the South By South West (SXSW) event in Austin, Texas, the four panelists offered up a handful of “landmines” that are currently embedded in the way developers and service providers are approaching mobile health.” – The landmines included: sloppy behavior change strategies, ignoring the data silo problem, the real market is not “patients” and the assumption that people are logical about health. Interesting read.

I love the idea of the Chrome Cr-48 laptop. The idea of a cloud based computing platform makes me feel all warm and fuzzy inside. A recent post by Louis Gray gives me hope that we’ll see more of it in the future. Speaking about his recent experience at the SXSW conference in Austin, TX Louis says “I expect to leave Austin on Monday with the same number of devices I came here with – three. Between the CR-48, my Samsung Galaxy Tab and my Android-based Samsung Epic, I can do everything I need to, including schedule my SXSW itinerary with the show’s dedicated app.” I hold great respect for Mr. Gray’s opinion as I find him to be one of the few unbiased tech reporters on the net.

Do you know what value-based purchasing (VBA) is? Well, VBA “is a payment methodology that holds health care providers accountable for the quality and cost of the services they provide by a system of rewards and consequences, conditional upon achieving pre-specified performance measures.” In other words, if you do good work you’ll get paid, otherwise you won’t. Hmm, sounds a lot like the same standard that most working class people are held to. If you want to learn more you can stop by the Deloitte website. More detailed information provided by Deloitte can be found here (PDF).

PharmTech.com: “Pharma’s manufacturing and supply chain needs a “radical overhaul” because it is underused, inefficient, and ill-equipped to cope with new types of products that will be coming to market in the near future, according to a report from PricewaterhouseCoopers (PwC).” – As an acute care pharmacist I tend to think inside the confined space of the pharmacy I’m working in; after all a pharmacy has to deal with supply chain problems all the time. Well, it makes sense that supply chains extend far beyond my little world. Unfortunately the problems run downhill and will directly impact patient care in the future if something isn’t done to straighten them out.

And to leave you with something on the lighter side:

I stumbled across a website called High Performance Pharmacy. The site is “based on a landmark study by The Health Systems Pharmacy Executive Alliance. The study identifies proven best practices for achieving high performance across 8 dimensions of hospital pharmacy practice. Read on to learn how your pharmacy can become a High Performance Pharmacy — delivering the best clinical outcomes for your patients and financial results for your entire health system.” It appears to be tied to McKesson somehow, which makes me look at the information with a bit of skepticism. With that said, I found the information on the site valuable. There’s a lot of material there so make sure you have a little time on your hands before you get started.

I spent a little time this week looking at unit-dose distribution systems. Most of the articles I read on the topic kept referring back to Chapter 10 Unit-Dose Distribution Systems in Making Health Care Safer: A Critical Analysis of Patient Safety Practices from AHRQ. The information on the site is good, but a little out of date. Actually I should say the information is old (2001), however it’s still applicable. How disappointing is that.

I’ve been rummaging around in the Chrome Web Store recently. The web store is growing rapidly and there are a lot of great applications to be found. Unfortunately, like all online app stores, there’s also a lot of garbage out there. Anyway, as I was trying out various applications this week I came across an interesting service called Diigo. Diigo is another in a long line of web-based applications designed to capture notes, bookmarks, images, etc, and help you organize and share that information in a somewhat coherent manner. It reminds me of Springpad. I’ll let you know more as I figure out how to use Diigo better.

Lifehacker: “The iPad is easily the best tablet you can buy right now, but that’s changing. Google showed off their upcoming tablets today, casting a spotlight on the iPad’s shortcomings.” – The Android OS vs. iOS war is as brutal as ever. Just read the comments following the post and you’ll see what I mean. Honestly I don’t think either the iOS or Android OS is the best platform for a tablet. The best possible platform for a tablet is one that seamlessly works across all devices and applications. Believe it or not, Microsoft currently has the best opportunity to make it happen. Notice I said opportunity, not chance. Don’t count Google out of the equation as they continue to dabble in just about everything these days.

Annals of Internal Medicine (Ann Intern Med. 2011;154:174-180): “High-Value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions – Conclusion: To preserve quality, we recommend careful assessment of both benefits and costs of interventions rather than focusing on either aspect alone. Evaluation of the effectiveness of interventions should include an analysis of both benefits and harms and use the best available evidence for each.” – This is an important distinction as I think many of us fail to see the long term implications of many of our decisions in healthcare. While this article is specifically addressing the clinical side of healthcare it could just as easily be applied to other areas as well such as automation, technology, safety, etc.

Annals of Internal Medicine (Ann Interm Med. 2011:154;160-167): “For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. Predicted inpatient deaths would increase by 1831 if all patients admitted with acute myocardial infarction were cared for in hospitals in the lowest quintile of spending rather than the highest. The association between hospital spending and inpatient mortality did not vary by region or hospital size.” – Hmm, and people think money doesn’t matter. So find the hospitals that like to spend money and avoid the ones that are trying to cut costs; easier said than done.

Agile Product and Project Management Blog: “Denial is incredibly dangerous because it enables a person to postpone facing reality and therefore delays the process of either identifying a different, feasible solution or recognizing that a company is currently on a fundamentally bad course and must change course. If you’re driving a car towards the edge of the Grand Canyon but are acknowledging the data provided by your eyes, you’ll realize you must stop or turn. But if you deny the data your eyes are providing, you can drive straight over the edge of the cliff to your doom.” – More than half the people I’ve worked with would simply drive off the edge and deny that it was a problem all the way to the bottom. Unless you talking about the people I’ve worked with in healthcare, then it’s more like 90%.

EMR Daily News: “Dr. David Blumenthal announced his resignation as health IT coordinator and will return to Harvard University where he had previously served as a professor.” – Now for the litmus test: will it make any difference? Probably not. People leave jobs everyday and the sun continues to come up.

ESPN: “The University of Iowa Hospitals and Clinics will fire three employees and suspend two others after an investigation confirmed they inappropriately breached the electronic medical records of hospitalized football players.” – Can you say HIPAA? When will people learn? Sorry, that was a rhetorical question. People will never learn.

Speaking of HIPAA, last weekend while I was at a cheer competition with my girls their was a gentleman in front of me was using an iPad. I’m always curious to see what people do with their tablets so I looked at the screen. He was flipping through a patient’s medical record looking for something. When he found what he was looking for he wrote out a prescription. I am all about mobile technology and think it’s clearly the future of medicine, but I could see everything – the patient’s name, age, conditions, and medication list. The guy made no attempt to shield the screen from prying eyes. I assume he was a physician handling a call, but what a breech in patient privacy. Healthcare systems will never be able to secure medical records when healthcare professionals behave in such a reckless manner.

There’s an interesting editorial in the February 2, 2011 edition of the New England Journal of Medicine. The editorial has a lot to say, but in a nutshell it says that academic medical centers are going to have trouble with the idea of an accountable care organization (ACO) model secondary to costs and reimbursement structure. “The effectiveness of ACOs will depend on the centralization of the administration of medical care, whereas clinical departments in medical schools operate on a decentralized model.” Looks like it’s time for a change.

Does anyone else think the ACO model is simply a rehash of the old “managed care” model that morphed into an “HMO” model? Feels strangely familiar to me.

For those of you that have had your head in the sand for the last couple of weeks, The Super Bowl is this weekend. We’ve got the Pittsburgh Steelers vs the Green Bay Packers. My wife is a huge Steelers fan so obviously the Steelers are the official pick of the Fahrni household. However, if I had to put money on the game I’d take the Packers. This should be a good one.

Have a great weekend everyone.

- True Grit was #1 at the box office last weekend. My family and I saw it a couple of weeks back. Not a great movie, but worth seeing. Let’s just say it’s worth the cost of a DVD rental. This weekend it’s all about The Green Hornet.

- I spent some time on the east coast this week; work related. It was cold and snowy pretty much the entire time I was there. Went through Virginia, West Virginia, Pennsylvania and New York. Of those places Virginia was my favorite. While I was in Virginia I had an opportunity to visit the University of Virginia Medical Center inpatient pharmacy. They’re doing some really cool stuff. I’m looking forward to a return visit a year from now to see what they’ve accomplished. I’d tell you my least favorite place during the trip, but that’s probably not Kosher.

- There was an interesting article recently in the Archives of Internal Medicine that discussed the effect of complex medication regimens on patient compliance. The article specifically looked at patients that were prescribed a statin or an angiotensin- converting enzyme inhibitor or renin angiotensin receptor blocker between June 1, 2006, and May 30, 2007. In other words they looked at patients with commonly prescribed medications. That’s a good thing. Reasons for lower compliance were discussed, and the article concluded that “Medication use and prescription filling for patients with cardiovascular disease is complex, and strategies to reduce this complexity may help improve medication adherence.” I don’t think that’s an epiphany as we’ve known this for a long time. Of course, as medication complexity goes up, adherence goes down. However, tucked deeply in the article is the mention of a “pharmacy home” where medication use is consolidated, simplified and pharmacists are involved directly with the patients. This is probably the most important takeaway from the article. One issue I have with the article is that none of the authors is a pharmacist. I find that disturbing. (Niteesh K. Choudhry, MD, PhD; Michael A. Fischer, MD, MS; Jerry Avorn, MD; Joshua N. Liberman, PhD; Sebastian Schneeweiss, MD, ScD; Juliana Pakes, MEd; Troyen A. Brennan, MD, JD, MPH; William H. Shrank, MD, MSHS. The Implications of Therapeutic Complexity on Adherence to Cardiovascular Medications Arch Intern Med. 2011;0(2011))

- HealthLeaders Media: “ The ACO model predisposes collaboration between hospitals and physicians who overall have not collaborated well with each other in the past.” – This from an article titled “5 Reasons Why ACOs Could Fail”. If you’ve ever worked in a hospital then you know that working with physicians can be, um, challenging. The hospital rarely, if ever, disciplines a rogue physician and unfortunately most physicians could easily be classified as rouge. It’s a hostile work environment to say the least. In order for healthcare reform to be successful the current relationship model between hospitals and physicians must change. No question about it.

- Journal of Advanced Nursing (PDF): “Large dose deviations or weight losses can occur while splitting tablets. This could have serious clinical consequences for medications with a narrow therapeutic-toxic range.” – I find this article interesting for a couple of reasons. First and foremost, compounding pharmacists have been saying this for years and people called them quacks. Several years ago I worked in a compounding pharmacy in San Jose, CA and the pharmacist there was adamant about the fact that tablets are not designed to be cut in half. The entire tablet contains the active ingredient, but there is no guarantee that the active ingredient is evenly distributed throughout the tablet. Chalk one up for compounding pharmacists who were well ahead of the curve on this one. The other thing I would like to point out here is the number of pharmacists listed as authors on the article. Bravo ladies and gentlemen. Why wasn’t this published in a pharmacy journal?

- The New England Journal of Medicine audio summary is available for the week of January 13, 2011. I’m telling you now that this is a fantastic way to deliver the abstracts from a particular journal. ASHP really needs to be doing this with the American Journal of Health-System Pharmacy (AJHP).

- My lovely wife bought me a Kindle DX for my birthday; that’s the big one. What an awesome device. It makes reading books and PDF articles a snap. I love this thing. I can even get journal articles downloaded directly through Whispernet, Amazon’s free 3G on the Kindle devices. This includes issues of AJHP. Unfortunately it requires anther paid subscription, which kind of pisses me off considering I’m already an ASHP member and paid subscriber to the paper copy of AJHP.

- I can’t believe I almost missed this one, but Motion Computing recently announced the release of the CL900 Tablet PC, a rugged, lightweight tablet designed for healthcare. I’ve only briefly looked at the device, but what I’ve seen so far is impressive. As you may or may not be aware, I am a fan of the Motion J3500 device and on the surface the CL900 looks like a smaller, lighter version. Cool!

- InformationWeek Healthcare: “As AT&T advances its healthcare strategy by providing technology that supports wireless, networked, and cloud-based solutions specifically for the healthcare industry, the company announced Tuesday that it will be partnering with Vitality to sell Vitality GlowCaps on Amazon.com.” – I think GlowCaps are pretty cool and even blogged about them here. With that said, I think the pricing structure is a tad bit high. According to the article “The Vitality GlowCaps will be available for $10 per cap and $15 per month for AT&T service.” Ouch!

- There’s a great on-demand webinar called “Use of Automation and Robotic Technology to Improve the Process for Preparing Compound Sterile Products” over at the ASHP Media site. The presentation is delivered by Bill Churchill of Brigham and Women’s Hospital in Boston, Massachusetts. I’ve heard Bill speak before. It’s worth an hour of your time.

- This is funny. The Borowitz Report: “Elsewhere, Verizon trumpeted its new iPhone, announcing, “For the first time, consumers will have a choice of which wireless carrier drops their calls.””

- Has everyone heard of Quora, the new social media website that has users ask and answer questions as “experts”. Can you say Wikipedia all over again? If I was going to look for information on how to change the oil in my truck I might have a look. Otherwise I’ll go to more reputable sources for my information. There’s an interesting little blurb over at hive.org by Dr. Chris Paton on Quora Health. Chris says, “There are already lots of questions and answers but, as yet, I haven’t seen many health professionals posting up replies. There are obviously lots of legal and ethical questions about giving medical or health advice through a site like this which may be deterring the professionals. This does mean, however, that many of the answers will be personal opinions and not backed by reliable evidence, and hence may end up being the wrong advice.” He makes a valid point, but who’s checking to make sure the information is reliable and evidence based? Please don’t go to sites like Wikipedia, Yahoo Answers, Twitter, Facebook or Quora for information pertaining to you or your family’s health. It’s just not a good idea.

- EHR reference in a comic strip? You bet.

- CES is over, but there’s a great article over at ReadWrite Mobile about the best new Android devices that appeared at CES 2011. I can’t tell you how excited I am to see all these new Android devices. Seriously, I am chomping at the bit to get my hands on all of them. Of course I’ll never see most of them, but that doesn’t matter. It’s the thought of seeing them and what the future holds that piques my interest.

- When do you think we’ll see the first physical Android Store? Think about it, something like an Apple Store or Microsoft Retail Store. People have a real interest and curiosity regarding Android tablets, netbooks and smartphones. With the exception of smartphones, it is nearly impossible to get your hands on any of these devices. Without playing with them for a few minutes it’s difficult to make a decision on which device to spend your hard earned money on.

- Ok people, it’s playoff time. This is the time of year that all football fans wait for. The BCS bowl disasters are over and it’s time to get down to business. On tap for this weekend in the AFC we have Pittsburgh vs. Baltimore and New York Jets vs. New England. And over in the NFC we have Green Bay vs. Atlanta and Chicago vs. Seattle. I like all the teams except New England. I hate the Patriots and hope they go down in a spectacular ball of burning white-hot flame. Otherwise I’ll just sit back and enjoy the games. Speaking of which, it’s time to go get comfortable on the couch.

Have a great weekend everyone.

Below is a list of opinions I’ve gathered over the past 12 months. Some are pharmacy related, some are technology related, some are personal, and some are just random thoughts.

And here we go…

Best idea for healthcare – An integrated healthcare solution; easier said than done

Worst idea for healthcare – An integrated healthcare solution. The current infrastructure won’t support it.

Biggest healthcare story of the year – Meaningful use and electronic health records (EHR)m

Biggest pharma story of the year - Withdrawal of propoxyphene from US market. Good riddance.

Biggest story in acute care pharmacy operations – Recalls and drug shortages; 2010 was the worst year in recent memory.

Best idea for new pharmacy practice model – PPMI from ASHP

Biggest disappointment in pharmacy practice – PPMI from ASHP

Biggest disappointment from a pharmacy organization – California Society of Health-System Pharmacists (CSHP). I reached out to CSHP regarding tech-check-tech in California and they blew me off. I received a generic response to my first email, then nothing from my follow up email back to them. It’s ok if your opinion is different than mine, but at least have an opinion. #Fail

Best idea in pharmacy that has yet to mature – Clinical Decision Support (CDS) and RFID

Best drug information resource, hardcopy – Lexi-Comp Drug Information Handbook

Best drug information resource, handheld/electronic – Lexi-Comp Lexi-Drugs

Best pharmacokinetics calculator, handheld/electronic – RxCalc for the iPhone, of course

Best medical reference, electronic/web based – UpToDate (includes access to Lexi-Drugs, online version)

Best customer support – Talyst – Disclaimer: I’ve been working for Talyst since the beginning of December 2010, but had this opinion log before then. That’s part of the reason I decided to go to work for them. I’m just sayin’.

Worst customer support – Integrated Informatics, makers of POMS

Best bar code scanner used this year – Code Reader 3500. Still my favorite.

Best article on bar-code technology – “Effect of Bar-Code Technology on the Safety of Medication Administration” NEJM 2010; 362: 1698-1707

Biggest bar coding challenge for me this year – Actually I had two challenges this year: 1) keeping up with bar-code changes from the manufacturers and 2) acting on analytics collected from out BCMA system.

Most valuable data collected – Data from our MAK (BCMA) system

Least useful data collected – Pharmacist intervention data. I just don’t see the value in continuing to collect data to justify our existence when no one does anything with it.

Best automated dispensing cabinet technology – Omnicell. While Pyxis is still king of the hill, Omnicell is chipping away with better R&D.

Best tablet that never was – Notion Adam Ink. The tablet looks great on video, and you can pre-order it, but I’ll believe it when I see it. You wonder why Apple is winning the tablet market; look no further than companies like Notion Ink and their year long tease.

Best eReader – Barnes & Noble Nook. Say what you will about the Kindle, but my daughter has a Nook and it’s a very nice, easy to use device.

Best eReader that no one is talking about – Barnes & Noble Nook Color. The Nook Color is an Android driven eReader with 7-inch LCD screen with touch interface, and it’s a great device.

Best information collection tool I used this year – Evernote. I couldn’t live without it. SpringPad is nice, but Evernote is still the big dog in this category.

Best file sync tool I used this year – Dropbox is simply awesome. SugarSync deserves mention. Microsoft has all the pieces in place, but has yet to deliver a coherent solution. Maybe next year boys.

Best screen capture utility – FastStone Capture. It’s light weight, easy to use and performs admirably. I use it all the time.

Best new desktop application I used this year – Skype

Best new smartphone application I used this year – Google Voice

Best convertible tablet PC I used this year –Lenovo X201 tablet PC, hands down.

Worst convertible tablet PC I used this year – Dell Latitude XT2 tablet PC. I used this tablet PC for about a year and always thought it was ok. That was until I purchased a Lenovo X201 tablet PC. Now I consider the Dell as an overpriced piece of junk.

Best slate tablet PC I used this year – Motion Computing J3400. The J3500 is the updated version of the J3400 rugged slate tablet. As far as Windows based slates go, I don’t think you’ll find a better device in the current crop of tablets.

Coolest new concept for a tablet PC – The Dell Inspiron Duo. I would love to see more tablet PC manufacturers use this design concept.

Worst marketing campaign for a tablet PC – The HP Slate 500. No wonder tablet PCs have such a hard time catching on.

Best not-a-tablet-not-an-ereader device – The Kno. Great concept, I hope it makes it.

Most popular “tablet” – Apple iPad

Most overhyped device – Apple iPad

Mobile device with the biggest impact on healthcare – Apple iPad

Biggest status symbol for physicians and executives in healthcare – Apple iPad

Most underrated “tablet” of 2010 – Samsung Galaxy Tab

Best tablet PC software – Microsoft OneNote. I use it all the time and love it.

Best PDF annotation software – PDF Annotator

Best tablet pc blogger on the ‘net – Warner Crocker (@WarnerCrocker) of GottaBeMobile.com.

Best UMPC blogger on the ‘net – Steve ‘Chippy’ Paine (@chippy) of UMPCPortal.com.

Most interesting blogger on the ‘net – Louis Gray. He blogs about things that interest me, and he appears to be less biased than most. I can appreciate that.

Best everything mobile site on the ‘net – GottaBeMobile

Best gadget site on the ‘net – Engadget

Coolest gaming gadget of the year – Kinect for Xbox. Bought one for my nephew for Christmas. Man, what a blast. And that doesn’t even include what you can do with it once it’s been hacked.

Best new smartphone – Samsung Galaxy S and the iPhone 4. Bought my daughter a Samsung Fascinate for Christmas and let me just say that it is one phenomenal smartphone.

Biggest surprise in the smartphone market – Windows Phone 7. I spent some time playing with one at the Microsoft Retail Store and it was really nice.

Biggest tragedy in smartphones – Basically the webOS died in 2010. I hope I’m wrong because the user interface is really something.

Most functional smartphone – Android smartphones. Take your pick.

Most exciting developments in an operating system – Android. It’s only just begun.

Best smartphone user interface – iPhone 4. HTC gets honorable mention here.

Most exciting non-hardware smartphone development – HTCSense.com. The website is a series of connected services for security, backup and remote control of your HTC device. I’m surprised Google hasn’t done something like this already. The potential is off the charts.

Best meeting/conference attended – ASHP Midyear 2010

Best advice I received in 2010 – Change jobs

Best presentation attended – There were two presentations I attended at this year that really caught my attention: 1) Alternatives to Barcoding: RFID and RTLS at the unSUMMIT and 2) Better Patient Care and Safer Staff with IV Compounding Automation at ASHP Midyear

Best presentation I gave this year – Hard to say really, but the presentation I did for Nova Southeastern University titled “Pharmacy informatics – One pharmacist’s perspective” had some pretty good informational content.

Best webinar attended – Barcoding End-to-End Solutions: From Pharmacy to Bedside. This webinar featured Dr. David W. Bates and Dr. Eric Poon from the NEJM article mentioned above.

Best vendor I worked with this year – Talyst

Worst vendor I worked with this year – Siemens

Best RSS Reader – Google Reader

Best email client – GMail

Best online collaboration tool – Google Docs

Best new thing that people won’t use – Google Buzz

Best search engine – Bing is gaining, but Google still rules.

Best browser for Windows machine – Google Chrome has now overtaken Firefox as my browser of choice.

Best extensions for Google Chrome
1. Chromed Bird
2. Clip to Evernote
3. Session Buddy
4. iReader
5. Docs PDF/PoserPoint Viewer (by Google)
6. Awesome Screenshot

Best consumer cloud provider – No brainer, Google

Most impressive push into the cloud – Microsoft with Window Azure

Best Twitter client for Android – Seesmic

Best Twitter client for the iPhone – TweetDeck

Best Twitter client for the desktop – Don’t know. I no longer use a desktop client for Twitter. I now use a combination of the Twitter website and the Chromed Bird extension for Google Chrome.

Best desktop operating system – Windows 7. I don’t care what anyone says, I like it.

Most exciting new development in a desktop operating system – Google Chrome OS. I’ve only seen glimpses of it, but I’m excited about its potential.

Most frustrating computer upgrade – Mac OS X Snow Leopard. I was forced to upgrade my 21-inch iMac  secondary to the purchase of an iPad. Following the upgrade it became slow and unresponsive, basically turning it into a very expensive paperweight.

Number of movies my wife, Lori and I saw at the theater this year – 47

Best movie that I saw in the theater- This is tough for me. I think I’m going to go with:
1. Iron Man 2
2. Red
3. How to Train Your Dragon

Most overhyped movies that I saw in the theater
1. The Other Guys
2. Harry Potter and the Deathly Hallows (Part I)

Worst movie that I saw in the theater- The American with George Clooney. The Wolfman was a close second.

Worst trend in movies – 3D. Someone please knock some sense into these people. I don’t know anyone that actually likes 3D.

Biggest grossing movie of 2010 – Toy Story 3. It did over $400 Million at the box office. Avatar actually grossed more domestically in 2010, but it was released on December 18, 2009.

Most overused word of 2010 – Meaningful use. I still don’t fully understand what it means.

Most valuable lesson learned in 2010 – Don’t wait so long to make a move and let people know what you want.

Best thing I did for myself – Changed jobs

Biggest surprise about my new job – The laptop assigned to me is older and in worse shape than the one I used to complain about when I worked in the hospital. Doh!

Best thing about the new job – The people and the projects.

Worst thing about the new job – Having to wear a “jacket and tie” when visiting “customers”.

Coolest commercials on TV – Geico (Therapist Sarge and Woodchucks) and E-trade (Solitary)

Worst advertising campaign – Visa and their Never Miss a Super Bowl commercials. Meet Larry “I’ve missed weddings. I have missed babies being born. But I have no intention of ever missing a Super Bowl, ever.” Makes me want to turn off the TV and spend a little time with the family. I assume that wasn’t Visa’s intent.

Best YouTube video of 2010 – iPhone4 vs HTC Evo. If you’ve ever met an Apple cultist, errr, I mean fanboy then you know they can’t be reasoned with because their minds are sealed off from rational thought. Baa-baa!

Biggest surprise in professional football – The Kansas City Chiefs. Well done.

Biggest disappointment in professional football – The Arizona Cardinals. What a difference a year and the loss of Kurt Warner makes.

Gutsiest coaching decision in professional football – The New Orleans Saints decision to open the second half of Super Bowl XLIV with an onside kick. Wow.

Best catch in the NFL 2010 – Randy Moss one-handed TD catch against the Jets. Crazy.

Biggest what-the-heck moment in pro sports – Jets assistant coach Sal Alosi tripping a Miami Dolphins player during kick coverage

Biggest disappointment in college football – Boise state losing a game and not going undefeated

Worst system in the universe to determine a sports champion – The BCS. Unfortunately it seems to work out year after year as teams like Boise shoot themselves in the foot.

Worst professional sport to watch on TV or in person – Major League Baseball

Best professional sport to watch on TV or in person – The NFL of course.

Most visited post on this website in 2010 – Best iPhne/iPod Touch Applications for Pharmacists originally posted September 14, 2009

Biggest blogging disappointment this year – My former employer censoring my blogging by whipping out a “social media” policy. Nice!

Here’s to a New Year full of new and wondrous things.

• The Chronicles of Narnia: The Voyage of the Dawn Treader was #1 at the box office last weekend. I haven’t seen it yet because my girls have no interest in it. That’s just weird. I thought for sure it would be at the top of their list. Tron Legacy is out and I’m really looking forward to seeing it this weekend.
• It’s unfortunate, but it looks like the RIM BlackBerry PlayBook won’t be making a public appearance until March 2011. RIM is doing some interesting stuff, but is it too little too late? Only time will tell. When I was in San Francisco this week I had the opportunity to interact with some Product Managers from RIM. When I asked them about the PlayBook they wouldn’t even confirm that it existed. Really? C’mon.
• I am, without question, a proponent of cloud computing. The potential of such a platform cannot be ignored. And like it or not the market is demanding that industry move in the direction of the cloud. Security is always a big issue with people and seems to be the battle cry for those that oppose it. Here’s one example at Coputerworld UK where Simon Phipps comments that cloud computing may not be the future platform of choice secondary to circumstances outside the technology, i.e. people, politics and service. He has a valid point, but all technologies suffer from problems. The cloud environment won’t be any different.
• If you’d like to see an alternate view on cloud security take a look at the Practice Fusion Blog. The authors spend a little time talking about some of the security benefits of the cloud.
• There’s a great article at GottaBeMobile that talks about the various technology failures and success of 2010. I don’t agree with everything on the lists, but I do find the list of successes interesting as Android based devices appear as four of the ten items on the list. Android is a disruptive technology that will continue to grow until something bigger comes along. And that could take a while.
• Check out the Laciefloat, a harddrive with trackpad. How cool is that? You can find more information at the Yanko Design site. The QR Code at the right will take you there.
• digitalHealth Summit: “The Digital Health Summit at the 2011 Consumer Electronics Show focuses on the booming market of consumer-based health and wellness innovations that sit at the convergence of technology and healthcare.” – The only questions I have are why haven’t I heard of the digitalHealth Summit before and how do I get it.

• What You’ll See
  • Telehealth Systems
  • Therapeutic & Diagnostic Medical Devices
  • Remote Monitoring Devices
  • Mobile Health Applications
  • Secured Wireless Communication Medical Devices
  • Medication Monitoring Equipment
  • Mobile Health Devices
  • Robotic Prosthetics
  • Personal Health Records
  • Communications Networks
  • Telemedicine Systems

• mobilehealthnews: “Worldwide about 70 percent of people are interested in having access to at least one mHealth application, according to a new research report from Pyramid Research. “ – No surprise as mHealth has become a new buzzword throughout the healthcare industry.
• I recently saw a commercial with a guy sitting on a beach using his smartphone to print a document on a printer halfway around the world. Great concept and it’s available as Web-connected printing through HP. There’s certainly a need for such functionality in a world screaming for instant gratification.
• Medscape for Pharmacists has a list of top 10 Medscape articles in 2010. Unfortunately access to the article requires registration, but the top 10 articles for 2010 were:

1. Is Hookah Harmful?
2. Abbott Withdraws Sibutramine From Market
3. Gemtuzumab Voluntarily Withdrawn From US Market
4. FDA Restricts Rosiglitazone; EMA Pulls the Plug
5. Potential Interaction Between Clopidogrel and Proton Pump Inhibitors
6. FDA Issues Second Warning Against Treating Leg Cramps With Quinine
7. Best Evidence Interview: CINODs — The NSAID Holy Grail?
8. How Can Leg Cramps Be Treated?
9. NDM-1 — Making Resistant Bugs in New Ways
10. DTaP-Tdap Mix-Ups Now Affecting Hundreds of Patients

• ASHP News: “Some pharmacists say the loss of propoxyphene will not be much of an issue for practitioners.Suzanne Nesbit, clinical pharmacy specialist in pain management at the Johns Hopkins Hospital in Baltimore, said the drug is on the formulary but now has a “special alert” about the market withdrawal.” – Propoxyphene is a terrible medication, especially in combination with acetaminophen. I’m glad to see it gone from the market.
• Medical News TODAY: “The release of the AIHW report today that shows more than 80 per cent of all premature deaths are due to chronic disease highlights the importance of a collaborative healthcare model to help deal with the growing pressures of chronic diseases. Pharmacists can play a bigger role in helping to manage chronic conditions as part of a collaborative health-care team. As medicine experts, they are often the first point of contact from patients suffering from chronic conditions.” – Hmm, where have I heard that before. That statement is 20 years old. I think we need to come up with a new one.
• The College Football season is basically over. Now I just have to sit around a wait for the bowl games to arrive. Like every other red-blooded American I will have myself plopped on the couch New Year’s Day watching football and eating myself silly. I can’t wait.
• On the other hand, the NFL season is heating up and everyone is getting ready for a playoff run. I’m in one of those precarious positions again this year as some of the teams I despise are still in the running. I loath some of those teams so much that if they get into the Super Bowl I won’t even watch it. Let’s hope that doesn’t happen.

Have a great weekend everyone.

• Tangled was #1 at the box office last weekend. I haven’t seen it, so really can’t comment on the movie. My wife and I went to see Faster instead. It was exactly what you would expect from Dwayne Johnson playing a touch good-bad guy. I’d see it again.
• I found an interesting article about a company called RCG Holdings Limited. RCG specializes in the commercialization of RFID and biometrics technology. “The Group offers a vast service of products and solutions, including RFID-enabled asset management systems, machine to machine (M2M) and Internet of Things (IoT) applications. It has developed an intelligent surveillance system using facial recognition technology called Fx Guard Windows Logon, which has been adopted by international computer manufacturers like Acer and NEC.” The FxGuard Windows Logon really caught my attention. You can find more information here. It’s pretty cool stuff.
• GottaBeMobile: “The QNX operating system was unveiled for the company’s forthcoming BlackBerry PlayBooktablet, which boasts a smooth operation with multimedia prowess and multitasking capabilities. Since the PlayBook was unveiled, RIM has been forthcoming in saying that the next-generation OS would appear in the company’s smartphone offerings as well and won’t be limited to tablets, demonstrating the scalability of QNX much like what Apple has done with iOS, Google with Android, and Nokia and Intel with MeeGo.” –RIM is doing some remarkable things, evident by the video below. My only concern is that it may be a little too late as the iOS and Android operating systems are slowly becoming the two giants in the industry. Only time will tell.

• There’s a great article at EMR Daily News that discusses the differences between SaaS and hosted solutions. As so eloquently put in the article “These terms [SaaS and hosted] are sometimes used interchangeably and they shouldn’t be. If you’re hearing these terms from the vendors you are speaking with you need to understand the difference.”
• I found an excellent list of things to consider when designing a user interface (UI) at the Ellen Beldner website. The list includes great tid-bits like “When in doubt, take it out” and “Users matter more than we do”. Healthcare vendors could certainly learn something from this list of recommendations for UI design.
• There’s been a lot said recently about the use of telemedicine including telemonitoring of patients and telepharmacy to handle remote checking. I think the concept is great, but I’m not quite sure where it fits in the overall scope of things. A recent New England Journal of Medicine (N Engl J Med 2010; 363:2301-2309) article found that using telemonitoring for patients with chronic heart disease didn’t improve outcomes. I can’t say that I’m surprised by this, as heart failure may not be the right disease state to employ heightened monitoring and interaction. Disease states where medication timing and compliance is crucial like diabetes and HIV might be worth exploration. Information presented at the mHealth session at ASHP Midyear where SMS reminders were successfully utilized in those disease states reinforces this idea.
• Clinical Transplantation “Taking Immunosuppressive Medications Effectively: A pilot randomized controlled trial in adult kidney transplant recipients” ( published online Nov. 16): “Using a randomized controlled trial design, 30 adult renal transplant recipients were screened for medication non-adherence using electronic monitoring. Fifteen non-adherent participants were randomized to receive either a continuous self-improvement intervention or attention control management.” The electronic monitoring consisted of medication bottles with microcircuits that recorded information on medication compliance and wirelessly transmitted the data to the healthcare provider. The study concluded that “The continuous self-improvement intervention shows promise as an effective and feasible approach to improve medication adherence in adult renal transplant recipients.” So a little bit of technology plus gentle reminders equals better compliance. Go figure.
• Pharmacotherpy: “Clinical pharmacists have served as principal investigators on a wide range of grants and contracts from all available funding sources, including peer-reviewed funding from the National Institutes of Health (NIH). Most important, clinical pharmacist development needs to be an academic and practice priority to ensure an adequate supply of clinical pharmacists as principal investigators to continue making substantial and meaningful contributions in meeting the needs of patients, improving public health, and expanding the roles of clinical pharmacists.” Well there you have it. I find it interesting that people keep saying the same thing over and over again. All pharmacists know this, so what are you going to do about it? Writing another article with outdated information certainly doesn’t help.
• Here’s an interesting product at IDAutomation.com: Native Barcode Generator for Google Docs. It’s a little pricey, but worth a look.
• This video at the Beacon Community site says it all. “Death by decimal point” and “it’s about system design”. Someone gets it.

• Wolters Kluwer is busy gobbling up various pieces of the healthcare market. From the EMR Daily News site: “Wolters Kluwer Health’s unit Lippincott Williams & Wilkins (LWW) today announced the acquisition of iCare LLC, makers of iCare EMR, an educational Electronic Medical Record (EMR) software program.” Last week they acquired Pharmacy OneSource, the maker of some pretty cool pharmacy applications. What are they up to?
• Interested in an eSeminar on mHealth? Well look no further than the HIMSS Event Center website where you can register for “Mobility and Population Health: A Clinical Case Study on the Role of Mobile Devices – The mCare Project”.
• MobileBeat: “Google’s Andy Rubin tweeted last night that over 300,000 Android phones are activated daily— that’s up from 200,000 daily activations in August. The news puts Android’s daily activations over both the iPhone and BlackBerry, and it even surpasses Nokia’s 260,000 daily Symbian activations (though research firm Canalys says those numbers may be closer to 325,000), Fortune reports. Android’s daily activations also point to Google nearing 10 million Android activations a month.” – It appears that people throughout the universe are beginning to realize they have a choice in the matter. Hmm, why would anyone want a choice? According to Apple we’re all supposed to just shut up and do as we’re told. Fickle people.
• I really love Acer’s ingenuity. At a press release last week, they announced the details for a dual-screen tablet, the Iconia. It sports a pair of 14-inch touchscreens. Here’s hoping it makes it to the market so we can all have the opportunity to drool on it.
• Google just keeps rolling along. It looks like the Google operating system and Chrome OS notebook will be available sometime early next year. Take a look at the video below showing a demo model of the Cr-48 Google OS notebook. I must say that I like the looks of the thing. They’ve clearly taken queues from Apple and their line of MacBook laptops. Nothing wrong with that. I’ve been wondering for quite some time when someone was going to start doing that. I love you Google.

• The activity at my site was pretty much status quo, but between Sunday, December 5 and Friday, December 10 the posts on Midyear were clearly on everyone’s mind. Here are the top four posts from those dates. See a trend?:

1. #ASHPMidyear rolls on
2. #AHSPMidyear, the end
3. #ASHPMidyear 2010 part deux
4. #ASHPMidyear day one comes to an end

• Time for a quick rant. Please avert your eyes if you don’t want to see it. Twice while at ASHP Midyear someone commented on the fact that I wasn’t wearing a “coat and tie”. I don’t like to wear a coat and tie. Never have and never will. I come from a fairly humble background and didn’t consider wearing a suit until much later in life. Will I wear one when required by my employer for my job? Of course I will. Someone is paying me to be a cog in the wheel. A grunt if you will, and as long as I take their money I’ll do as they ask. As I’ve said before either live with it, change it, or move on. However, when I’m on my own time I wear what I like. I dress in a professional manner most of the time and that should be enough. For some reason people equate a business suite with intelligence and station in life. I don’t. My initial thought of someone in a suit is that they’re trying to distract me from the important stuff by presenting me with something shiny, i.e. like a used car salesman. So, if you want to sit down with me and shoot the breeze or talk about informatics, pharmacy, life, kids, football, or whatever, feel free to approach me. I’d be happy to talk your ear off. On the other hand, if you want to size me up by what I’m wearing, don’t bother. I’m just sayin’.

On with the things that I found interesting this week.

- Megamind was #1 at the box office last weekend pulling down a respectable $29 million. I haven’t seen it yet, but would like to. As everyone already knows, the new Harry Potter movie is out and that’s all you’ll see in the number one slot for a while. I find the Potter movies entertaining, but don’t see what all the hype is about. Some have been good, and a couple of the releases have been fairly boring to be honest. Regardless, it’s on my list of movies to see. Probably as soon as tonight.

- I use a DROID for most of my mobile communication needs. I’ve come to rely on the onscreen touch keyboard because I find it a lot better than the physical keyboard on the device. Fast Company has a great post on 5 Alternative Android Keyboards. I’m really impressed with SlideIT, and being an old Palm guy, I’ve tried Graffiti for the Android. It’s pretty cool. Check out the videos at Fast Company.

- The Samsung Galaxy 7-inch tablet has made quite a splash. I’ve read many of the reviews and they’re all over the board. Take each one with a grain of salt. If you’re an Apple Fanboy, you probably won’t have much good to say. If you’re an Android lover, then you’ll have lots of good to say. I’ve had a couple of opportunities to play with the device and I like it. I like it a lot. It’s very responsive and the familiar interface – I’m a DROID user – makes getting around a breeze. I would like to see a wireless only version as I really don’t need the 3G. Regardless, it’s on my Christmas list of mush have toys.

- One of the great potential uses for the new wave of slate tablets is web conferencing. That’s one of the reasons I think the Cisco Cius may be a device for enterprise to take a good hard look at. According to TechCrunch, Fuze – a provider of web conferencing services – has announced an “Android tablet app [that] includes VoIP so users can attend a meeting via their tablet even if they don’t have a phone nearby.” Nice.

- Want to build an eReader Collection? Sounds cool doesn’t it. Take a look at the Digital Reader site. The author details how Duke University did exactly that. I thought about doing this myself as the bulk of keeping up with pharmacy literature can take up a lot of physical space.

- KevinMD (post by Jay Parkinson, MD): “We must design solutions by truly understanding how humans use tools, form communities, live, move, engage with friends, and love.” – Yep, makes sense to me.

- Interesting video at MobileBeat showing the speed of the BlackBerry PlayBook browser. See the video below. I can’t wait to lay my hands on a PlayBook. There’s something compelling about the user interface. Just a thought, but one thing I think tablet manufacturer’s should stop doing is comparing themselves to the iPad. It’s a mistake. The iPad owns the space at the moment, and it makes them look foolish in my humble opinion.

- Unofficial Google Blog: “If you have a phone or a tablet that runs Android 2.2+ or iOS 3.0+ and the Google Docs interface language is set to English, you’ll be able edit documents from your mobile device and the best thing is that you don’t need to install a new application.” – This is great news. Mobile phones, i.e. smartphones, are becoming the platform of choice for many people these days.

- Just in case you didn’t know, Wacom makes some incredible products designed with the pen interface in mind. If you have the opportunity make sure to check out the Medical & Healthcare section of their website, it’s really neat stuff. Don’t skip the case study page where you can read about the Radiation Therapy staff at Oregon Health & Science University (OHSU) in Portland, Oregon using Wacom’s interactive pen display technology. After browsing through the site I’ve decided that I need one of these. Note to self: add to Christmas list of must have toys.

- Healthcare IT Consultant Blog – “5 Reasons to Consider the Cloud for Health Data” ().

• It’s easy to access
• It’s cost-effective
• It imporves efficiency
• It puts patient information where it needs to be
• It’s user friendly

Umm, that about sums it up.

- NEJM This Week Audio – November 18, 2010. I absolutely love this format. It’s a downloadable mp3 file with this weeks article abstracts read out load. Simply awesome. AJHP should consider offering such a wonderful feature to their subscribers.

- GottaBeMobile: “10 Pounds of Apple Mobility – According to Apple’s spec sheets, the combination of my 15″ MacBook Pro, 13″ MacBook Air, iPad and iPhone 4 weigh just 10.3 pounds combined. Add in one AC adapter for both MacBooks, an iPhone/iPad charger and the weight of my backpack and the whole package is still less 13 pounds.” – A compelling reason to look at Apple products. My equivalent travel bag is well over 20 pounds. Just sayin’.

- Endgadget: “A team there led by Stephen Morgan and Michael Myrick [University of South Carolina in Columbia] have developed a so-called “blood camera” that uses a combination of infrared light and a transparent layer of the protein albumin — the latter of which acts as a filter and is able to highlight blood stains by filtering out wavelengths that aren’t characteristic of blood proteins.” - More information can be found at Analytical Chemistry, DOI: 10.1021/ac101107v.

- ASHP News: “FDA and Newport, Kentucky-based Xanodyne Pharmaceuticals announced today that the company has withdrawn its propoxyphene-containing products from the U.S. market over concerns about cardiotoxicity.” – It’s about time. What a worthless drug.

- Medscape – Ask the Experts – Is Vicodin the Right Choice for This Patient?

“The APAP [acetaminophen] dosage rules are:

* Patients should not take more than 4 g/day;
* Patients should take less than 4 g/day if taking it for a prolonged period of time;
* Elderly patients should reduce these limits to 3 g/day, or 2 g/day if taking it chronically; and
* Patients with liver insufficiency or a history of alcohol abuse should limit daily intake to 2 g and should not use APAP chronically (conflicting data exist on this point, but there are no studies of chronic use of APAP daily limits in this population).”

Vicodin is one of those drugs that is overused. Does it have a place in pharmacy practice today? Hardly. We have too many options for mild to moderate pain control. If you really need the hydrocodone consider something with more hydrocodone and less acetaminophen like Norco, Lortab 10/500, etc. Patients rarely, if ever, get themselves in to trouble with the hydrocodone in Vicodin. It’s usually the acetaminophen content that poses a challenge when several tablets are necessary to control pain. Of course mileage may vary and this is strictly my opinion. Take it for what it’s worth.

- There are some compelling games in the NFL this weekend like the Packers – Vikings, Colt – Patriots and the Giants – Eagles. Do yourself a favor and don’t miss out.

- And here’s my favorite commercial from this week. That kid makes me laugh, every time.

Have a great weekend everyone.