“What’d I miss?” – Week of January 9, 2011

As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.

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.

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