Saturday morning coffee [March 30 2013]

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

The coffee mug to the right comes straight from Moonstone Pottery in Los Osos, California. It’s a pretty cool mug. It was a gift from my brother, Robert. Thanks bro.

The Croods was #1 at the box office last weekend to the tune of nearly $44 Million. I didn’t see that one coming. I knew that the movie was out, but had no interest in seeing it. My family chose instead to see Olympus Has Fallen. It was terribly predictable and a bit corny, but I liked it. It was full of lots of gratuitous violence and gun play, which makes it my kind of movie. Just for the record, Jack the Giant Slayer has officially flopped at the box office. “Some people may joke about living on caffeine, but scientists now have genetically engineered E. coli bacteria to do that—literally. Their report in the journal ACS Synthetic Biology describes bacteria being “addicted” to caffeine in a way that promises practical uses ranging from decontamination of wastewater to bioproduction of medications for asthma.” – Now that’s my kind of bacteria. The journal article can be found here.

– There’s an interesting article over at U.S. Pharmacist about using PCAs in “older patients”. It’s pretty basic information, but worth a read if for nothing more than the section on medications used for PCAs; good summary.

– Eric Topol appeared on the Colbert Report to promote his book, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care”. Topol took the opportunity to demo some pretty cool mobile health technologies.

FDA Voice (FDA blog): “And serious problems at compounding pharmacies continue to occur. Just this week there have been two recalls of sterile compounded and repackaged drug products. In one recall, the presence of floating particles, later identified to be a fungus, were reported in five bags of magnesium sulfate intravenous solution, resulting in a nationwide recall of all sterile drug products produced by the pharmacy. In the other recall, all sterile drug products from a second pharmacy were recalled as a result of reports that five patients were diagnosed with serious eye infections associated with the use of repackaged Avastin.” – Compounding pharmacies continue to take it in the shorts. It’s going to get a lot worse before it gets better. The FDA should stay out of it. Remember, the FDA is controlled by the same people that brought you the IRS and the DMV.

– Finished reading Gone Tomorrow by Lee Child. It’s another Jack Reacher book. A friend passed it onto me after she was done with it. Good book. Highly recommended.

– Does anyone else reading this use Goodreads to keep track of their reading lists? I use it off and on. Apparently Amazon likes the service because they recently bought it. I don’t know what it went for, but reports are somewhere north of $100 million. Not bad, not bad at all.

– Here’s another great presentation from Rock Health called FDA 101: A guide for digital health entrepreneurs.

FierceHealthcare: Drug shortages force increased hospital costs, medication errors: “Treatment changes or delays stemming from cancer drug shortages lead to worse outcomes and higher costs, according to a national survey to be published in the April 1 issue of the American Journal of Health-System Pharmacy. Thanks to drug shortages, 93 percent [of 243 oncology pharmacists polled] reported delays in chemotherapy administration or changes in treatment regimens, 85 percent saw higher costs and 10 percent experienced reimbursement challenges.”

– Pharmacy Practice News:  Pain group says simple dosing change won’t fix prescription drug abuse problem: “Changing the label on opioid pain medications to limit their continuous use to 90 days would do little to stop drug abuse while depriving millions of Americans of the medication they need to live a reasonable life, according to a leading professional organization representing pain specialists.In written comments to the FDA, the American Academy of Pain Medicine (AAPM) renewed its commitment to fighting prescription drug abuse but warned that adopting the proposal could effectively eliminate the use of opioids for chronic noncancer pain, usually defined as pain lasting longer than 90 days.” The battle to curb abuse of prescription pain medications is far from over. The trick, of course, is finding a middle ground that will allow physicians to freely prescribe pain medications to patients that are in need without fear of retribution from regulatory agencies like the FDA.

– I received my Samsung Galaxy Nexus Android 4.2 Jelly Bean update last weekend. There are some pretty cool features rolled into the update such as Photo Sphere, the quick settings menu bar, lock screen widgets and a few minor UI tweaks. Overall it’s pretty cool. I’ve also noticed a bit of a slowdown in my phone when moving from one screen to the next, or when changing back and forth between applications. I’m not happy about that.

– I had to take a trip to Dallas, TX this week for work. Ended up flying on American Airlines. For those of you that don’t know me, I avoid American Airlines like the plague. I’ve never had a positive experience with those jokers; lost luggage, delayed flights, inability to check in, trouble getting a boarding pass through their online system, no record of my flight even though I have an email with confirmation number and flight info from them, etc. The trip started out fine, and I thought I was going to have to change my opinion of them; even if only slightly. But they botched it. My return trip got screwed up due to “mechanical failure”. Getting home turned out to be a bit of a hassle.

– While I was in Dallas this week I spoke to a small group of pharmacist about various pharmacy related topics. During one brief discussion I asked the pharmacists in the room if they saw any reason why a pharmacist needed to be physically in a pharmacy to help with the medication dispensing process. I said that I saw no reason for it, and that pharmacists would be “out of a job if it weren’t for the law requiring pharmacist to be present“. I expected some blowback, or at least some disagreement from someone in the group. Nothing. Crickets. What’s that say about the future of our profession?

– Just in case you were wondering, according to “Pharmacy Automation Systems Market – Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2012 – 2018, “the pharmacy automation systems market was valued at USD 4.7 billion in 2011 globally and is expected to grow to USD 7.8 billion by 2018”. Yeah, that’s a nice little number. What exactly do you think will cause this market to grow so readily? Do you think pharmacies all over the world will start automating like crazy over the next few years? I don’t see that happening in the U.S. anytime soon. We’re still crawling along like slugs.

– Ok, this is cool. There’s a website out there called Deep Fried Gadgets. Check it out if you have a minute.


– Anyone going to the ASHP Summer Meeting in Minneapolis, Minnesota? The meeting is being held June 1-5. Not sure if it’s worth attending or not. Feel free to drop me an email if you have any thoughts on attending. If you’re going to be at the conference let me know and we’ll grab some coffee and talk about taking over the world.

Point-Of-Care Corner: “The two biggest challenges with BCMA are implementing the hardware and integrating it with the various hospital IT systems.  The later has often been done by other hospitals that use your same IT systems.   The hardware piece has been done as well, but hardware implementations take time.  Think about the hardware implementation cycle time requirements: time to evaluate the hardware, time to order the hardware, time to get the order approved, time to receive the hardware, time to test the hardware, and time to implement the hardware.” – Not sure if I agree that these are the two biggest challenges, but they’re certainly in the top tier. My thoughts on implementing BCMA can be found here.

– Inability to access journal articles secondary to subscription requirements is really starting to piss me off. I used to read a host of journal articles on a wide range of subjects each and every week. Not anymore. Since moving out of the hospital environment I no longer have access to a medical librarian or a large group of journal subscriptions from which to pull. The concept of open source information is making more and more sense to me every day.

- I’ve been playing with a Samsung ATIC Smart PC 500T for the last couple of weeks. The 500T is an 11.6-inch Windows 8 slate tablet running an Atom processor. The pros: long battery life, the ability to run legacy apps, the S-Pen and the form factor. Cons: the Atom processor can be a little sluggish at time when you throw a heavy load at it, and the form factor. Yeah, I know I threw the form factor in there twice. The 11.6-inch screen is good for many things, but not so good for others. Overall I’ve been impressed with it. If you’re considering a non-Core Windows 8 slate, this could be the right machine for you.


– I’m still looking for a suitable Google Reader replacement. I’ve played with several. This week I circled back around to Feedly. I keep hearing good things about Feedly, but no matter how much I try to use it the results are the same, i.e. it’s not worthy. I will say that they’ve improved it’s usability for me by adding more “Google Reader like” features. And with the use of a little trickery you can make Feedly look and behave more like what I want. The Digital Reader has a good article on How to Make Feedly Look More Like Google Reader if you’re interested.

– I’m not sure what’s going on, but apparently March is a bad month for mental illness. I keep hearing people talk about March Madness. I can’t find a code for it in DSM IV so it must be either new or slang. Based on what I’ve heard it appears to be caused by lack of football on TV. With football between seasons people are having difficulty finding suitable sports to watch on TV and have resorted to some seriously deviant behavior. Fortunately football is just around the corner.

After the Sabbath, at dawn on the first day of the week, Mary Magdalene and the other Mary went to look at the tomb. There was a violent earthquake, for an angel of the Lord came down from heaven and, going to the tomb, rolled back the stone and sat on it. His appearance was like lightning, and his clothes were white as snow. The guards were so afraid of him that they shook and became like dead men.

The angel said to the women, “Do not be afraid, for I know that you are looking for Jesus, who was crucified. He is not here; he has risen, just as he said. Come and see the place where he lay. Then go quickly and tell his disciples: ‘He has risen from the dead and is going ahead of you into Galilee. There you will see him.’ Now I have told you.”

So the women hurried away from the tomb, afraid yet filled with joy, and ran to tell his disciples. Suddenly Jesus met them. “Greetings,” he said. They came to him, clasped his feet and worshiped him. Then Jesus said to them, “Do not be afraid. Go and tell my brothers to go to Galilee; there they will see me.” (NIV) – Matthew 28:1-10

That’s it folks. I off to do some physical labor. Have a great weekend, and Happy Easter.


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