Saturday morning coffee [August 17 2013]: Elysium, Pharmacogenomics, Gonorrhea, Limo Joust

So 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 below comes straight from Canada. My family and I spent a little time in Victoria, British Columbia this summer. What a beautiful place. It’s a great little town, and we were blessed with awesome weather. It was sunny and in the 70’s-80’s the entire time we were there. We spent some time milling around the town, rented a car and drove around the beach areas, and took a short trek to Butchart Gardens. I’m not a gardens-type of guy, but Butchart Gardens is really neat. We took a boat tour of the area and stayed for the fireworks show that took place late one night. Great memories. I would do it again.

Just a quick side note: this is the last coffee mug in my collection. Not sure what I plan to do for my next SMC. Any suggestions?

Elysium was #1 at the box office last weekend pulling in nearly $30 million. Don’t expect it to stay at #1 as reviews have been so-so. I’d like to see it. With that said, Sony Pictures certainly has kicked out some dogs this year. Elysium had a production budget of $115 million dollars, and I don’t think it’s going to make that back in U.S. theaters. Smurfs 2 is another Sony flick with a production budget over $100 million ($105 million), and it’s only done $51 million in domestic box office to date, although foreign traffic for it has been good. And then there’s White House Down, Grown Ups 2, The Call, and After Earth, yikes! Sony, who is it that gets to decide what movies you make? Whoever it is you need to make a change. Just in case you were wondering, I’m available.

Jerry Fahrni unemployment chronicles, day #23: Plan B, and plan C have failed. I start looking for positions out of state on Monday.

It appears that I’m in deep trouble. From USA Today: “A new study, out Thursday, finds that heavy coffee consumption is associated with a higher death risk in men and women younger than 55. In the study published online in the journal Mayo Clinic Proceedings, men younger than 55 who drank more than 28 cups of coffee a week (four cups a day) were 56% more likely to have died from any cause. Women in that age range had a twofold greater risk of dying than other women. The study looked at 43,727 men and women ages 20-87 from 1971 to 2002.” Crap, I’m a man younger than 55 and I drink way more than 28 cups of coffee a week. I average about 10 cups a day…<bows head in shame>.

The most visited post at jerryfahrni.com over the past 7 days was Why pharmacy continues to fail. Pharmacists are so cynical. On a positive note What’s the single most important pharmacy technology introduced into pharmacy operations in the last 10 years was the second most visited post. It was actually the #1 viewed post day to day since it went up.

Speaking of What’s the single most important pharmacy technology introduced into pharmacy operations in the last 10 years, I received a few responses after posting on Wednesday night.

Jason Poquette, a.k.a. The Honest Apothecary has this to say: “From the retail pharmacy side – I tend to think the software and programming introduced to the Rx filling process has been the biggest improvement. Scanning Rx’s, powerful drug-interaction software (which, by the way, still takes LOTS of professional judgment to weed out the unimportant), barcode scanning of bottles in the filling process and visual verification, POS integration.”

Todd Eury of Pharmacy Podcast offered this: “I’d say the evolution of the pharmacy management system. From inventory advancement, automated billing functions, to custom workflow processes. The Pharmacy Software management system is by far the greatest impact on a pharmacy operations.”

Greg Hart (@greghartpa) via Twitter: “…how about changes in total that allowed move from distribution to clinical? Would be robotics (checking benefits),…ADCs to push dispensing to floors, Rx systems to get clinical info into hands in Rx / floor?…I do think clinical move has been big. Just think where Rx would be without it.”

Scott Landers (@scottlanders) via Twitter: “I believe u r correct.  No great Rx tech advance in last 10 yrs.EMR and Escripts?  Still waiting for this too improve retail Rx. Poor data entry by MD offices >= bad handwriting in # of errors” – Not exactly a ringing endorsement.

Lifehacker is asking viewers to vote for the best paper notebook. There’s some great information in the comment section if your’re interested. I still take a lot of notes on paper. I’ve tried going digital, but I’ve never been able to reproduce the ability to simply doodle. I’ve tried Moleskin notebooks, which come highly recommended by many. They’ve worked well enough. I’ve also used the old-fashioned Mead composition books. They’re ok. I’ve even tried college lab notebooks because they’re laid out in a grid. Those worked fine. Lately I’ve gone to a loose leaf approach. I purchase loose sheets of sketch paper and clip them together with a report cover. I’ve found that ideas come in spurts, and sometimes I want to add something to an idea a month later. In bound books that may be 20 pages ago. With a loose leaf approach I simply add the notes, put the page in order and snap it together. Simple.

Sometimes I don’t think people understand what Microsoft Surface Pro is all about. For whatever reason Microsoft has failed to make people understand that Surface is simply another piece of hardware running Windows 8. That’s it. Of course Surface is a piece of optimized hardware to showcase Windows 8, but it’s still just a tablet. You can replace a laptop with Surface Pro because it’s a tablet hybrid that includes a keyboard.  I like the video below because it shows how someone would use a Surface Pro tablet in place of a laptop for everyday things.

Elon Musk’s Hyperloop has been getting quite a bit of press lately. What’s a Hyperloop? Oh, it’s a high-speed transportation system. Medium has a nice little write up on it that’s interesting enough.

Here’s a cool concept: “Place the pill you want to identify on the printable recognition card and snap a photo of the card using the ID My Pill iPhone app. Your pill will be identified automatically!” Now why didn’t I think of that? The ID My Pill app can be downloaded only for iOS, which makes it completely useless to me, but someone might find it interesting. Check the video below.

Speaking of apps for smartphones, The RxEconsult site has a write up on the Top 6 Free Pharmacy Apps for Patients. The apps include: 1) RxmindMe, 2) MedCoach, 3) GoodRx, 4) Pill Monitor, 5) Pill Tracker, and 6) MedTracker. Click the link to the site above for more details on the pros and cons of each app. I really should download as many of these as I can and review them. It would give me something to do.

Pharmacogenomics has been a hot topic in pharmacy circles for as long as I can remember. When I came out of pharmacy school it was going to change the way we practiced pharmacy, and people were lining up to specialize in it because it was “right around the corner”. Here we are more than 15 years later and pharmacogenomics is still right around the corner. The topic pops up every once in a while, and this week it was in the MIT Technology Review. According to the article “A startup called Genome Liberty is developing a consumer genetics test to gauge an individual’s ability to metabolize prescription drugs. Consumers who get the Genome Liberty drug response test would send a sample of saliva to the company’s lab. The company scans the genome for DNA variations in 11 liver enzyme genes, which are a subset of the dozens of genes encoding enzymes for drug metabolism.” It will be interesting to see if this turns into anything of significance or if it sinks into oblivion.

This is cool, researchers stack E Ink paper like real paper. “A group of human computer interaction researchers from Canada have come up with a system dubbed DisplayStacks, which allows you to physically stack a bunch of flexible E Ink displays and make them interact with each other.“ Neat concept. I had an idea like this a while back. Had to go back through my idea books to find it. Turns out it was January 11, 2009.

Here’s some good news from the Centers for Disease Control and Prevention. “Two new antibiotic regimens using existing drugs – injectable gentamicin in combination with oral azithromycin and oral gemifloxacin in combination with oral azithromycin – successfully treated gonorrhea infections in a clinical trial”. Gonorrhea is sometimes difficult to treat, and the nice things about these regimens is that they’re simple, convenient, and relatively cost effective. Gentamicin has been around forever.

Want to read about a physician’s experience using the healthcare system we’ve built in the U.S.? Dr. Ashish K. Jha writes a weblog called An Ounce of Evidence. Dr. Jha is a practicing Internist physician and a health policy researcher at the Harvard School of Public Health. In other words he’s got some street cred. Recently he took a tumble, dislocated his shoulder, and wound up in the ED.  He wrote about it here. His take-aways from the experience: “People who work in hospitals can be wonderful” and “we have a lousy system”. Read the post. It simply portrays what happens countless times in hospitals across the country every day.

Hahaha! A limo joust. What could possibly go wrong?