Saturday morning coffee [December 7 2013]

“There is never a better measure of what a person is than what he does when he’s absolutely free to choose.” – William M. Bulger

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….

LIFE: “President Franklin Roosevelt declared December 7, 1941 — when Japan launched more than 350 fighters, bombers, and torpedo planes against the U.S. naval base at Pearl Harbor in Hawaii — a “date which will live in infamy.” In fact, that Sunday morning is so seared into America’s memory that the tumult of the critical weeks and months afterward, as the U.S. responded to the attack, is often overlooked. Here, on the anniversary of Pearl Harbor, LIFE.com presents photos — most of which never ran in LIFE magazine — from Hawaii and the mainland, chronicling a nation’s resolute reply to an unprecedented act of war.” – Some amazing photos here. Roosevelt’s speech can be found here. I had an opportunity to visit the Pearl Harbor Memorial a few years ago. It was an amazing experience. One that is difficult to explain, but easily understood once you’ve experience it.

The Hunger Games: Catching Fire was #1 at the box office last weekend, and has been since it was released. I haven’t seen the movie, but my wife and daughter have. Both loved it. The movie has collected more than $300 Million in the U.S. with another $275 Million abroad.

I just finished reading “Inspired: How To Create Products Customers Love“ by Marty Cagan. Great book for anyone interested in product design or development, and a must for anyone thinking about working as a product manager.

I’m heading to ASHP Midyear 2013 in Orlando, FL tomorrow. I’ve been hired by a pharmacy technology company to be a “booth babe”, i.e. stand in their booth and answer questions about their product, and I’m excited to be going. If you happen to be at Midyear let me know, I’d love to hear from you. Perhaps we can grab a cup of coffee.

Is it just me or does it seem a little strange to have first class seats on airlines for domestic flights? Does anyone ever pay for those seats? Seems to me that a majority of those seats are offered free to frequent fliers. I’m sure it’s nice to have all those amenities, but wouldn’t it be nice if everyone had a couple more inches in their seating area? Just sayin’. I don’t rate high enough with United to get anything better than a seat in the cattle car. I’m not a big man – coming in at 6’ 1”, about 230 pounds – but those coach seats are a really tight fit.

My Evernote ‘clipping’ extension for Chrome stopped working yesterday. I’m a bit freaked out by that as I use it to clip a lot of web pages to Evernote. I also stated receiving a syncing error from Evernote last night. Not sure what’s going on, but I hope it’s only temporary.

It’s been a tad cold here in the Central Valley for the past few days; down into the low 20’s at night. It’s even possible that we could see some snow flurries, which is unheard of in these parts. My daughter is beside herself with excitement over the possibility of snow, no matter how minor. Unfortunately the citrus farmers hate it as it has the potential to cause a lot of damage to crops.

So, did Mike Tomlin do it on purpose or not? Tomlin was fined $100K for standing on the white stripe that borders the playing field and taking a step onto the field during Jacoby Jones’ kickoff return during the Steelers – Ravens game. I think he did it on purpose. Fortunately his actions didn’t change the outcome of the game.

Last weekend Alabama lost to Auburn on a spectacular play to end the game. This is the second spectacular finish for Auburn this year – Georgia game final play – and has effectively thrown the BCS rankings into total chaos.

I’ve been looking at IV room automation lately. Here’s a PDF version for a slide deck focusing on “Strategies for Minimizing Errors in I.V. Sterile Compounding”. There are some big names on those presentations like Rita Shane from Cedar-Sinai Medical Center down in Los Angeles, Eric Kastango, probably the foremost authority in the world on USP 797 and pharmacy, and Bill Churchill from Brigham and Women’s Hospital in Boston. If you’re at all interested in I.V. room safety have a look.

ComputerTalk for the Pharmacist: “We have seen a sector of healthcare, previously known for its lack of technology adoption, begin a complete about-face. One overall term for this sector is the “connected patient.” You may have known this sector as long-term care, nursing home, health services for the aging, independent and assisted living, or by other labels. This industry is truly reinventing itself in an effort to remain relevant and viable in a changing healthcare market.” – Technology has the potential to truly change how pharmacists interact with patients, especially in underserved populations like the elderly.

MedicalXpress: “An automated prediction tool which identifies newly admitted patients who are at risk for readmission within 30 days of discharge has been successfully incorporated into the electronic health record of the University of Pennsylvania Health System. The all-Penn team found that having been admitted to the hospital two or more times in the 12 months prior to admission is the best way to predict which patients are at risk for being readmitted in the 30 days after discharge.” – The article referred to can be found in the December 2013 issue of the Journal of Hospital Medicine, but there is a paywall in place.

It appears that medication errors are relatively common for patients admitted to mental health units. A recent study, published in the International Journal of Clinical Pharmacy, found that medication errors occurred in 212 of 377 (56.2%) of patients admitted to the assessment ward. The study was conducted between March to June 2012. The good news however, was that the errors were corrected by a simple pharmacy intervention performed by technicians. That’s right, technicians; pharmacy medicines management technicians to be precise. It’s clear to me that pharmacy technicians are underutilized. The full article is available online for free.

Here’s one I didn’t see coming. “Among patients younger than 65 [with diabetes], use of a mail order pharmacy was associated with significantly fewer overall emergency department visits (33.8% versus 40.2%, P<0.001), preventable emergency department visits (7.7% versus 9.6%, P<0.01), and serum creatinine laboratory monitoring tests following the initiation of angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy (41.2% versus 47.2%, P<0.01) compared with using a local pharmacy.” – Huh? Go figure. (Schmittidiel JA, et al “Safety and effectiveness of mail order pharmacy use in diabetes” Am J Manag Care 2013; 19(11): 882-887)

There’s a great post at KevinMD about “The problem with peer review in scientific publishing”. I’ve always been a little skeptical about how journals handle what goes in, and what ends up on the cutting room floor. Here’s the paragraph that says it all for me: “Flash back to 1998, when Annals of Emergency Medicine cleverly put together a fictitious manuscript riddled with errors and distributed it to 203 reviewers for evaluation. The errors were divided into major and minor categories. The major errors included such blunders as faulty or plainly unscientific methods, as well as blatantly erroneous data analyses. Minor errors consisted of failure to observe or report negative effects on study participants, incorrect statistical analysis, and fabricated references — just to mention a few. According to the authors, the majority of peer reviewers failed to identify two-thirds of the major errors in the manuscript. Forty-one percent of reviewers indicated that the manuscript should be accepted for publication”

Speaking of scientific literature (credit to McGill Vascular via this Tweet):

I read something interesting on Google+ the other day about potential uses for Google Glass. I cannot find the blurb, but the gist of it was that Google Glass has the potential to be a great tool for offering first person accounts on how to do something, i.e. a demonstration from the user’s point of view. That is an amazing idea, and potentially very useful in pharmacy operations. Having a demo video takes on an entirely new meaning. Something to think about anyway.

“I do not know where family doctors acquired illegibly perplexing handwriting; nevertheless, extraordinary pharmaceutical intellectuality counterbalancing indecipherability transcendentalizes intercommunications incomprehensibleness“. Yeah, about that. Notice that in this sentence the Nth word is N letter long, i.e. the first word is one letter long, the second is two letters long, and so on. Pretty cool. Hat tip to Twitter and Dave Walker for that one.

This is a very special time of year as we move from Thanksgiving into the Christmas season. A time when many of use do a little reflection and personal evaluation on just how blessed many of us are, and how some simply haven’t enjoyed such blessings. With that said, I’d like to mention two worthwhile charities that I choose to support here in the Central Valley: Fresno Rescue Mission and The Poverello House. Both do amazing work. Donating to such wonderful charities shouldn’t require the Christmas Season, but it’s worthwhile to mention nonetheless.

Have a great weekend everyone.