Saturday morning coffee [March 7 2015]

“Your reputation is in the hands of others. That’s what a reputation is. You can’t control that. The only thing you can control is your character.” – Dr. Wayne W. Dyer

So much happens each and every week, and 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….

Focus was #1 at the box office last weekend, which isn’t saying much as it pulled in a modest $18.7 million on its opening weekend. I don’t think Will Smith has done anything worth seeing since Independence Day.  Just sayin’.

EHR’s have been picking up steam for several years now. It’s inevitable that the EHR will become “the norm” in a very short period of time. Paper charts will eventually become a thing of the past. However, there will be bumps along the road. Nurses at Antelope Valley Hospital in Lancaster, California had an EHR system outage on Feb. 27. It caused the hospital to close its emergency department. In addition, the hospital experienced problems dispensing medication, verifying physician orders, reviewing patient labs and other diagnostic procedures, and reviewing patient records. Also Rideout Health, a two-hospital system in Marysville, California also said that its EHR system went down for about a week in February. Apparently the cause for this outage was a HVAC unit that burned out. Doh! I understand that things can’t always be perfect, but this is completely unacceptable in a healthcare environment. (via: iHealthBeat).

Speaking of EHR’s, I really enjoy reading the musings of John Lynn at the EMR & HIPAA website. He has great insight in the EHR space. I don’t agree with everything he says, but he always makes me think. Most recently he posted some thoughts on the new Epic App Store. I think it’s going to create some major problems for healthcare in the long run. Here’s what John had to say: “I believe the Epic app store is a way for Epic to allow for distribution of these apps that have been created by their customers (often with a tech partner) to other Epic customers… Some might say that this focus is great… However, this approach misses out on the opportunity of the Epic app store facilitating entrepreneurial innovators to build something on top of Epic that their customers didn’t even know they wanted yet. Epics current strategy is more in line with staying the entrenched incumbent. Real transformation comes when you provide a platform for innovation that goes beyond yourself and your customers.” I agree.

NVIDIA announced a new console this week, the NVIDIA SHIELD Console, and from what I’ve read it’s pretty slick. NVIDIA has done some great things in the gaming space with their processors designed for mobile devices. The best part is that it runs Android, and it’s coming in at under $200.

Samsung has managed to do it again with their new line of Galaxy phones. This week Samsung took the wrappers off the Galaxy S6 and S6 Edge. To me the Edge is a slick new design that will likely push all smartphones in a new direction. It reminds me of when the first Note arrived on the scene many years ago. Every tech writer out there bagged on it for its size. Then the consumer market decided they liked it and the size of smartphone screens hasn’t been the same since. I get that feeling with the Galaxy S6 Edge. Not everyone is happy, of course. Samsung decided to do away with expandable memory and a removable battery. Those are two features that I think are important. Unfortunately, the average consumer doesn’t give a rip. The average consumer isn’t all that bright. They just want a pretty phone that can take selfies and send and receive group text messages. Only technophiles get hung up on such things. If you’re interested in reading about the S6 and S6 Edge, you can jump on over to Engadget.

medGadget: “Researchers at MIT are using nanoparticles made out of gold specs surrounded by a hydrogel to turn off tumors’ ability to develop drug resistance by inactivating specific genes. The researchers tested the therapeutic approach on a triple negative breast tumor that is normally very difficult to treat. The tumor contains a gene that codes for the multidrug resistant protein 1 (MRP1) that activates a mechanism within the cell that pushes chemo drugs back out, effectively making the tumor drug resistant. The MIT nanodevice has a molecular complement to the MRP1 gene that binds to and blocks the expression of this gene while delivering a dose of chemo drug 5-fluorouracil, destroying the tumor’s defense system while stabbing it with a toxic strike. Within their laboratory study, the researchers were able to shrink triple negative breast tumor by 90% within two weeks.” – I’ve said it before, and I’ll say it again, nanotechnology is going to change pharmacy practice forever. The combination of pharmacogenomics and nanotechnology will make cancer treatment – and the treatment of many other diseases – so much better than it is now.

The profession of pharmacy is in serious trouble. Bad decisions by leadership, coupled with an ever expanding number of jobless pharmacists is  creating a perfect storm for complete and utter destruction of pharmacy as we know it today. “Recently, in most areas of the United States, the workforce demand for pharmacists has been contracting, in contrast to the still increasing number of graduates. By 2016, 14 000 to 15 000 PharmD students are expected to enter the workforce. This will represent more than double the number of graduates produced in 2001, leading some to predict a looming joblessness crisis for the profession…In addition to the obvious effects of a pharmacist surplus, the academy should be cognizant of additional forces that may shape pharmacy practice. A rapidly evolving health care environment, increasingly influenced by factors such as advances in technology and health care reform, may equally, if not more significantly, influence pharmacy. The confluence of external health care factors and a surplus of pharmacists may herald seismic, significant, and sustained changes for the profession.” This excerpt was taken from a recent article in the American Journal of Pharmaceutical Education. While I don’t agree with everything in the article, I believe it points out some very scary truths.

Drug shortages are a major problem in healthcare. The issue seems to have gotten much worse over the past couple of years. Some of the causes are out of the control of the profession, and some are the direct result of poor inventory management strategies. This week the U.S. Food and Drug Administration released a mobile application designed to help pharmacies search for drug shortage information. You can grab the Android version here. Unfortunately, what the application doesn’t show is the stockpile of medications in short supply that are being hoarded by many hospitals in the U.S. Put that stuff back into circulation and some of the pains caused by shortages will go away. Just stating the obvious, folks.

Recently I started using Evernote as my main source for data collection. I had pondered the idea of letting go of my Premium subscription, but thought better it. As a consultant, I’ve found myself in the position of doing a lot of project management lately. Something I’ve always disliked, but it’s obvious that it’s something I’m going to have to do. Evernote has some great features that seem to make things significantly easier. Using the right combination of notebooks and tags, along with Evernot’s ability to set reminders creates nearly the perfect all-in-one system. I’ll try to let you know how things go as I fine tune my strategy over the next several weeks.

This is the worst time of the year for sports. There’s really nothing going on. I think basketball is well underway, but who really gives a rip about basketball. I heard something about spring training starting for baseball. Seriously? It’s March, and does anyone even watch professional baseball anymore? Ugh, such a terribly boring sport. I sit here patiently waiting for football to start. At least there’s NASCAR.

Have a great weekend everyone.