Portable storage media, the scourge of patient privacy

LA Times: “Altogether, 16,288 patients’ information was taken from the home of a physician whose house was burglarized on Sept. 6, according to the UCLA Health System.

The data were on the physician’s external hard drive, officials said. Though the hard drive was encrypted, a piece of paper with the password was nearby and is also missing. The physician notified UCLA the next day and officials began identifying patients affected.”

I am continuously amazed at the number of security breaches involving patient healthcare information caused by careless use of portable storage media like external hard drives, flash drives, and even laptop hard drives. Patient information should never be stored or transported this way. I believe that utilizing cloud computing with simple browser access is a much better solution. 

What makes this particular incident so bad is the cause; reckless behavior by a physician. This wasn’t UCLA’s fault, per se. Sure, the medical center must accept a share of the responsibility, the lion’s share of the blame falls in the lap of the physician. Not only did the physician have sensitive patient information on an external hard drive, but was dumb enough to have the password to access the drive on a piece of paper next to it. Kind of defeats the purpose of encryption and passwords, doesn’t it.

For an eye-opening look at the magnitude of data loss and security breaches drop by DataLossDB.org sometime. It’s scary stuff.

Yeah, my Twitter account was hacked

A couple of nights ago I fell for a phishing scam on Twitter. I pride myself on being careful while online and especially when I use social media, so you can imagine my embarrassment when I discovered that I’d been duped.

Many of my followers were kind enough to tell me I’d been hacked prior to unfollowing me. And of course Twitter followed suite several hours later by sending me an email letting me know they’d reset my password and encouraging me to check my settings for suspicious third party apps. It didn’t really matter by then as I had already changed my password a couple of times. The damage had already been done.

I don’t typically believe in violence to resolve a problem, but this is one of those rare occasions where I think violence is the perfect answer. Just me, a locked room with the person who created the hack inside, a blowtorch, some sharp objects and a long rope with a noose at the end. Sounds fair to me.


Not everyone’s opinion should count

Contrary to what your mom told you as a kid, not everyone’s opinion should count.

There are several definitions for the word opinion. The one I like comes from Merriam-Webster and reads “belief stronger than impression and less strong than positive knowledge”. Opinions are beliefs; something you think. They are not rooted in fact – although facts can play a roll in forming an opinion – nor are they required to be acknowledged by anyone other than the one giving the opinion. You have your opinion and I have mine. What if they’re different? No matter because they’re opinions.

Where we get ourselves in trouble is when we start thinking of one’s opinion as fact, or something close enough to fact that is must be acted upon. I frequently see this when someone with “expert” stamped on the end of their name says something like “you should …” or “why don’t you …”. Instead of evaluating statements like these and thinking them through many people will simply accept  them as fact and act on them. This is a bad thing. Why? Because everyone has an opinion and they don’t often line up with each other. This is especially true in healthcare; pharmacy in particular.

crazyknifeWe have a habit of taking an idea, passing it around the table, collecting opinions and making every attempt to act on them all. I see this a lot with automation and technology. Hey, I’m all about functionality, but not at the expense of common sense. When you try to incorporate everyone’s opinion into a product you get the object to the right. I’m sure someone thought this was a good idea; someone must have requested all that functionality, right? Sure. It’s the most functional piece of utility equipment in the history of mankind, but practical it is not. Try putting it in your pocket. This is what many pieces of pharmacy automation and technology turn into once everyone’s opinion is taken into account.

This goes doubly when people start suggesting that something needs to be added secondary to safety; “that should be added because it’s a safety issue”. Ah, the battle cry of those that know their opinion can’t stand up to close scrutiny. I get this one all the time. I suppose walking around in a suite of chainmail armor and driving 25MPH on the freeway would be safer than the way we do things now, but I just don’t see that happening anytime soon. It’s just not practical. And at the most basic level we give up the marginal difference in safety for the efficiency and practicality of wearing jeans and t-shirts while driving 70MPH. It’s a matter of compromise between form, function and usability combined with taking a little responsibility for our actions.

You simply can’t replace human responsibility and accountability with automation and technology. We need people to be responsible for their actions. It’s the only thing that keeps us honest. Without it everyone’s life will be like Phil Connor’s (Bill Murray) in Groundhog Day before he figured it all out.

Why regulatory compliance is killing innovation in healthcare

Anyone that’s worked in healthcare knows about regulatory compliance. If not, then they should because it takes up about 50% of everyone’s time, energy and effort. I understand the theory behind regulations, i.e. protect the patient, but I think most of the time all additional regulations do is is create work for people that are already over burdened.

Ask a nurse how much time they spend documenting and double documenting things to meet some arbitrary rule or regulation. You’ll be surprised by the answer. Now ask a pharmacist or a physician. You’ll get the same ugly responses. I know a lot of my time as a clinician was spent generating documentation to cover my ass rather than helping care for a patient.

Unfortunately the need to comply with government agencies and silly rules inside the walls of healthcare has generated an unwanted side effect – lack of innovation. Why? Because all that innovative energy is spent on regulatory compliance instead of other, more useful things.

I’ve been involved in several conversations over the last month dealing with how to best use pharmacy automation and technology to increase efficiency and solve problems. Would you like to venture a guess as to what most of those conversations centered on? Yep, how to automate some documentation process or create technology to meet some new regulatory compliance. None of the discussions have been about providing better, safer, more complete patient care.

If you don’t think this is a major problem, think again. I was reading a blog by John Halamka last night in which he discusses the ‘Burden of Compliance’. In the blog John states that “[a]s we draft new regulations that impact healthcare IT organizations, we need to keep in mind that every regulation has a cost in dollars, time, and complexity.” Just remember, there is a finite amount of dollars and time floating around in healthcare these days. If a majority of those dollars and time are gobbled up by regulatory compliance, what does that leave for innovation to actually improve medication distribution, safe administration and better patient care? Precious little if you ask me.

Ever wonder why forklifts have roll cages?

I’ve driven my share of forklifts. I had several manual labors jobs before deciding to become a pharmacist. In fact, it was those manual labor jobs that helped me decide to go back to school and become a pharmacist in the first place. But that story is for another time.

I was searching for something completely unrelated to forklifts when I came across the video below. I was both horrified and amused.

How to make a profession vanish into thin air

magicThere appears to be a push in the pharmacy world to expand residency programs so “that, by 2020, postgraduate year 1 (PGY1) residency training should be required for entry into practice for all pharmacists who will serve in direct patient care roles.” This according to a recent article in the American Journal of Health-System Pharmacy. In addition the article states that “ASHP conducted a survey to determine if health systems were requiring specialized residency training—now known as postgraduate year 2 (PGY2) residency training—for clinical specialist positions10; 15% of the respondents indicated that such specialized training was required, and 67% indicated that a lesser-trained pharmacist would be hired to fill a clinical specialist position only if a candidate with specialized training could not be found.”  Basically acute care pharmacies are looking for pharmacists with more education instead of looking for good pharmacists.

Continue reading How to make a profession vanish into thin air

More fanboy douchebaggery

Someone, actually several people, posted this on Google+ today “Android is No. 1 in 35 countries, approaches 50% global market share”. The article attached to the headline can be found here.

Simple, right? Of course. It’s just someone passing on a bunch of shipment numbers from an article.

Enter the Apple fanboy:

#1 by what measure? Sales volume (# of units)? That is interesting, but Android still appears to be a very very distant 2nd (or maybe 3rd) in terms of application ecosphere for both users and developers. Compared to iOS, the typical Android app is flaky/buggy and incomplete….Android may be selling a lot of handsets, but they have a very long way to go to be the “#1″…”

I hate it when someone throws out an opinion like it’s fact. Saying something is better than something else with nothing more than an opinion is absolute worthless. Can you say something is faster? Sure, if you have the numbers to back it up. Bigger? Yep, piece of cake. Tougher? Absolute, if you have the data to prove it. More apps? If you know how to count. But to simply say something is #1 because the alternative is “flaky/buggy” makes you sound like a complete idiot. Unfortunately this is typical of the conversations I get into when iPhone users see that I use an Android smartphone or when I say I prefer Android over iOS. They just can’t understand why I’d use an “inferior device”. First of all I don’t think my Android smartphone is inferior. Furthermore I have reasons to choose Android over other operating systems, but they are my own. My opinion, my choice, my smartphone.

Is Android #1? I don’t know. I don’t care. And just in case you were wondering, the next time you feel the need to tell me how great your iDevice is, do me a favor and keep it to yourself.

Taking a break…

I started this blog more than two years ago at the behest of my brother, Robert. He and I used to spend a lot of time talking about technology and he encouraged me to put my ideas in writing in the form of a blog. It took quite a while before I finally took his advice, but eventually I got around to it.

It’s been quite a lot of fun, but my desire to keep up this blog has finally run its course. I find little interest in pharmacy technology these days as everything has turned into rehashed content presented under the guise of something new. The technology world has become one of followers with few true leaders and I find myself becoming more and more disgusted with “revolutionary” products and ideas. There are few real thinkers left in the world.

I watched Iron Man 2 last night with my girls. At one point in the movie Tony Stark tears his house apart to build the equipment necessary to synthesize a new element. Funny I know, but that image isn’t much different than one of the founding father’s of this country. Men like Benjamin Franklin, Thomas Jefferson and the like weren’t beyond punching a hole in the floor of their home to build a clock for example.  Those men were truly revolutionary thinkers. My brother and I have discussed the loss of such minds over time, and it’s disheartening.

I told myself when this blog was no longer fun that I would stop. Well, I’ve reached that point. I find myself generating more rants than informative posts these days. In fact this post went off in the direction of a rant for just a moment. I had to reel myself back in just to finish it up. But I’m not ready to completely give up on the idea of having a blog just yet. After some thought I’ve decided to just ignore it for a while and see if my interest returns. I’m skeptical that my interest will be jump started, but I think it’s worth a shot. Most of the time when I tire of something it’s usually for good. We shall see.

For now I’m taking a break.


Pharmacy Director needed…programming experience required?

As I alluded to in a recent post, I still get a fair number of emails and phone calls from pharmacy recruiters; actually got one of each today.

The following recruiter email arrived in my inbox a few days ago. I found a few things very interesting. Feel free to read the entire job description, but pay particular attention to the highlighter sections.
Continue reading Pharmacy Director needed…programming experience required?

The tail wagging the dog

WSJ: “The Food and Drug Administration said Tuesday that it will require some painkiller manufacturers to produce new educational tools in an effort to quell prescription-drug abuse.

The requirements will affect makers of long-acting and extended-release opioids, which include oxycodone, morphine and methadone.

Letters have been sent to manufacturers of the drugs describing the medication guides and tools for physician training that are now required, FDA Commissioner Margaret Hamburg said. The FDA will approve the materials, which will also be accredited by professional physician-education providers, she said, a step meant to combat bias in the materials.”

Oh. My. Gosh. Let me see if I can wrap my brain around this. The FDA is going to require that manufacturers of certain “painkillers” tell physicians how to properly use the drugs instead of requiring physicians to read the literature and do exactly what they’re trained and paid to do. Crud, it’s nothing a good pharmacist couldn’t fix. Why doesn’t the FDA simply require physicians to run these same prescriptions through a pharmacist for approval or give pharmacist prescriptive authority instead. It makes a lot more sense than putting the manufacturers in charge of the asylum. I would be utterly embarrassed if a drug manufacturer had to tell me how to properly use a drug because I couldn’t get it right. I think the healthcare system has officially reached a new low. Unfortunately this ain’t no limbo contest.