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John Poikonen
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Many Thanks to all the speakers that just were great at the RxTIGER event at AMIA Pre-Symposium.

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One of the best newsletters on PBM issues.......

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The recent botched executions got me thinking of the ethics of execution.  How can any health professional ethically participate?  As a pharmacists it is incomprehensible to consult or compound any set of drugs that would be used in an execution, IMHO.

It turns out Am Society of Health System Pharmacists (ASHP) has a policy on this:
"The decision by a pharmacist to participate in the use of drugs in capital punishment is one of individual conscience."  

Wow. What a cop out.

What ethical provision of any oath does participation in capital punishment comply with, exactly? IMHO - a disgraceful position.

My experience with ASHP is that it is a spineless CE factory that pretends to be a professional organization.   This is one more example of a long line of issues that they avoid and fail to stand up to support what is right. Disgraceful.


http://www.ashp.org/DocLibrary/BestPractices/EthicsPositions.aspx

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Save your $149. Answer is "not much". Wrong question. Ask: What is the impact on patient outcomes? What is the ROI? Same answer.

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Time for Bar code medication administration to go away and be replaced by Firefly technology 

Bar code medication administration (BCMA) is the biggest boondoggle in hospital pharmacy technology in my lifetime.    There is not a shred of evidence that it does anything to enhance patient outcomes.
The latest study on the evidence to prevent medication errors is completely unimpressive.  1% enhancement in medication error reduction in one group and no error reduction in another group.  So for a cool million (about the cost for a modest sized hospital), at best, you decrease medication errors by 1%, maybe.  The evidence suggests that barcode medication administration has a horrible ROI. 

Enter, Amazon to the rescue.  At the event to introduce their new phone on June 18, 2014, they showed off Firefly technology.  Take a picture of anything and....Boom, buy it on Amazon.  By all accounts it works well.  It is matching an image against a database.  Presumably millions of images.  So for the relatively trivial number of items to match in a hospital (~5,000 drugs, ~400 patients), can we please just use a cell phone picture to verify the right person with the right medication?  I would think so. 

http://www.ajhp.org/content/71/3/209.abstract 
http://www.technologyreview.com/news/528501/with-fire-phone-amazon-could-popularize-visual-search/ 
https://developer.amazon.com/public/solutions/devices/fire-phone 
http://gizmodo.com/firefly-lets-fire-phone-scan-just-about-anything-and-bu-1592717776

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Wow, the GOP party that can cure gays but not do anything about gun violence (or health care).

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From last year,  but worth repeating. A NRA spokesperson's reaction to learning there have been ZERO mass shootings in Australia since gun control went into effect in 1996? "Whoop-de-do."

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Nick P, ThePoikonenDynamic, doing a funk thing at the Fran Dagastino Memorial gig.  We all miss Fran.
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This has been around many times, and it may take many more times to get the message to Congress, but let's keep trying...this may or may not get the message across, but we have to keep trying!  Change has to be accomplished!

Think clearly about this, if they view themselves as ELITE (from us) as they have proven with their separate medical and retirement programs, then why not other programs.....

This is what Mark Levine has been talking about--a Constitutional convention by the States to get back to the laws of the Constitution.

This will take less than thirty seconds to read. If you agree, nothing to sign; just pass it on. This is an idea that we should address.

35 STATES SO FAR.....IT'S GROWING
One message to forward!
Governors of 35 states have filed suit against the Federal Government for imposing unlawful burdens upon them. It only takes 38 (of the 50) States to convene a Constitutional Convention.

For too long we have been too complacent about the workings of Congress. Their latest stunt is to exempt themselves from the Healthcare Reform that they passed ... in all of its forms. Somehow, that doesn't seem logical. We do not have an elite ruling class that is above the law. I truly don't care if they are Democrat, Republican, Independent or whatever. The self-serving must stop.

If each person that receives this will forward it on to 15 people, in three days, most people in The United States of America will have the message. This is one proposal that really should be passed around.

Proposed 28th Amendment to the United States Constitution: "Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators, Representatives of Congress; and, Congress shall make no law that applies to the Senators and/or Representatives that does not apply equally to the citizens of the United States ..."

You are one of my 15 (or more). Please keep this going.

PS: You can forward this message, or copy and paste it into a new message. While we still have that choice!
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