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The notion of a fully integrated electronic healthcare record across the entire health system is no longer pie-in-the-sky thinking. In reality, however, few hospitals have attained that level of technology penetration. But for those that have, the benefits are immense.

The basic principle of health-care treatment-"First, do no harm"-should apply also to the proper disposal of hazardous pharmaceutical waste. A new product, EcoRex, from Vestara in Irvine, Calif., is designed to achieve that end, using customized software to reduce the potential harm of such waste.

The Alaska Native Medical Center (ANMC) is the recipient of the 2006 Award for Excellence in Medication-Use Safety. McLeod Regional Medical Center and St. Joseph's/Candler Health System were honored as award finalists. The three sites were chosen by a multidisciplinary team based on four criteria: medication use system initiative/scope, planning and implementation, measurable outcomes and impact, and innovation and applicability.

Healthcare experts from two Michigan hospitals are helping the Food & Drug Administration find ways to prevent medical device errors. The FDA hired Beaumont Technology Usability Center (BTUC) late last year to help identify the causes of and risks associated with tubing and catheter misconnection errors. The move is part of an ongoing national effort by the FDA to closely monitor the safety of medical devices.

The results of a new study indicate that lower literacy and a greater number of prescription medications can lead to the misinterpretation of the instructions on prescription drug labels. The study, "Literacy and misunderstanding prescription drug labels," was released on-line in November and published in the Dec. 19 issue of Annals of Internal Medicine.

A 75-year-old man, D.P., is seen regularly in your hospital clinic for severe chronic obstructive pulmonary disease (COPD) as a result of a 50-year pack-a-day habit (FEV<50% predicted). He quit smoking last year but still admits to being a heavy drinker. His current medications include fluticasone/ salmeterol 250/50 mcg (Advair, GlaxoSmithKline) one puff twice daily and albuterol inhaler when needed. He has had several COPD exacerbations within the past year, necessitating oral steroid therapy. He was just diagnosed with osteoporosis: recent X-rays show two vertebral fractures. His physician is contemplating osteoporosis therapy. What do you recommend?

The National Comprehensive Cancer Network (NCCN) recently updated its guidelines for the prevention of emesis in patients receiving chemotherapy or radiation. The new guidelines serve as an update to the 2006 guidelines and are consensus based, with explicit review of the scientific evidence by a multidisciplinary panel of expert physicians and pharmacists.

There was a time when the diagnosis of cancer was ominous, but not anymore. Cancer has evolved into a chronic disease, with 95% of cancer patients treated in outpatient settings. Novel drug therapies and advances in radiation treatment have made many cancers survivable. That's good news for patients, and so is the fact that pharmacists are playing a more pivotal role in managing not only the clinical but also financial aspects of patient care.

CHD Meridian Healthcare, an I-trax Inc. company, appears to have struck the right note with large corporations seeking to bring on-site clinics to their employees.

Picture this. A man walks into a pharmacy to buy condoms. He hopes he can quickly whisk them from the shelf and pay for them without attracting attention. But ... they are locked up in a case along with the razor blade cartridge replacements. A note on the cabinet states, "Please ask attendant for assistance for items in this case."

What is Medicare Part D? What is the coverage gap? What's the best way to manage spending to delay or avoid reaching the coverage gap? What should seniors do if they are in the coverage gap? What medication options exist?

Legislation to mandate government negotiation on Medicare Part D drug prices has now passed the U.S. House of Representatives and been introduced in the Senate. And the debate has intensified across Washington. At a recent think tank session, Gerard Anderson, Ph.D., a health finance expert who has worked with Congressional Democrats, called for a law to let the government "trust in the markets, but make sure that they are working."

Seeking to provide hard data on the efficacy and impact of medication therapy management (MTM) sessions, a Florida Quality Improvement Organization (QIO) is studying the MTM results of Humana and AvMed Medicare patients in that state. The Florida Medicare Quality Improvement Organization (FMQAI) is working with the two prescription drug plans (PDPs) and pharmacists to set up the programs and educate patients and will publish its results in late 2007. FMQAI is the third-largest QIO in the country and has the second-largest beneficiary population.

On average, people who have a first cancer have a 14% higher risk of a subsequent primary cancer than the general population, according to a major monograph just released by the National Cancer Institute (NCI). The report, "New malignancies among cancer survivors," looks at two million cancer survivors over a nearly 30-year period and is called "by far the largest study to date of subsequent cancers."

The Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) recently released guidelines for the diagnosis and treatment of community-acquired pneumonia (CAP). These guidelines are the first collaborative effort between these two organizations on CAP guidelines. IDSA last updated its CAP guidelines in 2003.

New data from an innovative head-to-head phase II study of Abraxane (paclitaxel protein-bound particles for injectable suspension [albumin bound], Abraxis BioScience) versus standard Taxotere (docetaxel, Sanofi-Aventis) showed that weekly Abraxane boosted the tumor response rate by more than 60% over Taxotere given every three weeks in first-line treatment of metastatic breast cancer.

According to recent results from a Crohn's and Colitis Foundation study, 65% of patients with ulcerative colitis (UC) are poorly compliant with their medication. Now, a new therapy for the condition with once-daily dosing may offer patients a better chance for compliance. In January, the Food & Drug Administration approved Lialda, from Shire plc. Lialda is a delayed-release mesalamine product that utilizes MMX technology, a pH-dependent gastro-resistant coating that delays the release of the medication until it reaches the colon, the site of the inflammation in UC.

When it comes to the cost of dispensing medications and the dispensing fee paid by Medicaid, a new study confirms the bad news that many pharmacists already know. The national average cost of dispensing medications is $10.50 per prescription, not including the cost of the medicine, according to The Cost of Dispensing, a national study released recently by the Coalition for Community Pharmacy Action (CCPA). The coalition is an alliance between the National Association of Chain Drug Stores and the National Community Pharmacists Association.

More than 1.6 million physicians, pharmacists, and healthcare companies have registered for the new National Provider Identifier (NPI) numbers, but experts warn that time is quickly running out. Although the date of the switchover for the Centers for Medicare & Medicaid Services is May 23, officials at CMS and the National Council for Prescription Drug Programs (NCPDP) are urging pharmacists to be prepared by March 1 to ensure a smooth transition. And some payers, such as the state of Delaware, are requiring NPIs even before the May 23 deadline.