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Over the past several years, there has been a monumental push for hospitals to transition to electronic health records and computerized physician order entry, with the hope of standardizing and streamlining care, improving medication safety, and reducing errors. In fact, some studies estimate that more than 70% of prescriptions are now written electronically. Although CPOE has come a long way in a short period of time, is the technology living up to its potential?...CPOE systems are very fragmented both within hospital systems and between the hospital and the outpatient universe...CPOE in terms of safer medication prescribing is still a work in progress...We found several areas where CPOE systems fall short in terms of medication safety, and hospital pharmacists can play an important role in resolving some of these issues...

• CPOE and medication prescribing
• Interoperability
• CPOE aggravation
• The next frontier
• Room for improvement
• Hospital pharmacists’ role

When you have systems between inpatient and outpatient that don’t communicate, important information can get lost in translation…CPOE isn’t just a hospital pharmacy issue; it’s an issue for the profession at large...Pharmacy has a significant stake in the matter of CPOE, but we really are learning as we go along...that is why you see so much frustration between prescribers and the hospital systems. To solve the problem, multiple professions beyond just health care professionals, with different thought processes, will need to work together...

Zika virus infection, the scary new disease for which there is no vaccine or treatment, is “spreading explosively” from Africa and Southeast Asia...The United States and 20 other countries...have reported cases of the virus since Brazil reported the first cases of local transmission last May. Delivered by varieties of mosquitoes...it has boosted interest in mosquito-borne diseases...What’s needed is...modern genetic engineering techniques to more effectively prevent mosquitoes from delivering the viruses and parasites that cause disease….The FDA has long delayed the approval of a November 2011 application for a field trial to test a new biological control agent for the mosquito species Aedes aegypti. Although that field trial is concerned specifically with dengue fever, A. aegypti...also transmits Zika...Oxitec has created a new way to control Aedes aegypti. Male mosquitoes are bred in the laboratory with a specific genetic mutation that, in the absence of a certain chemical, causes their offspring to die before reaching maturity...This safe and effective control technique has been approved in Brazil and open field trials of these mosquitoes have been conducted in Brazil, the Cayman Islands, Panama and Malaysia...Eight months have passed since FDA promised last May to publish for public comment a routine environmental assessment of the Oxitec field trial in Florida. Only after FDA reviews the comments will FDA consider whether to grant approval. This delay is unnecessary and unconscionable.

Next week, Drug Channels Institute will release our updated, revised, and expanded 2016 Economic Report on Retail, Mail, and Specialty Pharmacies...provides a sneak peek at the largest pharmacies, ranked by total U.S. prescription dispensing revenues for calendar year 2015…We estimate that total revenues of retail, mail, and specialty pharmacies reached $364.1 billion in 2015, up 12.1% from 2014. The top tier of dispensing pharmacies—CVS Health, Walgreens Boots Alliance, Express Scripts, Walmart, Rite Aid, and UnitedHealth Group’s OptumRx—accounted for about 64% of U.S. prescription dispensing revenues in 2015...many of the largest pharmacies are now central-fill, mail and specialty pharmacies operated by such PBMs and payers as Express Scripts, Caremark, and UnitedHealth. This reflects the growing role of specialty drugs in the pharmacy industry. We estimate that specialty drugs account for 35% or more of revenues at these pharmacies.

Novartis wants every puff of its emphysema drug Onbrez to go into the cloud...The Swiss drugmaker has teamed up with U.S. technology firm Qualcomm to develop an internet-connected inhaler that can send information about how often it is used to remote computer servers known as the cloud...This kind of new medical technology is designed to allow patients to keep track of their drug usage on their smartphones or tablets and for their doctors to instantly access the data over the web to monitor their condition...It also creates a host of "Big Data" opportunities for the companies involved - with huge amounts of information about a medical condition and the efficacy of a drug or device being wirelessly transmitted to a database from potentially thousands, even millions, of patients...Wireless interfaces are a great benefit to certain patient groups...But...connectivity also means vulnerability...

Curation and quality are essential, because if the data isn’t right it can wreak more harm than good…While the development of accurate predictive analytics has the potential to head off debilitating and costly conditions among patients...it’s important not to rush in without the proper planning...The first thing to understand is you need to have the right technical infrastructure components in place and it has to address what you are looking to do with it...Is the data you have good enough to even do predictive analytics? Because if it isn't, that prediction may actually harm you more than it helps...other factors, including the presence or absence of skilled data scientists; a thorough understanding of how to localize predictive models from other health systems; and how to best integrate existing investments in electronic health records with analytics technology, must be carefully considered...even a platform that offers great analytics capabilities...may not be popular with either clinicians or financial executives if the caregivers need to toggle back and forth between an EHR and an analytics platform...If I'm looking at a patient in front of me right now, I don't have time to go somewhere else, and when I've gone somewhere else I've already lost the advantage of this massive investment in my EHR...So it has to be part of your system's ecosystem...

A very different kind of pharmacy opened in Redwood City on Wednesday. It's called a food pharmacy and is designed to encourage low-income people suffering with diabetes, to eat a healthy diet...It's the first of its kind ever to open in California...With a doctor's prescription, low-income diabetes patients can get food at this special pantry inside the Samaritan House Health Clinic, for free...The food is donated by the Second Harvest Food Bank, which says diabetes and other diseases run rampant among low-income people who often can't afford to eat healthier, or don't know how..."At Second Harvest, our clients have told us that one out of every three adults that we serve are suffering from diabetes. That's more than three times the national average. So it is a big problem among low-income communities," said Kathy Jackson, director of the food bank...The food pharmacy officially opened on Wednesday as a pilot program expecting to provide 100 diabetes patients with a ticket to healthier eating habits...Doctors say the cost of food is a lot less than the cost of treating the effects of a worsening disease.

This year the top motivation wasn’t hacktivism or vandalism, but 'criminals demonstrating attack capabilities,' Arbor Networks report claims....Cyberattacks around the world are growing in size and complexity, according to Arbor Networks 11th Annual Worldwide Infrastructure Security Report...For the first time, nearly half of the respondents were from enterprise, government and educational organizations, with service providers at 52 percent. Healthcare is one of the verticals included in the enterprise category...This report provides broad insight into the issues network operators around the world are grappling with on a daily basis...The findings from this report underscore that technology is only part of the true story since security is a human endeavor and there are skilled adversaries on both sides.

Distributed Denial of Service trends:

• Change in attack motivation
• Attack size continues to grow
• Complex attacks on the rise
• Cloud under attack
• Firewalls continue to fail during DDoS attacks

Advanced threat trends:

• Focus on better response
• Better planning
• Insiders in focus
• Staffing quagmire
• Increasing reliance on outside support

McKesson Pharmacy Systems & Automation has released the McKesson Clinical Programs Solution, a new platform that enables pharmacists to build customized wellness programs...the Clinical Programs Solution also allows pharmacists to maintain vendor programs for patients with specific medical conditions and saves time and labor costs by automatically synchronizing the data of patients enrolled in a clinical program with McKesson’s EnterpriseRx pharmacy management system...The Clinical Programs Solution offers a wide range of program management capabilities, including a patient-centric view of a patient’s programs and information, real-time notification if a patient is eligible for a clinical program when a prescription is being filled with EnterpriseRx, and a central platform for pharmacies with multiple locations to manage all of their clinical programs.

In an extraordinary move, the International Committee of Medical Journal Editors last week issued a proposal　to require researchers to share their clinical trial data as a condition for publication. And the researchers would also have to submit plans for how their data can be shared. The journal editors, who represent such periodicals as The New England Journal of Medicine and the Annals of Internal Medicine, believe data sharing "will help to fulfill our moral obligation to study participants, and we believe it will benefit patients, investigators, sponsors, and society." The move comes after protracted tussling over access due to safety scandals that revealed trial data for some products was never fully published or disclosed. We spoke with Harlan Krumholz, who runs the Yale Open Data Access project and works with companies to publish trial data, about the implications.

• Why does this matter?
• So how big a step is it for these journal editors to issue such a statement?
• Why do you think it took this long to take this step?
• Of course, a researcher may not follow through and share data even after submitting a plan, which raises a question about enforcing the requirement.
• What do you make, though, of the editors at The New England Journal of Medicine? In a recent editorial, they expressed reservations and set off a ruckus by saying that some researchers worry about　‘research parasites.’
• How much push back do you anticipate from industry?

Naturally occurring clay from British Columbia, Canada - long used by the region's Heiltsuk First Nation for its healing potential - exhibits potent antibacterial activity against multidrug-resistant pathogens, according to new research from the University of British Columbia...The researchers recommend the rare mineral clay be studied as a clinical treatment for serious infections caused by ESKAPE strains of bacteria (Enterococcus faecium, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) - cause the majority of U.S. hospital infections and effectively 'escape' the effects of antibacterial drugs...Infections caused by ESKAPE bacteria are essentially untreatable and contribute to increasing mortality in hospitals...After 50 years of over-using and misusing antibiotics, ancient medicinals and other natural mineral-based agents may provide new weapons in the battle against multidrug-resistant pathogens..