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Critical Opportunity Lost
After presenting to the emergency department, a woman with chest pain was given nitroglycerine and a so-called GI cocktail. Her electrocardiogram was unremarkable, and she was scheduled for a stress test the next morning. A few minutes into the stress test, the patient collapsed and went into cardiac arrest. Case review revealed that providers failed to notice the patient had an elevated troponin level prior to discharge. In the accompanying commentary, Jonathan R. Genzen, MD, PHD, and Heather N. Signorelli, DO, both of the University of Utah School of Medicine, discuss critical values and the importance of prompt communication as well as policies and procedures to ensure appropriate care is initiated.

Medication Mix-Up: From Bad to Worse
Admitted to the hospital with chest pain, headache, and accelerated hypertension, an older man with a history of chronic kidney disease and essential hypertension who had missed several days of his regular medications was to be started back on them gradually. One of his antihypertensive medications (minoxidil) was ordered via the EHR, but a vasopressor/antihypotensive medication with a similar name (midodrine) was dispensed. Fortunately, a nurse noticed the discrepancy before administration. Amanda Wollitz, PharmD, of Florida Hospital Orlando, and Michael O'Connor, PharmD, MS, of Intermountain Healthcare Pharmacy Services, review errors with look-alike, sound-alike medications and offer strategies to prevent them.

Precision Medicine: Health Care Tailored To You

The President's new Precision Medicine Initiative is a bold new enterprise to revolutionize medicine and generate the scientific evidence needed to move the concept of precision medicine into every day clinical practice.

What is Precision Medicine? It's an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.

Aren't we already using Precision Medicine? Yes, significant advances in precision medicine have already been made for select cancers, but the practice is not currently in use for most diseases. Many efforts are underway to help make precision medicine the norm rather than the exception.

What is the President's plan? The President's 2016 Budget invests $215 million in the Precision Medicine Initiative, including key investments to the National Institutes of Health and Food and Drug Administration to support research, development and innovation of this effort.

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