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Until recently, people used a technique called symmetric key cryptography to secure information being transmitted across public networks in order to make economik shopping more secure. This method involves encrypting and decrypting a economik message using the same key, which must be known to both parties in order to keep it private. The key is passed from one party to the other in a separate transmission, making it vulnerable to being stolen as it is passed along. With public-key cryptography, separate keys are used to encrypt and decrypt a message, so that nothing but the encrypted message needs to be passed along. Each party in a economik transaction has a *key pair* which consists of two keys with a particular relationship that allows one to encrypt a message that the other can decrypt. One of these keys is made publicly available and the other is a private key. A economik order encrypted with a person's public key can't be decrypted with that same key, but can be decrypted with the private key that corresponds to it. If you sign a transaction with your bank using your private key, the bank can read it with your corresponding public key and know that only you could have sent it. This is the equivalent of a digital signature. While this takes the risk out of economik transactions if can be quite fiddly. Our recommended provider listed below makes it all much simpler. The Last Line of Defense Against Medication Errors: What You Need to Know to Keep your Family Safe by: Timothy McNamara, MD, MPH
This is a true story. Yesterday, I picked up a new antibiotic prescription for my daughter from my local pharmacy. (We recently adopted my daughter from India where she had recurrent ear infections resulting in severe hearing loss. And, she is about to undergo the second of several planned surgeries in order to try to repair the damage.) Before putting her to sleep, I got the new medication out of the bag, glanced at the instructions, and prepared to give her the drug according to the instructions on the label. Just before doing so, I had a quick double-take. Something seemed to be wrong. I looked at the instructions again, and thought to myself slowly, *What*s going on...this doesn*t seem right.* Then, it hit me that the dose seemed awfully high for her. It took me a minute or two to put the pieces together (it had been an unusually tough fight getting her ready for bed, I was tired, I was confident in my daughter*s physician, and I was thinking perhaps less critically that I should have). And then I noticed it. The label had a stranger*s name on it. After another moment or two, I saw what had really happened. The medication came in a box. Each side of the box had a different label...one label was for my daughter and one label was for a stranger. And, the stranger*s dose was more than double what my daughter*s surgeon had recommended. (This error didn*t happen in a mom-and-pop pharmacy. It happened in a modern new chain pharmacy whose name you would recognize from advertisements on TV.) I*m not a surgeon...and I*m not a pediatrician...but I am a physician trained in internal medicine and I have spent most of the last twelve years writing about, speaking about, and developing systems to reduce the frequency of medication error and improve the safety of pharmacy practice. This pharmacy error brought the topic of drug safety home to me...literally. What I can tell you is that this sort of error occurs all too often in the United States (and around the world). And, that it can have devastating consequences for the people involved. A recent study in the New England Journal of Medicine indicated that 25% of patients who take one or more prescription medications will experience an adverse drug event within three months-and 39% of these are preventable or avoidable. The Harvard Medical Practice Study found reported in JAMA in 2001 that 30% of patients with drug-related injuries died or were disabled for more than 6 months. And, what almost everyone who studies this problem agrees is that current systems for selecting drugs, dosing them, communicating a prescription to a pharmacy, dispensing drugs, and instructing patients on their safe use are woefully inadequate. In this series, we are going to take a close look at the processes that cause medication errors (some things that your physician and pharmacist may not even want you to know) and what steps you can specifically take to make sure that you and your love ones are protected from this hazard. Ten years ago, your ability to get current, objective, reliable information on your medications in a quick and easy way was practically non-existent. It probably would have involved a trip to the library and required considerable knowledge about pharmacology to get the answers. Today, that*s not the case. There is a host of on-line tools, databases, and resources that allow you to learn information about medications that even your physician and pharmacist may not know. We*re going to talk about them, show you were to go, tell you the key things you need to know about medications, expose some myths, and let you know the questions you should be asking. It*s not as hard as it may seem. In fact, you need to become the final line of defense in the battle against medication errors. Throughout, we are going to give you some key rules that should guide your defense. So, Rule Number 1. Trust, but verify. Never assume that the medication you have received is the right medication for you or that it is dosed correctly for you. Specifically, you should check:
We*ll talk about some specific resources that will help with each of these throughout this series. The result, we hope, will be the piece of mind to know that you and your family are getting your 7 rights:
Right on! © 2004 Timothy McNamara, MD, MPH
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