Navigating Healthcare – Patient Safety and Personal Healthcare Management

Car Maintenance Offer Solution to EMR Challenges

Posted in Uncategorized by drnic on March 30, 2011
In a fun piece by the Onion titled: Quick-Lube Shop Masters Electronic Record Keeping Six Years Before Medical Industry offers an alternative solution to the current challenges of implementing an EHR. Since car maintenance is well tracked and probably many of us have experienced the sophistication of he follow up by your local lubrication center sending you a reminder that your car is due the following check ups Karl’s Lube & Go is “6 years ahead of the medical industry”

A comprehensive digital cataloging system that keeps track of its customers’ car maintenance history, oil-change needs, and past fuel-filter replacements puts Karl’s Lube & Go’s computerized record- keeping an estimated six years ahead of the medical industry’s, sources confirmed Friday. “We figured that a basic database would help us with everything from scheduling regular appointments to predicting future lubrication requirements,” said the proprietor of the local oil-change shop, Karl Lemke, who has no special logistical or programming skills, and who described his organizational methods, which are far more advanced than those of any hospital emergency room, as “basic, common-sense stuff.” “We can even contact your insurance provider for you to see if you’re covered and for how much, which means we can get to work on what’s wrong without bothering you about it. The system not only saves me hundreds of thousands of dollars per year, but it saves my customers a bundle, too.” 

Whilst tongue in cheek it has bothered me for many years to understand why I would unfailingly get reminders and even incentives from car maintenance but nothing from my local healthcare provider. But then maybe that has more to do with not having a primary care physician which as the USA article revealed: Half of men don’t go to the doctor that revealed

45% don’t even have a primary-care doctor

Yikes… and the survey goes further

40% of men in their 40s have never had their cholesterol tested, and 70% have never had a prostate exam

I tis no wonder men have a shorter life expectancy than women. Time to do something about this – it is not too late for a New Years resolution. Go find a primary care physician and schedule a check up…!


Simulated acupuncture can treat nausea effectively in cancer patients undergoing radiotherapy

Posted in Uncategorized by drnic on March 24, 2011
In a recent study comparing acupuncture with simulated acupuncture: 
Simulated acupuncture can treat nausea effectively in cancer patients undergoing radiotherapy

More compelling evidence of the power of the placebo effect and the power of our own thought and mind
The study from Karoli ska Institutet and Linköping University  in Sweden showed that patients, who received only standard care including medications for nausea, felt significantly more nau­sea than patients in both the real and simulated acupuncture groups.

Longer delays between heart attacks and elective surgeries lowers death rates and subsequent heart attacks

Posted in Uncategorized by drnic on March 24, 2011
Longer delays between heart attacks and elective surgeries lowers death rates and subsequent heart attacks

Forget the Treadmill – Get a Dog

Posted in Uncategorized by drnic on March 19, 2011
I could not have said it better myself. The NY Times piece with the same title (Forget the Treadmill – Get a Dog).

Among dog owners who went for regular walks, 60 percent met federal criteria for regular moderate or vigorous exercise

There is nothing like the whining and constant pestering of a dog staring at you to motivate you to get out and get some exercise. As Dr Reeves pu tit

“There is exercise that gets done in this household that wouldn’t get done otherwise,” he said. “Our dogs demand that you take them out at 10 o’clock at night, when it’s the last thing you feel like doing. They’re not going to leave you alone until they get their walk in.”

Not only do you get more exercise, it turns out the exercise is better

To the surprise of the researchers, the dog walkers showed a much greater improvement in fitness. Walking speed among the dog walkers increased by 28 percent, compared with just 4 percent among the human walkers.

And you get a best friend who never judges you, always forgives you, and the longer you are away he more excited he is to see you when you get back

Meaningful Yoose – A Doctors Voice

Posted in DrVoice, EHR, Healthcare Technology, Meaningful Use by drnic on March 18, 2011

Ross Martin MD (founder of the American College of Medical Informatimusicology as part of his self-proclamation as the world’s leading singer/songwriter of health information technology standards development organization songs) has written a new song – a Rap this time on Meaningful Use. Driven by a desire to bring the “Pants on the Ground” by General Larry Platt tune to Meaningful Use:

The Meaningful Yoose Rap from Ross Martin on Vimeo.

“Now you’re probably thinking man something ain’t right, this dude ain’t got the moves and his rappin ain’t tight”

“Got that one straight – I may not be too cool but this message is important so I’m willing to play the fool, tips your hats to the cats from the ONC

’nuff said!

Homeopathy Overdose Day

Posted in Uncategorized by drnic on March 4, 2011
30th January 2010 at 10:23 hundreds of people took part in the Homeopathy Overdose Event. This year a similar event with even more participation

Over the weekend of February 5th-6th 2011, protesters around the globe took part in the 10:23 Challenge. Protestors in seventy cities, over thirty countries, across all seven continents, held ‘overdose’ demonstrations at 10:23AM, to tell people there is nothing in it.

and many people around the world joined in the mass homeopathy overdoes. Here’s the video from the London event

I especially liked this challenge in Antarctica for Sleep and Insomnia

One of his comments:

The defibrillator was a Homeopathic defibrillator – working on the memories of being plugged in

Its is interesting to read the attempts at justification for this Pseudo science with  “Electromagnetic frequencies”  and “Nano-particles”:

Skeptics of homeopathy also have long asserted that homeopathic medicines have “nothing” in them because they are diluted too much. However, new research conducted at the respected Indian Institutes of Technology has confirmed the presence of “nanoparticles” of the starting materials even at extremely high dilutions. Researchers have demonstrated by Transmission Electron Microscopy (TEM), electron diffraction and chemical analysis by Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES), the presence of physical entities in these extreme dilutions. (24) In the light of this research, it can now be asserted that anyone who says or suggests that there is “nothing” in homeopathic medicines is either simply uninformed or is not being honest.

Probably best work was published in 2009: Trick or Treatment – Simon Singh and Edzard Ernst, MD (interesting background of the author Edzard Ernst, MD who was put into a new role, the first ever British professor of complementary medicine at Exeter University. He came to the same conclusion as this group and provides multiple data points from meta analysis of real clinical studies. Compelling data and reading

James Randi offers up this challenge worth $1,000,000 to any taker of Homeopathic remedies to prove their claims in a double blind cross over study – to date no takes

I concur with the 1023 view

Homeopathy is an unscientific and absurd pseudoscience, which persists today as an accepted form of complementary medicine, despite there never having been any reliable scientific evidence that it works.

The effects, where found are as a direct result of the well proven and studied “Placebo Effect“. Save your money and find better solutions

Glass Displays – A view into the future of Displays

Posted in Uncategorized by drnic on March 1, 2011
Gorilla Glass (foundation of the iPhone display) – Imagine the possibilities in healthcare

Watson and Healthcare – What’s All the Buzz

Posted in DrVoice, Healthcare Technology, Shuttle Launch, Watson by drnic on March 1, 2011

Fresh from an exciting and busy week at HIMSS in Orlando that was topped off with a personal highlight – witnessing the space shuttle launch from a Passenger Jet
Shuttle Launch from UA 304.jpgLaunch 1.jpg

and the video:

There continues to be tremendous interest and excitement surrounding the potential for IBM’s Jeopardy champion (Watson) to enhance medicine and ignite discussion on artificial intelligence in healthcare. This piece in the Boston Globe: The plan behind Watson: winning hearts captures the excitement and buzz we all felt at HIMSS last week that not only made Waston a household name it also garnered a huge audience with a big ratings swell. As Richard Mack put it:

“Watson has sparked the imaginations of those not just in the technology industry, but for an array of industries around the globe”

Indeed this thought provoking piece from Diagnostic Imaging: Will Watson Replace Radiologists? The question being what will the impact be in healthcare and specifically in radiology where radiologists review numerous images and base our findings on our experience and expertise, which are in turn based on reading articles and textbooks (our knowledge base) and as the author asks:

If we program all of these knowledge bases into a computer, then wouldn’t the computer be as good or likely even better than we are?

Interesting idea but I think this concept is more likely to follow form some of the automated image processing tools that are emerging, for example from Median Technologies and their LMS-Lung application:

that automates the detection, evaluation and follow-up of lesions identified in CT images. (this technology interestingly came out of missile tracking systems). Perhaps given identification of lesions and findings in images this could then be coordinated with existing reports using some component of Watson to link image findings with clinical conditions and provide some level of machine intelligence to support radiologists

But I think Dr Krishnaraj is right:

the personal relationship between a doctor and his patient can never be replaced. It is important, for example, to diagnose cancer, but how is that information communicated? I do not believe a computer will ever be able to demonstrate compassion or rest a hand of comforting support on the shoulder of a patient that is hurting

Watson is exciting technology but it does not replace the clinicians or the clinician patient interaction. Techcrunch reported on some of the back lash and lack of understanding in this piece: The Next Stop for IBM’s Watson: Healthcare?. Watson does not replace human intelligence. In fact the opposite is true it supplements human intelligence providing ready access to the large amount of information available today much as we access this information in our daily lives. For example, imagine you are shopping for fruit and come across Papaya in the supermarket, you have heard its good but have no idea how to select a good papaya so you turn to your smartphone and speak or enter “How to tell a ripe papaya” (which returns 17,400 results including pictures, videos and how tos). You apply that knowledge and select a good papaya based on new information and understanding. Watson extends this capability by helping understand the underlying meaning of the terms and linking the right information together to present a closer match to possible answers. In healthcare we are overwhelmed with new information presented in the form of randomized controlled trials, publications and research papers. A quick look at one resource (The Cochrane Collaboration)

that is working to provide the best evidence for healthcare and the ~4,000 published Cochrane Reviews,  the Cochrane Library and the updated list of treatment guidance and review of protocols and you get a sense of the mass of data that clinicians need to read, digest, process and then apply in clinical practice. Dr Watson brings processing power to the clinical coal face to improve diagnostic accuracy, efficiency and patient safety but not to replace clinicians. Or as Dr Krishnaraj put it the

“personal relationship between a doctor and his patient can never be replaced”