Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

I’m going to use some experiences that my 86 year old mother had this week with phone calls from both entities.  She’s a diabetic and has been for around 12 years and thus so is tuned in to taking her blood sugar readings every day and she does it like clockwork.  She also has a good record of getting in for her appointments for her annual physicals and breast screenings. 

A couple weeks ago she received a call from her Medicare Part D insurer reminding her that it is time for her annual physical.  She knew this already and we talked about it a couple weeks ago.  There’s nothing wrong with getting a reminder phone call and I understand where all of this is coming from, especially with healthcare reform and no co-pays required. What became a little less than tolerable though with the phone call was the insistence of the caller wanting to make a conference call and make her appointment for her.  The called asked if she would like to have her make the appointment for my mother.  When my mother said she preferred not and that she would call and make her own appointment, this is where the pressure cooker turned on.  Mom had one heck of a time convincing her that she would call and make the appointment and was brow beat over and over on how the caller from the health plan would do this for her, almost to the point of not accepting ‘no” for an answer. 

This is a bit heavy here to me as if the caller could see she is up to date on everything and does what she is supposed to do. This makes me wonder if the callers are on “pay for performance” for every appointment they make?  I know this stuff goes on with either a bonus or an evaluation on how successful they are with doing this job.  I spent over 25 years in sales and marketing and that is how some of this comes about.  Pay for performance is coming out our ears!

Tenet Signs National Agreement with Cigna – Hospitals To Receive Higher Compensation When Pay for Performance Quality Metrics Are Met

Shoot ask any MD about pay for performance in this area and they can tell you some of what they get too, i.e. they get drug over the carpet for patients not filling their prescriptions when in fact they have, but may have chosen a $4.00 generic source and have not used their “prescription” plan and by doing that actually saved money.  Insurers have some new algorithms and those spark new business model programs for compliance.  MDs also get bad nicks on their pay for performance for failure of deal patients who have not had their annual mammogram.

What are we doing with all the data we have?  We still need help and direction with many in knowing how to use it constructively  and productively. 

Health Net Creates Additional Performance Algorithms by Contracting With MedeAnalytics

This just rubbed me the wrong way for a caller to be so insistent and pushy.  Let’s move on to the next 2 compliance phone calls here.  She gets her diabetes strips from Walgreens who also called her.  Again as I mentioned above she’s been a diabetic for years and does her testing as she should, and does it twice a day, but the pharmacy said she needs to do it 3 times a day.  The pharmacy also said they had her next prescription ready for her too.  To this she said, hold off as I am getting too much and I don’t want to have too much on hand that might expire before I can use it.

Walgreens was basing their prescription refills and her needs on 3 times a day when in fact she does it twice a day.  They finally worked with her to let Mom get her own refills “when she needs them” but the caller on the phone was adamant about doing her readings 3 times a day.  

Translation: Mom is messing up the automated system her by doing it twice a day instead of 3 times a day I think <grin>.  They may or may not have a parameter that can be added for twice a day, either that or it requires someone in a supervisory position to make that change or a programmer to add it as a selected choice for the patient based on communications.   I realize working with data how automation is set into motion based on parameters.  if you miss your screening, Walgreens has buses running out there to help patients too.

AARP and Walgreens Sending Out a Fleet of Buses to Offer Free Screenings

Phone call number 3, which is also like 1 and 2 is unrelated.  This phone call comes from her healthcare provider again checking in with her medication requirements and they said twice a day is sufficient for her to take her readings and she told them about the pharmacy insisting she needed to do this 3 times a day. 

Now I know the three new words with medications is compliance, compliance, compliance, but when we have folks working in a pool of compliance phone call employees calling, let’s get on the same routine here if we can.  It’s things like this that make the whole system look stupid, and it is stupid.  So far, we have not heard from her mail order pharmacy but who knows they could be next.  At this point she is ok without having to hear from them too. 

On her physical, if they want to call back in a couple weeks if their data would not show an appointment being made with her doctor that is fine.  Knowing Mom though that will not be necessary, but I also understand everyone is not Mom and doesn’t follow the rules like she does. They actually made her feel bad and she resented the pounding and insistence of all this information all the way around from the drug store to the healthcare insurer.  Some pharmacies allow the pharmacists to collect pay for performance money too, but lucky Mom at this point United is not her carrier so hopefully this program will pass her by at 86 as she’s not physically able to be working out at the YMCA. 

UnitedHealthCare To Use Data Mining Algorithms On Claim Data To Look For Those At “Risk” of Developing Diabetes – Walgreens and the YMCA Benefit With Pay for Performance Dollars to Promote and Supply The Tools

Is there not a better way to do this I ask?  Can we all get on the same wave length and not badger the patients?  We have always worked through our doctors for all of this and I think that method is the best. 

By the way, at 86 years old Mom does her refills online and is right up to par on this as it is easier for her that way.  Seniors are into using the internet for convenience too so don’t think that doesn’t happen just due to age.  She also has a PHR with HealthVault too and granted I helped her out there but who cares she has it and knows how to pull it up if she needs the information.

I used Mom as an example but she is not alone in this as others will be getting the same so some courtesy and less pressure for compliance to meet their internal performance goals would be nice.  This is still the human business and it still pays to “listen” to the patient before jumping off a limb to be the “Shell Answer man” to dictate rather than advise with patient care. 

Shame on all these callers with lacking some common human sense and the ability to listen and shame on those directors who push these individuals to work and react in such a fashion – business model needs improvement.  BD

Read More: http://ducknetweb.blogspot.com/2010/09/compliance-police-out-in-force-for.html

OML exists to shrink the educational gap in all areas of the health sciences in developing countries, which globally face the same problem: doctors and nurses go without the latest professional information they need to provide proper health care to their patients. In response to this urgent demand for life saving knowledge, OML has built a powerful collaboration between publishers, authors, universities, and hospitals to provide formal medical references and continuing education materials for health sciences students and professionals living in the developing world. In recognition of OML's valuable contribution to medical health worldwide, several U.S. Government agencies have also joined in the effort.

Current textbooks in the health sciences fields of dentistry, medicine, nursing, pharmacology, and physical therapy are desired, as well as anatomy and basic science books. Textbooks need to be new or gently used, contain current information, and published within the last five years.

Trouble viewing the contents? Visit MedicineandTechnology.com

Become a fan of MedicineandTechnology on Facebook.

Read More: http://feedproxy.google.com/~r/mdjosephkim/~3/6FayRY0N5N0/donate-your-medical-textbooks-to.html

Radiofrequency ablation devices work by sending alternating current through the tissue. This creates increased intracellular temperatures and localized interstitial heat. When temperatures exceed 60°C, cell proteins rapidly denature and coagulate, resulting in a lesion. The lesion can be used to resect and remove the tissue or to simply destroy the tissue, leaving the ablated tissue in place.
Due to adverse effects such as charring, as well as perceived limitations on the use of RF devices, improvements have been developed and marketed which are designed to better control and direct the high temperatures produced at the tip of the RF device. These include so-called temperature controlled and fluid (saline or water) cooled versions.

Temperature Controlled
One way to control the temperature at the tip of the RF electrode is to build in a feedback mechanism between the tip of the device and the RF generator. For example, in a device such as Covidien’s Cool-tip system, the RF generator was designed with a feedback algorithm. This algorithm senses tissue impedance and automatically delivers the best amount of radiofrequency energy for the situation. The Cool-tip’s electrode design serves further to eliminate tissue charring while allowing delivery of the maximum amount of energy, resulting in the ability to ablate a larger zone of tissue more quickly.

Fluid Cooled
In the highly-popular fluid-cooled devices, the electrode’s internal circulation of water cools the tissue adjacent to the exposed electrode, maintaining low impedance during the treatment cycle. Low impedance permits maximum energy deposition for a larger ablation volume. It also decreases the risk of charring, and allows the surgeon to work faster.

Catheter Manipulation Systems
Another recent development is the use of routine RF electrophysiology catheters in conjunction with a robotic catheter manipulation system, for both diagnostic and ablative EP applications. Examples of such systems include Catheter Robotics’ Remote Catheter Manipulation System, Hansen Medical’s Artisan Control Catheter/Sensei Robotic Catheter System, and Stereotaxis’ Magnetic Navigation System.

Benefits of such systems include use of a catheter which is already familiar to the EP; the ability to manipulate the catheter (once it has been inserted into the heart) via a system from outside of the zone of radiation, and thus eliminate the need to wear the lead aprons; and the EP can then guide the procedure while watching the EP monitors and x-ray images.

Hansen Medical’s system has been used in the ablation of AF. The Stereotaxis Magnetic Navigation System utilizes two magnets, external to the patient, to create a magnetic field. This generates sufficient force to steer magnetically tipped, FDA-approved catheters and guidewires. The system has been used in various EP procedures, including mapping, pacing, and ablation.

RF ablation represents, on a share basis, a relatively minor segment of the aggregate ablation technologies market, but demonstrates an above average growth rate annually.

Ablation Market Worldwide, by Segment 2010

Source: Report #A145, "Ablation Technologies Worldwide"; MedMarket Diligence, LLC

bookmark to

Read More: http://feedproxy.google.com/~r/AdvancedMedicalTechnologies/~3/TuDrS0Q6x9o/

I talk a lot about our serious lack of role models today, not only in healthcare but in other areas of government and Dr. Oz certainly stands to defy what we get a daily dose of with the usual attitude and paradigm of “its for those guys over there’. 

He just recently turned 50 and went in for the suggested colonoscopy upon reaching that age. On September 7th, he’s slated to discuss more on his show.  He has a way with utilizing television and other medias to get his message across and sometimes it involved humor and is extremely funny, but we get the message. 

Dr. Oz Visits Jimmy Kimmel and Discusses Nutrition, Obesity, Size and Gives a Few Impromptu Exams (Videos)

So much of what we hear is critical and judgmental like this post below to where those who are making such statements are actually the pots calling the kettle black as we never hear about how they value healthcare technology and nothing about their own experiences, but that’s the world of self righteous politics where they have not learned how to share yet, just pass judgment on others.  Stuff like this in the news does little to help others and just continues to show what a bunch of non participants we have in Washington when it comes to healthcare technology too.

HHS National Plan to Improve Health Literacy – Not Going To Happen Until We Focus on Using Technology (The Tool for Literacy) Which Includes Role Models at HHS And Other Places in Government

This is pretty typical of what we hear and see in the news with this Congressman being a prime example of thinking that his radio show was so important he couldn’t even listen to what the rest of the world is saying about cell phone uses and gets pulled over while on a live radio show – big non participant and a real dog for a role model for sure. 

US Congressional Representative Gets Pulled Over for Using a Cell Phone While Driving And Was Live on the Air Doing Radio Interview

One of my favorite segments he covered was on the Oprah show with regenerative medicine where he walks us through Wake Forest and shows all what is going on there, and even to his own amazement he was astonished at how far this technology has come with people walking around with bladders grown in dishes from their own stem cells. 

The Oprah Show – Dr. Oz Explores and Explains Regenerative Medicine

This was great that Dr. Oz is taking the time out to share as he does everything right and he still was hit with the polyp, so it goes to show that nobody is exempt when it comes to healthcare and screening and again, hats off for taking the time to share, he gets social medial by all means, and too bad few in government get it. 

You can read and view more information at Dr. Oz’s Blog.  He stated it was an unexpected awakening and by sharing it’s a wake up call for all.  BD 

Dr. Mehmet Oz has always been outspoken about the importance of living a healthy lifestyle. So when the TV host, who boasts that he "always" takes his own advice, went in for a routine colonoscopy after his 50th birthday this year, he never imagined he'd have anything to worry about.

But during the examination, his doctor found an adenomatous polyp, or precancerous growth, inside his intestine, which if left behind, could have likely become colon cancer.
"This was a shakeup for me," Oz tells PEOPLE. "I have done everything right. I don't have any family history, and yet I'm high risk now."

Dr. Oz Has Colon Cancer Scare - Health, Dr. Oz : People.com

Read More: http://ducknetweb.blogspot.com/2010/09/dr-oz-has-colon-polyp-pre-cancerous.html

This is something that is needed like now.  I also posted about a movie that is coming out that discusses DDT and the desire to bring the chemical back and discussed the potential dangers and non dangers associated along with the decision to stop DDT back in the Nixon administration.

3 BILLION AND COUNTING Documentary About The Needless Ban of DDT–Decision of One Scientist and The Reason for the Huge Outbreak of Malaria and Why Bed Bugs are Back

Malaria and the cure has also been a big focus for the Bill and Melinda Gates Foundation.

Bill Gates - an optimist and a comedian – Fills the Room with Mosquitoes at TED

After some very extensive research  NITD609 was identified as a potential drug candidate. Plasmodium falciparum and Plasmodium vivax have been conquered the drug resistant strain of malaria we are seeing today.  Genomics research from the Scripps Research Institute played a major role in this investigation.

Scripps, Navigenics, Affymetrix and Microsoft team on groundbreaking health study – Personalized Medicine

A little information from the recent past above with Scripps using various technologies with genomics to include HealthVault personal health records to store a lot of their information derived from studies too.  BD 

An international team of scientists plans to begin clinical trials for a new malaria vaccine later this year.
Researchers from The Scripps Research Institute, the Swiss Tropical Institute, the Genomics Institute of the Novartis Research Foundation and the Novartis Institute for Tropical Diseases revealed their findings in the September 3 issue of the journal Science, according to HealthCanal.com.
Elizabeth Winzeler, a Scripps Research associate professor and member of the Genomics Institute of the Novartis Research Foundation, told HealthCanal.com that she was excited by the new compound.

After initially finding 275 potential candidates, Winzeler was able to narrow the field to just 17 that could be effective and safe for humans. After looking at the toxicity and pharmacokinetic profiles of those, one compound stood out as promising. It belonged to a chemical class of molecules known as spiroindolones. Spiroindolones had never before been associated with malaria.

Clinical trials to begin for new malaria vaccine | Vaccine News Daily

Read More: http://ducknetweb.blogspot.com/2010/09/clinical-trials-to-begin-for-malaria.html

The group has actually been conducting the FDA approved testing since 2004.  Other countries have studies doing about the same thing.  So far since 2004, 21 patients have been treated in the study.  The funding for the study comes from the Multidisciplinary Association of Psychedelic Studies. 

There will be a screening process for applicants to go through.  The group is also working to get the Department of Defense involved in the study as well.  BD 

A pair of psychiatric experts think they’ve got the answer to the soaring number of troops coming back from war with PTSD: have them undergo intensive psychotherapy — while they’re rolling on ecstasy.

Dr. Michael Mithoefer and Anne Mithoefer, a psychiatric nurse, are the South Carolina pair who’ve been spearheading research into ecstasy, known clinically as MDMA, since 2000. After one successful study on 21 PTSD patients between 2004 and 2008, they’ve now received the final okay from FDA and DEA officials to start a study entirely devoted to former military service members.

“My sense is that, especially after we published the results of the first study, these institutions are more open to the idea,” Dr. Michael Mithoefer tells Danger Room. “Obviously, this is still new and experimental, and it can take time to get through to big institutions.”

Vets Get Ecstasy to Treat Their PTSD | Danger Room | Wired.com

Read More: http://ducknetweb.blogspot.com/2010/09/fda-and-dea-approve-study-to-use.html

The drug is just barely off and running and the treatment is not inexpensive by any means and according to this notice put out by the FDA, they want additional information at CMS on how stroke victims are affected that have received the drug so this appears to be further exploration into the world of immunotherapy treatment to determine what effects and benefits are potentially available with strokes being on the list.   

Dendreon Announces CMS Evaluation of Provenge for Late Stage Prostate Cancer Patients

As I wrote back in March before the approval process took place, part of the evaluation from the FDA included looking at their sophisticated tracking system called “Intellivenge”. 

Dendreon “Intellivenge” Algorithmic Software Supporting Administration of Provenge – Seeking FDA Approval by May 1st

Dendreon uses a sophisticated tracking system with bar coding to ensure the correct blood is returned to the right patient after the incubation process.  This is important as someone would not want the blood from another patient, although I read it would not be fatal, but rather not as effective but still no room for error here. 

This is a brand new class of drugs and It appears to be a good question to find out what other uses and benefits may be derived with measuring additional potential benefits.  BD 

The Centers for Medicare and Medicaid Services (CMS) has called this meeting to consider the currently available evidence regarding the impact of labeled and unlabeled use of autologous cellular immunotherapy treatment on health outcomes of patients with metastatic prostate cancer.

As described on the FDA website at http://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ApprovedProducts/ucm213559.htm, “PROVENGE® (Sipuleucel T, APC8015) is an autologous cellular immunotherapy product consisting of peripheral blood mononuclear cells (PBMCs) obtained from patients by leukapheresis and activated in vitro with a recombinant fusion protein (prostatic acid phosphatase fused with GM-CSF). FDA will require the sponsor to complete a post marketing study to evaluate the risk of stroke in patients who receive sipuleucel-T.”

Provenge® has FDA approved labeling for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer.

Centers for Medicare & Medicaid Services

Read More: http://ducknetweb.blogspot.com/2010/09/cms-to-require-study-for-off-label-use.html

Hospitals are investing in robots and if you read this blog often enough, you have seen several posts on this topic and under the related reading below there’s a brief summary.  Their use though is also growing beyond just the hospital as this story in the New York Times shows how the CEO of Mozilla attends meetings via a Tele Presence Robot.  Over the last few years we keep hearing about how expensive it is for a person to physically travel to meetings and conventions.  Is your CEO thinking about this? 

Tele Presence Robots for Remote Workers – Invasion of the AnyBots

This hospital received accreditation from the Joint Commission to be a “stroke center” with using the robot and being able to tap into a facility like UCI or a number of other hospitals to have an interventional cardiologist available immediately.  They are using a robot from a company called “InTouch Health” and we have seen their robot at UCLA, Johns Hopkins and many additional places. 

Robots at Work in Orange County Hospitals - California

When you think about bad weather, and other disruptions with multi tasking CEOs today, is this the next glimpse you get and how the future communication with officers of companies is going?  There are robots for home monitoring for seniors too and the article below has a robot video that really reminds you of the old Jetsons cartoons with “Rosie”. 

New CPT Codes - Billing Codes for Robot and Home Monitoring Services – Telemedicine

Now this is where things get real interesting as the use beyond doctors is growing.  As mentioned above the CEO of Mozilla uses the technology for his meetings.  The robots are smart enough to know when to return to their charging stations too so if you are looking to stay outside the radar, the battery packs are where the power lies. Chances are too that they are also smart enough to send an alert out if anyone is messing around where they should not be.  You do have to open doors for these guys too.

The big selling point here is that tele conferences need to be set up in advance and with the robots the officer just logs on and sets the robot in motion. 

This video is interesting as it shows all types of robots that are work in progress.  The robot for termite exploration is interesting. How we as humans adjust and react is something we don’t quite know and understand yet, self included here of course.

The folks over at the XPRIZE foundation did a video to show how people react when the the boss shows up remotely and shows what he sees at the other end via the camera.

In a hospital this could really get interesting as we already have robo doctors floating around so add in some administrative tele presence here with the CEO or board members cruising through and you may never see them in the flesh again <grin>.  Someday it could be just a meeting of the robots while the humans stay at home, but again one human is needed to open the doors for them, but who knows that may be next.  A simple mouse or joy stick is all that is needed to control the robots remotely.  BD 

Dr. Shatzel, a neurologist, hustled not to the emergency room where the patient lay — 260 miles away, in Bakersfield — but to a darkened room at a hospital here. He took a seat in front of the latest tools of his trade: computer monitors, a keyboard and a joystick that control his assistant on the scene — a robot on wheels.

He guided the roughly five-foot-tall machine, which has a large monitor as its “head,” into the patient’s room in Bakersfield. Dr. Shatzel’s face appeared on screen, and his voice issued from a speaker.

Related Reading:

Military is Using Robotic Doctors too

Robots at Work in Orange County Hospitals – California

All Terrain Medical robot in development for the battlefield

Robodoc' coming to a hospital near you

Remote-Presence Robot Attends Patients at Ryder Trauma Center

Doctor monitoring via robot effective

Johns Hopkins demonstrates Robo Doc...

Remote-Presence Robot Attends Patients at Ryder Trauma Center

How technology is helping hospitals - UK

Doctor monitoring via robot effective

Johns Hopkins demonstrates Robo Doc...

Smarter Than You Think - The Boss Is Robotic, and Rolling Up Behind You - NYTimes.com

Read More: http://ducknetweb.blogspot.com/2010/09/robots-showing-up-everywhere-at.html

15% off scrub tops with code "top_value"

One again I thank ScrubsGallery for their continued support of the Medical Quack Blog.  Each month they offer a discount for readers and you can use the link in the image above to take advantage of the discount offered this month.

Next time you need to order scrubs or other healthcare apparel, please check out their website and compare. 

Read More: http://ducknetweb.blogspot.com/2010/09/scrubs-gallery-discount-for.html

Read More: http://feedproxy.google.com/~r/PlaceboJournalBlogMedicalHumorWithAPurpose/~3/ZCSVrKYBa4s/cost-of-care-by-ted-bacharach-md.html

Read More: http://www.thehealthcareblog.com/the_health_care_blog/2010/09/physicians-and-online-communities-1.html

Well we are getting a lot closer to the brain with treatments for sure and this same treatment has been used for severe cases of epilepsy.  If it works well and is safe, it certainly would seem to be an improvement over a large dose of drugs on a daily diet. 

UCLA has an exclusive worldwide license for the TNS with NeuroSigma, a Los Angeles–based neuromodulation company.  In 1997 the FDA approved the process for epilepsy and now in trials for depression.  As you read through here there were 2 different options for patients, one was to sleep with a device for 8 hours and the other option was to have miniature subcutaneous electrodes implanted under the skin.  80 percent had positive results with their depression in the results published relative to the trial.  If the economy keeps going the way it is, there could more of us standing in line for this soon <grin>, but again if it works and gives an alternative to being somewhat zoned out on medications then we might see real growth in a few years.  BD

In a recently completed clinical trial at UCLA, trigeminal nerve stimulation (TNS) achieved an average of a 70 percent reduction in symptom severity over an eight-week study period. The study’s principal investigator, Dr. Ian A. Cook, the Miller Family Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, presented the results at a recent National Institutes of Health conference on depression and other psychiatric disorders, noting that 80 percent of the subjects achieved remission, a highly significant result in this pilot study.

TNS is not new to UCLA. It was pioneered for treatment-resistant epilepsy in humans by Dr. Christopher M. DeGiorgio, a UCLA professor of neurology. The results of a positive 12-patient feasibility trial in epilepsy were reported last year in the journal Neurology. A larger, double-blind pilot epilepsy clinical trial is underway at UCLA and the University of Southern California.

The stimulator that was used in the depression clinical trial is about the size of a large cell phone. Two wires from the stimulator are passed under the clothing and connected to electrodes attached to the forehead by adhesive. The electrodes transmit an electrical current to the nerve. All the patients in the trial used the device for approximately eight hours every night while asleep. In contrast to antidepressants, no major side effects were noted.

Non-invasive therapy significantly improves depression, UCLA researchers say | BreakThrough Digest Medical News

Read More: http://ducknetweb.blogspot.com/2010/09/ucla-completes-clinical-trial-using.html

I am foremost and upfront all about having medical records and if you have read this blog long enough you know that I developed and wrote one years back, thus my comments tend to be realistic and I comprehend the fact that we can’t just jump on every new piece of software or algorithm that appears.  In every business today the formulas and algorithms are more complicated and the programming is work in progress.  When the tech folks (like me) who have to support all the various forms of software that are out there, begin to complain, you there’s a problem. 

Hospital Relies on High-tech 'Scribes' To Follow the Doctors and Enter Data to be Paperless

When you have spent time working with doctors first hand and as a partner to develop a system that will help them you learn to eat your own dog food right off the start and it is team work.  I started talking about the Common User Interface a couple of years ago and I still this is a good idea.  One young doctor told me he had to learn 5 different medical records system to get through his internship.

Medicine information is getting more complicated today too with all the information that has to be reviewed.  These doctors that like scribes may not at all be tech luddites, is just the amount of information and work flow needed and something have to give.  Of course the physician has to review what the scribe has entered to ensure this is correct. 

Using Scribes at the Hospital – Some Doctors Really Like This Idea

The good side about scribes is that many are med students working for not much more than minimum wage and it is a learning process for them as they go through school.  Here’s an interesting quote from this article:

T”he companies that develop and sell electronic medical records systems are "in total denial" about how complicated they are for doctors to use, Strumpf said. "They know these systems need scribes," he said. "They work with us to train our scribes on their systems, but they don't want to be public about it."

Again I mentioned the open source Common User Interface that could be adopted by any medical record company and this is the screens only and

Microsoft Common User Interface for Health Applications- Silverlight...and Windows Presentation Foundation

Here I am using and and doing a walk through back in 2008, so you can see this is not brand new.

Competition and who can build the best input algorithms are at the heart of all of this.  Back when I was writing if someone has something easier for clinicians to use, heck I was all over it as my ego was not that big, and this is a bit of a territory battle here. 

Here’s a doctor/developer in New Zealand that I know who is working with it in format and he’s not even using Microsoft code to do it, so enough about the complaint that you have to spend a lot of money to use format.

Common User Interface – EHR Development Work in Progress

Back at HIMMMS 2008 I was there helping promote Tablet PCs and I used from one of my MSDN meetings, a prototype that had

Electronic Medical Records of the Future

Back in 2006 I was already adjusting my program to work on Tablets too and if you are curious the link below has a few screenshots.  Keep in mind this was back before we had a lot of the new innovative code and system we see today so not bad though and it even changed colors for the user’s preference.

What Does an Antiquated EMR (Electronic Record System) Look Like

“More scribes are on the way. Ronald Reagan UCLA Medical Center, Emory University Hospital in Atlanta and Beth Israel Medical Center in New York City said they are exploring the idea. Physicians in other specialties, including urology and family practice, also are starting to adopt scribes.”

Again we all want electronic medical records and more importantly they need to address the needs and formats of the end users, doctors, nurses, etc. and time for programmers and businesses to eat a little dog food along this path.

Again, I like all of this and see the value but again I can’t jump on and promote every single program whether it’s for the consumer or for the clinician, as what seems to be practiced today with some jumping on every thing that shows up. I interface with people from all walks of life but I remember the physician side and the creation process and thus so, consumers would be wise to keep this in mind before going into attack mode with doctors who are not quite readily ripping their way through  medical records with expeditious input,   

Consumers also need to remember that their doctor is creating the equivalent of an income tax 1040 form for every visit and that can be 20-3- a day, so think of it this way, as a consumer how would you like to be filing your incomes tax forms 20-30 times a day, I think I made the the point. 

Remember some get the short form, some have to be itemized and some get audited (denied), so just think of the administrative time that goes into those 3 functions above and you have a pretty good idea of how complicated and detailed the record/billing side of healthcare is.  I’m not trying to give Scribes a big line of promotion here, just looking at things realistically and how they have evolved.  That coding in my background and working hand in hand with doctors writing an EMR a few years ago really helps me include what I feel is a realistic spin on all of this, nothing like first hand experience rather than listening to magpies.

(This is the Medical Quack and not the Medical Magpie) <grin>

Even UCLA is looking into scribes and they are one of the most connected and wireless capable facilities in California, so this has nothing to do with how wired a place is and how fancy the software is – it’s all about having a system that doctors and nurses can use without immense disruptions with patient care and if it takes a scribe to help them weather all of this, then so be it.  BD

Melissa Genove has dreamed of becoming a physician since childhood. To help her prepare, she spends as many as 35 hours each week shadowing emergency room doctors at Loma Linda University Medical Center. The 23-year-old listens intently as they examine patients, records their treatment plans in a laptop computer, and follows up on prescriptions, lab tests, consultations with specialists and anything else the doctors order.
Genove is not an intern, or even a medical student. She is the chief medical scribe in the hospital's emergency department — and one of several thousand young people pioneering a new healthcare field.

But while the conversion is underway, doctors estimate that their productivity plummets by about 30% as they learn to cope with a complicated new system. That's where scribes come in.
Like Genove, they are typically young, tech-savvy and undaunted by computers. They are willing to work for $8 to $10 an hour with no benefits. Most do the job part-time as college students and plan to go on to full-time careers in medicine or nursing. They say the experience gives them a valuable head start.

Leaders of the three biggest companies providing scribes estimate that about 200 emergency departments in community hospitals and academic medical centers currently use them. More scribes are on the way. Ronald Reagan UCLA Medical Center, Emory University Hospital in Atlanta and Beth Israel Medical Center in New York City said they are exploring the idea. Physicians in other specialties, including urology and family practice, also are starting to adopt scribes.

Scribes let doctors focus on patients - latimes.com

Read More: http://ducknetweb.blogspot.com/2010/09/scribes-in-healthcare-continue-to-grow.html

Trouble viewing the contents? Visit MedicineandTechnology.com

Become a fan of MedicineandTechnology on Facebook.

Read More: http://feedproxy.google.com/~r/mdjosephkim/~3/CWe28Mux54U/final-program-mhealth-networking.html

Read More: http://feedproxy.google.com/~r/PlaceboJournalBlogMedicalHumorWithAPurpose/~3/ncszHFiIJ0U/ardi-kicks-habit.html

This is a nice computer and along with a couple other bloggers you may see on the web with a few other discussing so this is a plus if as you get more than one perspective from a blog you follow.   I’m participating in evaluating and commenting on the Lenovo Think Centre M90z. . It has been supplied by Lenovo for my use in evaluating.  I’ll be adding some posts here and there on things that I find useful and what I am doing with the unit.

First thing I like is the fact that it is an all in one unit and I don’t have a tower to deal with as this was what lead me to buy my IMAC a couple years ago.

I have included a couple images here so you can see what I am talking about.  It has touch screen capabilities which I have been used to using with my tablet so have the desktop that does this too is great.  Being a tablet person since they came out, the first thing I tried out with the TIP input panel, the handwriting recognition.  It works great and recognition is fine with Windows 7.  I will be working eventually on the speech recognition too as those are some of the tools I use personally all the time.  I can easily use my fingernail to write! 

The unit has 4 mg of ram, but being it is a 32 bit system, just a shade under 3 can be accessed and that is true of any 32 bit computer.  I’ll be doing additional testing and one item I added was blue tooth on one of the USB ports as I use both a blue tooth mouse and keyboard with the unit.  I’m into wireless where ever I can be.  Connecting to my wireless network was very easy and nice to have that capability built in.

I also attached a USB TV Tuner to work with the Media Center to try it out as well.  A few years ago I did some demos for Microsoft and Intel on Media Centers so it was right up on top of my list. 

The television reception is good and the Media Center works well and the Windows 7 version has a few new little extras on the interface.  The computer is also a power saver and has “green” technology with power savers, etc.  Moving the unit around is easy enough with the handle on the top back side and it’s easy enough to pull the stand out and set it down, ready to use. 

This is the first of a few posts I will add here and this is more or less a simple introduction and stay tuned for more information later and a chance to win one of these units too.  BD 

Read More: http://ducknetweb.blogspot.com/2010/09/lenovo-thinkcentre-m90z-all-in-one.html