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Dr. Val Gives ABC News A Sneak Preview Of The Largest Health IT Convention Of The Year: HIMSS In Atlanta

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4. Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors and stream their interviews live via UStream. You can ask questions of the interviewees by submitting questions to @drval during the event. Dr. Val Jones will report to ABC News, DC via Skype from the convention floor on Wednesday, March 3rd at 10:50am. Here’s a sneak preview of HIMSS:

Stay tuned to the Better Health blog for more information about HIMSS coverage… Or meet Dr. Val at HIMSS during her “Meet The Bloggers” panel discussion.

Your social media guide to HIMSS:

1. Watch live interviews of exhibitors, conducted by physicians on UStream. Tune in to Dr. Val’s UStream coverage (beginning at 9:30am each morning at HIMSS, March 1, 2, and 3rd). Click here: http://www.ustream.tv/channel/live-from-himss-what-s-hot-in-health-it

2. Participate in real time via Twitter. Follow @drval and tweet your questions to her during the interviews. She may ask the interviewees YOUR questions LIVE. To follow Dr. Val, go to: http://www.twitter.com/drval or follow the Twitter hashtag #HIMSS10 during the event to see tweets from UStream attendees and others.

3. Meet the bloggers at HIMSS. There will be a special panel discussion with Dr. Val and other popular health IT bloggers scheduled in the HIMSS Social Media Center. Check here for times: http://www.himssconference.org/education/socialmedia.aspx

4. Watch Dr. Val Reporting from HIMSS on ABC News (DC only): Tune in to News Channel 8 at 10:50am, Wednesday March 3rd to get Dr. Val’s take on the hottest technology presented at HIMSS. Dr. Val will join ABC News’ Dave Lucas via Skype.

5. Follow the Better Health blog team. Better Health contributors -- nurses, doctors, and health writers -- will offer feedback via their blogs on HIMSS events, speakers, and exhibitors. You’ll see their blog posts on their individual blogs and also at Better Health. Flip cam clips of HIMSS events (captured by one of the Better Health MDs at HIMSS) will be featured as well.

6. Blog Talk Radio: HIMSS Wrap Up With Dr. Val and Dr. Anonymous. Tune in to the Dr. Anonymous show at 8pm ET, Wednesday, March 3rd to hear final impressions about the show. Call in to discuss the event with hosts, or join the chat room. Find the show here: www.blogtalkradio.com/doctoranonymous

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Better Health’s UStream interviewee line up will be published on the Better Health blog on Friday, February 26th. Requests for interview are scheduled by Dr. Val Jones through the HIMSS media list -- which is distributed to exhibitors at HIMSS. Most interview slots have already been booked, availability is limited.


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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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