April 8th, 2009 by Dr. Val Jones in Medblogger Shout Outs, News
Tags: CONNECT, EMR, federal agencies, Free, HIMSS, HIMSS09, Interoperability, National Health Information Network, NHIN, open-source, software
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Tim Cromwell’s mother-in-law is 86 years old. Her husband is a Korean War veteran who developed Alzheimer’s disease, and receives care from both the VA and private healthcare providers. Because she and her husband take so many medications, they actually replaced their dining room table centerpiece with a collection of orange and white pill bottles. Mrs. Spencer keeps a hard copy of all of her husband’s medical records in a large file box that she carries with her on a cart with wheels. She has no alternative for keeping all her husband’s providers up to date with his complex care, and lifting and transporting the records has become more difficult for her in her eighth decade.
If this story sounds all too familiar, then you’ll be glad to know that the government is facilitating electronic medical and pharmacy records portability. One day it may be possible for Americans to dispose of those hard copy files, knowing that any provider anywhere can access their records as requested.
Tim Cromwell is passionate about alleviating his mother-in-law’s need to carry medical records around, and believes the way to do this is through the US Department of Veterans Affairs’ participation in the Nationwide Health Information Network (NHIN). Working in compliance with NHIN standards, the Federal Health Architecture group recently oversaw the creation of software (called CONNECT) that creates a seamless, secure and private interface with hospitals, and over 20 federal agencies’ medical records systems (including the Social Security Administration, Department of Defense, Veterans Affairs, the Centers for Disease Control and Prevention, and the National Cancer Institute).
On April 6, 2009, NHIN released the CONNECT software necessary to make Electronic Medical Records systems interoperable. The software is “open-source” and free to all who’d like to incorporate it into their EMRs. Those who add the free software will be able to share data with NHIN’s member groups, which include early adopters like the Cleveland Clinic, Kaiser Permanente, Beth Israel Deaconness Medcial Center, and MedVirginia.
This means that if Mrs. Spencer and her husband receive their care from participating hospitals and federal programs, they’ll never have to tote paper records again. But it may take some nudging from patients and healthcare professionals like you to grow the network. If you’d like your hospital to participate in the NHIN network, encourage them to view the NHIN website here.
April 5th, 2009 by Dr. Val Jones in News
Tags: Blogging, CAQH, Chicago, Dr. Val Jones, drval, Exhibitors, Exhibits, HIMSS, HIMSS09, McCormick Place, Star Trek
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My husband Steve and I are at the HIMSS (Healthcare Information and Management Systems Society) conference in Chicago. There are about 30,000 attendees this year and the event is being promoted on billboards around the city and in hotels within a 3 mile radius of McCormick Place. Since President Obama has set aside 20 billion dollars for electronic medical records creation and adoption, members of HIMSS have responded with jubilation (and perhaps even some salivation).
The HIMSS conference might strike outsiders as a kind of Star Trek convention without the costumes. The 881 exhibitors in attendance range from health technology giants like GE, Philips, and IBM to small EMR start ups and software engineering companies to facilitate patient care. There is even a “village” on the convention center floor devoted to demonstrating inter-operability of data systems. Standards organizations like NIST, non-profits like CAQH, and government agencies like the CDC are aggregated together at booths on a huge blue carpet – all working together to share information in formats that their computers can all recognize.
As I looked out on this sea of exhibits, the size and scope of the healthcare industry really struck me. I had been to medical conventions at McCormick place before (the AAFP meeting was there last year, for example), but this time it was filled, floor-to-ceiling, with companies that were not (with few exceptions) hospitals, provider groups, pharmaceutical companies or insurers. Instead, this was an entire additional array of companies, all making a living on healthcare.
The exhibit hall opens today at 2pm, and I’ll be at the conference through April 8th, blogging and Twittering (follow me on Twitter here) my thoughts and discoveries. I’ve got my dark suit, comfortable shoes, and pocket protector in place.
May we all live long and prosper.
April 2nd, 2009 by Medgadget in Better Health Network, News
Tags: Accident, Cardiology, Defibrillator, Electircal Shock, ICD, Medgadget, NEJM, Washing Machine
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An interesting case of electrical interference has been reported by Danish physicians in the New England Journal of Medicine. A patient with an implanted cardiac defibrillator was taking a shower when he got zapped twice for no apparent reason. The physicians, speculating on the cause of the events, sent an electrician to the man’s house to see if some type of electromagnetic interference could have been at fault. Turns out that a self-installed washing machine didn’t have its ground cable connected, turning house wiring into the washing machine’s private radio station.
More about the story at Discover Health News…
Article extract in NEJM: Inappropriate ICD Shocks Caused by External Electrical Noise
**This blog post was originally published at Medgadget.com**
March 26th, 2009 by Stacy Stryer, M.D. in News, Opinion
Tags: HIV, sexually transmitted diseases, Stacy Beller Stryer, teen birth, teen pregnancy, teens
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The number of teens giving birth in the United States has increased for the second year in a row, after a decline for 14 consecutive years. According to a reported recently released by the Centers for Disease Control, the birth rate increased from 41.9 births per 1000 teens in 2006 to 42.5 births in 2007. Not only does becoming pregnant and giving birth as a teen increase the risk of serious medical problems for the newborn, including low birth weight and an increased risk of death, but it also makes it more likely that a mom will have many socioeconomic difficulties, including a greater chance she will end up on welfare, not receive a high school degree, and live below the poverty level (which translates to difficulties for newborns as they get older).
Obviously, teens who become pregnant did not use a condom during intercourse, or at least not correctly. Therefore, these teens are also at risk of developing sexually transmitted diseases, such as Chlamydia, gonorrhea, and AIDS. Unfortunately, some of these infections, such as HIV, can pass through the placenta, and infect the unborn fetus. Given the fact that the risk of developing HIV and AIDS in adults is increasing in some areas of the United States, it also makes it more likely that an infected female will become pregnant. A report recently published stated that the rate of HIV is greater than 3% in Washington DC, which is considered an epidemic.
Although researchers don’t know why the number of babies born to teens has increased for the second year in a row, they speculate that increases may be due to increased risk taking, more relaxed and changing attitudes, portraying sex as OK or even a positive experience on TV, increased risk taking by teens, changing attitudes, and having teen role models who become pregnant (Miley Cirus, Jamie Lynn Spears, Bristol Palin).
How are we going to improve these statistics? We must ensure that sex, STDs, teen pregnancy and contraception is not only taught at school but also discussed in our own home – over and over. Our teens must not only learn our values, but also how to keep themselves healthy. It is fine to teach abstinence at home, but parents should also teach about condoms as a way to protect their teens. Often, we are the last to know that they have become sexually active. (Regular communication and discussion with our teens may give us the privilege of finding out sooner!)
It is also important to teach our teens how to deal with a certain situation before it happens, such as what to do when someone of the opposite sex makes an advance. If your child hasn’t been taught what to do in situations such as a teen making a physical advance, friends trying to increase poor behavior via peer pressure, watching drinks carefully , and others, she will probably be more likely to freeze up when such a situation arises and allow it to get out of hand. My rule of them it to talk about these tough subjects about 2 years before your teens may be in such a situation. This gives them time to think about it and formulate a plan of how to say “no” or how to stay safe. We need to see a reversal of the teen birth rate – in order to do this, we need the community, schools and parents all to work toward a common goal of educating and protecting our teens.
March 24th, 2009 by Dr. Val Jones in News
Tags: Castle Connolly, Childhood Leukemia, Dr. Carol Bradford, Dr. Diane Meier, Dr. Emil Freireich, Dr. Judd Moul, MD Anderson Cancer Center, National Physician of the Year Awards, Nationcal Cancer Institute, NCI, New York City
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I attended the fourth annual Castle Connolly National Physician of the Year Awards last night in New York City. It was truly moving to hear the incredible stories of triumph of each honoree – from military surgery (Dr. Judd Moul), to curing head and neck cancer (Dr. Carol Bradford), to expanding palliative care services for people not expecting a cure (Dr. Diane Meier) – each awardee embodied the very best character and principles one can hope for in a physician.
But perhaps most moving of all was the story of lifetime achievement award-winner, Dr. Emil Freireich. Dr. Freireich was born to Hungarian immigrants, his father died when Emil was 2 years old, his mother worked in a sewing factory to provide for his needs growing up. Through sheer grit and determination, Emil managed to get himself to college and then medical school. He began his career in 1955 at the National Cancer Institute (and has been working at MD Anderson Cancer Center since 1965) where he was provided a challenge: to cure childhood leukemia. Here is what Dr. Freireich had to say about how things have advanced in the field of leukemia in his lifetime:
In 1955 when I began my career at the National Cancer Institute, children diagnosed with leukemia usually lived for about 8 weeks. They had about a 1% chance of surviving a year – and they had a median age of 5 years old at diagnosis.
The worst thing about leukemia was not the short life expectancy, but the way the children died. You see, leukemia destroys blood platelets (the part of the blood that allows it to clot), and produces its own anti-coagulant. So every child with leukemia died of massive hemorrhaging. As a doctor in 1955, when I entered the leukemia ward, all I saw was blood. The children were bleeding in their urine, stool, lungs, and even from their eyes. They would cough to breathe and spew blood as high as the ceilings. The wards were red with death.
But now, thanks to years of research and the development of combination chemotherapy, leukemia is not a death sentence. In most cases it can be cured, and in all cases we can stop the bleeding.
The most rewarding part of my career has been treating young children with leukemia, and watching these same children grow up to become physicians who treat other children with leukemia. I have passed the torch on to them, and I believe that they will one day find the cure for other cancers too. I believe we will get there soon.
I had the chance to interview Dr. Freireich for this blog last year. You may read more here. Congratulations to all the awardees of the event – carry the torch high for us docs, we need more stories of hope like yours… and thanks to Castle Connolly for such an inspirational evening.
