September 27th, 2011 by StevenWilkinsMPH in Research
Tags: Cut-And-Paste, De-skilling, Doctor-Patient Communication, Electronic Medical Record, EMR, Outcomes, P4P, Paper Records, Patient Information, Patient-Centered Medical Home, Pay for Perfomance, Poll, Quality of Care, Recorded Data, Research
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Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine. It is called de-skilling. De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things. Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), Pay for Performance (P4P), Patient Centered Medical Home (PCMH) requirements and so on.
Examples of physician de-skilling were revealed in a recent study which consisted of in-depth interviews with 78 primary care physicians regarding EMR use. EMRs are all about standardization – what data is captured and recorded, how data is reported, how data is used, and so on.
Over the course of the interviews, physicians in the study described significant examples of de-skilling behavior. Most indicated that Read more »
*This blog post was originally published at Mind The Gap*
September 27th, 2011 by RyanDuBosar in Research
Tags: Adverse Effects, Alzheimer's, Amnestic Mild Cognitive Impairment, beta-amyloid peptides, Biomarkers, Clinical Dementia, Cognition, Diabetes, Function, Further Studies, Intranasal Insulin Administration, Jason Karlawish, Lumbar Puncture, Metabolic Rate of Glucose, New York Times, Phase II Trial, Research, University of Pennsylvania, VA Medical Center
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Intranasal insulin stabilized or improved cognition and function and preserved cerebral metabolic rate of glucose in brain regions affected by Alzheimer’s disease, concluded researchers from a phase II trial. But more and larger trials are needed before any conclusions can be drawn, they also cautioned.
Insulin is important to normal brain function, and reduced insulin levels may contribute to Alzheimer’s disease, researchers noted. To examine the effects of intranasal insulin in adults with amnestic mild cognitive impairment or Alzheimer’s disease, researchers conducted a randomized, double-blind, placebo-controlled trial in a VA medical center.
The intent-to-treat sample consisted of 104 adults with amnestic mild cognitive impairment (n=64) or mild to moderate Alzheimer’s disease (n=40) defined as Clinical Dementia Rating scores of 0.5-1 and Mini-Mental State Examination scores greater than 15.
Participants received Read more »
*This blog post was originally published at ACP Internist*
September 26th, 2011 by Medgadget in News, Research
Tags: Abdomen Movement, Anesthesiology, Breathing, Carbon Dioxide Monitor, Chest Movement, Critical Care, Medicine, Non-invasive, Pediatrics, Post Surgery, Radio Waves, sids, Signal Strength, Sleep Apnea, Surgery, University of Utah, Wireless Network, Wireless Transceiver
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A couple years ago, a team of researchers from the University of Utah managed to create a wireless network made from standard home automation devices to “see” through walls.
Now, the engineers are using the same technology to monitor breathing in patients with sleep apnea, post surgery, and babies at risk for SIDS. The system consists of Read more »
*This blog post was originally published at Medgadget*
September 25th, 2011 by RyanDuBosar in Research
Tags: American College Of Physicians, Annals of Family Medicine, Antidepressants, Behavioral Survey System, CNN, Confidentiality, Demographic Differences, Depression, Dr. Richard Kravitz, Encouragement, Hesitation, Hispanics, Mental Health, Patient Communication, Primary Care, Psychiatry, Research, Study
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More than two in five patients hesitate to discuss depression in the primary care setting, leading researchers to offer practical tips on how to encourage people to broach the subject.
The big reasons for not talking to doctors included fears about patient confidentiality and fear of losing emotional control in front of the doctor, among those with a history of depression. Among those with no prior history, a fear of antidepressants/psychiatry and the perception that primary care isn’t the right setting are two big reasons.
To learn why patients choose not to talk about their depression, researchers Read more »
*This blog post was originally published at ACP Internist*
September 23rd, 2011 by M. Brian Fennerty, M.D. in Research
Tags: Colon Cancer, Colonoscopy, Endoscopy, Examination, Gastroenterology, Inspection, Journal Watch Gastroenterology, Look Again, Narrow-band imaging, Patient Care, Polyp, Removal, Retroflexion, Right-sided colon polyp, U-turn
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The right side of the colon seems to be the Achilles heel of colonoscopy because polyps there tend to be flat and harder to find, and we confer the least protection from later colon cancer in that zone.
A recent article summary in Journal Watch Gastroenterology concludes that when we see a right-sided colon polyp, we may have missed another, so we should go back and look again.
This provocative recommendation represents a major change in the way we normally perform colonoscopy. But the issue is, and always has been, how to identify and remove all polyps from the colon.
So the questions I have Read more »
*This blog post was originally published at Gut Check on Gastroenterology*
