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Could Our Healthcare System Function Without Power In The Digital Age?

* Bzzzzzaaaaapp *

Suddenly, the light went out. There was complete and utter darkness. Then, about 3 seconds later, the lights returned. My computer with its flat screen poised before me, remained dark. I hesitated a moment, then pushed the power button. Within a few more moments, the computer restarted. All seemed intact.

But what if it wasn’t?

Today with our myriad of computer systems, electronic medical records, e-mail messages, paging systems, digital xray machines, blood chemistry analyzers, automated blood pressure cuffs, etc., etc., etc., what would happen if we had no power or functional electronic medical record, just for a week?

Could our health system function?

We have entered the era when our medical students and residents have never entered a written order and “flagged it.” Our unit secretaries wouldn’t have a clue how to take off an order from a “flagged” chart. How would we order a stat portable chest xray without a computer? And what about our written notes. Would they include the date and time in the lefthand column, or would that be forgotten in our hurry to write our manual progress notes? Would our digital phone systems work? How about our pagers? Doctors can no longer find manual blood pressure cuffs on our wards since hospitals have moved to automated blood pressure cuffs that upload their readings into the electronic medical record automatically.  Have our nurses and medical assistants lost the art of taking a manual blood pressure? Read more »

*This blog post was originally published at Dr. Wes*

CDC Promotes Infection Prevention Guidance For Outpatient Settings

As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care.

Today, CDC is pleased to present the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. a summary guide of infection prevention recommendations for outpatient settings. Although these recommendations are not new, this guide is a concise, one-stop resource where ambulatory care providers can quickly find evidence-based guidelines produced by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

Repeated outbreaks and notification events resulting from unsafe practices highlight the need for better infection prevention across our entire healthcare system, not just in our hospitals. Based primarily upon elements of Standard Precautions, including medical injection safety and reprocessing of reusable medical devices, this guide reminds healthcare providers of the basic infection prevention practices that must be followed to assure safe care.

I urge you to use this guidance document, and the accompanying Infection Prevention Checklist for Outpatient Settings to assess the practices in your facility to assure that patients are receiving the safe care that they expect and deserve.

I also invite you to view our CDC Expert Video Commentary on Medscape titled New Infection Prevention Guidance for Outpatient Settings to learn more about the guidance.

*This blog post was originally published at Safe Healthcare*

Misleading Medical Tweets Could Cause Harm

This is not a lesson about the limitations of 140-character messages on Twitter.

Rather, it is a warning about careless Tweets that mischaracterize the real meat of the message in longer stories linked to in the Twitter message. As I wrote on Twitter in response to these two episodes, “Better not to Tweet on complex health care topics than to mischaracterize your own story with a misleading 140 characters.”

First, my friend Andrew Holtz caught the fact earlier this week that Men’s Health Magazine tweeted:

If you’re a smoker, you NEED to get a CT scan. Here’s why: http://ow.ly/5x34y

That “here’s why” link took you to a Men’s Health Magazine story, that despite being headlined “The Medical Test Every Smoker Needs,” went on to explain:

Don’t run out and ask for a CT scan, though. More than 96 percent of the positive screens in the study were false positives, which could subject you to unnecessary surgery, cancer treatments, and the complications that come with them. They’re also expensive: A chest CT scan can cost up to several thousands of dollars.

So look at how silly Men’s Health looked on this confusing back-and-forth message:

1. You NEED to get a CT scan.
2. It’s a test “every smoker needs”
3. But don’t run out and ask for one.

Then this morning I caught AARP doing the same thing. They tweeted:

Are you a smoker? CT scan those lungs – they’re proven to cut risk of lung cancer death for 55-plus: http://aarp.us/rdleHu

That links takes you to a story that includes caveats such as the following: Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Are Patients Charging Their Doctors For Time In The Waiting Room?

Patients are starting to bill doctors for making them wait, reports CNN.

“When he keeps patients waiting more than 15 minutes, Dr. Timothy Malia, a primary care physician in Fairport, New York, hands them a $5 bill. If patients in Eugene, Oregon, wait more than 10 minutes to see Dr. Pamela Wible, they receive a handmade soap or a bottle of lotion. When Dr. Cyrus Peikari, an internist in Dallas, recently had to miss a day of work because of a family emergency, he gave the patients whose appointments he canceled $50 at their next appointment.”

I’ve been kept waiting at doctors’ offices. I’ve been kept waiting as pharma reps walked past a full waiting room bearing plates of food. But I’ve also been kept waiting as doctors have handled other patients, undoubtedly more complex cases than mine.

Practice administrator and blogger Brandon Betancourt sums up the point nicely, and further extends the idea to every delay faced in life, such as toll booths on turpikes tied up with traffic.

I’ve also been squeezed into the schedule for emergency appointments, undoubtedly making someone else wait. And I’ve also been treated by phone on nights, weekends and holidays, and I’m not so sure that my primary care physician gets reimbursed for that.

So, kudos to those few physicians who respect their patients’ busy schedules enough to reward them. But I’m Read more »

*This blog post was originally published at ACP Internist*

Dengue Fever: Mosquito Born Illness Now Found In Texas, Florida, And Hawaii

Asian tiger mosquito, Aedes albopictsDengue fever is a viral (flavivrus) disease transmitted by Aedes albopictus and female A. aegypti mosquitoes. It is estimated that 50 to 100 million people in more than 100 countries are infected each year with dengue viruses.

There are four different types of dengue virus, and there is no cross-immunity, so a person may be stricken with dengue fever four times in his life. The most active feeding times for dengue vector mosquitoes is for a few hours after daybreak and in the afternoon for a few hours just after dark (dusk).

As opposed to the night-feeding mosquitoes that transmit malaria, these species tend to be “urban,” may also feed during daylight hours (also indoors, in the shade, and during overcast weather), and are known to bite below the waist. Dengue fever is seen chiefly in the Caribbean and South America, as well as other tropical and semitropical areas, such as Southeast Asia, Africa, and Mexico. In the United States, cases have been noted in Texas, Hawaii and Florida. The larvae flourish in artificial water containers (e.g., vases, tires), often in a domestic environment.

The incubation period following a mosquito bite is two to eight days. The disease is self-limited (five to seven days) and characterized in older children and adults by a sudden onset of symptoms, including: Read more »

This post, Dengue Fever: Mosquito Born Illness Now Found In Texas, Florida, And Hawaii, was originally published on Healthine.com by Paul Auerbach, M.D..

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