December 26th, 2011 by PeterWehrwein in Research
1 Comment »
We are fast entering the era of the electronic health record, when it will be possible to call up our medical records on our computers and mobile devices. Medication lists, lab results, appointment schedules—they’ll all be available with clicks of your mouse or taps on the screen of your smartphone or tablet.
But one question that’s far from settled is whether the electronic health record should include the notes that doctors make about them. A doctor’s notes can be straightforward, such as a reminder that an additional test might be needed. But they can also include somewhat speculative observations and hunches about a patient and his or her medical conditions. The Open Notes project is a research program designed to test the consequences of giving patients access to doctors’ notes. Harvard-affiliated Beth Israel Deaconess Medical Center is one of the test sites.
The Open Notes project is far from finished. But results of a survey of the expectations that doctors and patients have for note sharing are being reported in today’s Annals of Internal Medicine.
I don’t think there are any great surprises here. More than half of the primary care physicians Read more »
*This blog post was originally published at Harvard Health Blog*
November 12th, 2011 by Medgadget in Research
No Comments »
Cost scrutiny and comparative effectiveness research are playing a growing role in shaping healthcare delivery. In light of that, Abiomed Inc. (Danvers, MA) has recently announced the results of a study that showed the company’s Impella heart pump significantly reduced major adverse events at an incremental cost per quality-adjusted life year. “The cost-effective message is directly tied to the financial impact of these better clinical outcomes for patients treated with Impella,” Jeffrey Popma, MD, the director of the angiographic Core Laboratory at Beth Israel Deaconess told Medgadget. Popma was responsible for the planned analysis of the angiographic results.
The device, which the company describes as the “world’s smallest heart pump,” demonstrated an increase in ejection fraction of more than 20% and an improvement in Read more »
*This blog post was originally published at Medgadget*
August 31st, 2011 by Toni Brayer, M.D. in Uncategorized
No Comments »
I am smacking myself on the forehead and saying, “Why didn’t I think of this?” Dr. Richard Parker, Medical Director at Beth Israel Deaconess Medical Center, has sent out a list to his physician colleagues of 56 common medical tests and procedures. What is revolutionary is that there are prices next to each item. You non-physicians may be surprised to know that we doctors have no idea what the tests or drugs we order actually cost. Unless we get billed as a patient, we are as clueless as you are.
As I wrote before, the ostrich excuse just won’t fly any more. We all need to be aware of the cost of care and have skin in the game. Some will argue that price can’t be the only driver. I’ve heard physicians say you can’t compare one price to another because “quality” costs more. I say prove it. Read more »
*This blog post was originally published at EverythingHealth*
February 2nd, 2011 by PJSkerrett in Book Reviews, Health Tips
No Comments »
There isn’t much new in the latest iteration of the “Dietary Guidelines for Americans.” Three years in the making, the 2010 guidelines (released a tad late, on January 31, 2011) offer the usual advice about eating less of the bad stuff (salt; saturated fat, trans fats, and cholesterol; and refined grains) and more of the good stuff (fruits and vegetables; whole grains; seafood, beans, and other lean protein; and unsaturated fats). I’ve listed the 23 main recommendations below. You can also find them on the “Dietary Guidelines” website.
The guidelines do break some new ground. They state loudly and clearly that overweight and obesity are a leading nutrition problem in the United States, and that a healthy diet can help people achieve a healthy weight. They also ratchet down sodium intake to 1,500 milligrams per day (about two-thirds of a teaspoon of salt) for African Americans and people with high blood pressure or risk factors for it, such as kidney disease or diabetes. But the guidelines also leave the recommendation for sodium at 2,300 milligrams a day for everyone else, a move that the American Heart Association and others call “a step backward.”
Vague language spoils the message
One big problem with the guidelines is that they continue to use the same nebulous language that has made previous versions poor road maps for the average person wanting to adopt a healthier diet.
Here’s an example: The new guidelines urge Americans to eat less “solid fat.” What, exactly, does that mean — stop spooning up lard or Crisco? No. Solid fat is a catchphrase for red meat, butter, cheese, ice cream, and other full-fat dairy foods. But the guidelines can’t say that, since they are partly created by the U.S. Department of Agriculture USDA), the agency charged with promoting the products of American farmers and ranchers, which includes red meat and dairy products. “Added sugars” is another circumlocution, a stand-in for sugar-sweetened sodas, many breakfast cereals, and other foods that provide huge doses of sugar and few, or no, nutrients. Read more »
*This blog post was originally published at Harvard Health Blog*
September 23rd, 2010 by Felasfa Wodajo, M.D. in Better Health Network, Interviews, Opinion, Research
No Comments »
We recently reported our interview with Dr. Henry Feldman of the Beth Israel Deaconess in Boston and his experience using the iPad as his sole computing device while attending on the wards. Overall, his experience was positive, while accessing the hospital networks, using clinical applications and questions about security. Be sure also to check out Future Docs blog and Dr. Arora’s experience using the iPad on the wards to get more real-world perspectives on using the iPad on the wards.
Among the few difficulties Dr. Feldman had, one was that typing long notes on the glass keyboard was cumbersome, requiring the use a desktop computer for admission and discharge notes. This may now turn out to be one of the easiest problems to solve, if two recently announced iPad cases are any indication. Sena and Kensington are both releasing iPad cases with built-in bluetooth keyboards. Each has a built in battery and the cases fold into dimensions not much larger than a standard iPad case. Read more »
*This blog post was originally published at iMedicalApps*
