July 23rd, 2011 by Peggy Polaneczky, M.D. in Opinion
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My practice has been using the EPIC electronic medical record for 5 years now, and it’s taken about that long for me to figure out how to tweak the system to make myself more efficient, and for the system to evolve to a place where I could tweak it myself.
Case in point – Quick Actions.
EPIC’s most recent upgrade includes little self-made macros called “quick actions” that turn repetitive tasks into a mouse click. I’m using quick actions to manage my results in basket in much the same way you may be using Rules in Outlook to manage your email.
Some of my macros are actually little work-arounds for a system that is not yet entirely integrated and a patient population that has not yet embraced online results communication. About half of my patients sign up for online results – I’m working hard on the rest…
Like many of you, I like a clean inbox, but need a place to park messages that are awaiting some future task for completion. I’ve decided to use the “results notes” inbasket for this purpose, so you’ll see some of my macros moving messages there.
I now have the following Quick Action options whenever I view a lab report – Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
January 23rd, 2011 by Peggy Polaneczky, M.D. in Opinion, Research
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In a well done placebo-controlled study published in this week’s Journal of the American Medical Association (JAMA), use of escitalopram (Lexapro) reduced hot flashes in menopausal women.
Investigators enrolled 205 women, randomizing them to either Lexapro 10 mg or placebo, with instructions to increase to two pills a day if needed after four weeks. Lexapro users experienced about a 60 percent reduction in hot flash frequency over the eight-week study. About half ended up on the larger 20 mg daily dose by study’s end. The drug’s effect was apparent at about one week of use, and it was well tolerated.
As in almost studies of menopausal treatments, the placebo group also experienced a significant reduction in symptoms — about 40 percent — but the difference between placebo and drug groups was significant. Compared to placebo users, Lexapro users had a bigger rebound of symptoms when stopping their treatment, were more satisfied, and more likely to want to continue the study drug, another validation of the drug’s efficacy. Read more »
*This blog post was originally published at tbtam*
January 17th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Tips, Research
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Cancer of the ovary is a particularly nasty disease. It often remains asymptomatic until it has reached an advanced, incurable stage, and scientists have been unable to develop an effective screening test for the disease like the ones in widespread use for cancers of the breast and cervix.
The dismal status of ovarian cancer screening was underscored a year ago when an NIH-sponsored study showed that over 70 percent of cancers detected by transvaginal ultrasound and CA 125 biomarker testing — the two best ovarian screening tests we’ve got — had reached stage III or IV at the time the patients screened positive. That’s about what happens when women aren’t screened at all.
That wasn’t the worst of it, however. In just the first year of that screening program, positive test results obligated 566 surgical procedures which uncovered only 18 cancers. That’s an awful lot of unnecessary surgery and associated morbidity right there. Things were no better on the false-negative side of things. Overall, 89 cases of ovarian cancer were diagnosed during the NIH study, and a third of them had been missed by both screening modalities.
What’s new?
The NIH study didn’t evaluate the impact of screening on ovarian cancer mortality, but a recent study by Laura Havrilesky and colleagues at Duke did indeed address the point. Sadly, the results were abysmal. Read more »
*This blog post was originally published at Pizaazz*
December 14th, 2010 by Jeffrey Benabio, M.D. in Better Health Network, Health Tips
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Not all skin cancers are from sun exposure. Viruses such as human papilloma virus (HPV), the virus that causes genital warts, also cause skin cancer. Skin cancer from HPV develops on genital skin in both men and women. It’s rarely talked about, but it’s important and can be deadly.
Did you know that half of all deaths from skin cancer other than melanoma are from genital skin cancer? You probably also didn’t know that women are more likely to die from genital skin cancer as they are from skin cancer that developed from sun exposure (again, excluding melanoma).
We dermatologists are inexhaustible when it comes to warning people about the dangers of sun exposure, but we should also be warning people about the dangers of genital warts. HPV protection, which includes HPV vaccines, is as important as sun protection in preventing death from non-melanoma skin cancer.
Genital warts can lead to deadly skin cancer. If your dermatologist has not checked your genital skin, be sure your primary care physician or gynecologist does. This is especially important, because unlike other sexually-transmitted diseases (STDs) which often have symptoms, HPV or genital warts often don’t. It may be embarrassing, but it could save your life.
*This blog post was originally published at The Dermatology Blog*
December 14th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, News, Opinion, Quackery Exposed, Research
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Confused about hormone replacement therapy (HRT)? I can’t imagine why…
*This blog post was originally published at tbtam*
My practice has been using the EPIC electronic medical record for 5 years now, and it’s taken about that long for me to figure out how to tweak the system to make myself more efficient, and for the system to evolve to a place where I could tweak it myself.
