May 3rd, 2009 by KevinMD in Better Health Network
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Bolstered by the stimulus, there’s no doubt that there’s a significant push for doctors and hospitals to adopt digital medical records.
I’ve written before how we’re essentially throwing money at Windows 95 technology, but now, as an article from BusinessWeek points out, there’s a real danger in moving too fast.
Somewhat under-publicized were the incompatibilities with older systems in the Geisinger Health System, which after spending $35 million on software, noticed a spike medication errors that required another $2 million to fix.
Or what happened at the University of Pennsylvania, which found medication errors stemming from software designed to prevent mistakes.
Worse, there is no national database tracking the errors that are caused from electronic medical records. Because most of the programs are not open-source, confidentiality agreements meant to protect proprietary technology also serve to hide mistakes.
Ideally, these issues need to be resolved before throwing more money into bad technology. But, because of the intuitive notion that technology automatically improves health care, no one seems to be advocating a more cautious route which may, in actuality, better serve patients.
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Better Health Editor’s Note: Please read this post for more in-depth coverage of how difficult it is to transfer health records electronically.
April 18th, 2009 by CodeBlog in Better Health Network
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This story was related to me from a coworker:
I was taking care of a man who was on bipap. (Bipap is a form fitting mask that goes over the mouth and nose to help augment breathing. It has successfully been used numerous times in place of intubating patients and putting them on ventilators.) He was becoming restless and tired of the mask. I had to wait for the doctor to come and see him, though, before I could remove it.
Due to his medical condition, it was very important that he get an aspirin that day. Since I couldn’t give it to him by mouth (because of the mask), I had to explain to him that I’d need to give it rectally as a suppository.
He nodded his consent and I proceeded to give the aspirin.
A short while later, the doctor came to see the patient and agreed that we could take the bipap mask off for awhile. I happily entered the patients room to take the mask off… and before it was even off his face, he stuck his finger in the air and said,
“FOR THE RECORD, that is a hell of a way to take an aspirin!!”
It’s a hell of a way to give one, too.
*This blog post was originally published at Gina Rybolt, RN’s Code Blog.*
April 16th, 2009 by eDocAmerica in Better Health Network
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Stroke is a major cause of disability and death in the U.S. and worldwide. Modern medicines like statins (and old ones like aspirin) are helpful in preventing both initial and secondary stroke in patients at risk. But, are there simple things you can do to lower risk?
Yes, you say! Well, indeed, you are correct. Twenty thousand men and women (age range, 40–79) without histories of stroke or heart attack were recently analysed in the U.K. for the effect of 4 simple behaviors: not smoking, regular physical activity, moderate alcohol intake (1–14 drinks weekly), and high fruit and vegetable intake .
Patients engaging in 3 or 4 of the activities were significantly less likely (2 times!) to suffer a stroke over the next decade. Patients who slipped up a bit and only did 1 or 2 of the activities did have significant stroke risk, though not quite as much as those who sat on the sideline and engaged none of the behaviors.
So, grab the baton and step up to prevent stroke. As always, questions and comments are welcome.
*This blog post was originally published by Jerome Ecker, MD at the eDocAmerica blog.*
April 14th, 2009 by Dr. Val Jones in Book Reviews
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I recently met the author (Dr. Jill Grimes) of Seductive Delusions: How Everyday People Catch STDs at the AMA’s 29th Annual Medical Communications Conference in Albuquerque, New Mexico. Jill is a family physician in Austin, Texas, with a kind and down-to-earth demeanor. Jill is the type of doctor you like immediately – she makes you feel at ease because of her unpretentiousness.
Jill told me that she wrote Seductive Delusions out of sadness and frustration with her inability to protect young people from STDs. Jill saw new cases of sexually transmitted diseases in her patients every week, and wanted very badly to reverse this trend. No amount of counseling “after the fact” had a sufficient effect on new cases, so she decided to launch a preemptive strike: an educational book targeting those who never thought they could contract an STD.
Seductive Delusions uses a “case based learning” approach to educating readers about STDs. Each chapter begins with two true life stories about young people who succumb to STDs. Characters are based upon the lives of patients whom Jill has treated over the years, but stories are blended to protect anonymity. The story-telling format (followed by fact-based summaries) makes the content more entertaining and engaging to read. I doubt that a textbook could hold readers’ attention as effectively as Seductive Delusions does.
I chose to read Seductive Delusions cover-to-cover in 2 sittings, and such a concentrated dose of horror stories made me feel hesitant about ever having sex again. I can also say that there was one uncomfortable moment in an airplane (I read the book on the way back from Albuquerque) when the man sitting next to me glanced at the cover and gave me a very shifty look, and spent the rest of the flight leaning noticeably towards the seat on the opposite side.
That being said, I did enjoy the book. Jill’s characters have an innocent quality to them – like the cast from “Leave It To Beaver.” And I think that was exactly her point – you’d never expect the Cleaver family to be touched by STDs, and yet the truth is that they are succumbing to them in record numbers. Part of the danger of being one of those supposedly “low risk” individuals is that sufficient precautions against STDs are not taken due to a false sense of security.
I had assumed from the title of the book that “everyday people” would include a wider range of characters than were presented. I have been concerned about the reemergence of STDs, for example, in the retiree community in Florida, and thought that Seductive Delusions might touch on that unexpected risk group. However, the target demographic for the book is the late teen to thirty-something heterosexual male and female. I agree with Jill that there’s an educational gap there – but I would have enjoyed her casting a wider net.
The other potential short coming of the book is that the narratives describing how the various characters contracted an STD are so engaging that the reader is left disappointed at never hearing about the long-term outcomes for these individuals. I became emotionally invested in the story (for example) of how Evan contracted HIV from his very first girlfriend (a woman who had been with a man who used IV drugs prior to dating Evan). I felt as if I were there with Evan when he received the devastating news about being HIV positive, and then he drifted away from the pages of the book never to be heard from again. The lack of resolution left me with an uneasy feeling – probably the same feeling that Emergency Medicine physicians experience at the end of each shift.
Nonetheless, I would highly recommend this book to all sexually active young people. It is eye-opening and disturbing in the right sort of way. It’s the kind of book that will help people think twice before they become intimate with others, and take stock of the true health risks involved. I can only hope, along with Jill, that this book will reach the right eyeballs at the right time – and reduce the devastating spread of sexually transmitted diseases in America and beyond.
