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*
June 24th, 2011 by Linda Burke-Galloway, M.D. in Research, Video
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One of the most dreaded complications in obstetrics is a stillbirth that is defined as the absence of life upon delivery of the baby. There are approximately 3million stillbirths that occur each year globally and one-half million in the U.S. In developing countries, the most common reasons of stillbirths were prolonged labor, pre-eclampsia and infections whereas in the U.S., the most common causes are abnormal genes, abnormal growth (aka growth restriction) and maternal diseases. According to medical studies, unexplained fetal loss is the most common reason for stillbirths that occur after 28 weeks. Risk factors for stillbirth include women who have infections, abnormal chromosomes, genetic disorders and umbilical cord complications. Race and socioeconomics also play a role. Black women have twice the risk of having a stillbirth as Caucasian women. Smoking and advanced maternal age also poses an increased risk.
Until recently, there are no screening tests available to see if a woman was carrying a baby at risk for stillbirth. However, a medical study presented at a conference reported that stillbirths can now be predicted using Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
June 23rd, 2011 by BarbaraFicarraRN in Health Tips, Opinion
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[image: iStockphoto]
Ladies imagine planning your daily events based around the timing of you menstrual cycle.
Some women suffering from uterine fibroids have a menstrual flow so heavy that it can impede their life.
“Everything must be planned around their menstrual, and it can be very draining physically (from the anemia of blood loss), as well as, mentally from the resulting stress this creates,” says Dr. John Lipman, Director of Interventional Radiology & Center For Image-Guided Medicine, Emory-Adventist Hospital, Atlanta, Georgia. “This can imprison women such that their entire life is tied to the menstrual cycle. They may not work or even be able to leave the house for several days each month. Even if they can work, the frequent interruptions throughout the day often makes this time very unproductive,” he adds.
“Uterine fibroids are the most common non-cancerous tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues that grow in and around the wall of the uterus, or womb. The cause of fibroids is unknown. Risk factors include being African-American or being overweight.”
According to The National Women’s Health Information Center – U.S. Department of Health and Human Services Office on Women’s Health, about 20 percent to 80 percent of women develop fibroids by the time they reach age 50.
Dr. Lipman writes: Read more »
*This blog post was originally published at Health in 30*
June 10th, 2011 by Peggy Polaneczky, M.D. in Health Tips
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In a large multicenter study enrolling over 70,000 women, annual screening with transvaginal pelvic ultrasound and ca125 blood testing did not reduce deaths from ovarian cancer, and in fact led to an increase in complications due to screening.
Investigators in the NCI-sponsored Prostate, Lung and Ovarian Cancer (PLCO) Screening trial randomly assigned over 78,000 women age 55-64 years of age to either annual screening with transvaginal pelvic sonograms for 4 years plus CA125 testing for 6 years or usual care at 10 study sites across the US., and followed the groups for up to 13 years. Over that time period, ovarian cancer rates in the screened group were 5.7 per 10,000 person-years vs 4.7 per 10,000 persons-years in the usual care group, with 3.1 deaths vs 2.6 deaths per 10,000 person years, respectively. Over 3000 women had false positive screening results, a third of whom had surgery and 15% of those operated on had a complications from their surgery. Deaths from other causes did not differ between the groups.
The investigators concluded that annual screening for ovarian cancer does not reduce mortality, and in fact caused harms among women with fals positive abnormal results.
This is not the first study that failed to find efficacy for ultrasound and ca125 in reducing mortality from ovarian cancer, but Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
June 8th, 2011 by Peggy Polaneczky, M.D. in Health Tips
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NPR is running a typical media hype story on oocyte preservation (egg freezing), featuring the standard happy family photo with their “miracle” baby born after thawing and fertilizing a cryopreserved egg.
It’s a heartwarming story and a pretty photo, but far from a complete picture of what women need to know about this still experimental fertility preserving procedure. Nowhere does the article tell women the actual success rates of occyte cryo-preservation.
So before you run out to freeze your eggs, know this – the chance of having a pregnancy after egg freezing is less than a 50/50 shot – at most about 39%, according to the latest data. That’s about the same odds you’d have if you just wait till 40 to try to get pregnant on your own. In addition, while somewhere between 1 and 2 thousand infants have been born using the technology, we do not yet have data on their long term outcomes. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
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.
