June 26th, 2009 by DrWes in Better Health Network
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I filter through progress notes looking for the few sentences different from the day before, only to find them sandwiching pages and pages of electronically-produced babble dutifully and automatically mass-reproduced in every note. I wonder, has anyone ever looked retrospectively at the mess created by this process developed to assure doctors were doing what they said they were doing? Ironically, I find we’re rarely reading most of what we re-create each day.
But we’re sure good at following the rules.
Next.
I now see prescription refills for each and every bottle of prescriptions ever filled by a patient, the date a patient filled it, and how many pills they received with each prescription. I’m not sure why. I sat awestruck in clinic yesterday when the list extended 94 pages, double-spaced, since January, 2009. No one, and I mean no one, filled that many prescriptions, did they? Or did they? Am I supposed to correct that list? Oh, by the way dear referring doctor, my note’s at the bottom of that listing.
Next.
I get pre-surgical notifications, even though I was the one to notify everyone else about the need for admission, just so I can click on the patient’s name again, lest it not appear I’m not doing enough, I guess.
Next.
I get EKG results forwarded for me to sign electronically, even though I’ve already read them, and signed them, by hand, on the EKG. I get notified again that the order I entered for that EKG now has a result, and I have to click on that to tell the computer, “I know.” But that, you see, is not enough. I must also log in, review, and sign off on my EKG’s on the EKG server, too. After all, I’m responsible, and it’s all about quality.
Quality three times over.
Now, multiply that same process for each and every other test I have ordered.
Next.
I see orders for things I’m not sure I ordered, just to be sure I’m responsible, and watching, literally hundreds of times per day.
Next.
I get e-mails and electronic notifications, and electronic communications, as if I know the difference.
Next.
I bypass nursing notes that are mere QA checklists and say nothing about the patient, except that a nurse was there last night.
Next.
I feel guilty entering data as I talk to my patient while serving my electronic master. Yet I find the stakes are high to assure accuracy and timeliness in clinical electronic reporting. After all, you never hear the bullet that hits you.
Next.
I go home on call, am paged, and reprimanded by a patient who wonders why I can’t look up their medication list on-line, even though I’m standing in the grocery store.
Next.
Worst of all, I find myself sending myself messages, just to make sure I do something tomorrow that I could not get done today.
Killing me softly …
… with information overload.
*This blog post was originally published at Dr. Wes*
June 22nd, 2009 by Medgadget in Uncategorized
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SonoSite just released their SonoRemote for controlling the company’s M-Turbo and S Series ultrasounds during interventional procedures like joint injections or central line placements. In addition to traditional style buttons, the remote control features voice recognition and can be programmed to understand commands in any language. So now you can hold the probe in one hand and the syringe in the other, and not have to fiddle with reaching over to the unit to take snapshots or change parameters.
Voice or touch activated
Programmable to your voice and language
Adjust system controls from a radius of 10 meters
No need to break the sterile field
Drop-tested to 3 feet
Works with M-Turbo® and S Series™
Press release: SonoSite Begins Customer Shipments Of Ultrasound Remote Control
Product page: SonoRemote
Flashbacks: M-Turbo™: New Portable Ultrasound from SonoSite ; SonoSite S-ICU™ Ultrasound Tool; S-Nerve™ from SonoSite; The SonoSite® MicroMaxx™; Titan
*This blog post was originally published at Medgadget*
June 17th, 2009 by Gwenn Schurgin O'Keeffe, M.D. in Better Health Network, Opinion
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Cell phones are their feature are an ever growing topic in today’s families. It used to be that the hot button issue was whether to get the phone. Now, we have to deal with all the features: texting, Internet, camera…to name the tip of the iceberg!
Clearly we’re becoming a more mobile society with our cell phones taking over features previously reserved for our computers. A recent Nielsen Wire report confirms this observation showing that in Q1 of 2009 21% of cell phone owners used their phones to search the Internet, up from 16% in Q4 of 2008.
At the moment, digital plans are pricey so it’s easy to lock our kids out of their cell phone Internet access. However, not too long ago we said the same exact thing about texting and now we have affordable unlimited texting plans.
Given the impulsivity of tweens and teens and how difficult it is for us to help kids with appropriate Internet use on computers, do we want to open the door to having them have access to the Internet on cell phones? Once data plans become more affordable, should we let them have cell phone internet access?
Perhaps it would be easier to answer if asked slightly differently. How are our teens and tweens doing with the digital cell phone freedom they have right now? Given the rise of extreme texting and sexting, I’d say not so great. Before we open the door to new issues and digital freedoms they are not ready for, we have to help them more with the freedoms they already have – and are clearly struggling with. Plus, as parents, we are still sorting out the issues with the digital uses of technology our kids are currently using. Let’s sort those out first before we give the green light to other mobile freedoms that will certainly be more complex and harder to control.
If all goes well, data plans will remain unaffordable for a while longer so we won’t have to cross another digital bridge none of us are ready for.
*This blog post was originally published at Dr. Gwenn Is In*
June 7th, 2009 by Gwenn Schurgin O'Keeffe, M.D. in Better Health Network
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If we had a power outage for a really, really long time, how would you fare? Really…could you go a really, really long time with out your computer, TV, cell phone over, say, your refrigerator? If you had access to a super powered generator what would you turn on? In other words, what would you find “essential” – things like refrigerators, the stove and perhaps a light or two…or technology.
A recent article in USA Today is quite illuminating. It turns out that many people, adult people, are so hooked on technology that in the case of a massive power outage they would actually put their lives and those of their kids at huge risk by turning on things like video games over truly essential items like lights and a refrigerator by running the games in a closed garage.
The USA Today article points out the highlights of a new study in this month’s Pediatrics about the dangers of gas-powered generators. The study notes that after Hurricane Ike, an ER in Houston treated 37 people from gas-generator-related carbon monoxide poisoning. Of those people, 54% were under the age of 18 and 75% of this group were playing video games.
This study highlights that our sense of “what is essential” has become skewed towards all that is plugged in. If our kids can not deal without technology for a bit, if we can not deal without technology for a bit, it’s time we took a collective big step back and realized that we actually can. It will feel strange and foreign for a day or so but life will go on because our “essentials”…food, shelter, oxygen, family…are met.
*This blog post was originally published at Dr. Gwenn Is In*
June 6th, 2009 by Berci in Better Health Network
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Who has never heard about Jay Parkinson, founder of HelloHealth service, the first online medical practice? Now please meet Dr. Hodge, the first iPhone doctor.
Hodge’s start-up Personal Pediatrics aims to equip a fleet of self-starter pediatricians in major metro areas with iPhones, cloud-based practice software and the marketing know-how to court new parents, families and corporate health programs alike. The company’s plan points to a growing trend of doctors returning to what was once a mainstay of the profession: the house call.
Hodge has already established that the iPhone doctor model works — after more than a decade working in a pediatrics office in St. Louis, Missouri, where she saw up to 35 patients a day for about 10 minutes each, Hodge traded in the patient assembly line to launch Personal Pediatrics. That was three years ago. Back then she had her laptop and Palm Treo in tow.
I have to mention one thing first. The whole health 2.0 movement is not about transforming the healthcare system into an online service, but there are more and more people who want to reach healthcare services through online or mobile applications.
If there are no patients who want to be online, no doctors will build such services. That’s how it works.
*This blog post was originally published at ScienceRoll*
