September 2010
5 posts
Great 2010 Congressional Election Infographics →
The New York Times has some helpful interactive infographics on this year’s congressional elections. Notice how slim the margin is between a Democrat and a Republican controlled House. Also, despite how much their executives must despise the Internet for what it has done to the newspaper industry, the Times consistently makes outstanding use of this new medium.
Smartphones Will Outsell PCs Next Year →
Asymco calls it like it is:
If the 1 million/day benchmark holds, and all indications are that it will, then the total smartphone/iPad/touch market will be greater than the total PC market next year.
The healthcare IT industry seems oblivious to this seismic shift. Eclypsis, Epic, and Cerner are the only EMR vendors whose products really meet meaningful use criteria. How many of them have...
Racist TN Republican on The Daily Show →
Tennessee Republicans have been protesting the expansion of a local Islaamic center down in Murfreesboro on the grounds that it is a terrorist training camp in disguise. They actually believe this, as a Daily Show interview with local opposition organizer Laurie Cardoza-Moore reveals. Since appearing on the show, Cardoza-Moore claims that she’s been receiving death threats on her cellphone....
Apple Debuts New iPods, iTunes, Apple TV, and More
Apple hosted it’s yearly iPod event today from California, debuting lots of new products. Interested parties can visit Apple’s homepage to see it all firsthand. Here are the items that excited me the most.
iPod Touch: Thinner, Video Chat, HD Video/Photo Camera.
This is the christmas present this year. There are plenty of people you know who don’t want an iPhone but would enjoy...
Orange Introduces HD Audio Mobile Phone Calls →
Orange, a UK mobile phone carrier, has debuted a new high-definition phone service called HD Voice. Although the service requires that you purchase a new mobile phone, the calls themselves don’t use any hardware not already present in most phones. Orange has made HD Voice an open standard in the UK. I hope that something similar follows in the states.
I’ve been waiting for something...
August 2010
42 posts
Will Healthcare IT Embrace the iPad?
iMedicalApps reviews some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too:
All in all, these developments bode well for the adoption of the iPhone and iPad as a mainstream, IT-blessed mobile healthcare solution.
iPad enthusiast medical...
Flight Sim Software Limitations to Blame for Half... →
USA Today reports:
However, as realistic as they may seem, simulators are only as good as the data used to program them. Current simulators aren’t accurate when a plane goes out of control, which has prevented their use in training for the leading killer in commercial aviation.
The computing power necessary to simulate that kind of turbulence is more readily available than ever....
Progress Report On Electronic Health Records In... →
Health Affairs has published an article on EMR adoption rates across all U.S. hospitals. Their findings more or less reinforce what other similar studies found, in particular:
We found that public and rural hospitals had 40 percent lower odds of having adopted at least a basic electronic record in the year before the survey, compared to private nonprofit and urban hospitals, respectively.
...
Video: Adorable Robot Delivers Hospital Meds →
This is a video of the TUG robot by Aetheon, used instead of a vacuum tube system to deliver medications and other items throughout a hospital. It’s cute.
Huber Needles Recalled for Coring →
MedPage Today reports that the FDA has recalled several brands of Huber access needles because of “coring,” which means they punch a thin sliver of silicone out of an otherwise self-healing access port when being inserted.
“Coring may lead to infection, damage or death of tissue, swelling, or other serious adverse health consequences, occurring as a result of the core...
Rapid Response Team Reduces Inpatient Cardiac... →
A retrospective study has demonstrated that the introduction of a rapid response system at a particular Veterans Affairs hospital reduced cardiac arrests by 57 percent. Way to go!
Imagining a Universal Health Record
Heather Leslie (a.k.a @omowizard) on her concept of a universal health record:
A uhr is simply a non-proprietary pool of standardised health data which can be used for any purpose we want – PHR, EHR, EMR, SEHR, IEHR, research, epidemiology, reporting & stats, shared care, clinical decision support & more. There is no particular EHR application associated with it; in fact it works with...
Your Patient is My Patient, Too
While on my way back to the unit after transferring a patient to a medical/surgical floor, I was stopped in the hallway by another patient’s wife. I could hear an IV pump beeping from her husband’s room. “Are you a doctor?” she asked. “No, ma’am,” I replied, “I’m a nurse. Can I help you?” She asked me to come see why the IV pump was...
4 tags
Nurses Need Better EMRs
There’s always a lot of stink from physicians over usability problems with EHRs: too many clicks, too many contextual menus, etc. The gist of these complaints is, “Physicians aren’t data entry clerks!” The computer is getting in the way of their interactions with their patients.
So what about nurses? Aren’t we laboring under the same demand to eat our cake and...
4 tags
Where are All the iPhone EMRs? →
EMR & HIPAA Dot Com are putting together a wiki of EMR vendors with information on OS and device compatibility. So far out of the thirty-one they’ve counted, how many are natively supported on MacOS? Nine. How many on iOS devices? Zilch.
5 tags
Google launching a Chrome OS Tablet on Verizon →
There’s really no more room for doubt; touchscreen tablet devices are not going to be a passing fad. They’re the way forward. So to all you EMR developers out there… cough-cough… quit screwing around already. There’s lots of money to be made.
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Learning About EMR Database Encryption the Hard... →
Robert J. Rogers, MD on EMR database encryption:
In an informal survey of my physician friends, none of them understood the importance of encryption. None had asked their vendors about encryption. Many of these doctors host their own servers.
I blame the developers and vendors. Encryption should be the default setup.
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Twifficiency Actually not a Scam →
Did you get hooked by that “Twifficiency score” thing today on Twitter? Well it wasn’t a scam. It was a rookie coding mistake by some 17-year-old Scottish bloke learning oAuth.
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Great Design of the Week: Field Notes County Fair...
My Field Notes County Fair boxset came in the mail last week. I haven’t bought any of their special editions before, but this one was on sale for 33% less than the regular Field Notes. A set of 50 memo books, one for each US state, comes together in a nice package with a decorative ribbon and some free pens.
Click here and here to see photos.
I depend on Field Notes in the hospital....
3 tags
Cleveland Clinic Redesigns the Hospital Gown,... →
From a Newsweek interview:
“I’ve been a nurse for almost 30 years, and the [traditional] gown leaves much to be desired,” says Jeanne Ryan, who works at Cleveland Clinic and has led the redesign project for the past three years.
Three years? Healthcare efficiency at work. (Via @drves.)
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Midodrine to be Pulled After 14 Years of FDA... →
From The Happy Hospitalist (anonymous):
The drug has been on the market for 14 years without proven efficacy? I just have one question: Why now? It has been 14 years. Why would the FDA care now? Why didn’t they care after five years? Why didn’t they care after ten years?
(Via Dr. Wes.)
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What the Heck is openEHR ? →
Here’s the official description from openEHR.org:
The principal challenge for health ICT is to represent the semantics of the sector, which are far more complex than in other industries. Doing this requires a knowledge-oriented computing framework that includes ontologies, terminology and a semantically enabled health computing platform in which complex meaning can be represented and...
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The EMR Nurses Need
Among the litany of complaints about the (un)usability of EMRs, it’s easy to lose sight of the big picture. More than the poor design choices and overall ugliness of existing software, by far the single biggest failure of HIT companies is that none of them has yet to produce an EMR that nurses actually need.
There is a huge opportunity being wasted here. Other industries have been able to...
3 tags
"Hello, Everybody!" Obama Demos New Healthcare... →
I just wish this video was about how to sign up online for a public option. Without a public option, the individual mandate will simply increase the customer base for private insurers without deincentivising unfair and unethical practices. (Via Brad Wright.)
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Furosemide IV on Backorder Until Late August →
All three vendors, APP, American Regent, and Hospira, are affected. No reasons for the recall were given. Torsemide IV is still available, from American Regent. But nobody get flash pulmonary edema until at least September, okay?
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Eat, Pray, Love, Die of Multi-Drug-Resistant... →
The Lancet Infectious Diseases Journal has published a study on NDM-1, a bacteria resistant to many broad-spectrum antibiotics, including carbapenems. The bacteria are found most often in India, Pakistan, and Bangladesh. Researcher Timothy Walsh:
“Because of medical tourism and international travel in general, resistance to these types of bacteria has the potential to spread around the world...
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What Happened to Yahoo →
Paul Graham, a former programmer for Yahoo, on the necessity of hiring only the best programmers:
Once you have bad programmers, you’re doomed. I can’t think of an instance where a company has sunk into technical mediocrity and recovered. Good programmers want to work with other good programmers. So once the quality of programmers at your company starts to drop, you enter a death spiral from...
2 tags
Texas Whistleblower Nurses Split $750K... →
Still, despite being vindicated after less than an hour of jury deliberation, they can’t find work. Aren’t these exactly the kind of nurses we want watching out for our patients? I guess Texas hospitals prefer their patients smeared with olive oil when having bits of scissor caps sewn into them.
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Great Design of the Week: Red Bull
I don’t know how long this little punched-out bull has been decorating the pull-tabs of Red Bull cans. I only noticed it this afternoon at the gas station. Anyways, I think it’s delightful. It’s inspired me to start a weekly feature about everyday design that is unobtrusive yet quietly beautiful.
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The Doctor's Inbox
Dr. Wes, a blogspot-blogging physician, posted a follow-up to his post last week on email correspondence between physicians and patients. The majority of emails he receives tend to be for very simple things like checking a lab result.
Current EMRs don’t make reviewing and sharing lab values efficient. Dr. Wes writes:
[O]ur current model of the electronic medical record sending every single...
3 tags
But... But... It's an iPad !
by Jared Sinclair, RN
There seems to be a pervasive belief among educators that by putting things “on the computer” they are somehow more informative or engaging than they are on a chalkboard or on paper. Anyone who has been through college since the late 90s knows what I mean. We have been beaten to death by PowerPoint presentations. Contrary to what these educators may think, a bulleted list...
The Decline of the American Newspaper, and the... →
In the August 9th issue of the New Yorker, George Packer quotes Senator Christopher Dodd on how the deterioration of the nation’s newspapers has contributed to the dysfunction of the Senate:
I used to have eleven Connecticut newspaper reporters who covered me on a daily basis. I don’t have one today, and haven’t had one in a number of years. Instead, D.C. publications only see...
2 tags
Bill Moyers on Net Neutrality →
While today’s press conference with Verizon and Google is still fresh news, I thought it would be helpful to link to the indispensable Bill Moyers’ broad coverage of net-neutrality.
My two cents: an open Internet is essential to both the free market and to democracy. It a enables small businesses to reach customers on an equal footing with big businesses, and it allows new ideas to...
1 tag
Sharpie's New 'Liquid Pencil' →
Writes like a pen, erases like a pencil, permanent after three days. I can’t wait to try these on our ICU flowsheets at work. (Via Daring Fireball.)
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Top Ten Wishlist for Next Generation EHRs →
From an anonymous commenter at Change Doctor:
1.Less configurable. The Demotivators® said it best “When people are free to do as they please, they usually imitate each other”. Every hospital or physician practice is unique — they uniquely solve the exact same problems everyone else is facing.
2.Better designed. End-user input and UI design should be part of the specs, not the pilot.
Amen!...
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AdvancedMDs CEO on EHR Late Adopters →
Eric Morgan, president and CEO of AdvancedMD:
It’s like the person back 10-15 years ago who resisted e-mail. Finally, everybody including Grandma got on e-mail, because if not, they couldn’t stay in touch with their grandkids and it became a problem. I think we’re going to have a similar situation where, regardless of where you are in EMR adoption, you’re going to realize one day that you can’t...
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Interview With Randall Oates, MD, Founder of... →
Dr. Oates on the core problem with the state of EHRs:
What is mainly missing is an accurate perception of reality. That is… recognition that it is nothing less than insanity to expect physicians to become data entry clerks! In the future, we are going to look at the current approaches to EMR implementation in the same fashion as we now view the practice of leeching and blood-letting of the past....
Never Again →
Joe Klein’s amazing apology for not having the courage to oppose the Iraq War:
The issue then was as clear as it is now. It demanded a clarity that I failed to summon. The essential principle is immutable: we should never go to war unless we have been attacked or are under direct, immediate threat of attack. Never. And never again.
(Via Paul Krugman.)
Magazines: the Power of Print →
Last week’s issue of the New Yorker offerred me my first glimpse of the “Magazines: the Power of Print” campaign announced by five major publishers on March 1st. Here are some photos I took of the ad. This is, after all, about the quality of paper over pixels:
Full spread Logo closeup
The logo is a very clever mashup of iconic magazine titles. As for the campaign itself, I...
Eight Reasons why Healthcare Costs Are Rising →
George Lundberg, MD on the point that everyone misses when arguing about rising healthcare costs:
It is the decisions of patients and physicians that are the principal drivers of healthcare costs.
I.e., not malpractice suits or this or that particular drug or piece of tech. He goes on to list the eight factors he believes are making healthcare so expensive. They are worth reading in situ, so...
Forget HIT: We Need Low-Tech, Unsexy, Grassroots... →
From an anonymous commenter at Kevin MD:
So we can all sit and perfect the tools for a few folks that never needed them anyway, or we can recognize that the kinds of solutions required for healthcare in the US today have nothing to do with fancy IT, or prioritization on search engines, and everything to do with low-tech, unsexy approaches toward grass-roots public health. Sorry to be the voice of...
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Why We Need a Healthcare IT Revolution (and Why We...
It’s a universally-accepted fact that healthcare lags behind most other industries in terms of information technology utilization. Less than one percent of our hospitals have gone fully paperless. Half of them are halfway electronic. An astonishing ten percent have no electronic medical records whatsoever.
Why should these numbers disturb us? Because healthcare costs are on their way to...
Paul Krugman on How to Judge Character →
Man do I love Paul Krugman:
Long ago — basically when I started writing for the Times — I decided that I would judge the character of politicians by what they say about policy, not how they come across in person. This led me to conclude that George W. Bush was dishonest and dangerous back when everyone was talking about how charming and reasonable he was. It led me to conclude that Colin Powell...
J.E. Smith Questions the Very Idea of "Non-Western... →
This isn’t the typical kind of subject matter for my website, but I found myself saying “yes” too many times while reading this post that I felt obliged to mention it here. In it, Justin E. Smith explains his misgivings with the idea of non-western philosophy:
I believe there is a serious problem when we set out from an implicit definition of ‘philosophy’ according...
No Harm Found When Nurse Anesthetists Work Without... →
Many state boards of health assume that CRNAs are more likely to have higher rates of mortality and complication than anesthesiologists and therefore require them to work under the supervision of a doctor. That assumption turns out to be unfounded:
A multivariate analysis showed that nurse anesthetists had a lower incidence of mortality and complications than did doctors practicing alone.
Wow....
Ottawa Hospital Wakes Up, Hires Outside IT Expert,... →
Ottawa Hospital Chief Executive, Dr. Jack Kitts, on hiring an IT guru without healthcare IT experience:
“Health care is probably at the bottom of the pack when it comes to information systems, information technology and advancing our business processes or patient service delivery,” said Kitts. “So why not bring someone in who has no baggage, no preconceived beliefs or notions about what is...
IBM Entering the EHR Clusterfu- I Mean, Industry →
They’re partering with Aetna to provide cloud-computing EHR services to large physician practices. IBM has the distinction of being the first company in this industry to know that the year is 2010. Hopefully the competition will learn something.
July 2010
22 posts
1 tag
You Should be Able to do That on an iPad
by Jared Sinclair, RN
So I’m buying a car today when I struck up idle conversation with the dealer about Macs and iPads and software.
“Every computer I have is a Mac,” he said. “At home I’ve got an iMac, a Macbook, and my wife has an iPad.” He said his wife owns an interior design business and she runs it with several iMacs.
He was telling me all this while...
Texas Medical Board Files Complaint Against Dr.... →
The accusations against Arafiles were originally made by two nurses at Winkler County Memorial Hospital, who were fired shortly after filing their complaints. They have since been acquitted.
Arafiles is likely going to get his just desserts, but for me a looming question remains: what about the hospital administrators who, either directly or indirectly, were complicit in the firing of these...
Image-Processing Algorithm Reduces CT Radiation... →
One of the scientists explains how they overcame the image-quality drawbacks of low-dose CT scans:
“When we use very low doses, the noise gets so high that it’s hard to tell what you are seeing,” said Juan Carlos Ramirez Giraldo. “With this algorithm, we’re trying to maintain both the image quality, so that a doctor can recognize the anatomic structures, and the...