Medstory - the intelligent health searh engine : "Medstory's mission is to enable users to search complex fields on the Web intelligently. We're starting with health and medicine – an area where many people will appreciate a service that helps them quickly get high value information, and a field where we have expertise based on our work with health-related organizations.
To us, providing intelligent search means supporting an understanding of both a user's intent behind a search and the results that are delivered. For a field like health and medicine, we believe that search engines should deliver more to users than just a list of Web pages. Our approach is to try to synthesize the meaning of every user search in the context of health and medicine, and then share this knowledge with the user to help refine and guide their search."
Tuesday, February 27, 2007
Tech firms in a fever about health - USATODAY.com
Tech firms in a fever about health - USATODAY.com: "IBM, Intel, Microsoft and other tech companies are increasingly betting that the health care industry will help them grow as their traditional markets mature.
Americans spent almost $2 trillion on health care in 2005, according to the most recent study from the Department of Health and Human Services. Yet, many doctors and nurses 'still use pen and paper and clipboards' to record patient data, says Scott Eckert, CEO of PC-maker Motion Computing."
Lots of money to be made by clever companies who can help doctors ( and patients) to get their act together !
Americans spent almost $2 trillion on health care in 2005, according to the most recent study from the Department of Health and Human Services. Yet, many doctors and nurses 'still use pen and paper and clipboards' to record patient data, says Scott Eckert, CEO of PC-maker Motion Computing."
Lots of money to be made by clever companies who can help doctors ( and patients) to get their act together !
Sunday, February 25, 2007
In Practice: Dealing With Death
In Practice: Dealing With Death: "Wollner recommends a seven-step communication process outlined nearly 10 years ago by the Educating Physicians in End of Life Care (EPEC) project. The project — an effort by the American Medical Association and the Robert Wood Johnson Foundation — suggests that physicians approach patients to whom they must give bad news by:
* Preparing. Choose a quiet, comfortable location where there will be no interruptions, turn off pagers and phones, and decide — asking the patient, if possible — who else should be in on the discussion. Adds Wollner, “Make sure you truly know all of the medical details of the patient’s case beforehand.”
* Assessing. Find out what the patient already knows and wants to know. “Some people want every laboratory test, every fact you can give them, while others, often the elderly from other cultures, may say, ‘You’re the doctor, you decide’ or ‘Talk to my son or daughter,’” Wollner says.
* Warning. Old calls this “firing a warning shot.” It is simply saying, “I have some bad news.”
* Describing. Present the facts of the case in a succinct but caring way and in terms that patients with no medical background will e"
* Preparing. Choose a quiet, comfortable location where there will be no interruptions, turn off pagers and phones, and decide — asking the patient, if possible — who else should be in on the discussion. Adds Wollner, “Make sure you truly know all of the medical details of the patient’s case beforehand.”
* Assessing. Find out what the patient already knows and wants to know. “Some people want every laboratory test, every fact you can give them, while others, often the elderly from other cultures, may say, ‘You’re the doctor, you decide’ or ‘Talk to my son or daughter,’” Wollner says.
* Warning. Old calls this “firing a warning shot.” It is simply saying, “I have some bad news.”
* Describing. Present the facts of the case in a succinct but caring way and in terms that patients with no medical background will e"
Providing patients with access to their medical records - problems and solutions
Dr Brian Fisher of the Record Access Collaborative , UK has some excellent tips for doctors who are concerned about the downsides of patients being able to read their own medical records. This wisdom is based on years of practical experience !
" 1.3.3 Safety Issues and recommended actions
Whilst accepting the benefits of record access, practices also worry about the safety of full record access. The commonest concerns centre on third party information, litigation, seeing bad news and children. Our experience has been that the following simple precautions avoid much risk. It does mean that whoever reads the letters or results needs to see them from a lay point of view.
• Third party information: the identity of the provider of third party information.must remain concealed from the patient The data that a third party provides can be seen by the patient, (for instance, if a wife reports the drinking of the husband but does not want herself to be identified) but the identity of the giver of that information must be kept from the patient reading the record.
We recommend that records are checked for third party information before access is enabled. We have further documentation on this issue if you need. Practices will be able to allow record access to consultations after a date of their choosing. This will allow practices to ensure appropriate recording practices are in place.
• Serious test results and potentially frightening letters should probably be excluded until a face-to-face meeting. When reading letters or checking results, look for new frightening information that you feel patients should not be expected to see on their own without discussion and putting into context.
We recommend that the practice should ensure that clinicians read letters and results before they are included in the records. If this is not possible, the practice will be enabling patients to see information before it can be put into context by the practice.
• Children. There are no legal precedents that cover this area, except for the usual “Gillick competence” approach. It is essential that children’s records are only seen by the parents/carers with the child’s permission. Different surgeries have developed different policies. The simplest is that record access is only allowed for children over a certain age, say 10 years old.
We recommend that access should be disabled when a child reaches 10. We shall be consulting on the best approach to this issue over the next few months.
• Carers. Patients are often keen for their family to have access to their records. Sometimes younger members can use the computer more easily, sometimes access to the data could make care a great deal safer. In our view, so long as people are not being coerced, it is up to the patient.
1.3.4 Changes in style and culture that may be needed.
• It would be helpful to write notes in as clear a style as possible. However, patients reading even handwritten records say that they understand 60% of what they read.
• Derogatory comments are always unacceptable.
• All clinicians should be writing anyway as if patients can see whatever they write. Current legislation enables patients to obtain access to records on request, though GPs are allowed to charge for this access. Doctors can only censure access if:
It may cause serious harm to the physical or mental health, or condition of the patient or any other person
It may relate to or be provided by a third person who had not consented to the disclosure.
• Third party information given to clinicians needs to be handled carefully, for instance when a mother tells you about her son’s behaviour and asks you to intervene without revealing your source.
• Recording speculative differential diagnoses is only a problem if they have not been discussed with the patient.
• Do not write anything you don’t want the patient to see. This open style does put a premium on honesty. It is best to explain that a colonoscopy is looking for cancer rather than write notes to yourself that a patient may see in the future.
• It is worth every member of the practice obtaining a reasonable understanding of the PAERS system in order to answer patient queries.
1.3.5 Ways by which the system can save time
• Patients can look at their results on computer (if you get your results by electronic links) without contacting reception.
• Patients can look at their immunisations on computer without contacting reception.
• Patients can read their letters without contacting a clinician.
• Patients can share information with family, carers and other healthcare professionals, reducing the requests for clinical information from the practice.
• We shall, in the future, be enabling the system to remind patients about key appointments, such as BP and medication reviews
Will there be an increase in consultation time?
There may be concerns that patients will want more explanation and ask more questions. Our experience is that access appears to be time-neutral. Some patients do take longer, but research also shows that:
• access is used by patients to keep consultations short. They do this by looking at the data beforehand and only asking about things they need to ask
• one paper showed that there was no increase in time taken.
• The practice will save time when people can look up their information without consulting anyone at the practice: allergies, immunisations – for forms etc
1.3.6 Will there be an increase in complaints?
There is no evidence for an increase in litigation as a result of access. On the contrary, the evidence is good that relationships are improved
1.3.7 Are patients made anxious?
A small minority are, most are reassured. The group of patients who have the most difficulties are patients with psychiatric problems. Research suggests that this group is still pleased to have seen the information even if it upset them. Upset can be therapeutic.
1.3.8 What if patients see errors in the records?
Research suggests that, at the moment, if patients see errors, they tell no-one. We see access as improving record-keeping. Patients should be encouraged to report errors. The commonest are simple demographic errors (evidence suggests that most practices have 10% demographic errors). If patients can tell us about them, accurate mobile numbers for instance, that can help practices significantly.
Patients do misunderstand entries sometimes. The vast majority are easily dealt with by simple explanation.
1.3.9 Is the record secure?
The main risk to security in the current system is that an attacker might guess or steal a patient’s account log-in information and use it to log-in themselves. This risk is higher if patients use weak passwords, fail to keep their passwords secret, use public computers or do not keep their home systems patched up to date and protected from viral and trojan software. Token based two factor authentication will mitigate much of this risk.
A simple study conducted in two surgeries suggests that about 3/4 of patients are content with a pin and password , while a quarter would prefer 2 factor authentication.
It is possible that members of the family, for instance, will be able to see records, perhaps by glancing over patients’ shoulders or by coercing them. As with internet banking and other protected sites, once the record has been delivered, we can assume that the patient becomes fully responsible for its security.
" 1.3.3 Safety Issues and recommended actions
Whilst accepting the benefits of record access, practices also worry about the safety of full record access. The commonest concerns centre on third party information, litigation, seeing bad news and children. Our experience has been that the following simple precautions avoid much risk. It does mean that whoever reads the letters or results needs to see them from a lay point of view.
• Third party information: the identity of the provider of third party information.must remain concealed from the patient The data that a third party provides can be seen by the patient, (for instance, if a wife reports the drinking of the husband but does not want herself to be identified) but the identity of the giver of that information must be kept from the patient reading the record.
We recommend that records are checked for third party information before access is enabled. We have further documentation on this issue if you need. Practices will be able to allow record access to consultations after a date of their choosing. This will allow practices to ensure appropriate recording practices are in place.
• Serious test results and potentially frightening letters should probably be excluded until a face-to-face meeting. When reading letters or checking results, look for new frightening information that you feel patients should not be expected to see on their own without discussion and putting into context.
We recommend that the practice should ensure that clinicians read letters and results before they are included in the records. If this is not possible, the practice will be enabling patients to see information before it can be put into context by the practice.
• Children. There are no legal precedents that cover this area, except for the usual “Gillick competence” approach. It is essential that children’s records are only seen by the parents/carers with the child’s permission. Different surgeries have developed different policies. The simplest is that record access is only allowed for children over a certain age, say 10 years old.
We recommend that access should be disabled when a child reaches 10. We shall be consulting on the best approach to this issue over the next few months.
• Carers. Patients are often keen for their family to have access to their records. Sometimes younger members can use the computer more easily, sometimes access to the data could make care a great deal safer. In our view, so long as people are not being coerced, it is up to the patient.
1.3.4 Changes in style and culture that may be needed.
• It would be helpful to write notes in as clear a style as possible. However, patients reading even handwritten records say that they understand 60% of what they read.
• Derogatory comments are always unacceptable.
• All clinicians should be writing anyway as if patients can see whatever they write. Current legislation enables patients to obtain access to records on request, though GPs are allowed to charge for this access. Doctors can only censure access if:
It may cause serious harm to the physical or mental health, or condition of the patient or any other person
It may relate to or be provided by a third person who had not consented to the disclosure.
• Third party information given to clinicians needs to be handled carefully, for instance when a mother tells you about her son’s behaviour and asks you to intervene without revealing your source.
• Recording speculative differential diagnoses is only a problem if they have not been discussed with the patient.
• Do not write anything you don’t want the patient to see. This open style does put a premium on honesty. It is best to explain that a colonoscopy is looking for cancer rather than write notes to yourself that a patient may see in the future.
• It is worth every member of the practice obtaining a reasonable understanding of the PAERS system in order to answer patient queries.
1.3.5 Ways by which the system can save time
• Patients can look at their results on computer (if you get your results by electronic links) without contacting reception.
• Patients can look at their immunisations on computer without contacting reception.
• Patients can read their letters without contacting a clinician.
• Patients can share information with family, carers and other healthcare professionals, reducing the requests for clinical information from the practice.
• We shall, in the future, be enabling the system to remind patients about key appointments, such as BP and medication reviews
Will there be an increase in consultation time?
There may be concerns that patients will want more explanation and ask more questions. Our experience is that access appears to be time-neutral. Some patients do take longer, but research also shows that:
• access is used by patients to keep consultations short. They do this by looking at the data beforehand and only asking about things they need to ask
• one paper showed that there was no increase in time taken.
• The practice will save time when people can look up their information without consulting anyone at the practice: allergies, immunisations – for forms etc
1.3.6 Will there be an increase in complaints?
There is no evidence for an increase in litigation as a result of access. On the contrary, the evidence is good that relationships are improved
1.3.7 Are patients made anxious?
A small minority are, most are reassured. The group of patients who have the most difficulties are patients with psychiatric problems. Research suggests that this group is still pleased to have seen the information even if it upset them. Upset can be therapeutic.
1.3.8 What if patients see errors in the records?
Research suggests that, at the moment, if patients see errors, they tell no-one. We see access as improving record-keeping. Patients should be encouraged to report errors. The commonest are simple demographic errors (evidence suggests that most practices have 10% demographic errors). If patients can tell us about them, accurate mobile numbers for instance, that can help practices significantly.
Patients do misunderstand entries sometimes. The vast majority are easily dealt with by simple explanation.
1.3.9 Is the record secure?
The main risk to security in the current system is that an attacker might guess or steal a patient’s account log-in information and use it to log-in themselves. This risk is higher if patients use weak passwords, fail to keep their passwords secret, use public computers or do not keep their home systems patched up to date and protected from viral and trojan software. Token based two factor authentication will mitigate much of this risk.
A simple study conducted in two surgeries suggests that about 3/4 of patients are content with a pin and password , while a quarter would prefer 2 factor authentication.
It is possible that members of the family, for instance, will be able to see records, perhaps by glancing over patients’ shoulders or by coercing them. As with internet banking and other protected sites, once the record has been delivered, we can assume that the patient becomes fully responsible for its security.
Benefits of a PHR - a personal view from the UK
This is a guest post from Dr Brian Fisher of the Record Access Collaborative, UK.
" We have been showing patients their records on paper for many years, at Wells Park Practice. Our published experience, easiest to see at www.icmcc.org which includes investigating the reactions of patients with cancer to seeing their records, suggests the following conclusions, so long as simple safety procedures are carried out, as described later:
• It enhances communication between clinician and patient.
• It increases the onus on the clinician to tell the truth
• It increases patient satisfaction
• It enables patients to correct data errors, the commonest ones being demographic data, but the errors can also be about clinical process and outcomes.
• Patients feel better informed and almost always reassured, even when they read bad news.
• Patients feel they understand about 70% of what they read.
• It appears to improve compliance and support health education messages, such as smoking quit rates
• It is likely to improve self-care."
" We have been showing patients their records on paper for many years, at Wells Park Practice. Our published experience, easiest to see at www.icmcc.org which includes investigating the reactions of patients with cancer to seeing their records, suggests the following conclusions, so long as simple safety procedures are carried out, as described later:
• It enhances communication between clinician and patient.
• It increases the onus on the clinician to tell the truth
• It increases patient satisfaction
• It enables patients to correct data errors, the commonest ones being demographic data, but the errors can also be about clinical process and outcomes.
• Patients feel better informed and almost always reassured, even when they read bad news.
• Patients feel they understand about 70% of what they read.
• It appears to improve compliance and support health education messages, such as smoking quit rates
• It is likely to improve self-care."
Friday, February 23, 2007
Mayo offers health info through cell phones - Jacksonville Business Journal:
Mayo offers health info through cell phones: "Mayo Clinic has teamed with a subsidiary of an information technology company to develop a software application that delivers health information directly to cell phones.
The Mayo Clinic InTouch wireless health program will be available this month on several major carriers' cell phones. It is a collaboration between Mayo and Digital Cyclone Inc., a subsidiary of Garmin Ltd.
Wireless subscribers have access to first aid tips, a symptom checker that provides self-care guidelines or advises emergency care for more than 45 common symptoms, more than 100 short health news videos and health alerts and drug watches.
Subscribers can enter their area code or zip code for a list of nearby emergency and urgent care facilities. If the phone has global positioning system capability, it automatically finds the nearest accredited facility without typing a zip or area code."
The Mayo Clinic InTouch wireless health program will be available this month on several major carriers' cell phones. It is a collaboration between Mayo and Digital Cyclone Inc., a subsidiary of Garmin Ltd.
Wireless subscribers have access to first aid tips, a symptom checker that provides self-care guidelines or advises emergency care for more than 45 common symptoms, more than 100 short health news videos and health alerts and drug watches.
Subscribers can enter their area code or zip code for a list of nearby emergency and urgent care facilities. If the phone has global positioning system capability, it automatically finds the nearest accredited facility without typing a zip or area code."
Physicians Tap Technology To Revitalize Family Practices
Physicians Tap Technology To Revitalize Family Practices: "A small but increasing number of physicians are trying to use technology and curb overhead costs to make family practices more manageable and profitable, the Wall Street Journal reports.
The number of primary care physicians has dropped by half in the past 10 years, according to a series of surveys by the American Academy of Family Physicians. However, the trend of converting to 'micropractices' could help counter the decline in primary care medicine, according to the Journal. "
The number of primary care physicians has dropped by half in the past 10 years, according to a series of surveys by the American Academy of Family Physicians. However, the trend of converting to 'micropractices' could help counter the decline in primary care medicine, according to the Journal. "
Consumers: The Missing Puzzle Piece in Health IT?
Consumers: The Missing Puzzle Piece in Health IT? : "'It is not a surprise that consumers have not been so engaged in the discussion' of health IT 'because it doesn't affect their daily lives,' Zamore said. Most consumers are satisfied with the health care they receive at the micro level, according to Zamore. Patients generally like and trust their doctors and think they receive quality care. However, he said that at 'the macro level, it's clear that the system is riddled with inefficiencies ... and is extremely inconsistent.'
'Most of the health IT conversations that have been going on here on Capitol Hill haven't really addressed the patient health care experience,' Zamore explained.
Technology has been integrated into almost every sector of our everyday lives except for health care. Zamore said, 'People want to have technology as part of their health care relationship, but they just don't have that opportunity right now.'"
'Most of the health IT conversations that have been going on here on Capitol Hill haven't really addressed the patient health care experience,' Zamore explained.
Technology has been integrated into almost every sector of our everyday lives except for health care. Zamore said, 'People want to have technology as part of their health care relationship, but they just don't have that opportunity right now.'"
Thursday, February 22, 2007
MEDecision and Christiana Care Illustrate Economic Benefit of Electronic Health Records
MEDecision and Christiana Care Illustrate Economic Benefit of Electronic Health Records: "The HealthCore report concludes that each transmitted Patient Clinical Summary generated an average total savings of $545 on emergency department visit costs and first day hospitalization expenses for the subset of patients who were subsequently admitted. In addition, the study finds that using the Patient Clinical Summary resulted in significant savings on laboratory testing, cardiac catheterization, and medical and surgical supplies.
“These results indicate that health information exchange is a promising means for achieving important changes in our healthcare system,” said MEDecision Executive Vice President and Chief Medical Officer Henry DePhillips, M.D., one of the Webinar’s presenters. “We now have an economic value associated with openly sharing patient clinical data and delivering it to the point of care. And that value is statistically significant.”"
“These results indicate that health information exchange is a promising means for achieving important changes in our healthcare system,” said MEDecision Executive Vice President and Chief Medical Officer Henry DePhillips, M.D., one of the Webinar’s presenters. “We now have an economic value associated with openly sharing patient clinical data and delivering it to the point of care. And that value is statistically significant.”"
Sunday, February 18, 2007
Personal Health Records: Employers Proceed with Caution - CHCF.org
Personal Health Records: Employers Proceed with Caution - CHCF.org: "With health care spending on the rise, employers are increasingly at the forefront of shaping solutions to promote employee wellness. Some are beginning to offer personal health records (PHRs) as a tool to improve health and manage costs."
Japan Plans To Digitize Health Information - iHealthBeat - Daily News Digest on Health Care Information Technology
Japan Plans To Digitize Health Information - " Japan's Health Ministry plans to use IT to improve medical treatment and nursing care, according to the Nikkei Report.
Physical exam data beginning in fiscal year 2008 will be stored electronically to improve health management. The plan also calls for digitizing medical facilities care and cost statements beginning in FY 2009. The data will let the ministry analyze and identify nationwide cost trends, according to the Nikkei Report.
Electronic health data could lead to more appropriate treatment and safer practices. The plan calls for implementing IT by FY 2010, and the provisions next month will be endorsed and included in the government's broader IT strategy. The ministry also will look into using smart cards equipped with advanced personal identification functions to prevent the disclosure of personal health data (Nikkei Report, 2/14)."
Physical exam data beginning in fiscal year 2008 will be stored electronically to improve health management. The plan also calls for digitizing medical facilities care and cost statements beginning in FY 2009. The data will let the ministry analyze and identify nationwide cost trends, according to the Nikkei Report.
Electronic health data could lead to more appropriate treatment and safer practices. The plan calls for implementing IT by FY 2010, and the provisions next month will be endorsed and included in the government's broader IT strategy. The ministry also will look into using smart cards equipped with advanced personal identification functions to prevent the disclosure of personal health data (Nikkei Report, 2/14)."
Wednesday, February 14, 2007
Patients who make me smile
I enjoy talking to patients my email.
One of my patients needs an egg donor, and she sent me her picture and her physical traits, so I could match a donor fer her.
I loved her last line -
" I am a software engineer, so would prefer somebody with academic excellence.(Almost feels like I am looking for a bride :)"
One of my patients needs an egg donor, and she sent me her picture and her physical traits, so I could match a donor fer her.
I loved her last line -
" I am a software engineer, so would prefer somebody with academic excellence.(Almost feels like I am looking for a bride :)"
Patients with a sense of humour !
I answer a lot of queries from infertile patients by email.
Many infertile men are obsessed with their sperm count; and want to know how to improve it. I explain to them that the sperm account is not a bank account, that we should not worry about the number. The quality of the sperm are as important as the quality - and in any case, we treat couples - not numbers or lab reports !
One of my patients wrote back, saying - " I only wish my sperm count was like a bank account - one could beg, borrow or steal to boost it :).
Many infertile men are obsessed with their sperm count; and want to know how to improve it. I explain to them that the sperm account is not a bank account, that we should not worry about the number. The quality of the sperm are as important as the quality - and in any case, we treat couples - not numbers or lab reports !
One of my patients wrote back, saying - " I only wish my sperm count was like a bank account - one could beg, borrow or steal to boost it :).
Tuesday, February 13, 2007
Approaching Death:
Approaching Death:: "Dying is at once a fact of life and a profound mystery. Death comes to all, yet each person experiences it in ways that are only partly accessible to the physician or family member, the philosopher or researcher. In principle, humane care for those approaching death is a social obligation as well as a personal offering from those directly involved. In reality, both society and individuals often fall short of what is reasonably—if not simply—achievable. As a result, people have come both to fear a technologically over-treated and protracted death and to dread the prospect of abandonment and untreated physical and emotional distress.
A humane care system is one that people can trust to serve them well as they die, even if their needs and beliefs call for a departure from typical practices. It honors and protects those who are dying, conveys by word and action that dignity resides in people—not physical attributes—and helps people to preserve their integrity while coping with unavoidable physical insults and losses. Such reliably excellent and respectful care at the end of life is an attainable goal, but realizing it will require many changes in attitudes, policies, and actions. System changes—not just changes in individual beliefs and actions—are necessary."
A humane care system is one that people can trust to serve them well as they die, even if their needs and beliefs call for a departure from typical practices. It honors and protects those who are dying, conveys by word and action that dignity resides in people—not physical attributes—and helps people to preserve their integrity while coping with unavoidable physical insults and losses. Such reliably excellent and respectful care at the end of life is an attainable goal, but realizing it will require many changes in attitudes, policies, and actions. System changes—not just changes in individual beliefs and actions—are necessary."
Monday, February 12, 2007
The Shared Record
The Shared Record: " How would a single shared record benefit you as a patient?. There are numerous important benefits and, depending upon the final structure and format of the record, these may include the following:
A shared record is built up by input from several clinicians and standard information need only be recorded once, avoiding duplication and saving time which can better applied to the consultation process.
A shared record is only beneficial to the clinicians treating you if they are accurate. When you have access to your own record this enables you to check the record for errors and/or omissions so that they can be corrected.
A single shared record, which is web-based, can be accessed instantly from anywhere at any time by yourself or other authorised persons. This may be particularly important in an emergency or when you need treatment away from home. There is also a possibility the patients and clinicians may be able to communicate with each other using the facilities which the Shared Record provides.
When you have ready access to your own Health Record, whether it be on paper, on disc or via the web, you have much more information to become more involved in your own healthcare. ‘Knowledge is power’ and access to your record empowers you to become more involved in decisions about your own health."
A shared record is built up by input from several clinicians and standard information need only be recorded once, avoiding duplication and saving time which can better applied to the consultation process.
A shared record is only beneficial to the clinicians treating you if they are accurate. When you have access to your own record this enables you to check the record for errors and/or omissions so that they can be corrected.
A single shared record, which is web-based, can be accessed instantly from anywhere at any time by yourself or other authorised persons. This may be particularly important in an emergency or when you need treatment away from home. There is also a possibility the patients and clinicians may be able to communicate with each other using the facilities which the Shared Record provides.
When you have ready access to your own Health Record, whether it be on paper, on disc or via the web, you have much more information to become more involved in your own healthcare. ‘Knowledge is power’ and access to your record empowers you to become more involved in decisions about your own health."
Sunday, February 11, 2007
New Health Information Resource Now Available Across India
New Health Information Resource Now Available Across India: "All Indian residents now have complimentary access to reliable, up-to-date health research evidence on health care interventions from The Cochrane Library. Thanks to sponsorship provided by the Indian Council of Medical Research (ICMR), the online database is now available to 60 million internet users in India.
Lorne Becker, Co-chair of The Cochrane Collaboration Steering Group was also delighted about the agreement: "The ICMR is a very forward thinking organisation and we feel that this agreement is a meeting of minds over medicine. We are hoping to be able to do even more good work in this part of the world and produce many Cochrane Reviews with Indian contributors."
The Cochrane Library is available at http://www.thecochranelibrary.com "
Lorne Becker, Co-chair of The Cochrane Collaboration Steering Group was also delighted about the agreement: "The ICMR is a very forward thinking organisation and we feel that this agreement is a meeting of minds over medicine. We are hoping to be able to do even more good work in this part of the world and produce many Cochrane Reviews with Indian contributors."
The Cochrane Library is available at http://www.thecochranelibrary.com "
Younger women denied IVF | UK News | The Observer
Younger women denied IVF | UK News | The Observer: "Young women are being denied test tube baby treatment until their late thirties under NHS rationing plans, even though age sharply reduces their chances of conceiving a child.
The move means even couples diagnosed early with fertility problems are being told to wait years before they can have IVF. A 39-year-old's chances of conceiving through the treatment are only half those of a woman under 35."
This is one of the reasons why so many couples from the UK come to India for IVF treatment. They cannot afford to waste precious time on a waiting list !
The move means even couples diagnosed early with fertility problems are being told to wait years before they can have IVF. A 39-year-old's chances of conceiving through the treatment are only half those of a woman under 35."
This is one of the reasons why so many couples from the UK come to India for IVF treatment. They cannot afford to waste precious time on a waiting list !
Saturday, February 10, 2007
Patients can carry records anywhere on secure smartcard
Patients can carry records anywhere on secure smartcard: "Patients in London can now have their medical histories handy wherever they are, by uploading them onto a new USB plug-in smartcard called the Health eCard.
Buying the card should enable patients to show their records to any medical professional, saving time and improving consultations when their notes are not available."
Buying the card should enable patients to show their records to any medical professional, saving time and improving consultations when their notes are not available."
Visit a CarePage
Visit a CarePage: "CarePages are available to everyone free!
Use CarePages to connect family and friends and share news, support and encouragement. Whether you are in the hospital, receiving care at home, or recovering, CarePages provides the forum to share stories and get support."
Use CarePages to connect family and friends and share news, support and encouragement. Whether you are in the hospital, receiving care at home, or recovering, CarePages provides the forum to share stories and get support."
Friday, February 09, 2007
The white parents, an Indian baby and the new £3bn fertility tourism-News-UK-Health-TimesOnline
The white parents, an Indian baby and the new £3bn fertility tourism-News-UK-Health-TimesOnline: "Drs Anjali and Aniruddha Malpani, a husband and wife team, say that two-thirds of the patients attending their clinic in Bombay are from abroad. The Duncans were the first white couple to whom they gave an Indian embryo. It was a situation that raised emotional and ethical questions.
“We invested a lot of time in counselling for this one,” Dr Anjali Malpani said. “It is absolutely ethical if the patient wants it. It is a personal choice. It is a lot like adoption but you have the feeling of a natural pregnancy.”"
“We invested a lot of time in counselling for this one,” Dr Anjali Malpani said. “It is absolutely ethical if the patient wants it. It is a personal choice. It is a lot like adoption but you have the feeling of a natural pregnancy.”"
myHealth Reminders
myHealth Reminders: "People often get reminders about when to change their oil or clean their carpets, but they often forget important dates, including key health-related ones. Our personalized system helps you take care of yourself by reminding you of preventative health screens and other periodic exams recommended for the general population. Our service:
* Matches your reminders to your age and gender.
* Follows nationally recognized guidelines to ensure accuracy.
* Automatically ages with you to guarantee recommendations are current.
* Contains a descriptor and explanation of each health check-up's importance.
* Is sent via email at the time you choose."
* Matches your reminders to your age and gender.
* Follows nationally recognized guidelines to ensure accuracy.
* Automatically ages with you to guarantee recommendations are current.
* Contains a descriptor and explanation of each health check-up's importance.
* Is sent via email at the time you choose."
Healthcare Decision Assistance
Healthcare Decision Assistance DecisionAssist tools can help you make important decisions about your healthcare options. These decisions include whether to have a particular surgery, proceed with a test, take certain medications, or use other healthcare services.
The tools allow you to select from a list of the most common factors to consider in making your decision, so that you can weigh and learn more about the factors that are most important to you. The tools also provide key points, questions to ask your doctor, recommended reading, and alternative options.
The tools allow you to select from a list of the most common factors to consider in making your decision, so that you can weigh and learn more about the factors that are most important to you. The tools also provide key points, questions to ask your doctor, recommended reading, and alternative options.
Web portals and virtual hospitals
Web portals and virtual hospitals: "Well-designed portals can tackle these shortcomings head-on. For one thing, an increasingly Web-savvy population wants to be connected to providers.
Consumers who book flights and check account balances via the Web wonder why they cannot book physicals and check their cholesterol scores online. So for many hospitals, offering interactive services—both in the clinic and the inpatient settings—is simply a matter of fulfilling demand. "
Consumers who book flights and check account balances via the Web wonder why they cannot book physicals and check their cholesterol scores online. So for many hospitals, offering interactive services—both in the clinic and the inpatient settings—is simply a matter of fulfilling demand. "
Michigan physicians test benefits of Web-based visits
Michigan physicians test benefits of Web-based visits: "Seeking efficiency, cost-effectiveness and improved communication with patients, physicians in a Michigan health system have been testing a Web portal for virtual office visits.
Walsh said eVisit has potential to help reduce inpatient, outpatient and ER costs through preventative measures. If (patients) have the eVisit, they can get early access to a doctor and potentially avoid an ER visit."
Walsh said eVisit has potential to help reduce inpatient, outpatient and ER costs through preventative measures. If (patients) have the eVisit, they can get early access to a doctor and potentially avoid an ER visit."
Wednesday, February 07, 2007
The Art of Defensive Medicine
The Art of Defensive Medicine" Defensive medicine is the use of costly medical treatments for the sole purpose of
avoiding potential litigation. Physicians often order additional tests or treatments, despite the presence of a conclusive diagnosis. Although it is not certain how great an effect these practices have on overall costs, much evidence has been found through physician surveys that this is standard practice. One study found that 76% of doctors are concerned that malpractice litigation has hurt their ability to provide quality care to patients.18
Seventy nine percent claimed that they had ordered more tests than necessary, and 91% knew other physicians that ordered an excessive number of tests. In addition, 41% of
physicians claimed that they had prescribed unnecessary medications, such as antibiotics for viral illnesses. Defensive medicine not only adds to the costs of health care but also increases patients’ risks."
avoiding potential litigation. Physicians often order additional tests or treatments, despite the presence of a conclusive diagnosis. Although it is not certain how great an effect these practices have on overall costs, much evidence has been found through physician surveys that this is standard practice. One study found that 76% of doctors are concerned that malpractice litigation has hurt their ability to provide quality care to patients.18
Seventy nine percent claimed that they had ordered more tests than necessary, and 91% knew other physicians that ordered an excessive number of tests. In addition, 41% of
physicians claimed that they had prescribed unnecessary medications, such as antibiotics for viral illnesses. Defensive medicine not only adds to the costs of health care but also increases patients’ risks."
10 Signs That You Need a New Doctor
10 Signs That You Need a New Doctor: "How do you know when it's time for a new doctor?"
Read this list to find out !
Read this list to find out !
Tuesday, February 06, 2007
Screening tests aren't as precise as we think | Chicago Tribune
Screening tests aren't as precise as we think | Chicago Tribune: "Researchers say doctors tend to overstate the accuracy of common tests, often because even experts misunderstand the tests' limitations. The reality is, screening tests such as mammograms for breast cancer and PSA tests for prostate cancer are imprecise tools for determining whether a patient actually has the disease. Yet even when given statistics that show a test's initial results are likely to be wrong, many doctors maintain faith that the tests generally are accurate.
In one study last year, three-quarters of obstetricians overestimated the accuracy of a test for Down syndrome. The error is multiplied when physicians relay misinformation to their patients, who may worry unnecessarily over a bad outcome or assume false confidence when the news is good."
This is why patients need to be well-informed ! You cannot afford to leave everything upto your doctor - he may not be as smart as you think he is !
In one study last year, three-quarters of obstetricians overestimated the accuracy of a test for Down syndrome. The error is multiplied when physicians relay misinformation to their patients, who may worry unnecessarily over a bad outcome or assume false confidence when the news is good."
This is why patients need to be well-informed ! You cannot afford to leave everything upto your doctor - he may not be as smart as you think he is !
Sunday, February 04, 2007
Sample Letter to Request Health Records
Sample Letter to Request Health Records: Your medical records are your property ! However, many patients are scared to ask doctors for a copy of their own medical records. Here is a sample letter you can use to request a copy for your own file.
Sample Letter to Request Health Records
[Your name]
[Your address]
[Date]
[Name of care provider or facility]
[Address]
RE: [Your medical identification number or other identifier used]
Dear
The purpose of this letter is to request copies of my medical records as allowed by the Health Insurance Portability and Accountability Act (HIPAA) and Department of Health and Human Services regulations.
I was treated in your office [at your facility] between [fill in dates]. I request copies of the following [or all] health records related to my treatment.
[Identify records requested, e.g. medical history form you provided; physician and nurses' notes; test results, consultations with specialists; referrals.]
[Note: HIPAA also allows you to request a summary of your medical records. If you prefer a summary, you should agree to a fee beforehand.]
I understand you may charge a “reasonable” fee for copying the records, but will not charge for time spent locating the records. Please mail the requested records to me at the above address. [If you request that the records be mailed, you may also be charged for postage.]*
I look forward to receiving the above records within 30 days as specified under HIPAA. If my request cannot be honored within 30 days, please inform me of this by letter as well as the date I might expect to receive my records*.
Sincerely,
[Your signature]
[Your name printed]
*Under HIPAA you can be charged a “reasonable” fee for copying records. You may also be charged for postage if you ask that records be mailed to you. HIPAA allows 30 days for a provider to respond to your request for records, with one 30-day extension for good reason.
Your state laws may include a lower fee for copies of records or a shorter time for the provider to respond to your request. The Georgetown University Center on Medical Rights and Privacy includes state-specific guides for 32 states. Before composing your request for medical records, visit this site for information about your state. http://hpi.georgetown.edu/privacy/records.html
Sample Letter to Request Health Records
[Your name]
[Your address]
[Date]
[Name of care provider or facility]
[Address]
RE: [Your medical identification number or other identifier used]
Dear
The purpose of this letter is to request copies of my medical records as allowed by the Health Insurance Portability and Accountability Act (HIPAA) and Department of Health and Human Services regulations.
I was treated in your office [at your facility] between [fill in dates]. I request copies of the following [or all] health records related to my treatment.
[Identify records requested, e.g. medical history form you provided; physician and nurses' notes; test results, consultations with specialists; referrals.]
[Note: HIPAA also allows you to request a summary of your medical records. If you prefer a summary, you should agree to a fee beforehand.]
I understand you may charge a “reasonable” fee for copying the records, but will not charge for time spent locating the records. Please mail the requested records to me at the above address. [If you request that the records be mailed, you may also be charged for postage.]*
I look forward to receiving the above records within 30 days as specified under HIPAA. If my request cannot be honored within 30 days, please inform me of this by letter as well as the date I might expect to receive my records*.
Sincerely,
[Your signature]
[Your name printed]
*Under HIPAA you can be charged a “reasonable” fee for copying records. You may also be charged for postage if you ask that records be mailed to you. HIPAA allows 30 days for a provider to respond to your request for records, with one 30-day extension for good reason.
Your state laws may include a lower fee for copies of records or a shorter time for the provider to respond to your request. The Georgetown University Center on Medical Rights and Privacy includes state-specific guides for 32 states. Before composing your request for medical records, visit this site for information about your state. http://hpi.georgetown.edu/privacy/records.html
ALERT: For a Complete Medical History, Compile Your Own Health Records
ALERT: For a Complete Medical History, Compile Your Own Health Records: "Like most people, you've probably moved many times during your life. Settling in to any new community usually means establishing a relationship with a new doctor, dentist or other health care provider. Over time, it's easy to forget when you were treated, by whom — even for what. Even if you've stayed in one place, it's still likely you've received medical care from various providers over time.
There is no one place you can go to get your complete medical history. Each healthcare provider you see keeps his or her own files detailing your visits and treatment. The same is true for hospital stays, physical therapy, laboratories, dentists, optometrists, chiropractors, pharmacies and so on. Only you are in the position to pull all the records together to compile your complete medical history.
If you don't already keep a personal health record, now is the best time to start. Do not rely on your ability to go back in time to collate a complete medical file. The longer you wait, the more difficulty you may have in obtaining older health records."
There is no one place you can go to get your complete medical history. Each healthcare provider you see keeps his or her own files detailing your visits and treatment. The same is true for hospital stays, physical therapy, laboratories, dentists, optometrists, chiropractors, pharmacies and so on. Only you are in the position to pull all the records together to compile your complete medical history.
If you don't already keep a personal health record, now is the best time to start. Do not rely on your ability to go back in time to collate a complete medical file. The longer you wait, the more difficulty you may have in obtaining older health records."
Good medical care for the elderly: a guide for caregivers
Good medical care for the elderly: a guide for caregivers: "'I now know that the primary caregiver is the person most likely to know when a loved one needs medical attention.
Some of the book's major messages are:
• Family caregivers do not need medical training to be effective members of the caregiving team.
• Most medical caregivers have little or no training in geriatrics, making misdiagnosis a serious danger.
• The elderly are most at risk to suffer medication errors, adverse drug reactions, delirium, dehydration, malnutrition, and to fall because of age-related problems.
• Family caregivers are able to detect subtle changes in the status of their loved ones and should advocate for an accurate diagnosis and proper treatment.
• Family caregivers are in a good position to work with medical caregivers to prevent complications.
• Family caregivers can protect their loved ones and themselves by utilizing clearly written, legal documents that will make their decisions about end-of-life care enforceable.
"This book enables me to give confidence to the elderly and to their caregivers," said Hannah. "I want them to know that you don't need a medical degree to be effective. The caregiver spends more time with their loved one than anyone."
Some of the book's major messages are:
• Family caregivers do not need medical training to be effective members of the caregiving team.
• Most medical caregivers have little or no training in geriatrics, making misdiagnosis a serious danger.
• The elderly are most at risk to suffer medication errors, adverse drug reactions, delirium, dehydration, malnutrition, and to fall because of age-related problems.
• Family caregivers are able to detect subtle changes in the status of their loved ones and should advocate for an accurate diagnosis and proper treatment.
• Family caregivers are in a good position to work with medical caregivers to prevent complications.
• Family caregivers can protect their loved ones and themselves by utilizing clearly written, legal documents that will make their decisions about end-of-life care enforceable.
"This book enables me to give confidence to the elderly and to their caregivers," said Hannah. "I want them to know that you don't need a medical degree to be effective. The caregiver spends more time with their loved one than anyone."
The $100 Un-PC - Newsweek:
The $100 Un-PC - Newsweek "Despite the country's rise as an outsourcing hub, PCs are selling slowly—far more slowly than mobile phones or motorbikes—because they are too expensive, too complicated to use and too difficult to maintain. What people have been waiting for, some experts think, is a new approach to computing that boils the essence of Internet access down to its lowest cost—and lowest risk. Jain plans to offer all this in lease deals that include easy-to-use hardware, Internet connection, application software and service—for $10 a month."
People like Rajesh Jain ( who is a good friend) make India proud ! The $ 100 PC would be very useful for providing healthcare to homes all over the world because it would allow inexpensive remote healthcare monitoring; telemedicine; and online chats and consultations !
This is a whole new world - and Indians are inventing it !
People like Rajesh Jain ( who is a good friend) make India proud ! The $ 100 PC would be very useful for providing healthcare to homes all over the world because it would allow inexpensive remote healthcare monitoring; telemedicine; and online chats and consultations !
This is a whole new world - and Indians are inventing it !
Saturday, February 03, 2007
The Hindu Business Line : Babies waiting to happen
The Hindu Business Line : Babies waiting to happen: "Interestingly, even foreigners are making a steady beeline to India. 'A lawyer from America came to us on her own. She had never been to India before,' says Dr Aniruddha Malpani of Malpani Infertility Clinic in Mumbai, to indicate changing Western mindsets about healthcare in 'third world' countries.
A driving factor is cost. One IVF cycle costs $20,000 in the US and £3,500 in the UK, says Dr Malpani (also the first, together with wife Anjali, to open India's first sperm bank in Mumbai in 1990). Quality treatment is available in India at a much cheaper cost."
A driving factor is cost. One IVF cycle costs $20,000 in the US and £3,500 in the UK, says Dr Malpani (also the first, together with wife Anjali, to open India's first sperm bank in Mumbai in 1990). Quality treatment is available in India at a much cheaper cost."
Thursday, February 01, 2007
Sermo - Know more. Know earlier.
Sermo - Know more. Know earlier.: "Sermo introduces the power of market pricing to information gathering. The Sermo business-model is based on 'information arbitrage', the opportunity that arises when breaking medical insights intersect with the demand for actionable, market-changing events in healthcare. Our clients include some of the nation's most prestigious financial institutions, healthcare companies, and government agencies: any organization that benefits from early insight into clinical events. These parties create a financial incentive that is used to generate, sustain, and support participation in an online physician community."
I wonder if this model could be applied to other professionals, such as share-brokers ? or to patients ?
I wonder if this model could be applied to other professionals, such as share-brokers ? or to patients ?
Health information technology improves patient care | Ocala.com | Star-Banner | Ocala, Fla.
Health information technology improves patient care | Ocala.com | Star-Banner | Ocala, Fla.: "Dr. Eugene Turner has his patients' information in the palm of his hands. Literally.
Everyday, after he wakes up, he turns on his Palm Treo cell phone, logs into Ocala Regional Medical Center's electronic patient information system, and checks his patients' records.
'More than once I've been contacted about a patient and through [the software] I can order tests before seeing the patient,' said Turner, an anesthesiologist. 'That to me, has the greatest advantage. I can start processing stuff before I see the patient.'
The portable patient information software, called Patient Keeper, available to Ocala Regional's physicians, is just one example of new technology that's finding its way into the local and national health care systems and replacing the old-fashioned paper charts and records."
It's got a "coolness factor" too ! Doctors who are "early adopters" can wow their patients !
Everyday, after he wakes up, he turns on his Palm Treo cell phone, logs into Ocala Regional Medical Center's electronic patient information system, and checks his patients' records.
'More than once I've been contacted about a patient and through [the software] I can order tests before seeing the patient,' said Turner, an anesthesiologist. 'That to me, has the greatest advantage. I can start processing stuff before I see the patient.'
The portable patient information software, called Patient Keeper, available to Ocala Regional's physicians, is just one example of new technology that's finding its way into the local and national health care systems and replacing the old-fashioned paper charts and records."
It's got a "coolness factor" too ! Doctors who are "early adopters" can wow their patients !
Doctors, nurses warming up to digital devices - Pittsburgh Tribune-Review
Doctors, nurses warming up to digital devices - Pittsburgh Tribune-Review: "In many doctors' offices, and even in patients' homes, health care is stepping into the Information Age.
Laptop and handheld computers are making it easier to record and retrieve information about patients' conditions. The Internet is putting up-to-the-minute data in the hands of health care providers. And high-tech devices are making it faster and simpler to order laboratory tests and have prescriptions filled.
Nationwide, about one in four doctors is making some use of electronic health records, according to a study published in October by the Institute for Health Policy at Massachusetts General Hospital in Boston.
But Julie Shroyer, a registered nurse with Excela Health Home Care and Hospice, has used a laptop computer with a special home health software package for about eight years."
Once doctors have got over the initial learning courve and the teething problems have been sorted out, no one has ever gone back to a paper system after using a paperless EMR !
Laptop and handheld computers are making it easier to record and retrieve information about patients' conditions. The Internet is putting up-to-the-minute data in the hands of health care providers. And high-tech devices are making it faster and simpler to order laboratory tests and have prescriptions filled.
Nationwide, about one in four doctors is making some use of electronic health records, according to a study published in October by the Institute for Health Policy at Massachusetts General Hospital in Boston.
But Julie Shroyer, a registered nurse with Excela Health Home Care and Hospice, has used a laptop computer with a special home health software package for about eight years."
Once doctors have got over the initial learning courve and the teething problems have been sorted out, no one has ever gone back to a paper system after using a paperless EMR !
Hope, challenges in computerizing medical records - The Boston Globe
Hope, challenges in computerizing medical records - The Boston Globe: "The health care industry and state and federal governments have pinned great hopes on electronic medical records, which proponents say will help reduce medical errors and costs. Patients typically are treated by multiple physicians, clinics and hospitals, and a computerized records network allows doctors to find information quickly in an emergency, alerting them, for example, if a patient has a dangerous allergy to a medication, or if they are about to order an expensive test a patient has already had.
'What you're seeing in North Adams is revolutionary,' said Dr. John Halamka, chief information officer for Harvard Medical School and Beth Israel Deaconess Medical Center in Boston.
But North Adams' experience shows just how challenging it will be to switch to computerized records on a large scale, and link them into a network that allows so many people access. Every family must be asked to sign consent forms allowing their health information to be entered into the system. During the first month of learning to use computerized records, some doctors in the city lost business because they worked more slowly, seeing between 20 and 50 percent fewer patients. Doctors and office staff are struggling to find time to type and scan information from thousands of pages of paper medical record."
It maybe a steep learning curve, but it's well worth the effort !
'What you're seeing in North Adams is revolutionary,' said Dr. John Halamka, chief information officer for Harvard Medical School and Beth Israel Deaconess Medical Center in Boston.
But North Adams' experience shows just how challenging it will be to switch to computerized records on a large scale, and link them into a network that allows so many people access. Every family must be asked to sign consent forms allowing their health information to be entered into the system. During the first month of learning to use computerized records, some doctors in the city lost business because they worked more slowly, seeing between 20 and 50 percent fewer patients. Doctors and office staff are struggling to find time to type and scan information from thousands of pages of paper medical record."
It maybe a steep learning curve, but it's well worth the effort !
MyMedLab.com
MyMedLab.com: "Welcome to MyMedLab.com, your new partner in health care. We’re a 21st century health care provider created to help you privately learn about your health. Our company represents a revolutionary approach to health care that is designed to save you money and provide you direct access to the latest medical technology. We’re committed to providing you with the best, most comprehensive health information available today.
Common sense tells us we can’t work to fix a problem we’re not aware of. That’s where we can make a real difference for your health and your family. Even with all the new treatment options available, nothing can match the huge benefits of early detection.
Smart consumers today are taking charge of their routine health and using the same technology, once only available to doctors, to find potential problems early, even before symptoms appear. This is when treatment and changes in lifestyle can be the most effective and least costly.
MyMedLab.com provides you with our convenient, quality lab testing at a cost that is 50-80% LESS than the same testing would cost at your doctor’s office or local hospital. Lowest Cost Guarantee How? We know health care. It’s like any other business, you don’t get what you deserve, you get what you negotiate. Think of us as your new “Laboratory Agent” in health care."
This is such a clever idea ! It provides patients convenience and economy !
Common sense tells us we can’t work to fix a problem we’re not aware of. That’s where we can make a real difference for your health and your family. Even with all the new treatment options available, nothing can match the huge benefits of early detection.
Smart consumers today are taking charge of their routine health and using the same technology, once only available to doctors, to find potential problems early, even before symptoms appear. This is when treatment and changes in lifestyle can be the most effective and least costly.
MyMedLab.com provides you with our convenient, quality lab testing at a cost that is 50-80% LESS than the same testing would cost at your doctor’s office or local hospital. Lowest Cost Guarantee How? We know health care. It’s like any other business, you don’t get what you deserve, you get what you negotiate. Think of us as your new “Laboratory Agent” in health care."
This is such a clever idea ! It provides patients convenience and economy !
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