Friday, April 27, 2007

Lessons from Herodotus « All of us are smarter than any of us…

Lessons from Herodotus « All of us are smarter than any of us…: "I ran a workshop for “Connecting for Health” yesterday, and someone gave me this little story, entitled “A classic example of knowledge in practice”.

They have no physicians, but when a man is ill, they lay him in the public square, and the passers-by come up to him, and if they have ever had his disease or have known anyone who has suffered from it, they give him advice, recommending him to do whatever they found good in their own case, or in the case known to them; and no one is allowed to pass the sick man in silence without asking him what his ailment is.

Histories of Herodotus: A history source of Persian Empire of Achaemenian era.
Herodotus (c. 484-225 BC).

In our “knowledge-sharing civilisation” I wonder whether we have the equivalent of too many physicians, no public square, a lack of passers-by or just a lack of intellectual compassion?"

By allowing patients to share their PHRs online, we can get the best of both worlds !

Teaching patients how to manage their health data

Teaching patients how to manage their health data: What we need.
"1. Personal content management tools -- to help people organize their personal information (and other information they've aggregated) their way, and identify who they will permit to access it under what circumstances ('permissioning')
2. Metadata tools (invisible to the user) -- to automatically reorganize this personal content for effective, permitted use by others
3 . Social networking applications -- to help people identify other people (inside and outside their organization) with particular expertise or shared interests, connect and collaborate with these people and with people in the individual's self-defined networks, via Simple Virtual Presence, browse and subscribe to others' permissioned personal content, and publish their own permissioned content."

The PHR would be the underpinning of this personal content. We then need develop these tools , so that patients can make intelligent use of their personal health data ! " was created when Mark Pearson, the company founder, set up a web site for his sister-in-law after she was hospitalized. Mark created the page because 'Mary' needed a way to communicate with friends and relatives without burdening herself or her close family. It became the main source of information, allowing Mary to spend less time responding to inquiries and more time recovering. Family and friends could get the latest update on her condition, see pictures of her, and get important contact information. The response was phenomenal.

When Mark began receiving requests from friends to set up pages for other people, he decided to create easy-to-use templates so patients could create their own.

Now, with, expecting parents can create web pages to keep family and friends updated on a pregnancy as well as show their new baby!

As grows, we are committed to providing users with simple, easy-to-use tools for creating personal web pages.

Technology is changing the way we communicate with family and friends and, now, staying in touch is easier than ever!"

Health care 2.0

Health care 2.0: "Despite the fact that the Internet is decades old and the Web is already into its adolescence, it seems at times that the health care industry has scarcely begun its online journey. Pens, paper pads and manila folders are still part of the daily activity in medical practice.

The industry is changing, but with so many practitioners still getting familiar with the first iteration of the Web, what will the world of Web 2.0 mean for them? What do blogs, podcasts, vodcasts, RSS feeds, wikis, Flickr, BitTorrent, folksonomies, Asynchronous JavaScript and Extensible Markup Language and other even stranger-sounding tools hold in store?

“In every focus group we’ve done, there’s been no conception from anyone of what Web 2.0 is,” said Eric Dishman, manager of Intel’s Proactive Health Strategic Research Project, a five-year-old program that’s looking for ways technology can help seniors take better care of their health at home. “But when you show them what can be done, they immediately understand its impact.”"

Thursday, April 26, 2007

Connecting for Health - Common Framework - Schematic

Connecting for Health - Common Framework - Schematic: "The Common Framework helps health information networks to share information among their members and nationwide while protecting privacy and allowing for local autonomy and innovation. It consists of a set of mutually-reinforcing technical documents and specifications, testing interfaces, code, privacy and security policies, and model contract language. It was developed by experts in information technology, health privacy law, and policy, and has been tested since mid-2005 by Connecting for Health prototype teams in three states."

Denmark, U.S. military on parallel paths to e-health

Denmark, U.S. military on parallel paths to e-health : "Denmark, which spends about half of what the United States does on health as a share of gross domestic product, is ahead of America in instituting e-health records, or EHRs, with more than 90 percent of general practitioners using computerized records. Now Denmark is developing the content and structure for an international EHR standard.

Danish doctors began relying on EHRs years ago, without government incentives. Some in the audience asked Kverneland how that happened, noting that U.S. doctors are struggling to adopt EHR systems, even with government support.

Kverneland answered, 'They gained money by using electronic health records.' Time savings translated into dollar savings, he said."

RX for disaster: Service makes drug info mobile: Scientific American

RX for disaster: Service makes drug info mobile: Scientific American: "Drug store chains are banding together to bring emergency prescription drug information to people stranded by natural disasters. A group representing some of the nation's biggest drug retailers -- including CVS, Eckerd, Rite Aid, Walgreens and Wal-Mart -- said on Tuesday they have developed Rx History, a service that can allow licensed prescribers and pharmacists anywhere in the country to securely access a patient's prescription history. The move comes in response to displaced hurricane victims and is part of a larger movement to make health information more portable."

Wednesday, April 25, 2007

Dosia: At Last: An Electronic Personal Health Record

Dossia : An Electronic Personal Health Record That's Yours For Life: " The Dossia Network and Dossia-enabled Personal Health Records will enable you to be an active partner in managing your health care. Dossia will allow you to:

* Share complete and up-to-date health information with your providers
* Avoid potentially dangerous delays, mistakes and miscommunications when more than one health professional is involved in your care
* Use your time in the doctor's office more effectively
* Keep track of chronic illnesses
* Help family members manage their health care

As a communication tool Dossia enabled Personal Health Records will help cut down on medical errors and eliminate waste. This will improve the quality of the care you receive and reduce inefficiency in the health care system."

Wal-Mart Plans To Open 400 In-Store Clinics -

Wal-Mart Plans To Open 400 In-Store Clinics : "Wal-Mart Stores, the world's largest retailer, plans to open as many as 400 in-store health clinics over two to three years and could raise the total to 2,000 in seven years, it said Tuesday. Wal-Mart called the clinic program part of moves it is making to implement 'customer solutions to America's health-care crisis.' Other steps included a $4 generic drug prescription program and support for a coalition seeking comprehensive health-care reform by 2012.

Wal-Mart said it would contract with local hospitals and other organizations to operate the walk-in clinics, which lease space from Wal-Mart and are run as separate businesses."

Doctors and hospitals can learn from Wal-Mart that if we give patients what they want ( friendly, inexpensive medical care, when they want it, where they want it) , we will all succeed !

Wal-Mart CEO Calls on Businesses To Step Up Health IT Efforts - iHealthBeat - Daily News Digest on Health Care Information Technology

Wal-Mart CEO Calls on Businesses To Step Up Health IT Efforts : "Just who is responsible for transforming the U.S. health care system? The private sector? The public sector? Health care providers? According to one of the nation's top business leaders, transforming health care is a shared responsibility.

'The time for politics in our nation's debate on health care has passed,' Lee Scott, CEO of Wal-Mart, said on Tuesday at the World Health Care Congress in Washington, D.C. According to Scott, it's time to take action, and businesses should be a 'catalyst for positive change.'

Scott said that businesses can further the effort to transform health care through three steps:

* Empowering consumers;
* Applying technologies; and
* Increasing efficiencies."

Infertility and menstrual myths and misconceptions

Many infertile women obsess over their menstrual periods. They know there is a connection between ovulation, fertility and the menstrual period, but are often very confused as to what this really is.

Making a baby needs only four things - eggs, sperms, a uterus and fallopian tubes. Unfortunately, since they cannot see any of these , they track the only thing they can see - their menstrual flow.

While the regularity of the menstrual cycle is in fact a very good marker for ovulation, the quality of the menstrual blood flow ( duration; the presence of clots; the amount ; or how dark the blood is ) is completely unimportant. After all, the menstrual flow just represents the old uterine lining which is being shed.

However, misconceptions about menstrual flow abound - and because infertile women are often very poorly informed about their bodies, these myths find a fertile ground in their heads.

As it is , infertile women have low self-esteem and an inferiority complex because they cannot conceive. Their bodies have let them down and they feel flawed and defective. Their mind often plays games with them, and these doubts and concerns fester and proliferate. Minor inconsequential problems, which are normal anatomic variants ( and are often seen in fertile women) are perceived as being the cause of infertility ! While fertile women do not worry about variations in their menstrual pattern, infertile women do so all the time ! For example, many women believe that if the flow is scanty, the "bad blood" will accumulate in the body and the
" menstrual toxins " will cause infertility. This is why some women still ask the doctor to perform a D&C ( dilatation and curettage) to "clean the uterus".

Often their only source of information is their fertile friends, and when they compare notes, they often notice differences in their menstrual patterns - differences which are of no importance but which get magnified in their head, until this is all they can think about !

It's surprising how even well-informed women fall prey to some of these myths. For example, I had a doctor who was going through an IVF cycle. She had a lot of cervical mucus because she had grown a large number of follicles and had high estrogen levels. However, she was worried that the "leaking fluid" meant that her eggs had ruptured before we could retrieve them !

It takes a lot of counselling to explain to infertile women that they should stop worrying about their menstrual flow. Unfortunately, once a misconception has taken root, it's extremely hard to get rid of it !

IAPO | Declaration on Patient-Centred Healthcare: Patient Information | A global voice for patients

IAPO | Declaration on Patient-Centred Healthcare: Patient Information | A global voice for patients: "Patient Information – Accurate, relevant and comprehensive information is essential to enable patients and carers to make informed decisions about healthcare treatment and living with their condition. Information must be presented in an appropriate format according to health literacy principles considering the individual’s condition, language, age, understanding, abilities and culture."

Everyone is entitled to a good doctor

Everyone is entitled to a good doctor " When patients and their relatives say they have a “good doctor”, they mean a doctor whom they feel they can trust without having to think about it. They equate
“goodness” with integrity, safety, up-to-date medical knowledge and diagnostic skill, and the ability to form a good relationship with them. For them, good doctors are clinically expert and at the same time are interested in them, kind, courteous, empathetic and caring. All these attributes matter to them because they know that their doctors’ decisions can affect the outcome of their illness — even make the difference between life and death, or between enjoying a speedy recovery and suffering serious disability. "

Dallas store helps consumers with medical research

Dallas store helps consumers with medical research : "With information on the Internet as confusing as it is, some savvy consumers still turn to medical textbooks to find answers to their questions. 'A lot of people use Google to try to find information because they think they can find everything on the Internet,' says Sean Faulkner, director at Majors Scientific Books in Dallas.

'We call it the Amazon effect. But, frequently, all they can find is a little description of a book which they bring with them when they visit us trying to find more information,' Mr. Faulkner says. Recently, consumers have visited the store seeking information on topics ranging from autism to fibromyalgia, irritable bowel syndrome, premature babies and yoga.

'Consumers may find things on the Internet that are not from a reputable source and valid publisher,' Mr. Faulkner says."

A book is a book is a book !

Making medical fact-finding easy

Making medical fact-finding easy : "Faced with a minor illness or major health-care crisis, many people turn to the Internet for information. But with the misinformation that absolutely anyone can post on the Web, and the medical jargon, the task can be daunting. Physicians provide basic information, but they don't have time to answer every question.

Medical librarians have master's degrees or doctorates, often with special certification in health care. They are trained to distinguish good information from bad. Major hospitals have offered medical library services to physicians on staff for years. A new trend is the development of libraries that offer medical information to consumers.

"Librarians can save consumers time because they have a wealth of information resources available to them that are not available to the general public," says Jean Shipman, president of the national Medical Library Association in Chicago. "

I feel every hospital should have a patient education library ! Not only will this save the doctor's time
( because he can refer the patient or family to the library for more information); it will also help to keep patients much happier, because they are better informed !

Sunday, April 22, 2007

Kaiser Permanente HealthConnect

Kaiser Permanente HealthConnect: "The Kaiser Permanente HealthConnect program integrates the clinical record with appointments, registration and billing to deliver improvements in care delivery and patient satisfaction across the Kaiser Permanente organization.

Key points about KP HealthConnect:

* Privacy of information is a top priority in designing and implementing KP HealthConnect. The design of the software ensures that sensitive medical information will be protected.
* Patient Safety will be enhanced by KP HealthConnect. Drug interactions and allergic reactions will be prevented by software that knows what medications the patient is taking and checks for conflicts. A patient's medical history will be available to every clinician who is involved in that patient's care--at the same time--even if the doctor is in Georgia, a nurse is in Colorado, and the specialist is in California.
* Relationships and personal care will be honored and enhanced by KP HealthConnect. One of the key goals of the project is to free up doctors' and nurses' time to spend with patients rather than on paperwork. Our own studies have already found that, for instance, having a computer in the exam room enhances communication between the doctor and patient.

KP is a beta test-site for the promises -( and problems ! ) of implementing an EMR system !

HealthNex: Independent Health Banks

HealthNex :Independent Health Banks : "The model of Independent Health Banks suggests that medical records will not be kept anymore by healthcare providers; rather they will be sustained for the entire lifetime of an individual by new players in the healthcare industry- 'Independent Health Records Banks' which will be (1) independent of healthcare providers / insurers / government-agencies and (2) regulated by new legislation.

The fundamental principle of the new legislation is that the copy of a medical record stored in such an EHR bank is the only medico-legal copy. The record is sustained objectively by an EHR bank and all authorized parties can have access to it. Such a bank acts as a custodian/trustee. Multiple competing banks will be established by private enterprises (once the appropriate legislation will be in place), much like financial banks.

Healthcare providers could reduce their costs of medical records archiving as this function will be carried out by the EHR banks. Insurers will support it as it will improve the quality of care their customers get. Privacy will be better protected as no global patient identifiers will be needed since a bank account number will be the only access key that the individual needs."

This is an interesting concept - and we may need this to overcome initial teething problems, to help patients overcome their fears about privacy and security.

Paperless Medicine - Health For Life -

Paperless Medicine - Health For Life - "things do not reliably happen because your doctor and the health-care system still largely use paper to communicate. This paper is shuttled from one hospital to another, often doesn't arrive on time and sometimes doesn't show up at all. Some of the most important information is written in longhand, and how legible is your doctor's handwriting? We now spend nearly $2 trillion a year on the preservation of our health. Yet we still rely primarily on antiquated record-keeping.

Fortunately, there is a growing movement to change that, using electronic information technology. While only 24 percent of providers today use electronic health records in their offices, that figure is increasing rapidly. More doctors are using computers to order diagnostic tests and treatments. Gradually, institutions are building systems with common coding systems that allow them to exchange data.

In our view, the single most important benefit of electronic records is that they make it possible to deliver information to your doctor at the moment he is making decisions about your care. Instead of having to read through what can be hundreds of pages in your medical record to find a particular test result, he now has the data available in an instant."

There are 2 ways of achieving this goal.

1. Top-down, where the government provides the funding to implement this on a nationwide system, as the NHS is trying to do in the UK ( and failing miserably)

2. Bottom-up, where individual doctors, hospitals, clinics and patients do this for themselves. I feel this is far more likely to be succcessful and effective , if we adopt the open-source model.

Patient groups special: Swallowing the best advice?

Patient groups special: Swallowing the best advice? : "They are supposed to be grassroots organisations representing the interests of people with serious diseases. But Drummond Rennie, professor of medicine at the University of California, San Francisco, and deputy editor of the Journal of the American Medical Association, believes that some patient groups are perilously close to becoming extensions of pharmaceutical companies' marketing departments. 'There's a crisis here,' he contends.

Rather than grassroots, the word Rennie uses to describe such organisations is 'astroturf'. Originating in the black arts of politics and public relations, astroturfing is the practice of disguising an orchestrated campaign as a spontaneous upwelling of public opinion."

Whom can you trust ? The only solution is to become well-informed - and to analyse all the information you receive critically.


MORE DOCTORS AND MEDICAL CENTERS ARE GOING "PHARM-FREE".: "I support the pharm-free movement. The reformers are making progress. Yet there is a long way to go, and the question remains whether the larger medical community will ever become pharm-free.

You can help. If your doctor uses drug company giveaways, bring a stack of writing pads and inexpensive pens to your next office visit. If your doctor asks why you are giving these to him, smile and say, 'It just looks better.' Your doctor will get the point. Be nice about it. It's tough for anyone to turn down a freebie. Doctors are no different. At the same time, doctors' first allegiance is supposed to be to their patients. A word from a patient can have a lot of influence."

Saturday, April 21, 2007

Web to check doctor fatigue

Web to check doctor fatigue : "A new internet tool will help doctors in Australian hospitals determine whether their workloads are placing them at dangerous levels of fatigue. The Australian Medical Association has developed a fatigue risk assessment website that allows doctors to track their work, recreation and sleeping hours over a week and gives them a risk rating. Doctors are thought to be at low risk if they work less than 50 hours a week, at significant risk if they work between 50 and 70 hours a week and at a high risk if they work more than 70 hours."

Failed e-health vision costing $1.5 billion per annum

Failed e-health vision costing $1.5 billion per annum: "Australian Centre for Health Research, the report strongly supports the introduction of online information sharing and an e-health network to transform the health care sector. The report's author, Monash University professor, Michael Georgeff, said today providers operate in disconnected silos that hinder continuity of care.

'The business model we use in health is based on an industrial enterprise where the focus is often on the management of physical resources with very little attention to the management of knowledge,' he said.
'In business, high priority communications is handled electronically but in health care it is pen and paper delivered by hand. 'No less than 25 percent of all Australians suffer from a chronic illness and nearly every one of them would be better off with improved knowledge sharing and more effective management of patients.'"

Wednesday, April 18, 2007

Insurer Will Let Members Access Their Health Data From Cell Phones -- Health Record Mobility

Insurer Will Let Members Access Their Health Data From Cell Phones -- Health Record Mobility: "Some people keep tabs on their favorite stocks using their cell phones. Soon, members of Blue Cross of Northeastern Pennsylvania will be able to check their diagnoses and other key health information in the same way: from their cell phones.

Starting at the end of March, Blue Cross of Northeastern Pennsylvania, known as BCNEPA, will begin providing 100,000 of its members--and later to all 600,000 members--secure electronic access to their own and their dependents' personal health records. The information, which includes recent diagnoses, prescribed medications, allergies, and immunization history, will be culled from the insurer's claims data as well as information that the member supplements."

Mobiles to check patients' health

Mobiles to check patients' health: "A mobile phone that gives its owner a health check is being developed by experts at Leeds University. The device can be used to check vital signs, glucose and blood oxygen levels. The results are then sent straight to a remote computer where a nurse or doctor can analyse them and contact the patient if anything is wrong. The university said the phone would mean patients at risk could avoid making frequent trips to their GP for routine checks."

What is in the Diseases Database? Diseases Database

What is in the Diseases Database? Diseases Database: "The Diseases Database is a cross-referenced index of human disease, medications, symptoms, signs, abnormal investigation findings etc. This site provides a medical textbook-like index and search portal covering areas including

* Internal medical disorders
* Symptoms and signs
* Congenital and inherited disorders
* Infectious diseases and organisms
* Drugs and medications
* Common haematology and biochemistry investigation abnormalities"

Great starting point when you are hunting for information !

Web-linked pillbox reminds patients to take meds

Web-linked pillbox reminds patients to take meds: "Grandpa may not remember whether he took his medication, but his pillbox does. A new device, the Med-eMonitor, alerts patients when it's time to take their pills. If they miss doses or take the wrong medication, the device sends a message to a secure Internet site via a standard phone line. Patients will then receive a check-up call from a health official."

Could this technology be incorporated in a cellphone ?

Self service technology for patients

Self service technology for patients: "Within a few months of activating self-service kiosks—portable wireless devices that enable patients to verify their own registration information—the long lines at Newark Beth Israel have disappeared. Now, rather than wait to see a registration clerk who reads the information aloud, patients access their own records from one of 12 kiosks. They are offered in three of the hospital's busiest outpatient areas: cardiac cath lab, same-day surgery, and preadmission lab and radiology testing. If the patients spot an error, they highlight it and a clerk later corrects the information. If the information is correct, they move ahead for the procedure or test. 'We don't have any more big crowds in the waiting areas,' says Schittone."

This makes sense. Just like supermarkets allow customers to choose their own goods, thus replacing store clarks, this clever technology replaces the medical admission clerical staff, by allowing patients to DIY ! Record-keeping to leap out of Stone Age in Canada Record-keeping to leap out of Stone Age in Canada : "Advocates of centralized, electronic record-keeping also believe the new system will result in fewer medical errors.

'When you talk to clinicians about what they need in terms of making a more accurate diagnosis, they will tell you they need lab results, medication history and access to diagnostic images from radiation technologists,' he said. 'This is really about presenting an individual history to the right provider at the right time to improve the outcome. That's what this is all about.'

The project's aim is to have every physician's office in the province hooked up to the system, with ready access to individual medical records, although only with patient consent. 'The more this is used, and the more people on the system,' Mr. Canham said, 'then the more valuable it becomes.'"

Blogs and patients

Blogs and patients:"Blogs have increasingly become a popular part of the Internet. In the healthcare industry, blogs help track a patient's journey with chronic disease or procedures with lengthy recovery times, creating the ability for a patient to post their feelings and all the interactions that take place when facing certain decisions. The result is a patient's-eye view into what would be required with the procedure, and what to expect, valuable to health consumers in similar situations as well as their friends, families and other members of their support system. This interaction can be the deciding factor for many patients as they face choices about the treatment options available."

openEHR Primer - Electronic Health Records

openEHR Primer: "An EHR has the following characteristics:

* patient-centred: one EHR relates to one subject of care, not to an episode of care at an institution;
* longitudinal: it is a long-term record of care, possibly birth to death;
* comprehensive: it includes a record of care events from all types of carers and provider institutions tending to a patient, not just one speciality; in other words there are no important care events of any kind not in the EHR;
* prospective: not only are previous events recorded, so is decisional and prospective information such as plans, goals, orders and evaluations."

Monday, April 16, 2007

Sample letter to a doctor

Sample letter to a doctor: " When you are asking for help from a doctor you have never met, but have determined is an expert on your problem ( as result of your internet search) , you may want help in figuring out how to talk to them.

The following is a sample letter .

Dear Dr. Smith:

Paragraph I: Introduction and explanation of why you have chosen to write this particular doctor

I apologize for writing without the benefit of an introduction, but do so on behalf of my mother who has been diagnosed with lung cancer. I read of your (insert reason why you think they are a fit: research on the drug Iressa, expertise in new drug development, expertise in a new surgical procedure) and write with the hope that you might be willing to help.

Paragraph II: Summary of the medical situation

My mother, (insert name), was diagnosed with stage IIIA non-small cell lung cancer in June 2000. At that time, she underwent surgery to remove a portion of her right lung at ABC hospital in XYZ town. It was noted that the cancer had spread to the adjacent and even distant lymph nodes. As a result, my mother also underwent (specific details) eight weeks of radiation therapy and ten weeks of chemotherapy with the following drugs: (insert names of medications used if known). She then entered a remission.

Paragraph III: Current concern and how the doctor can help

Last week, we learned that my mother’s cancer has recurred in a single nodule in the remaining area of her right lung. My mother is eager to take all possible aggressive measures to combat this disease. I read of your recent work with a clinical trial (again, insert the reason you think they are a fit) and wondered if you would be willing to evaluate my mother as a candidate for participation in this trial.

We understand that this is one of many such requests that come across your desk and greatly appreciate any guidance that you can lend.

Thank you, in advance, for your help. I look forward to hearing from you at your earliest convenience. "

Doctors are often willing to help someone in need ! All you need to do is to learn how to ask nicely !

HealthCare Advocates, Inc.

HealthCare Advocates, Inc.: "Healthcare isn't as simple as it used to be. And getting the best care is getting more difficult. Wouldn't it be nice to have a friend who knows the ins and outs of the healthcare system? When you're a member of HealthCare Advocates, you do. HealthCare Advocates brings together the talents of doctors, nurses, lawyers, insurance specialists, social workers and healthcare policy and ethics professionals to make sure members get the best healthcare possible. Working as a team, HealthCare Advocates' professionals see to it that your health insurance works the way it's supposed to. We'll work closely with you and your healthcare insurance company to resolve issues quickly. What's more, you'll be able to tap into the wealth of knowledge and experience of the HealthCare Advocates group through several services offered as part of HealthCare Advocates' membership.

As a member, whenever you or your loved ones need help, HealthCare Advocates will be there for you. When you have medical questions, insurance disputes, questions about coverage, even if you've been denied access for a certain medical procedure, HealthCare Advocates can help. We've combined the strengths of our experts to offer members such valuable services as medical research, insurance dispute resolution, bills and forms consolidation services, health counse"

The Health Resource- Custom Medical Research Reports

The Health Resource- Custom Medical Research Reports: "The Health Resource is a professional medical information research organization whose expert medical researchers are here to help you and your loved ones learn about all the treatment options for your cancer or other medical condition. More and more people look to the Internet for answers and guidance when they are diagnosed. There is so much information available it is overwhelming. If only there was an easy way to sort through all the medical resources and pull out what is reliable and specific to your medical situation.

That is what The Health Resource will do for you. Many of our clients tell us that our service is exactly what they were looking for, but didn't know existed. Let us save you time and effort, freeing you to concentrate on yourself or your loved one."

Judge: web sites for health - consumer guidelines - how to search the Internet for health information

Judge: web sites for health - consumer guidelines - how to search the Internet for health information: "This site provide wise advice on how to search the Internet for health information.
Information includes:

How to search
How to judge the quality of the information you unearth
How to manage the information ( and your doctor !)

Excellent coverage of:
* Information searching
* Gateways - searchable catalogues to good quality health Web sites
* Search engines
* Search tips
* Confidence building - learning how to search"


MediReminder: "MediReminder is a program that sends you automated reminders to tell you when to take your medication as prescribed. It’s that extra reminder that you sometimes need to make sure you are always putting your health first. Taking your medication as prescribed by your doctor helps you get the most out of your medication, a key factor in improving your health. Getting started with MediReminder is easy. You can customize MediReminder to meet your individual needs. It only takes a few minutes."

Reminders can be by:
  • email – automated reminders are sent directly to your email address
  • telephone call – automated reminders are sent directly to your phone’s voice messaging system
  • text message (SMS) – automated reminders are sent to your cell phone

informing healthcare | Health Record Banks

informing healthcare | Health Record Banks"The solution is to empower each consumer to own and control an electronic copy of all their health records in a Health Record Bank. This health record bank would serve as the designated agent of the consumer to store and safeguard a complete copy of her medical records and make them available (in full or in part) solely as she directs. An institution is needed (as opposed to having each consumer hold their own records) to allow for worldwide immediate availability of health records coupled with ironclad computer security to protect privacy.

Whenever care is received, the prior records would be available (with consumer permission) from the health record bank, and the new information generated would be deposited in the consumer’s account. Each bank would have three standard transaction windows: withdrawal — for access to records, deposit — to accept new records, and search — to accept search requests from authorized medical researchers and public health authorities. There would be many competing health record banks, and each consumer would have an account at the bank of their choice."

Interactive Health Communication

Interactive Health Communication : "IHC applications have great potential to improve health and well-being. Compared to more traditional media, interactive media may have several advantages for health communication efforts. These include: improved access to individualized health information; broader choices for users; potential improved anonymity of users; greater access to health information and support on demand; greater ability to promote interaction and social support among users, and between consumers and health professionals; and enhanced ability to provide widespread dissemination and immediate updating of content or functions."

Piloting a virtual health care helper - Mass High Tech: The Journal of New England Technology:

Piloting a virtual health care helper : "'Laura' is quick to give a concerned look or words of encouragement to people as they try to lose weight. She is empathetic and appears to understand the art of forming relationships. All that, and she is but an animated character that lives in a new computer program under development at Northeastern University. Partners Healthcare System Inc., the largest health-care provider in Massachusetts, is gearing up for a clinical trial of the computer program through its Center for Connected Health. The study aims to determine whether Laura, a virtual weight-loss coach, can help obese people to become more active and lose weight."

This is a great idea ! Ideally, the virtual helper could be a tool which could be programmed in to the ubiquitous cell-phone everyone carries these days !

Checklist for evaluating online PHRs

Checklist for evaluating online PHRs In researching commercially available personal health record products,CalRHIO found 61 different online PHR offerings. The Personal Health Record industry is at a very early stage of development. Currently there are no established standards, although
several have been proposed or are in formation. To help organizations and individuals that
are interested in using PHRs make the best choice among the proliferation of products,
CalRHIO developed a list of criteria for elements that should be included. The criteria provide
a minimal standard of completeness, usability, portability, and vendor stability. The criteria
provide a first-level screen. Consumers will need to apply their own situation and needs to
determine which product is the best fit. Proposed criteria and the rationale for each appear in the chart An evaluation score card also follows. These documents are available online at

Letter to a Two-Year-Old: Baby's Days Out

Letter to a Two-Year-Old: Baby's Days Out: "Dear Abhishek, Happy Birthday! This is my third letter to you (2005 and 2006). As you turn two on April 19, it is once again time to reflect on the year that was and what's to come. [Here are some recent photos of Abhishek. ] It all culminated with you coming with me for the office picnic. That was in the last week of December. You stayed happily without your mother for an entire day. You didn't eat much - I just don't have the perseverance and patience that your mom has! But you managed quite well with the junk food I gave you. It was a great experience.It was a great experience. You grow up a little that day. And perhaps, so did I - as a father."

A reminder as to why "baby-lust" can be such a strong driving emotion - and why couples will move heaven and earth to have a baby !

Sunday, April 15, 2007

Don't Be Embarrassed

Don't Be Embarrassed " Tell your doctor everything. Spit it out all at once. You could also try writing out all your symptoms and bring that paper with you to the appointment. When you check in, tell them you have written it out because you’re embarrassed and because you thought it might help the doctor. Offer that paper to them (make sure it’s legible). If the office staff doesn’t take it, then offer it again to the doctor “I wrote this out because I’m so embarrassed speaking these things..could you read it doctor? Then I think I could answer any other questions you may have.”

This is good advise - it will save both you and your doctor valuable time !

Saturday, April 14, 2007

HONEST MEDICINE: 9 Important Articles That Expose Some of Big Pharma's Highly Questionable Practices

HONEST MEDICINE:9 Important Articles That Expose Some of Big Pharma's Highly Questionable Practices: "9 Important Articles That Expose Some of Big Pharma's Highly Questionable Practices."
This is well-worth reading . It will open your eyes ( and your doctor's too !) as to how pharmaceutical companies manipulate medical practise !

How to Research your Diagnosis :: DiagKNOWsis

How to Research your Diagnosis :: DiagKNOWsis: " Researching your diagnosis and treatment options will empower you in all your medical decision-making. The following approach works well for information gathering.

1. Get Organized
You will need some sort of binder or filing system to keep track of all the information you acquire. One way to keep your findings organized is to use the charts we've developed. Link here to download the chart.
2. Doctors and Medical Professionals
Your physician and other professionals should be your primary source of information, but not your only source of information. Find one who will be willing to partner with you in your search for information. Learn more about working with professionals here.
3. Second Opinions
When your primary doctor suggests that surgery, difficult drugs, or any other difficult treatment is the best option for you, then it's time to get a second opinion. Learn more about second opinions here.
4. Your Medical Records
You have the legal right to acquire all medical records produced on your behalf. Laws vary state-to-state, but in general, you must obtain these records through your primary physician (the person directing your tests and treatment.) Contact your primary physician and ask for copies of all your records: notes, test results, pathology, others.
5. Non-Medical Professionals
There is a large group of other professionals, some health-related, who may be able to help you.
6. The Internet
You'll find a wealth of information on the internet. Not all the information is credible, however, and all your findings should be confirmed with your physician(s). One of the biggest benefits of the internet is that new information can be found everyday. Further, you will find access to others who share your diagnosis, and a way to get updated news every day.
Sometimes the internet will lead you to articles available only to subscribers, often doctors only, and the articles will be very expensive to purchase. Check with your primary physician to see if s/he has a subscription and will be willing to provide you with a copy of the article. Or check with your local library by taking all the publication information you have (title, pub, author, dates, etc.) They may be able to find a branch in their system that can obtain the article you seek at little or no cost.
7. Media, Books and Articles
Your local library, bookstores, newspapers, health channels on TV, and other media may help you find information. News can be emailed to you on a daily basis through Google, Yahoo, MSN and others.
8. Networking
Other people can be a very important source of information. Ask everyone you know if they know others who have the same condition or disease. Ask to be referred, even to people you don't know, if you think they have information that can be beneficial to you. You never know who knows exactly the right person who can help you.

9. Participate in Support Groups
Support groups comprised of other patients who share your diagnosis, and their friends and loved ones, can be a lifeline. Check your phone book, online, local newspapers, and your library to find groups that can help you.
10. Help Others
Nothing reinforces learning like teaching someone else. So it is true with health and knowledge empowerment. By helping others, you will learn to deal better with your own situation. You can start by providing feedback to diagKNOWsis. Your feedback will help others who find this website."

sick girl speaks: Getting Your PhD in Patientology

sick girl speaks: Getting Your PhD in Patientology: "Everyone knows that “Knowledge is Power”. When it comes to healthcare, it can enhance or even save your life. The more you can learn about your illness and the treatments, the better able you will be to make informed decisions and ask the right questions. Information can be gathered from other patients, the internet, reading books and asking lots and lots of questions to the medical professionals around you. Take control, knowledge is the first key in being an effective Patient Advocate."

Empowering patients with the tools they need to make tough medical decisions

Empowering patients with the tools they need to make tough medical decisions: "You -- or a loved one -- have been diagnosed with a disease or condition you know very little about. Or perhaps you fear you have a medical problem and don't know what to do next. You may be worried or frightened. You may feel paralyzed by the news, and incapable of dealing with it. You have questions, and you are frustrated by your inability to get immediate answers.

Or perhaps you understand the diagnosis, but the treatment just doesn't seem to have a positive effect. Your symptoms may not improve, or perhaps new ones appear. People are giving you advice: doctors, family, friends. But some advice conflicts with other advice. It's difficult to know what to do. was started to help you sort out the questions, answers, and advice. It is provided by patients, from a patient's point of view. It was begun by someone who has been right where you are.
It will help you take responsibility for your own health and medical decisions. It teaches you to become a better health and medical care consumer."

The Top Ten Unfounded Health Scares of 2006

The Top Ten Unfounded Health Scares of 2006: "Since its founding in 1978, the American Council on Science and Health (ACSH) has been dedicated to providing scientifically sound health information to American consumers. As part of that mission, ACSH has frequently countered misleading and alarmist health news in print, broadcast, and online media. In a classic ACSH publication, Facts Versus Fears: A Review of the Greatest Unfounded Health Scares of Recent Times, ACSH evaluated 27 of the greatest health scares of modern times, reviewing the basis of each, describing their presentation in media, and presenting scientifically accurate information on each topic. The current publication, The Top Ten Unfounded Health Scares of 2006, is organized along similar lines. Unfortunately, old scares seem neither to die nor to fade away—some of these that garnered media attention in 2006 are replays of earlier scares, sometimes with a new twist."

The next time you read a health-related newspaper story, remember this article !

Running a hospital: Do I get paid too much?

Running a hospital: Do I get paid too much?: "Notwithstanding this level of legal guidance, the issue often arises as to whether hospital CEO salaries are out of line. Americans are often ambivalent about high salaries for corporate executives: They often complain about them, but, at the same, time, everybody hopes that he or she can someday earn them! Putting aside that personal sociological observation, let me ask you the question directly: Do you think I earn too much?"

Here's a thought-provoking blog entry by the CEO of a leading US hospital. By comparison, do doctors get paid too little ?

Thursday, April 12, 2007

Medical Tourism –A Doctor’s Perspective

Our personal experience with medical tourism has been extremely positive. We have been running an IVF clinic for the last 15 years, and have noticed a huge surge in patients who come from overseas for IVF. In the beginning, most of these were NRIs; or would come from the Middle East, but in the last 2-3 years, we have treated many Caucasian couples, who come from the US and the UK. In fact, the majority of our patients these days come from abroad !

So why do they fly half way around the world to get a baby ? There are many reasons for this ! Initially, patients would come to us because our charges were a fraction of the cost of what a US clinic would charge. Today, they come to us for many other reasons as well.

Our clinic has a very high pregnancy rate and one of the reasons we are very good at what we do is because we specialize in providing IVF treatment ( we only see infertile couples and do not treat any other gynecological problems). We do not have a waiting list. We do not employ assistants, and provide highly personalized care, so we can tailor our treatment to suit our patient’s needs. We treat couples as intelligent individuals, and invite their input in the decision making process, so they have peace of mind they did their best. We are a patient-friendly boutique clinic, and we take pride in pampering our patients !

Our website at allows couples to read our 300 page book, How to Have a Baby, which is designed to empower infertile couples with information. They can view 20 IVF videos online; and also get a second opinion from me, free of cost. This allows overseas patients to develop confidence in our professional expertise and abilities. I reply to all my emails myself within 48 hours, and this allows them to build a relationship with me well before they come to the clinic.

Medical tourists can be demanding patients ! They have often lost faith in their own medical system; and many of them are doctors and nurses who make their own medical decisions. They are challenging to treat and I enjoy doing so, because they are well-informed and capable of thinking out of the box – it does take guts to travel to India for medical treatment !

Many of our patients come to us because of word of mouth. We have been interviewed by many international newspapers, magazines and TV channels, and this has given us global recognition. Infertile couples can be highly vocal – and once they get pregnant, they are very happy to refer other patients to us. Because they have high expectations of us, all our staff has to be on their toes to ensure they provide high quality treatment – and this helps us to improve the level of the service we provide to our Indian patients as well .

Medical tourism represents a huge opportunity for doctors and hospitals who are willing to tap this market. Firstly, they need to identify niche areas where the demand is the highest. These include: elective surgical procedures which are not covered by insurance, such as : cosmetic surgery and dentistry; expensive surgical procedures which cost an arm and a leg in the US, such as bypass surgery and joint replacement; and alternative medicine , such as health spas for stress management.

Secondly, they have to go out of their way to build a world-class reputation by being transparent, accountable, responsive and patient-centric.

Finally, they should be willing to provide a “point-to-point” service, which takes care of all the needs a medical tourist will have – including: visas; local hospitality ( airport pickup and hotel stay) and sightseeing.

The need for medical tourism is going to grow as the US healthcare industry goes through a shake-up. Third party payment by insurance companies and employers is going to decline, and patients are going to have to start paying for their own treatment through their own pocket, because of the introduction of HSAs, or health saving accounts. They will then start seeking out the most cost-effective healthcare providers – and India can shine !

Unfortunately, the lack of support which the government provides has been a great disappointment, and I feel doctors and hospitals are given step-motherly treatment. The foreign exchange which IT companies earn is tax-free, so why shouldn’t the same consideration be provided to medical services too ? The government should be proud to export medical services, and since Indian doctors have such a good reputation globally, they can leverage this to earn foreign exchange and reverse the brain drain. We do hope the government will put its money where its mouth is, and formally recognize the superb value Indian doctors and hospitals provide to overseas patients, so that medical tourism can be encouraged and supported.

Wednesday, April 11, 2007

Medical Tourism - Best of Both Worlds Plan

Medical Tourism - Best of Both Worlds Plan: "Imagine visiting a world class doctor in your city, someone you would not normally be able to afford through your insurer (unless you are prepared to pay a huge co-pay). Now imagine going to another country with your surgeon to get your surgery done and then returning home to receive continuity of care from the same surgeon. This is why it is called the best of both worlds – your own American doctor takes care of you every step of the way, only your geography changes during surgery.
With the Best of Both Worlds program you will be able to meet your doctor in advance and receive follow up care with them, plus you get to visit a beautiful country.

PlanetHospital is perfect for employers and insurers who want to take advantage of the cost advantages offered by overseas hospitals without compromising the quality and continuity of care. It also allows a company to provide its employees access to some of the top surgeons in their city affordably.

PlanetHospital's Best Of Both Worlds Plan™ will allow top US surgeons to provide pre and post op care to a patient in the US while helping the patient and their employers save a significant amount on their surgeries by agreeing to let the surgeon perform the surgery in a foreign hospital. "

This is a clever idea ! I think we are going to see a lot of bright innovations in this burgeoning area, which will help medical care to become more affordable for US patients. US doctors will soon have to start becoming more competitive and cost-conscious !

Medical Tourism In India

Medical Tourism In India: "Not just cost savings or the high standard of medical care facility, but also the waiting time is much lower for any treatment in India than in any other country. Medical help is often an emergency and situations can turn worse if the treatment is delayed. While you might have to wait for several months to get a surgical operation done in the US, in India things can be arranged within a week.
Medical Tourism India - at a glance

* Low cost medical treatment
* High quality medical care
* Low wait time for critical treatments
* Fluent English speaking staff

A combination of many factors has lead to the recent increase in popularity of medical tourism. Exorbitant cost of healthcare and medical facilities in advanced countries, ease and affordability of international travel, favorable currency exchange rates in the global economy, rapidly improving technology and high standards of medical care in the developing countries has all contributed their share to this rapid development of medical tourism.

Medical Tourism - Medical Tourism Process

The Medical Tourism Process: While it is true that the internet has made booking hotels and airline tickets much easier, even organising a holiday for fun can be a challenging task. Putting together a trip for receiving medical treatment overseas can sometimes seem to be an overwhelming challenge ! You have so many tasks to handle and coordinate - doctors; hospitals; hotels; airlines ! If you want to become a medical tourist to ensure you get good value for your money, this site describes a useful process you can follow, to ensure you get good medical care - and also have an enjoyable holiday !

Wednesday, April 04, 2007

SugarStats - online management of diabetes

" The SugarStats interface is simple and easy-to-use . The day view is the core of the system where you can input statistics for any given day. Each day has 4 different modules to add/edit/delete statistics for blood sugar readings, medication, food intake and physical activity.

We’ve used web technologies such as Ajax in order to make data input as easy as possible. What does this mean? This means SugarStats works more like a regular desktop application than an actual website."

This is a clever use of web technology to help patients with diabetes better manage their disease. A similar model could easily be used for most chronic illnesses !

Diabetes PHD - smart tool for diabetics

" In order to provide the most accurate health information to you, Diabetes PHD will ask you to create a personal health record. You will be asked to enter as much information as you can about your health history: height, weight, cholesterol levels, blood pressure readings, last dilated eye exam, current medications, A1c number, and so on.

In a short time, Diabetes PHD will determine a personalized Results Overview for you, showing your current risk for diabetes, heart attack, stroke, kidney failure, as well as foot and eye complications. By changing certain variables in your profile, like stopping smoking, losing weight, taking ACE inhibitors, getting a regular foot exam etc., you will be able to see how making these changes would affect your future health."

Monday, April 02, 2007

Wikis, blogs and podcasts: a new generation of Web-based tools for clinical practice

Wikis, blogs and podcasts: a new generation of Web-based tools for clinical practice

The latest generation of collaborative Web-based tools, namely wikis, blogs/photoblogs, blikis and podcasts/vodcasts, offer many unique and powerful information sharing and collaboration features. In this paper we have explored how these Web 2.0 applications would prove useful on the long run for virtual collaborative clinical practice and learning, based on the currently available initial online medical/health-related examples and literature about these tools. Careful thinking and research are still needed in order to find the best ways to leverage these emerging tools to boost our teaching and learning productivity, foster better 'communities of practice', and support continuing medical education/professional development (CME/CPD) and patient education.

How do you know you're getting the best care possible?

How do you know you're getting the best care possible?

Speaking, I think, both for those of us at Google and most of you, given our specific condition or conditions and medicines, just knowing what the guidelines and generally accepted standard of care is for us specifically would be hugely helpful in knowing what to discuss with our doctors and what to research further. Today, even if we can figure out which sites upon which to rely, it is hard to find this out. We don’t know where to start. Our treatment scares us, or our drugs have worrying side effects, or we’re just frightened that we’re not getting the treatment we should be getting.

Honestly, this information can even help our doctors sometimes. They are over-worked and often pressed for time and it cannot ever hurt to double check. Sometimes they didn’t get accurate or complete information from us. While most drug-to-drug and drug-to-condition interactions are known to our doctors, they do change and the doctor might miss a new one or not know about all your drugs because we forgot to tell your doctor about one.

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