MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'basics'. Sat, 03 Sep 2011 01:59:26 +0100 http://www.medworm.com/index.php?rid=4821467&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2011%2F05%2F12%2Fupcoming-event-fda-basics-webinar-on-foreign-inspections-may-17-2011-at-1230pm-et%2F Did you know that FDA foreign inspections have doubled since 2008? Did you know that foreign food inspections alone have quadrupled since 2010? As part of FDA Basics, FDA is hosting a webinar on foreign inspections where you can learn more. Susan Laska, the Deputy Director of the Division of Foreign Field Investigations, will give an overview and answer questions about FDA’s Global Inspection program. The free 30 minute webinar will be held Tuesday May 17, 2011 at 12:30 pm ET. There are a limited number of spots available for the webinar. Materials from the webinar will also be made available on the FDA website following the presentation. Learn more about the webinar, including instructions about how to join the webinar. Ann Witt, Transparency Initiative Coordinator (Source: FDA Tr... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4821467 Thu, 12 May 2011 19:55:50 +0100 4821467 http://www.medworm.com/index.php?rid=4715131&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2011%2F04%2F15%2Fupcoming-event-fda-basics-webinar-by-the-center-for-drug-research-and-evaluation-on-the-bad-ads-program-april-28-2011-at-12-noon-et%2F Did you know that healthcare providers can play an important role in ensuring that prescription drug advertising and promotion is truthful by recognizing and reporting misleading ads? As part of FDA Basics, FDA is hosting a webinar where you can learn more. Catherine Gray, Pharm.D., in the Division of Drug Marketing, Advertising, and Communication (DDMAC) in FDA’s Center for Drug Research and Evaluation will present an overview of the FDA’s “Bad Ad” program, specifically focusing on how to identify misleading prescription drug promotion and report this activity to the agency. The free 30 minute webinar will be held Thursday, April 28 at 12 noon ET. There are a limited number of spots available for the webinar. Materials from the webinar will also be made available on the FD... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4715131 Fri, 15 Apr 2011 12:58:12 +0100 4715131 http://www.medworm.com/index.php?rid=4561279&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2011%2F03%2F08%2Fmaterials-available-from-fda-basics-webinar-on-fdas-role-in-ensuring-the-safety-of-the-nation%25e2%2580%2599s-blood-supply%2F Did you miss the FDA Basics webinar about FDA’s vital role in ensuring the safety of the nation’s blood supply? You can learn about FDA’s five overlapping layers of blood safety and review rules that are designed to make sure we have a safe and available blood supply, including rules related to donor screening and testing of blood for blood-borne infectious agents. Materials from the webinar are now available. We have posted a link to view and listed to 30 minute webinar and posted a link to download a copy of the presentation slides. You can also find materials from past FDA Basics webinars. (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4561279 Tue, 08 Mar 2011 20:21:21 +0100 4561279 http://www.medworm.com/index.php?rid=4460662&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2011%2F02%2F10%2Fdid-you-know-that-fda-plays-a-vital-role-in-ensuring-the-safety-of-the-nation%25e2%2580%2599s-blood-supply%2F As part of FDA Basics, FDA is hosting a webinar where you can learn more FDA’s role in ensuring the safety of the nation’s blood supply.  The featured speaker, Richard Davey, MD, Director of the Division of Blood Applications, Office of Blood Research and Review in FDA’s Center for Biologics Evaluation and Research, will discuss how the agency safeguards the nation’s blood supply and protects the five million people who receive blood transfusions annually. Dr. Davey will provide an overview of these safeguards and will focus on the donor screening process and the testing of blood for blood-borne infectious agents.  After the presentation, there will an opportunity to ask questions. The free 30 minute webinar will be held Tuesday, February 15th, at 2 p.m. ET. There are a l... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4460662 Thu, 10 Feb 2011 17:23:26 +0100 4460662 http://www.medworm.com/index.php?rid=4372919&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2011%2F01%2F19%2Fmaterials-available-from-fda-basics-webinar-on-the-fdas-center-for-tobacco-products-state-enforcement-program%2F Did you miss the FDA Basics webinar about FDA’s Center for Tobacco Products State Enforcement Program?  FDA is contracting with states and U.S. Territories to help with compliance and enforcement activities in order to limit the availablity of tobacco products to young people. Materials from the webinar are now available on the FDA Basics website. Check out the “What’s New” tab on the FDA Basics homepage to download materials from the webinar.  We have posted a link to view and listen to the 30 minute webinar and posted a link to download a copy of the presentation slides. You can find materials from past FDA Basics webinars here. Afia Asamoah, Transparency Initiative Coordinator (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4372919 Wed, 19 Jan 2011 16:00:05 +0100 4372919 http://www.medworm.com/index.php?rid=4266782&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F12%2F15%2Fmonthly-visitor-and-rating-statistics-now-available-on-fda-basics%2F FDA Basics is the agency’s web-based resource that provides basic information to the public about FDA and the work of the agency (see January 12 blog post).  Now available on FDA Basics are summary statistics about the number of visitors coming to the site each month, the number of comments submitted by the public each month,  as well as the average rating (based on a 5 point scale) for the content on FDA Basics.    The statistics will be updated monthly and are available here. Let us know what you think of the new metrics page on FDA Basics.  And continue to check out the content on FDA Basics.  You can suggest additional questions and rank how useful you found the answers we provided.   New content is added on a regular basis (see the “What’s New” ta... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4266782 Wed, 15 Dec 2010 15:27:33 +0100 4266782 http://www.medworm.com/index.php?rid=4246053&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F12%2F09%2Fmaterials-available-from-fda-basics-webinar-on-melamine-the-cause-of-the-pet-food-and-infant-formula-recalls%2F Did you miss the FDA Basics webinar on how FDA uncovered and confirmed the presence of contaminants in the 2007 pet food recalls? Materials from the webinar are now available on the FDA Basics website. Check out the “What’s New” box on the FDA Basics homepage to download materials from the webinar.  We have posted a link to view and listen to the 30 minute webinar and posted a link to download a copy of the presentation slides. You can find materials from past FDA Basics webinars here. Afia Asamoah, Transparency Initiative Coordinator (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4246053 Thu, 09 Dec 2010 14:26:09 +0100 4246053 http://www.medworm.com/index.php?rid=4197621&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F11%2F24%2Fupcoming-event-fda-basics-webinar-on-melamine-the-cause-of-the-pet-food-and-infant-formula-recalls-tuesday-november-30-2010-at-2-pm-et%2F Did you know that FDA regulates that can of cat food, bag of dog food, or box of dog treats or snacks in your pantry? Do you know how FDA uncovered and confirmed the presence of contaminants in the 2007 pet food recalls? As part of FDA Basics, FDA is hosting a webinar where you can learn more.  The featured speaker, Renate Reimschuessel, Research Biologist from the Division of Animal Research, Center for Veterinary Medecine, will discuss how FDA investigated and found contaminants that were imported into the United States and used as ingredients in pet food.  After the presentation, there will be an opportunity to ask questions. The free 30 minute webinar will be held Tuesday, November 30 at 2:00 p.m. ET. There are a limited number of spots available for the webinar.... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4197621 Wed, 24 Nov 2010 14:54:43 +0100 4197621 http://www.medworm.com/index.php?rid=4135141&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F11%2F04%2Fmaterials-available-from-fda-basics-webinar-on-the-food-emergency-response-network-fern%2F Did you miss the FDA Basics webinar on the Food Emergency Response Network (FERN)?  FERN is an organization of the nation’s regulatory food testing laboratories whose purpose is to detect, identify, respond to and recover from bioterrorism or public health emergencies involving our food supply. Materials from the webinar are now available on the FDA Basics website. Check out the “What’s New” box on the FDA Basics homepage to download materials from the webinar.  We have posted a link to view and listen to the 30 minute webinar and posted a link to download a copy of the presentation slides. You can find materials from past FDA Basics webinars here. Afia Asamoah, Transparency Initiative Coordinator (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4135141 Thu, 04 Nov 2010 18:34:20 +0100 4135141 http://www.medworm.com/index.php?rid=4109344&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F10%2F27%2Ffda-basics-video-available-about-drug-development-for-minor-use-in-major-species-and-for-use-in-minor-species%2F As part of FDA Basics, FDA has posted a video with Dr. Margaret Oeller, director of  FDA’s Office of Minor Use and Minor Species Animal Drug Development in the Center for Veterinary Medicine.  Dr. Oeller discusses FDA’s role in encouraging drug development for specific ”minor uses” in major species and for specific diseases affecting  “minor species,” which include zoo animals, honeybees, game birds, and aquaculture.  There are only seven major species; all other species are considered “minor species.”  View the video below. (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4109344 Wed, 27 Oct 2010 15:11:09 +0100 4109344 http://www.medworm.com/index.php?rid=4089076&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F10%2F20%2Fupcoming-event-fda-basics-webinar-on-the-food-emergency-response-network-fern-tuesday-october-26th-100-p-m-et%2F Did you know that there is an organization of the nation’s regulatory food testing laboratories whose purpose is to detect, identify, respond to and recover from bioterrorism or public health emergencies involving our food supply? As part of FDA Basics, FDA is hosting a webinar where you can learn more.  The featured speaker, Carl Sciacchitano, Director of the Division of Field Science in FDA’s Office of Regulatory Affairs (ORA), will describe the Food Emergency Response Network (FERN) and its role in protecting the nation’s food supply.  After the presentation, there will be an opportunity to ask questions. The free 30 minute webinar will be held on Tuesday, October 26, at 1:00 p.m. ET. There are a limited number of spots available for the webinar.  ... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4089076 Wed, 20 Oct 2010 15:02:57 +0100 4089076 http://www.medworm.com/index.php?rid=4061963&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F10%2F13%2Fnew-fda-basics-video-available-about-the-effective-and-proper-uses-of-medicines-and-devices-in-children%2F As part of FDA Basics, FDA has posted a video with Dr. Dianne Murphy, director of FDA’s Office of Pediatric Therapeutics.  Dr. Murphy discusses how FDA helps to develop knowledge about the proper and effective use of drugs and devices in children.  View the video below. (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4061963 Wed, 13 Oct 2010 10:26:29 +0100 4061963 http://www.medworm.com/index.php?rid=4061964&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F10%2F07%2Fmaterials-available-from-fda-basics-webinar-on-%25e2%2580%259cgeneric-drugs%2F Did you miss the FDA Basics webinar about generic drugs? Materials from the webinar are now available on the FDA Basics website. Check out the “What’s New” box on the FDA Basics homepage to download materials from the webinar.  We have posted a link to view and listen to the 30 minute webinar and posted a link to download a copy of the presentation slides. ** There were audio difficulties during the first couple of minutes of the 30 minute webinar.** You can find materials from past FDA Basics webinars here. Afia Asamoah, Transparency Initiative Coordinator (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4061964 Thu, 07 Oct 2010 08:00:43 +0100 4061964 http://www.medworm.com/index.php?rid=4061965&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F09%2F20%2Fbasics-webinar-generic-drugs%2F Did you know that generic drugs are safe and effective alternatives to brand name drugs? Did you know that generic drugs can reduce the cost of prescription drugs for both consumers and the government? As part of FDA Basics, FDA is hosting a webinar where you can learn more. The featured speaker Robert West, a supervisory pharmacist in the Office of Generic Drugs in FDA’s Center for Drug Evaluation and Research (CDER), will give an overview of generic drug regulation.  After the presentation, there will be an opportunity to ask questions. The free 30 minute webinar will be held on Monday, September 27, at 1:00 p.m. ET. Sign in early, since there are a limited number of spots available for the webinar. Materials from the webinar will also be made available on the FDA Web site. Click ... FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4061965 Mon, 20 Sep 2010 21:22:23 +0100 4061965 http://www.medworm.com/index.php?rid=4061966&cid=t_100124_4_f&fid=38622&url=http%3A%2F%2Ffdatransparencyblog.fda.gov%2F2010%2F09%2F20%2Fnew-fda-basics-main-page%2F It’s been almost 9 months since the FDA Basics section of the FDA website launched. After collecting web traffic data during this time, we decided to make some minor changes to the main page in hopes of improving your experience. The changes include: Cleaner look-and-feel Easier access to the major content areas, videos, and webinars Restructured slideshow The newly redesigned FDA Basic main page will launch later this month. In the meantime, see below for images of the current main page (1st picture) and the new main page (2nd picture). Click the images below to see the full size image. Current FDA Basics Main Page New FDA Basics Main Page Post a comment below to let us know what you think. Afia Asamoah, Transparency Initiative Coordinator (Source: FDA Transparency Blog) FDA Transparency Blog blogs http://www.medworm.com/rss/comments.php?id=4061966 Mon, 20 Sep 2010 14:36:35 +0100 4061966 http://www.medworm.com/index.php?rid=3467933&cid=t_100124_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FIs9kdFk3Bos%2F Double Dot beach umbrella from PB teen I strongly believe in that “healthy summer glow.” My vitamin D levels are through the roof. In other words, I am a sun worshipper. I spend as much time as I can outside, avoiding the shade like the plague. Of course, I wear SPF (more or less) and no longer bask Bain de Soleil-style on a chaise lounge. The change in habits is due, in part, to the good sense that 30-some-odd years can bring, and, in part, because my two-year-old son (and ever-present tag-a-long) inherited his dad’s powder-like skin complexion. If I plan to go to the beach, park, or pool for any length of time with toddler in tow, I need to execute a two-pronged strategy: Divert and protect. Besides my handy SPF-45 spray, here are a few new tools to help keep my little one – and ... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=3467933 Wed, 14 Apr 2010 16:09:20 +0100 3467933 http://www.medworm.com/index.php?rid=3433091&cid=t_100124_129_f&fid=39065&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fgluten-freesimplicity%2FGNKb%2F%7E3%2FasNQotQg_4Y%2F Get the recipe!!! You gonna like this! (c.2010, wtb) Seed this on Newsvine Share this on Linkedin Share this on Devmarks Add this to Google Bookmarks Submit this to Script & Style Email this to a friend? Subscribe to the comments for this post? Tweet This! Share this on Technorati Stumble upon something good? Share it on StumbleUpon Share this on Reddit Post this to MySpace Share this on Mixx Digg this! Submit this to DesignFloat Share this on del.icio.us Share this on Blinklist Share this on Facebook Post this on Diigo Add this to Mister Wong Add this to Izeby Share t... Gluten-Free Simplicity blogs http://www.medworm.com/rss/comments.php?id=3433091 Fri, 02 Apr 2010 00:40:52 +0100 3433091 http://www.medworm.com/index.php?rid=3358617&cid=t_100124_139_f&fid=38879&url=http%3A%2F%2Fwww.virology.ws%2F012_W3310_10.wmv Download: .wmv (369 MB) | .mp4 (77 MB) Visit the virology W3310 home page for a complete list of course resources. (Source: virology blog) virology blog blogs http://www.medworm.com/rss/comments.php?id=3358617 Fri, 12 Mar 2010 02:09:47 +0100 3358617 http://www.medworm.com/index.php?rid=3126580&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Fthe-milk-ejection-reflex-or-let-down-reflex%2F It can help to understand the physical mechanisms behind breastfeeding. One of those mechanisms is the milk-ejection reflex or “let-down” of the milk. The baby’s suckling signals the pituitary to release prolactin and oxytocin. Oxytocin is the hormone that triggers the let-down reflex, which causes the alveoli to contract and push the milk out. How to Recognize the Milk Ejection Reflex or Letdown Some mothers, especially in the early days of breastfeeding, feel a “pins-and-needles” sensation or an achy feeling in the breast when the milk lets down. (If that pins-and-needles feeling is exceptionally painful and continues throughout the nursing session and not just at let-down, that can be a sign of thrush, a yeast infection). The let-down happens shortly after ... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3126580 Tue, 29 Dec 2009 10:21:08 +0100 3126580 http://www.medworm.com/index.php?rid=2974127&cid=t_100124_129_f&fid=39065&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fgluten-freesimplicity%2FGNKb%2F%7E3%2Fuix5m3awkI4%2F :   It is one thing to be about to try new foods here and there that are made by another person for us.  But unless one is extremely resourceful,  that can be  a difficult thing to expect on a regular [...] (Source: Gluten-Free Simplicity) Gluten-Free Simplicity blogs http://www.medworm.com/rss/comments.php?id=2974127 Mon, 09 Nov 2009 12:46:36 +0100 2974127 http://www.medworm.com/index.php?rid=2881168&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Freview-of-laugh-and-learn-dvds%2F Conclusion I enjoyed these DVDs and will be passing them on to my sister who is due with her first baby later this month. If you have watched any of these DVDs, please leave a comment and let us know your opinion as well. If not, stop by on Monday and enter the contest to win your own set of “Laugh and Learn” DVDs! Post from: Breastfeeding 1-2-3 (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=2881168 Sat, 10 Oct 2009 20:21:32 +0100 2881168 http://www.medworm.com/index.php?rid=2871551&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Fbreastfeeding-success-in-the-hospital%2F Here’s another guest post from pediatrician and author Dr. Marianne Neifert. I enjoyed her new book so much that not only did I review Great Expectations: The Essential Guide to Breastfeeding on my blog, I also took the time to post my first-ever review on Amazon.com. Today she talks about how breastfeeding success begins in the hospital: Five Hospital Practices that Extend Your Duration of Breastfeeding Photo by Vedrana Bosnjak Your hospital experience — brief as it may be — can have a powerful impact on your long-term breastfeeding success. Making hospital changes in maternity care practices has been shown to significantly increase breastfeeding initiation and duration rates. The Baby-Friendly Hospital Initiative (BFHI) — launched in 1991– is a worldwide cam... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=2871551 Tue, 06 Oct 2009 20:44:58 +0100 2871551 http://www.medworm.com/index.php?rid=2598542&cid=t_100124_180_f&fid=38604&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmakeitgreat%2F%7E3%2Fr04qTKe-xsc%2F Some of you have asked me privately how to get started blogging. If you asked about how to do this, this article is for you. If you already have a blog, some of this may be too basic for you. Over the next few days, I’ll be writing about the basics of blogging, from getting started to writing your first few articles, to finding images that work for your blog and even some more advanced things that I’ve found useful. How to Start a Blog for Free Go to http://wordpress.com or http://blogger.com and sign up for a free blog. Make the userID your name or something close to your name, or choose your mantra. I started out with MakeItGreat.Blogspot.com (no longer in service). Wordpress.com wasn’t around when I got started writing my blog, or I just didn’t know about it. I would use Word... Phil Gerbyshak blogs http://www.medworm.com/rss/comments.php?id=2598542 Tue, 14 Jul 2009 06:20:00 +0100 2598542 http://www.medworm.com/index.php?rid=2405414&cid=t_100124_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F13%2Fextended-periods-of-sunlight-might-act-as-suicide-trigger%2F Midweek Mental Greening People often associate becoming depressed during dark winter months with Seasonal Affective Disorder (or, SAD). SAD can actually affect people during any season, including the bright and sunny days during spring and summer months; however, according to a recent Swedish study, regardless of the similar symptoms, SAD doesn’t seem to be the culprit when it comes to the high number of suicides happening in places that experience extended sunlight like Sweden and Greenland. The researchers speculated that light-generated imbalances in serotonin — the brain chemical linked to mood — may lead to increased impulsiveness that in combination with a lack of sleep drives people to kill themselves. “We found that suicides were almost exclusively violent and incre... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2405414 Wed, 13 May 2009 17:54:56 +0100 2405414 http://www.medworm.com/index.php?rid=2234038&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F_62PV7iHmaQ%2F La Leche League of Argentina produced this helpful breastfeeding video “Breastfeeding in 10 Steps” in Spanish: “Amamantar en 10 Pasos.” Tags: amamantar, breastfeeding tips, breastfeeding-video, la lactancia materna de vídeo, La-Leche-League, Liga de La Leche Argentina, LLL, Spanish breastfeeding helpShare This (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=2234038 Tue, 03 Mar 2009 21:00:51 +0100 2234038 http://www.medworm.com/index.php?rid=2122050&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2Fs_nVSmDhHls%2F Mommy’s Little Breastfeeding Book: 101 Tips Your Baby Wants You to Know about Nursing is a great book! I love the concept and the philosophy presented. This little breastfeeding book is condensed enough to read in an hour yet it is jam-packed with helpful tips for successful breastfeeding. It has all the things I would want to tell a pregnant friend to encourage her to make the decision to breastfeed and to help her get started. One of my favorite tips? 41. A good rule of thumb is that Mommy puts the food in and Daddy takes it out. A little humor goes a long way to setting the right tone in this helpful but not preachy, quick-start guide to the basics of breastfeeding. At $8.95 list price this would make an excellent addition to a baby shower gift. The author Michele Leigh Carnesecc... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=2122050 Wed, 21 Jan 2009 22:01:07 +0100 2122050 http://www.medworm.com/index.php?rid=2073979&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F12%2Fhospice-cops-is-your-hospice-compliant.html I've been going over my checklists for compliance for my hospice's implementation of the new Medicare Hospice Conditions of Participation for the thousandth time, and was wondering how many hospices across the nation are not 100% compliant at this point.The new COPs went into effect on December 2nd, and my hospice was not ready. We're nearing a month later, and my hospice is still not 100% compliant. Where are those nursing home and and DME contracts we mailed out? How many layers of bureaucracy can any one contract have to go through before someone can sign it?I'm guessing that I'm not near alone. There are regulations in the new COPs that are hard to accomplish (especially for small hospices). There are also some that nobody seems to fully understand. I don't think Medicare even understa... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=2073979 Sun, 28 Dec 2008 19:59:00 +0100 2073979 http://www.medworm.com/index.php?rid=1948504&cid=t_100124_167_f&fid=37833&url=http%3A%2F%2Fnutrition.edublogs.org%2F2008%2F10%2F30%2Faspirin-101%2F Estimates figure that about 60 percent of people ages 65 and older take an aspirin at least once a week, some on the recommendation of their doctor (to prevent heart disease) some now. This common, over-the-counter medication can cause some serious side effects. Regular use should be discussed with a doctor. Aspirin is routinely recommended by the American Heart Association for people who’ve had a heart attack, stroke caused by blood clot, unstable angina, or “ministrokes.” Further more the American Heart Association recommends that people who have yet to experience an event but who are at increased risk because of family history, say, may also stand to gain from aspirin therapy. Here are some things you may not know about Aspirin. 1. Aspirin would have a hard time gettin... Nutrition and Wellness Biology 50 blogs http://www.medworm.com/rss/comments.php?id=1948504 Thu, 30 Oct 2008 22:41:38 +0100 1948504 http://www.medworm.com/index.php?rid=1892587&cid=t_100124_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F10%2F21%2Fif-youre-new-to-pain-management-i%2F I posted last week on some of the basic domains of knowledge that I personally think are important when you’re new to pain management.  For more detailed curricula, the best place to go is IASP, where you can see some older but still relevant examples of curricula such as this one for occupational therapy and physiotherapy. To break the area down a bit, because it really is quite a daunting list of topics, I thought about some of the basic conceptual material as being quite helpful to organise learning.  The first topic that I think is fundamental to understanding pain is the biopsychosocial model, and a quite nice summary of the model is this one by Dr Shaheen Lakhan.  A lightly longer, albeit older couple of papers are here.  A much more recent paper is briefly summarised here,... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1892587 Mon, 20 Oct 2008 18:17:02 +0100 1892587 http://www.medworm.com/index.php?rid=1883659&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2Fny7Zbd8cRDg%2F In this video Dr. Jack Newman guides a woman in using the cross-cradle hold to latch her baby onto the breast. While there are many different breastfeeding positions, the cross-cradle hold can be particularly helpful for newborns. Note how the mother is not forcefully pushing the baby’s head onto the breast, but rather is simply supporting the head and bringing the baby tummy-to-tummy and using her arm on the baby’s back and hand under the baby’s face. This position also allows for breast compressions (using the mother’s thumb on top of the breast and four fingers underneath the breast to compress the breast when baby is just “nibbling” and not actively sucking and swallowing large mouthfuls). Tags: breastfeeding-video, cross-cradle hold, Dr. Jack New... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1883659 Fri, 17 Oct 2008 00:57:03 +0100 1883659 http://www.medworm.com/index.php?rid=1747637&cid=t_100124_93_f&fid=36982&url=http%3A%2F%2Fprep4md.blogspot.com%2F2008%2F08%2Fhow-to-study-microbiology-microbiology.html As with any other subject when you start studying Microbiology you need to learn the basics and then little by little you can add more details, facts, examples, etc. And that is what Ill be taking about in this series of posts. "Microbiology Basics"Classification:Because there are many bugs that you will be studying in this subject you will probably find it easier to study and remember the bugs if you put them in clusters.As long as medically important bacteria are concerned, put in your mind that we have 6 Gram +ve bugs and all the others are Gram -ve.Of all the Gram +ve bugs only two are cocci and the other 4 are rods. The two cocci are Streptococcus and Staphylococci. Now two of the 4 rods are capable of forming spors, namely, Bacillus and Clostridium. Last two Gram +ve cannot form spor... My M.D. Journey! blogs http://www.medworm.com/rss/comments.php?id=1747637 Sat, 30 Aug 2008 12:59:00 +0100 1747637 http://www.medworm.com/index.php?rid=1723422&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F08%2Fwhat-is-main-thing.html I have no clue who first said, "The main thing is keeping the main thing the main thing", but I owe them a debt of gratitude. That odd little line has helped keep me focused through the years, and it is very timely advice for the hospice industry. My last couple of posts have dealt with the necessity of hospices moving from the relaxed business practices of the past to the world of having very serious best practices in place to ensure operational efficiency. I'm sure it isn't the most popular stuff I've ever written, but I am also sure that it is something hospices must face.Today I want to deal with what, exactly, the main thing is. Hospice, as defined by the Hospice Medicare Benefit, is the main thing.Hospices today often do so much more than what they did twenty five years ago. Just bec... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1723422 Thu, 21 Aug 2008 16:07:00 +0100 1723422 http://www.medworm.com/index.php?rid=1693962&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2FtT9G7hug3j8%2F My newborn and I had our first “official” outing (other than to the offices of the pediatrician or midwife) on the day she turned three weeks old. We attended the community talent show at the local library, which I was pleased to see had a huge display of breastfeeding information (see above) in honor of World Breastfeeding Week! The talent show was so great. There is nothing cuter than: a 3-year-old belting out How Great Is Our God, a 4-year-old barely whispering the ABCs, another 4-year-old humming the Indiana Jones theme song, and a darling girl tap dancing on industrial carpeting in the library rec room! My own 6-year-old did an abridged reading of the book Chrysanthemum. I could not have been prouder and I wouldn’t have missed it for anything! It did take a lot of co... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1693962 Sun, 10 Aug 2008 02:02:37 +0100 1693962 http://www.medworm.com/index.php?rid=1664217&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F07%2F29%2Fcontinuity-of-care-document-for-clinical-data-exchange%2F HL7 Basics.  Prior to the approval of the Continuity of Care Document (CCD) as an ANSI Standard in 2007, electronic clinical document exchange could utilize one of two formats: HL7 Clinical Document Architecture (CDA) or ASTM Continuity of Care Record (CCR). In an effort to combine the two closely related formats, the Continuity of Care Document was created. CCD harmonizes the two separate standards by using CCR within the broader context of CDA. It shares summary information about the patient in an easy-to-read format, using CCD templates to constrain the data. The information can be read by the human eye or processed by a machine (such as an EMR system), and can be sent electronically or manually carried by the patient. CCD is widely compatible with new and existing technology/standards... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1664217 Tue, 29 Jul 2008 19:49:20 +0100 1664217 http://www.medworm.com/index.php?rid=1655420&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F07%2F25%2Fhl7-dates-and-times%2F Moving dates and times between systems via HL7 has two primary challenges: Clock skew/drift — the systems don’t agree on the definition of “now” Time zones — the systems differ in their offset from UTC/GMT While both problems are easy to understand, the two challenges are solved in very different ways. Here is a summary of each problem: Clock Skew or Clock Drift: Systems exchanging data “almost agree” on the current date and time — but not quite. For example, the RIS system thinks it is 4:15pm while the registration system thinks it is 4:17pm. Time Zone: The receiver of a message needs to know if the dates and times in the message are using the same time zone as the receiver or a different one. e.g., a radiology clinic based in Tucson rec... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1655420 Fri, 25 Jul 2008 20:13:52 +0100 1655420 http://www.medworm.com/index.php?rid=1655421&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F07%2F25%2Fhl7-time-zone-qualification%2F Both HL7 V2.x and V3.x support complex date structures. In the real world most V2.x messages are encoded using the local time on the system that generates the message. In addition, many interfaces do not support the concept or use of time zone. This can be a big challenge when building interfaces and often site-to-site negotiation is required should the data moving across the interface need interpretation in another facility in a different time zone. Said another way, historically HL7 messages were “always local” within a hospital or clinic. As the scope of using these messages pushes to regional or national level, the time zone is much more critical. In addition, the challenge of time zones directly applies even at the local level when daylight savings time kicks in and out. A... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1655421 Fri, 25 Jul 2008 16:34:59 +0100 1655421 http://www.medworm.com/index.php?rid=1637720&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F07%2F18%2Fwhat-is-an-hl7-adt-feed%2F Any “feed”, whether an ADT feed, ORU feed or ORM feed, is basically a streamlined way of getting messages. In the HL7 standards world, ADT, ORU (order messages) and ORM (results messages) are the most common HL7 messages. Of those three, ADT messages are the most commonly used. ADT stand for “admissions, discharges, and transfers”. It basically means demographics; anytime you think of ADTs, think demographics: the patient’s name, the patient’s location in the hospital, his or her address, phone number, gender, etc. There are many different types of ADT message types, such as: Registering a patient Discharging a patient Merging patient files to avoid duplication An ADT feed is one way an application or a provider can get all that information from a clin... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1637720 Fri, 18 Jul 2008 19:33:12 +0100 1637720 http://www.medworm.com/index.php?rid=1593792&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F07%2Fhow-to-choose-hospice-why-some-things.html (This post is part of a series of posts. To read from the begining of the series go here.)This is my final post in the How to choose a hospice series for now. As time goes on, I'll think of other suggestions, but nine is enough for now.In this post I'll tell you a few of the things that don't matter and some that do. Most of this post is in response to other websites that have lists of things that are important when choosing a hospice. Some have good suggestions, some are silly, and some are downright self serving. Here's my list of what is and is not important:What doesn't matter:The for profit/not-for-profit status of a hospice. You will hear non-profit hospices preach that for-profit hospice is the most evil thing in the history of civilization, but it just isn't true. There are bad non... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1593792 Mon, 07 Jul 2008 14:02:00 +0100 1593792 http://www.medworm.com/index.php?rid=1556274&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F06%2Fhow-to-choose-hospice-why.html (This post is part of a series of posts. To read from the begining of the series go here.)There is little better than the recommendation from someone who has experience with a specific hospice. If you have friends that have used hospice in the past, you should talk to them. Be warned though that hospice is overwhelmingly popular with families who have used it, so one glowing recommendation doesn't mean you have found the best hospice. Again, most hospices are good at caring for the average patient, so if your friend's loved one was an average patient, you should expect a positive review. Ask your friend the questions from the other posts and see what you learn.If your loved one lives in a nursing home, I'm going to assume that you have followed the instructions from part 2 that says that y... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1556274 Mon, 30 Jun 2008 14:02:00 +0100 1556274 http://www.medworm.com/index.php?rid=1537893&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F06%2Fhow-to-choose-hospice-why-staffing.html (This post is part of a series of posts. To read from the begining of the series go here.)In "Why Size Matters", I talked about how many patients each nurse has. This time I want to talk about how much attention you should expect and who you should expect to get it from.First, frequency of visits. Your nurse should visit at least twice a week. Any nurse that thinks they can keep up on a hospice patient's condition by visiting once a week is delusional. Find a hospice that promises a minimum of two nursing visits a week. It shouldn't be too hard.Second, find out who makes the visits. The question you should ask is if the same nurse will visit every time. There are two different theories on how to use nurses. As with everything in hospice one is best for the patient and one is best for the p... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1537893 Mon, 23 Jun 2008 14:02:00 +0100 1537893 http://www.medworm.com/index.php?rid=1522031&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F06%2Fhow-to-choose-hospice-why-size-matters.html (This post is part of a series of posts. To read from the begining of the series go here.)No matter what they tell you, size does matter. To be honest, I can't decide how much it matters. That means that while this post is good advice, it is not as important as many of the other suggestions you'll receive in this series.You don't want a hospice that is too big. You don't want a hospice that is too small. You want a hospice that is just right.What is too big? I'd say anything over 90 patients in any given office. Make sure you find out how many the office closest to you has, because there are companies that have one huge office and many other offices that are a better size. You should only care about the office that you will be working with. As a hospice grows larger there is no way to avoi... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1522031 Mon, 16 Jun 2008 14:02:00 +0100 1522031 http://www.medworm.com/index.php?rid=1502520&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F06%2Fhow-to-choose-hospice-why-pharmacies.html (This post is part of a series of posts. To read from the begining of the series go here.)My thoughts on this subject have changed quite a bit since I first wrote this series in March of 2005. Then I was not a fan of hospices that use the large "mail order" hospice pharmacies, now I believe that those pharmacies may be the best option for some hospices.Your hospice is in charge of providing all medications that are needed to control the symptoms associated with your hospice diagnosis. With that charge comes a lot of responsibility. Your goal is to have your pain controlled. The hospices goal is to control your pain in a cost effective manner. I used to think that a hospice that was willing to hire an out of state pharmacy was a sign that the hospice was more focused on the cost control sid... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1502520 Mon, 09 Jun 2008 14:02:00 +0100 1502520 http://www.medworm.com/index.php?rid=1484862&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F06%2Fhow-to-choose-hospice-why-location.html (This post is part of a series of posts. To read from the begining of the series go here.)For part three of this series I want to deal with the most important question - location, location, location.I want to say from the top that I am not talking about where the office is located. Many hospices operate out of some really dumpy buildings in really bad locations. Hospice is one of the few businesses where the client almost never visits the office, so many hospices save some money by operating out of spaces that should be condemned. Many hospices operate out of houses instead of office buildings. All of this is to say that you should pay zero attention to what the office looks like or where it is.Before I explain myself please know that of all the words I spill and all the advice I give in t... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1484862 Mon, 02 Jun 2008 14:01:00 +0100 1484862 http://www.medworm.com/index.php?rid=1472443&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F05%2Fnew-cops-are-published.html One of my first posts on this blog was about my dreams and requests for the upcoming changes in the Medicare Hospice Conditions of Participation. Well, a few years have gone by, and I'm finally going to get to see if my dreams have come true. According to NHPCO, the newly revised final COP's have been posted at the Federal Register. They are not available on the internet yet, but should be tomorrow. Of course, the document is 800 pages, so it may take some time to sort through. We should know most of what is in them, but there are still a lot of people who are holding their breath hoping there are no surprises.This is a huge moment in the history of hospice in America, but it is going to take us a few weeks to actually understand what happened today. (Source: Hospice Blog) Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1472443 Tue, 27 May 2008 20:30:00 +0100 1472443 http://www.medworm.com/index.php?rid=1470112&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Fwww.breastfeeding123.com%2Fbreastfeeding-basics-ten-tips-on-how-a-pregnant-woman-can-prepare-for-breastfeeding%2F Welcome Carnival of Breastfeeding readers! For Pregnancy Awareness Month, this round of carnival entries focuses on pregnancy and breastfeeding. Because I have already shared my stories of breastfeeding during pregnancy and of tandem nursing, I want to share ten tips on how a pregnant woman can prepare for breastfeeding. 1. DO NOT let anyone tell you it is necessary to toughen up your nipples for breastfeeding. 2. DO some reading about breastfeeding. Good choices are: ~ The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning ~ The Womanly Art of Breastfeeding: Seventh Revised Edition ~ The Nursing Mother’s Companion: Revised Edition ~ The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solving Guide to Breastfeedi... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1470112 Mon, 26 May 2008 16:18:39 +0100 1470112 http://www.medworm.com/index.php?rid=1467831&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F05%2Fhow-to-choose-hospice-why-management.html (This post is part of a series of posts. To read from the begining of the series go here.)Part three is an easy follow up question to the one you asked in part 2. Now that you know who owns the company, you need to know how many offices they have, where the offices are, and which one is the home office. You now need to know if the "big cheese" works out of your local office. (I use "big cheese" because this could be different people with different titles for different hospices. If the owner actually works for the company, then clearly the owner is the big cheese. The big cheese's desk is the place where the buck stops. You need to know who the big cheese is and where he/she works.You need to understand three things to understand why this question is important.First, most states limit how m... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1467831 Mon, 26 May 2008 14:01:00 +0100 1467831 http://www.medworm.com/index.php?rid=1451777&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F05%2Fhow-to-choose-hospice-why-ownership.html (This post is part of a series of posts. To read from the begining of the series go here.)As I said in the previous post, the differences between hospice companies are often small and usually hard to find. This post deals with one thing that I feel is a huge difference; Ownership. Who owns the hospice is a very important question, because it gets to the very core of the reason the company exists. If a company is listed on the stock exchange, then the stockholders are the owners. Do you think they invested in the company because they wanted to own the stock of a company that takes good care of people? Do you think Charles Schwab advises their clients to invest in HCR Manor Care (the owner of the national chain Heartland Hospice) because they treat people right? No, investors buy stock becau... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1451777 Mon, 19 May 2008 14:01:00 +0100 1451777 http://www.medworm.com/index.php?rid=1436828&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F05%2Fhow-to-choose-hospice-why-it-matters.html This is the first in a multi part series on how to choose a hospice. The later posts will go into detail about what you need to know and how to find out, but before I get into all of that I wanted to talk about why it matters. If you pump truth serum into most hospice workers they will tell you that there isn't much difference between their company and the others, and in reality there isn't. We all work under the rules of the Medicare Hospice Benefit. Medicare tells us what staff we must have, what we must pay for, who does and does not qualify for hospice, how often we can or can't do certain things, who we contract with to provide certain services, and even who we can't contract with. The Medicare Hospice Benefit rules hospice in the United States today. With that fact in mind, I'm going... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1436828 Mon, 12 May 2008 14:01:00 +0100 1436828 http://www.medworm.com/index.php?rid=1437152&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F288561379%2F Ameda offers a free online instructional video “Your Baby Knows How to Latch-On.” The five-minute clip talks about proper latch and demonstrates how a newborn latches himself on the breast with a minimal amount of guidance from his mother. The video is offered through these links in English and in Spanish. Click here for more breastfeeding videos. For more help with latch-on, see the Checklist for a Good Breastfeeding Latch. Tags: ameda, angela white, breast, breastfeeding, breastfeeding blog, breastfeeding videos, breastfeeding-video, free, lactation, latchShare This (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1437152 Mon, 12 May 2008 09:07:55 +0100 1437152 http://www.medworm.com/index.php?rid=1426310&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2008%2F05%2Fhow-to-choose-hospice-updated.html Over the next few weeks I will be publishing an updated set of posts on how to choose a hospice. This is a series I posted first in March of 2005. The format will remain the same and much of the content will remain the same. My thoughts on some issues have changed over the past couple of years (I may have even been wrong about a few things.) and the industry has changed quite a bit. I think this series, out of all the rambling I have done, is probably the most important, so I wanted to try to keep the series updated to the current trends in hospice. There are also many people reading this blog who didn't read it in 2005, and I hope you will all feel free to give your thoughts and advice in the comments section. Argue with me when you think I'm wrong; Lord knows many of you probably know mo... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1426310 Wed, 07 May 2008 21:40:00 +0100 1426310 http://www.medworm.com/index.php?rid=1353118&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F265167034%2F A good latch is the key to breastfeeding success. It minimizes discomfort and maximizes the transfer of breast milk. So how do you know whether or not you’re doing it right? Go down the checklist: __ In the cradle or cross-cradle positions, the baby should be resting on his side, his tummy facing your tummy, shoulder and hips aligned, mouth level with the nipple __ The baby’s mouth should be covering at least a half inch of the areola, the dark area of skin around the nipple __ His nose is touching or nearly touching the breast __ Both the top lip and bottom lip are flared out __ Once your milk lets down (starts to flow freely), you can see the baby’s jaw moving all the way back by his ear __ The baby’s temple may wiggle, too __ You can hear the baby swallowing (you... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1353118 Sun, 06 Apr 2008 17:32:19 +0100 1353118 http://www.medworm.com/index.php?rid=1317932&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F255259251%2F I received this question today: If breastmilk has been thawed and wasn’t used, can I refreeze it? If not, and I store it in the fridge, what’s the shelf life? Good questions! If breast milk has been thawed and was not used, it should not be refrozen. In the back of the refrigerator (not in or near the door), thawed milk can be stored up to 24 hours for later use. For more information on storage and handling of expressed breast milk, see: LLLI.org: La Leche League Storage Guidelines for Pumped Milk Kellymom.com: Breastmilk Storage and Handling Kellymom.com: Human Milk Storage — Guidelines for Premature or Hospitalized Infants (these guidelines are more restrictive) Tags: breast milk, breast milk storage, breastfeeding, breastmilk, lactation, milk storage, pumpingShare This... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1317932 Fri, 21 Mar 2008 02:06:38 +0100 1317932 http://www.medworm.com/index.php?rid=1237115&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F236211730%2F The Department of Health in the United Kingdom pledged the funding necessary to establish a new breastfeeding helpline in conjunction with The Breastfeeding Network and the Association of Breastfeeding Mothers. The new helpline number will be: 0844 20 909 20. The Government News Network notes: 3. The National Breastfeeding Helpline will be available in England, Wales, Scotland and Northern Ireland. 4. The National Breastfeeding Helpline is staffed by trained volunteer mothers from the Breastfeeding Network and the Association of Breastfeeding Mothers who have all breastfed themselves, and who take calls in their own homes. Calls will be charged at 5p per minute from BT lines plus a 3p call set up charge from BT residential lines. Mobiles and other providers’ charges may vary. The li... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1237115 Sat, 16 Feb 2008 20:53:29 +0100 1237115 http://www.medworm.com/index.php?rid=1221355&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F232943553%2F “Ultrasound examination of the lactating breast during breastfeeding by Peter Hartmann’s research team in Perth, Australia has provided new information about what occurs within the breast during let-down (Kent 2002). This team has found the following after observing many mothers and babies during breastfeeding: * On average 75 percent of the mothers had more than one let-down. * The women had on average 2.2 let-downs per breast. * The more let-downs a woman had, the more milk her baby received. * Babies received on average 2 1/3 oz. (70 ml) of milk at a feeding and slightly more than one ounce (35 ml) per let-down. * On average 35 percent of babies came off the breast during a let-down.” – “The Breastfeeding Answer Book,” p. 19. Tags: breastfeeding, brea... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1221355 Mon, 11 Feb 2008 04:55:04 +0100 1221355 http://www.medworm.com/index.php?rid=1198768&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F228692252%2F “Alveoli: Tiny milk-producing sacs that are arranged in clusters throughout the breast. Each breast has hundreds of alveoli. Once the milk is produced, it’s secreted into tube-shaped ducts that travel to the nipple.” Source: whattoexpect.com Tags: alveoli, anatomy, breast milk, breastfeeding, breasts, definition, lactationShare This (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1198768 Mon, 04 Feb 2008 04:16:32 +0100 1198768 http://www.medworm.com/index.php?rid=1108812&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F203718696%2F In this video, registered nurses and lactation consultants Corky Harvey and Wendy Haldeman offer advice and reassurance about breastfeeding in public. These women project the right attitude (in my opinion) about nursing in public — anywhere (except the public restroom), anytime, with confidence. I especially love their answer to the question: “How do I deal with curious kids when nursing in public?” The one tip I would add about nursing a distractible baby in public is to use a sling! VideoJug: Tips For Breastfeeding In Public Share This (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=1108812 Fri, 21 Dec 2007 00:18:09 +0100 1108812 http://www.medworm.com/index.php?rid=1093047&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2007%2F12%2Fbut-doctor-certified-them.html ConclusionThese are two examples of why doctor certification isn't always to be trusted. Is this the core of the cap problem? Not even close! My point here is that the argument that we should be trusting doctors to make certification decisions without any oversight or system abuse indicators just doesn't hold water. The patient's attending physician is, in my mind, the only logical person to certify hospice appropriateness, but that doesn't mean the system is perfect. Oversight is still necessary, and that was the point of the hospice cap from day one. (Source: Hospice Blog) Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1093047 Thu, 13 Dec 2007 20:06:00 +0100 1093047 http://www.medworm.com/index.php?rid=1021256&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2007%2F11%2Fhospice-cap-madness.html I finally got a chance to check out the web site of the group that is producing all of this press about the Medicare Hospice Cap. They call themselves the National Alliance for Hospice Access, and their web site does a good job of making it seem like fighting against the Hospice Cap is a no brain decision. As usual, I think only half the story is being told, but they do a very good job of telling their half of the story. I might talk more about that later; this post is written to address an article that slipped past me until now.There is a link to this article in the Daily Oklahoman on the NAHA website. The article really makes me mad. (Thus the title of this post.) I mean really, really, really makes me MAD! The article makes me more sure than ever in my thought that the television news s... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=1021256 Mon, 12 Nov 2007 21:07:00 +0100 1021256 http://www.medworm.com/index.php?rid=998605&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2007%2F10%2Fmy-problem-with-tv-news-story.html I posted here about a story on a local news channel about the Medicare Hospice Cap issue. In that post I said that something about having an actual hospice family interviewed made me a bit uneasy, but I "couldn't put my finger" on why. I've put my finger on it now.A comment left on that post said:I think using a real hospice patient makes this important story easier to understand and relate to at a personal level.That's when my brain clicked on what was bothering me, the patient, or more specifically his wife, didn't seem to actually understand the hospice cap. Here's the offending part of the transcript as best I could transcribe it:(narrator) - Al is just one example of a hospice patient that has lived longer than [the] time Medicare allows hospice funding.(Al's wife) - It makes me angry... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=998605 Mon, 29 Oct 2007 21:45:00 +0100 998605 http://www.medworm.com/index.php?rid=959030&cid=t_100124_87_f&fid=36050&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FBreastfeeding123%2F%7E3%2F171346337%2F What do you do if you notice your breastfed baby has green, frothy stool? Here is the scoop on green poop. There are two main considerations when a baby has green watery bowel movements: (1) oversupply and a foremilk/hindmilk imbalance, or (2) baby’s reaction to something the mother consumed. Oversupply and Foremilk/Hindmilk Imbalance It may take several weeks for a mother’s milk supply to regulate. When a mother experiences oversupply, the baby can take in too much low-calorie, lactose-rich foremilk and not enough high-calorie, fat-rich hindmilk. That can lead to fussiness, gassiness, low weight gain and/or green, watery stools. A mother can attempt to remedy the foremilk/hindmilk imbalance by “block feeding”: feeding on the same breast for any feedings during a t... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=959030 Wed, 17 Oct 2007 23:33:09 +0100 959030 http://www.medworm.com/index.php?rid=832538&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F30%2Fhow-widely-adopted-is-hl7%2F HL7 is extensively adopted within the healthcare community. The HL7 family of standards has been under development since the late 1980s and represents the de facto method of moving clinical healthcare data. To clarify, the term “HL7″ can mean many different things based on who asks the question. However, when most people say “HL7″ they mean the “HL7 2.X messaging standard.” A much smaller number of people mean HL7 3.X, CCOW, EHR, CCD, CCR, CDA, etc. If we use the common definition of HL7 (HL7 2.X), it is fair to say that most hospital-based clinical software applications support HL7. “Support” in this context means that they can send or receive a subset of the HL7 2.X messages. Specifically, a typical software application will use between fiv... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=832538 Thu, 30 Aug 2007 16:24:31 +0100 832538 http://www.medworm.com/index.php?rid=777591&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F03%2Fwhat-is-a-bar-message%2F In the HL7 standard, Billing Account Record (BAR) messages are used to add or change the patient’s billing account information. Outlined below are the trigger events used to transmit clinical information to the billing accounts. BAR^P01:  Establishes a patient’s account in billing (usually sent from a registration system) BAR^P02:  Deletes a patient’s billing/accounts receivable records BAR^P05:  Updates a patient’s account BAR^P06:  Notifies that an account is no longer open (i.e., no new charges can accrue to this account) BAR^P10:  Communicates Ambulatory Payment Classification (APC) grouping For more on the HL7 Standard, request a copy of our HL7 Reference Guide, the most requested resource for healthcare interfacing professionals. (Source: NeoTool Health... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=777591 Fri, 03 Aug 2007 21:02:20 +0100 777591 http://www.medworm.com/index.php?rid=708772&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F07%2F02%2Form-vs-rde-for-hl7-pharmacy-orders%2F When designing an HL7 interface to send pharmacy orders from a clinical application to a pharmacy system, it can sometimes be a challenge to determine which HL7 message type to use to send different types of information. Since both ORMs and RDEs can be used to send pharmacy orders, the question sometimes arises as to whether one should use ORM or RDE for pharmacy orders. Either approach is valid. Ultimately the question is not “Should I use ORM or RDE for pharmacy orders?”, but rather “Do my sending and receiving applications support exporting and importing of ORMs, RDEs or both for pharmacy orders?” Some vendors may choose to only export/import pharmacy orders as ORMs with additional segments or Z-segments as needed, while other vendors may choose to support expo... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=708772 Mon, 02 Jul 2007 15:39:12 +0100 708772 http://www.medworm.com/index.php?rid=708773&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F07%2F02%2Fwhat-is-an-rde-message%2F The HL7 message type, RDE (Pharmacy/Treatment Encoded Order Message), is used by clinical applications to send an order to the pharmacy and/or dispensing systems. It may be sent as either an order containing a single pharmacy/treatment order for a patient or as an order containing multiple pharmacy/treatment orders for a patient (e.g., 1 mg tablet of Aspirin, 0.5 mg 0.5% Albuterol).  The transmission of orders occurs between the clinical application placing the order (the placer) and the clinical application filling the order (the filler). Typically, the clinician (e.g., physician) is entering orders on the HIS application which acts as the placer application in HL7 parlance. The system to which the order is targeted (e.g., the lab in the case of a complete blood count order) is the fill... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=708773 Mon, 02 Jul 2007 15:37:17 +0100 708773 http://www.medworm.com/index.php?rid=700678&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F06%2F27%2Fwhat-is-the-producer-id-in-hl7%2F The Producer’s ID in HL7 v2.x is a specific field of the OBX segment. This field (OBX-15) contains a unique identifier of the responsible producing service provider. In HL7, there are messages used to communicate orders and results for procedures like lab tests, x-rays, etc. The clinical laboratory is a producer of lab test results and the radiology department is the producer of an imaging diagnostic report.  Typically, when the Producer’s ID field is null, the receiving system assumes that the observations were produced by the sending organization. The Producer’s ID should be reported explicitly when the test results are produced at outside laboratories. This information supports CLIA (Clinical Laboratory Improvement Amendments) regulations in the US. In the US, th... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=700678 Thu, 28 Jun 2007 00:07:21 +0100 700678 http://www.medworm.com/index.php?rid=700679&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F06%2F27%2Fwhat-is-an-obx%2F In HL7 v2.x, the OBX is a segment used to transmit a single observation or observation fragment. It represents the smallest indivisible unit of a report. The principal mission of an OBX is to carry information about observations and results in report messages (i.e., ORU or MDM).  Sometimes, the OBX segment is found as a part of an order message (ORM or RDE). In this case, the OBX carries clinical information needed by the receiving system. For example, an OBX is needed to report the menstrual phase information which should be included on an order for a pap smear to a cytology lab. The OBX segment can be used to contain encapsulated data, e.g., a CDA document or a DICOM image or any of the MIME (Multimedia Internet Mail Extension) support formats such as JPEG, GIF, and FAX. If the a... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=700679 Wed, 27 Jun 2007 23:54:43 +0100 700679 http://www.medworm.com/index.php?rid=675459&cid=t_100124_87_f&fid=34867&url=http%3A%2F%2Fwww.thediabetesblog.com%2F2007%2F06%2F13%2Finsulin-pumps-101%2F Filed under: Type 1, Type 2, Childhood, Adult Onset, SupportInsulin pumps are especially helpful to match your insulin to your lifestyle, instead of the other way around. The pump delivers insulin in varying, small amounts throughout the day, more closely resembling a healthy pancreas. Type 1 diabetics of all ages are using the insulin pump, and even some type 2 diabetics have chosen to try the pump. Insulin pumps boast better blood glucose control, even a potentially lower A1C. The American Diabetes Association lists some pros/cons of the insulin pump. The pump eliminates the need for multiple injections, significantly reduces large swings in blood glucose, makes diabetes management easier, and can improve the quality of life. Pumps have a convenient disconnect port so you can shower, swi... The Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=675459 Wed, 13 Jun 2007 04:00:00 +0100 675459 http://www.medworm.com/index.php?rid=674939&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F06%2F12%2Fwhat-is-a-rhio%2F There is much written about RHIOs. RHIO stands for Regional Health Information Organizations. The Office of the National Coordinator for Health Information Technology (ONC) defines a RHIO in the following way: “…support state and other regional projects that help harmonize the privacy and business rules for health information exchange. There are over 100 regional projects under way that are funded by the Federal government. Several other projects are being supported by private industry efforts or are substantiated by State Governors and/or state legislation.” RHIOs raise positive and negative impressions, but they have admirable, yet very challenging, goals for healthcare in the US.   (Source: NeoTool Healthcare IT Blog) NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=674939 Wed, 13 Jun 2007 00:10:51 +0100 674939 http://www.medworm.com/index.php?rid=631519&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2007%2F05%2Fstate-of-hospice-industry.html Carreen, a reader in Kansas, sent me a link to this article, published by Massachusetts General Hospital, which is probably the best thing I have read recently about the state of the hospice industry.There are some things in the article that I question, but overall, they have the story right. (It is very hard to summarize hospice, and I think they took a few liberties for the sake of brevity.) Hospice has grown a lot in the past 20 years, but it has quite a bit of growing to do. What will hospice look like when the next generations is ready to use it? We are just starting to sort that out, and this article does a good job of pointing out the areas of concern.Thanks for the heads up Carreen! (Source: Hospice Blog) Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=631519 Wed, 23 May 2007 16:30:00 +0100 631519 http://www.medworm.com/index.php?rid=631511&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F23%2Fhl7-publishing-schedule%2F Here is the 2007 HL7 publishing schedule. This schedule provides the details on the content and ballot cycle for HL7. (Source: NeoTool Healthcare IT Blog) NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=631511 Wed, 23 May 2007 14:26:32 +0100 631511 http://www.medworm.com/index.php?rid=623351&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F18%2Fhl7-25%2F HL7 2.5 is the latest published version of the 2.X messaging standard. (Note that HL7 2.6 is nearing final ballot with another set of updates and should be released in 2007.) It seems almost surreal to be writing about this standard as “new” and “not widely used” given that it was published in January 2003. However, as I often discuss in HL7 training classes, over four years after the release of 2.5, most US-based healthcare applications are still using HL7 2.3 or 2.3.1. Frank Oemig, long time HL7 community member and 2002 HL7 volunteer of the year, wrote a great summary of the HL7 2.5 release that is published on Ringholm’s web site. Here is Frank’s summary of 2.5: A number of new events, segments, messages and an entire chapter have been added in HL7 v... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=623351 Sat, 19 May 2007 21:38:49 +0100 623351 http://www.medworm.com/index.php?rid=623352&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F18%2Fthe-chapters-of-the-hl7-standard%2F The HL7 2.X message standard has multiple chapters that provide the general rules by which HL7 compliant applications should communicate. The chapter layout came about in the beginning of HL7 based on the committees structure used to create the standard. In the early days of HL7 - 2.3 and before - the standard itself was a bit inconsistent. That is, parts of the standard had typos or obvious conflicts. Later releases of HL7 cleaned up these problems and, generally, the chapters now agree with each other. Outlined below is a list of the major chapters of the HL7 standard; this is helpful when someone says, “The PID segment is defined in Chapter Three.” BTW, are you looking to gain an overview of HL7? If so, snag a free HL7 Reference Guide or attend a NeoTool-taught HL7 Training... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=623352 Fri, 18 May 2007 22:07:02 +0100 623352 http://www.medworm.com/index.php?rid=611662&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F14%2Fhl7-engine-mapping%2F In a prior post, I described the motivation for mapping HL7 messages. As described in that post, the HL7 2.X messaging standard is the most widely used method to move healthcare information yet the details of the messages vary greatly from system to system. An HL7 engine provides several functions and one of the key features of an engine is the ability to map from one set of application assumptions to another set. Said another way, an HL7 interface engine takes a message in one format and maps or transforms it into another format. The starting and ending message formats will be controlled by the applications involved. Prior to HL7’s market dominance, the variety of message formats was large. This meant that typically an interface’s data elements closely matched the data model in the so... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=611662 Tue, 15 May 2007 00:00:30 +0100 611662 http://www.medworm.com/index.php?rid=611663&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F14%2Fwhy-map-hl7-messages%2F HL7 messaging provides a method to move or transfer information between two or more clinical software applications within a healthcare setting. There are two major versions of HL7: HL7 2.x and HL7 3.x. In the United States, today almost all production HL7 interfaces use the HL7 2.x message format. This posting introduce the motivation for mapping between different vendor’s HL7 implementations. (Also available on this web site is an extensive 14 page paper covering the history of HL7 2.X and the pros/cons of HL7 3.X.) The need to map HL7 messages is typically caused by one or more of the following: Applications implementing different versions of the HL7 standard Different workflows or application data models in the sending and receiving applications Applications not correctly impleme... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=611663 Mon, 14 May 2007 20:30:12 +0100 611663 http://www.medworm.com/index.php?rid=592938&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F07%2Fwhy-filter-hl7-messages%2F Sometimes it is necessary to have messages “filtered” on an HL7 interface. Filtering reduces the number of messages that are sent on an interface due to business or technical requirements. For example: A clinical application might have a performance problem with 30,000 ADT messages arriving on an interface each day — if the number could be reduced, the performance issue might be resolved. A department might want to reduce the “excess patient noise” in the target application. For example: Neonatal Intensive Care (NICU) application only had six beds, there is no need to have patient demographic information loaded into the NICU application for an adult patient checking in for dialysis or an outpatient lab test. Likewise, the Radiology department might only want... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=592938 Mon, 07 May 2007 05:33:44 +0100 592938 http://www.medworm.com/index.php?rid=587453&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F02%2Fhl7-mlp-minimum-layer-protocol-defined%2F TCP/IP protocols mean that the data just starts coming in a stream, so how do you know where one HL7 message ends and the next one starts? There is no set size. Some messages are quite concise, with a couple segments. Other HL7 messages are extremely long with repeating observation segments that contain an entire doctor’s report. Minimal Lower-Layer Protocol (MLP) is how you wrap an HL7 message with a header and footer to insure you know where a message starts, where a message stops, and where the next message starts. These headers and trailers are usually non-printable characters that would not typically be in the content of HL7 messages. The header is a vertical tab character <VT> its hex value is 0×0b. The trailer is a field separator character <FS> (hex 0×1c... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=587453 Wed, 02 May 2007 20:50:21 +0100 587453 http://www.medworm.com/index.php?rid=582815&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F01%2Fhl7-conference%2F There are several ways to define HL7 Conference: A HL7 Working Group Meeting (WGM) that is held three times per year — typically held in January, May, and September. A phone call or face-to-face meeting where HL7 specifications are reviewed or exchanged. During this HL7 conference, there is a “meeting of the minds” with respect to the data elements and work flows that will be supported by the HL7 interface. A HL7 training session, class, or tutorial that provides in depth coverage of HL7 standard or an overview of HL7 features and functions. (Source: NeoTool Healthcare IT Blog) NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=582815 Tue, 01 May 2007 15:53:38 +0100 582815 http://www.medworm.com/index.php?rid=582816&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F01%2Fhl7-working-group-meeting-wgm%2F HL7’s Working Group Meeting (WGM) is held three times per year, typically in January, May, and September. Historically, these meetings were held exclusively in the United States. As of 2007, one meeting per year is held outside the US in order to have HL7’s international community more easily participate in the standards-building process. In 2007, the “non-US” meeting was in Cologne, Germany while, in 2008, it is scheduled for Vancouver, BC, Canada. In 2009, there are rumors of holding it somewhere in the Pacific Rim, specifically Japan. At a typical WGM, there are 350 to 500 attendees that volunteer their time to help push the HL7 standards forward. These attendees represent a mixture of healthcare software vendors and providers (clinics and hospitals). Prior to ... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=582816 Tue, 01 May 2007 13:10:39 +0100 582816 http://www.medworm.com/index.php?rid=579009&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F04%2F30%2Fhl7-tutorial%2F HL7 typically involves moving message data between two or more software applications within a clinical setting. Without a standard way of defining the types of data that can be sent, messaging is very difficult. Therefore, HL7 outlines the data model and workflows that are broadly supported. Radiology Today published an article that provides an HL7 tutorial. In addition, on this web site, you can read a 14-page white paper that outlines HL7 version 2 and HL7 version 3 — including a background and tutorial on HL7. (Source: NeoTool Healthcare IT Blog) NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=579009 Mon, 30 Apr 2007 13:21:12 +0100 579009 http://www.medworm.com/index.php?rid=573535&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F04%2F27%2Fuse-of-national-provider-identifier-npi-in-hl7%2F Centers for Medicare & Medicaid Services (CMS) is pushing ahead on the implementation of the National Provider Identifier (NPI) regulations under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. In theory, there is a deadline of May 23, 2007 to use NPIs. As part of the move to NPIs, HL7 transactions can/should contain the new numbers. The good news is that HL7 has supported the use of multiple IDs for a long time via the CX and XCN data types. Background: A user of NeoTool’s HL7 integration engine (NeoIntegrate) asked if HL7 was going to dedicate a field for the National Provider Identifier (NPI). The context for using NPI could be while moving HL7 charges (DFT), admission/demographics (ADT), or via master files (MFN). In short, the XCN, PLN, and CX data t... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=573535 Fri, 27 Apr 2007 16:41:35 +0100 573535 http://www.medworm.com/index.php?rid=549639&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F04%2F17%2Fhl7-z-segment-questions-and-answers%2F On a previous HL7 Z-Segment post, a reader responded with two questions. Outlined below are the questions and my answers. HL7 Question 1: Can I insert a Z-segment anywhere in the HL7 message or can I only place the Z-segment at the end? HL7 Answer:  You can place the Z-segment anywhere in the HL7 message. There is no rule in HL7 that dictates where a Z-segment should be located in a message. One popular approach is to insert the Z-segment in the message so it is grouped with similar information contained in the message. For example, if you are storing insurance specific data, you may want to create a ZIN segment and place it in the insurance group in your message directly after the IN3 segment.  Another approach is to place any Z-segments at the end of your message, so systems that are... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=549639 Tue, 17 Apr 2007 23:26:19 +0100 549639 http://www.medworm.com/index.php?rid=540346&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2007%2F04%2Fhospice-chaplain.html It is a bit funny to me that I have written so little about the role of the hospice chaplain, since that is how I first entered the world of hospice. I guess my lack of writing on the subject is about in line with the lack of attention that many hospices give to this position. Although Medicare does require all hospices to have a chaplain, what, exactly, this person is supposed to do and how often he/she should do it is very much up in the air.Obviously I have a bias since I am talking about my chosen field here, but I believe that most hospices short change the chaplain position greatly. In all reality, I think that the industry as a whole may very well ignore this position a bit too much. Proof? The generally accepted industry staffing standards claim that a full time social worker shoul... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=540346 Fri, 13 Apr 2007 02:04:00 +0100 540346 http://www.medworm.com/index.php?rid=530849&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fwww.hospiceblog.org%2F2007%2F02%2Fhospice-in-assisted-living-facility.html Assisted Living Facilities have been showing up on every corner over the past few years. They are a great alternative for people who can't keep up their own house but don't need to be in a nursing home. Most are very nice and allow their residents much more freedom and privacy than nursing homes. Hospice sees patients in both facilities.If you have read this blog much at all, you know that the relationship between hospices and nursing homes is, shall we say, strained. This is not true in Assisted Living Facilities, but that doesn't mean there isn't a problem.If you have been approached by your Assisted Living Facility about hospice care, the discussion probably included the phrase, "hospice can help you stay here longer." Which is often a thinly veiled threat that, if you don't accept this... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=530849 Mon, 09 Apr 2007 21:32:00 +0100 530849 http://www.medworm.com/index.php?rid=510847&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F03%2Frespite-care.html I promised last week that I would write something about the different levels of care available through the Medicare Hospice Benefit. Thus, I want to quickly give the basics of hospice respite care. It is, in my mind at least, the most simple or easy to explain level of care.The Respite Level of Care is offered to any Medicare hospice patient for the express purpose of giving the primary caregiver (usually the family) a break or to allow them to attend to family business. In respite care the hospice admits the patient into a facility for up to five days while the family does whatever the family needs to do. (In my experience, Respite Care is most often used when there is a death in the patient's family requiring the caregiver to travel for a funeral.)The hospice has control over where the p... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=510847 Fri, 30 Mar 2007 17:04:00 +0100 510847 http://www.medworm.com/index.php?rid=483283&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F03%2Fhospice-continious-home-care.html I have not talked much, if any, about the different levels of hospice care provided for by the Medicare Hospice Benefit. I'll try to rectify that over the next few weeks.First, I want to deal with Continuous Home Care, because it is the most misunderstood, confusing, or abused portion of the Medicare Hospice Benefit. The confusion comes from a bit of a vague description of what qualifies a patient for continuous care and the fact that continuous care doesn't actually have to be continuous. Many hospices use CHC as a marketing tool to nursing homes, and that has only added to the problems within the hospice community. I'll deal with the marketing portion more later. First, let me try to define and explain what Continuous Home Care is supposed to be.In its most basic form, Continuous Home Ca... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=483283 Mon, 19 Mar 2007 14:31:00 +0100 483283 http://www.medworm.com/index.php?rid=464683&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F02%2Fhospice-team-concept-works.html If you need further proof that the team concept used by hospice would work for people who have a chronic/terminal illness but more than six months to live, then you should read the article in the February issue of the American Journal of Managed Care titled "Patient-Centered Management of Complex Patients Can Reduce Costs Without Shortening Life". (The link takes you to the page where you can download the full article.) You can read the article yourself for the details and exact numbers, but here is my one minute summary:They studied insurance patients in California who had a life limiting condition. Those in the study were broken into two groups. The first group received case management as usual while the second group received intense case management by nurses specially trained in this ty... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=464683 Tue, 20 Feb 2007 14:58:00 +0100 464683 http://www.medworm.com/index.php?rid=464208&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F02%2F15%2Fwhat-is-hl7-continuity-of-care-document%2F The HL7 Continuity of Care Document (CDD) is the result of a collaborative effort between the Health Level Seven and ASTM organizations to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR) and HL7’s Clinical Document Architecture (CDA) specifications.  The CCD will enable greater interoperability of clinical data and “allow physicians to send electronic medical information to other providers without loss of meaning.” With CCD, the CCR is represented and mapped into the HL7 CDA. These are structured XML standards for clinical information exchange. The harmonized standards should support greater streamlined exchanges with Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems as well as various healthcare ... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464208 Thu, 15 Feb 2007 18:10:25 +0100 464208 http://www.medworm.com/index.php?rid=464685&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F02%2Fhospice-articles-in-new-your-times.html (Thanks to Pallimed for pointing these out to me. If you are not reading their site, then you are missing out on some great information!)The New York Times published a couple of articles about hospice this weekend.The first discusses open access which I have talked about some already. It is a good look at the movement although it focuses mainly on insurance companies who are actually paying for this service. My focus is much more on hospices who are eating the cost of expensive treatment, but if the Times can get more funding for this type of care, I'm all for it!The second is a short article about patients who thrive on hospice and end up being discharged because they are too healthy. My favorite type of patient!They are good reads and subjects that need some wider attention. (Source: Hos... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=464685 Mon, 12 Feb 2007 16:16:00 +0100 464685 http://www.medworm.com/index.php?rid=464686&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F02%2Fhospice-reduction-in-bush-budget.html Received an alert from NHPCO today indicating that part of President Bush's proposed budget is a 0.65% cut in the Medicare Hospice reimbursement rate starting next year and continuing every year thereafter. Let me be clear on what this means. If this passes, next year when it is time for Medicare to figure out how much of a raise I should get (usually it is around 3%), they will subtract 0.65 from whatever number they decide upon. Thus, I will get a 2.35% raise next year instead of 3%. Don't buy into the hype that we are getting our payment rates cut. We are not getting as big of a raise as we expected. That is never good news, but it is far from them actually cutting payment rates. This is an effort to slow the growth of Medicare.I have posted my thoughts on rate cuts before (here also). ... Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=464686 Wed, 07 Feb 2007 19:38:00 +0100 464686 http://www.medworm.com/index.php?rid=464214&cid=t_100124_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F02%2F01%2Fwho-uses-hl7%2F You may have read about how HL7 relates to various healthcare IT initiatives like ELINCS, CCR, and HL7 CDA. You may also be aware of the sea-tide change among clinics and their EMR systems as they now are actively building integration solutions to exchange clinical information between various healthcare providers (e.g., hospitals, imaging centers, labs, etc.). At the core, HL7 plays a prominent role in legacy interfaces between HIS, RIS, and LIS systems in healthcare facilities. However, have you considered who actually ‘uses’ HL7 in their day-to-day operations to support all these interfaces? While the medical staff in a healthcare facility benefit from the exchange of patient data between applications, medical staff do not directly use HL7. HL7 is supporting the work of... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464214 Thu, 01 Feb 2007 14:11:10 +0100 464214 http://www.medworm.com/index.php?rid=464689&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F01%2Fnew-york-times-hospice-article.html The death of Art Buchwald prompted this very good story in the New York Times about hospice. It is a great summary of what hospice is and some of the major hurdles it faces. Thanks to Pallimed for pointing this one out to me. (Source: Hospice Blog) Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=464689 Mon, 29 Jan 2007 15:10:00 +0100 464689 http://www.medworm.com/index.php?rid=464691&cid=t_100124_116_f&fid=34685&url=http%3A%2F%2Fhospiceblog.blogspot.com%2F2007%2F01%2Fcnas-take-on-nursing-homes-and-hospice.html Patti at Nursing Assistants Net has a post up talking about the series of posts (here, here, here, here, here, here, here)we had last fall about nursing home residents receiving hospice care. It is a validation of many of my thoughts about a nursing home's lack of ability to rise to the occasion on its own.It's worth reading if you are still undecided about the need for hospice in the nursing home setting. (Source: Hospice Blog) Hospice Blog blogs http://www.medworm.com/rss/comments.php?id=464691 Mon, 22 Jan 2007 22:49:00 +0100 464691