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 'failure'. Sat, 03 Sep 2011 01:55:51 +0100 http://www.medworm.com/index.php?rid=5182380&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2F7AuH1DzxsVU%2F You probably agree that the #1 reason why people can’t pursue their passions is MONEY. It takes time to find a way through which your passion can replace the secured paycheck. However, there is another equally important reason. On the surface, you can call it the fear of failure! However, there is a much deeper and critical aspect of your fear of failure, specially when it comes to pursuing your passion. It doesn’t hurt that much when you fail to achieve an average goal that you’re not so emotionally attached to it. But when it comes to your passion and what you’ve put your heart in, it looks like there is no comeback. Peter Buffett brilliantly put it in his book ‘Life Is What You Make It’ when he said, “If, in the many facets of life at which we are destined to ... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=5182380 Thu, 01 Sep 2011 06:05:31 +0100 5182380 http://www.medworm.com/index.php?rid=5181902&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F08%2F30%2Fring-the-bells-that-still-can-ring-letting-go-of-perfectionism%2F Of all of the concerns clients bring to therapy, perfectionism can be one of the most relentless and the most difficult to overcome. It shows up under any number of guises, from the more mundane to more serious versions: “I’m not going to try to learn how to waterski because I know I won’t be any good at it.” “Anything less than an A is not a good enough grade.” “I need to punish myself for not being perfect.” Perfectionists engage in multiple problematic thoughts, feelings, and behaviors. They tend to fear failure, disapproval, and making mistakes. Sometimes they fear success. They overemphasize “shoulds” and engage in all-or-nothing thinking. They constantly pressure themselves to succeed. A shameful belief about inner “badness” often is at the core of pe... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5181902 Tue, 30 Aug 2011 16:51:17 +0100 5181902 http://www.medworm.com/index.php?rid=5169546&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fresearch-shows-decrease-in-time-from-hospital-arrival-to-heart-attack-treatment%2F2011.08.27 Heart attack patients are now being treated on average 32 minutes faster than they were five years ago, and medical societies are touting it as evidence of the success of national campaigns to treat heart attacks more quickly. The study, “Improvements in Door-to-Balloon Time in the United States: 2005-2010,” found that the average time from hospital arrival to treatment declined from 96 minutes in 2005 to just 64 minutes in 2010. In addition, more than 90% of heart attack patients who required emergency angioplasty in 2010 received treatment within the recommended 90 minutes, up from 44% in 2005. Also, the study reported that (more…) *This blog post was originally published at ACP Hospitalist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5169546 Sat, 27 Aug 2011 18:15:00 +0100 5169546 http://www.medworm.com/index.php?rid=5169547&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-importance-of-physicals-for-young-athletes%2F2011.08.27 Increasing numbers of young people participate in outdoor activities, including strenuous competitive athletics. In so doing, they subject their bodies to stresses that are more intense and prolonged than those presented by a largely sedentary life. Every story of a sudden death in a young person is a tragedy, and usually accompanied by commentary pondering the role and utility of pre-activity screening. Could the death have been prevented? What was the physiological condition of the deceased? Could the collapse, often attributed to a heart problem, have been predicted? Was there an examination or evaluation that might have indicated that the deceased was at greater risk, or should have been held out of the activity? These are all important questions, with no simple answers. Sudden collaps... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169547 Sat, 27 Aug 2011 16:00:00 +0100 5169547 http://www.medworm.com/index.php?rid=5158993&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiac-devices-causing-more-infections-whats-the-cause%2F2011.08.25 A new report published online in the Journal of the American College of Cardiology and reported in theHeart.org and elsewhere, suggests the infection rate of cardiac implantable electronic devices (CEID’s) between 1993 and 2008 has greatly increased from 1.53% in 2004 to 2.41% in 2008 (p < 0.001) with a dramatic rise in 2005: Click image to enlarge The authors explain this sudden increase on the basis of comorbities: (more…) *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5158993 Thu, 25 Aug 2011 18:00:00 +0100 5158993 http://www.medworm.com/index.php?rid=5161563&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fwomen-with-atrial-fibrillation-focus-on-etiology-and-treatment.mp4 An important observational study published in JAMA tracked over 34 000 women for more than 15 years and showed that cardiovascular mortality was significantly higher for women who developed atrial fibrillation as an incident event. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=5161563 Thu, 25 Aug 2011 14:45:00 +0100 5161563 http://www.medworm.com/index.php?rid=5159257&cid=t_120514_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fhow-antagon-and-other-gnrh-anatgonists.html In the past, most in-vitro fertilization (IVF) centres used pituitary down-regulation with gonadotrophin-releasing hormone (GnRH) agonists to prevent a premature LH surge and premature ovulation and luteinization. However, this required at least 7–14 days of GnRH agonist pretreatment. This is why researchers developed molecules which would cause an immediate blockage of the GnRH receptors on the pituitary gland, to stop the pituitary from producing gonadotropins instantly . This was felt to be a more rational approach , as these would induce instant downregulation , and prevent a spontaneous LH surge more effectively . Brand names of the GnRH antagonists include Antagon and Cetroride. Thus , treatment with the antagonist can be limited to only those 4-6 days when high oestradiol levels... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5159257 Wed, 24 Aug 2011 04:41:00 +0100 5159257 http://www.medworm.com/index.php?rid=5139648&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fsafe-technology-factors-contributing-to.html Conclusions Duplicate medication order errors increased with CPOE and CDS implementation. Many work system factors, including the CPOE, CDS, and medication database design, contributed to their occurrence. Duplicate orders can result in over-medication, failure to discontinue, or other medication errors if not caught. They by definition increase risk. The questions are simple: Considering that this was a "Northeastern US community tertiary care teaching hospital", not a small hospital in a remote town somewhere lacking in HIT experience, and that "duplicate medication order errors increased with CPOE and CDS implementation", is CPOE: A safe technology, in a practical sense in the complex clinical setting (with complexities that are 'Hiding in Plain Sight'), in 2011?A technology ready f... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5139648 Thu, 18 Aug 2011 15:50:00 +0100 5139648 http://www.medworm.com/index.php?rid=5139649&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Ffrom-senior-clinician-down-under.html A poster who wishes to remain anonymous, a Senior Clinician in the state of Victoria, Australia, added this comment to my March 2011 post on 'anecdotes.' (That post was entitled "Australian ED EHR Study: An End to the Line "Your Evidence Is Anecdotal, Thus Worthless?".)He makes a critical point I think has gotten lost in the HIT domain (emphases mine): Anonymous August 15, 2011 9:26:00 PM EDT said... Anecdote and Medicine. We are actually talking about two different things here. 1. Anecdotal reporting of a new and potentially exciting finding in Medicine is NEVER a reason to widely implement a new treatment or procedure. It represents the lowest category of evidence in any systematic review In any orthodox system of medicine in the developed world a new intervention would not be r... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5139649 Wed, 17 Aug 2011 22:25:00 +0100 5139649 http://www.medworm.com/index.php?rid=5139650&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fwhy-bankers-need-to-stick-to-banking.html [Note: this post is very rich with hyperlinks. To fully understand the post, at least open the hyperlinks in a separate window and browse their material - ed.] In April 2011 I referenced a 2007 comment about health IT ROI, by then-Congressional Budget Office (CBO) head Peter Orszag, in a post entitled "Medicare/Medicaid Cuts? Spend Money on Patients - Not Computer Experiments": ... More on purported cost savings - Peter Orszag, former head of the Congressional Budget Office, said the use of electronic health records, without a major change in health care delivery, "would not significantly reduce overall health care costs" in the agency's 2007 report on long-term health care spending. He also said that according to data from the report, the return on investment for EHR's "is not going to ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5139650 Wed, 17 Aug 2011 20:27:00 +0100 5139650 http://www.medworm.com/index.php?rid=5130673&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fnational-programme-for-it-in-nhs-aug.html Conclusions and recommendations 1. The Department has been unable to deliver its original aim of a fully integrated care records system across the NHS. Poor progress since 2002 has meant the Department has had to reconsider what the expenditure can deliver. Many NHS organisations will now not receive a system through the Programme which will not provide for the transmission of individual case records across the whole NHS. The Department should review urgently whether it is worth continuing with all elements of the care records system, to determine whether the remaining £4.3 billion could be used to better effect to buy systems that work, are good value and deliver demonstrable benefits for the NHS. 2. There has been a substantial reduction in how many NHS bodies will receive new systems... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5130673 Mon, 15 Aug 2011 00:38:00 +0100 5130673 http://www.medworm.com/index.php?rid=5125985&cid=t_120514_180_f&fid=38608&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FLifeDev%2F%7E3%2FZxyJSPUNRlQ%2F If you’ve ever been to a live show of a famous act, say U2, it seems like they do everything perfectly and effortlessly. It turns out that even bands like U2 make mistakes. They just know how to cover them really well so that you don’t know you’re seeing one. I sing and play guitar in a band for a few hundred people each week at our church. I’ve been doing this for the past seven years or so, and it’s really helped me become comfortable performing in front of larger crowds. Ironically, the performances that have helped me most aren’t the good ones, but rather the times I’ve failed. (You can’t really tell how comfortable you are with performing in front of people until you’ve failed numerous times.) And there are times when no matter how... LifeDev blogs http://www.medworm.com/rss/comments.php?id=5125985 Fri, 12 Aug 2011 14:49:58 +0100 5125985 http://www.medworm.com/index.php?rid=5103317&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fmedical-data-mix-up-major-system-error.html This from Down Under. Apparently an American IT system by Cerner was involved:Medical data mix-up, major system error Kate Hagan | August 5, 2011 MELBOURNE hospitals have sent incorrect patient records to GPs due to an error with Victoria's troubled health technology program over the past two months. The discharge summaries from Eastern Health and the Royal Victorian Eye and Ear Hospital mixed patients' names with other patient data, including test results and diagnoses.[A major patient misidentification error - ed.] The data was faxed to GPs under the HealthSMART program, which Health Minister David Davis has described as ''the myki of health''.[I think 'myki' refers to the contactless smartcard ticketing system being introduced on public transport in Victoria, Australia. Did I mention I... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5103317 Fri, 05 Aug 2011 16:15:00 +0100 5103317 http://www.medworm.com/index.php?rid=5096111&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fyou-saw-it-here-first-uk-nhs-pulls-plug.html You saw it here first. Or, at least well before the pundits admitted this.I've been predicting this event for quite awhile at this blog (e.g., see posts about the UK NPfIT at this blog query link). From the Independent:The Independent (UK)NHS pulls the plug on its £11bn IT systemAfter nine years and with billions already spent, doomed computer system is abandonedBy Oliver Wright, Whitehall EditorWednesday, 3 August 2011A plan to create the world's largest single civilian computer system linking all parts of the National Health Service is to be abandoned by the Government after running up billions of pounds in bills. Ministers are expected to announce next month that they are scrapping a central part of the much-delayed and hugely controversial 10-year National Programme for IT.Instead, lo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5096111 Wed, 03 Aug 2011 21:20:00 +0100 5096111 http://www.medworm.com/index.php?rid=5096218&cid=t_120514_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FUSTuFGYGhvM%2F LITFL puts you to the test, with 10 of the best Questions and Answer from this months EM Critical Care Article on Noninvasive Ventilation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5096218 Tue, 02 Aug 2011 01:52:36 +0100 5096218 http://www.medworm.com/index.php?rid=5086181&cid=t_120514_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F6lpnY5uHtW0%2F LITFL puts you to the test, with 10 of the best Questions and Answer from this months EM Critical Care Article on Noninvasive Ventilation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5086181 Tue, 02 Aug 2011 01:52:36 +0100 5086181 http://www.medworm.com/index.php?rid=5069406&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F07%2Fon-ehr-warnings-sure-experts-think-you.html I frequently mention what I call an "irrational exuberance" about health IT affecting the judgment of otherwise intelligent people.Here's an example where an expert's prescient warning about HIT problems was ignored.This letter of April 21, 2010 was FAXed to the CEO and CC'd to the CMO of the hospital where my mother was injured due to a May 19, 2010 EHR-related error.Incidentally, they have, to my knowledge, no postdoctorally-trained Medical Informatics specialists on staff, and possibly nobody with substantive formal training in the domain.Names of people and places have been redacted. To the best of my knowledge, the letter's concerns were ignored:April 21, 2010CONFIDENTIAL[name redacted]President and CEO[name redacted] Hospital[address redacted]Re: Electronic medical records observatio... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5069406 Tue, 26 Jul 2011 14:39:00 +0100 5069406 http://www.medworm.com/index.php?rid=5050779&cid=t_120514_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F07%2Fwhy-ivf-cycles-fail-and-how-we-can.html Recurrent implantation failure View more presentations from Aniruddha Malpani (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5050779 Wed, 20 Jul 2011 02:48:00 +0100 5050779 http://www.medworm.com/index.php?rid=4997503&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F07%2Fblogscan-forensic-statistics.html Several interesting points are raised in the newsletter of the American Association of Physicians and Surgeons (AAPS) in a post entitled "Forensic Statistics" in their July 2011 newsletter headlined "Numbers." Healthcare Renewal is cited:Forensic StatisticsWhile claims from RCTs fail to replicate about 20% of the time, the problem with epidemiology is so bad as to constitute a crisis, writes S. Stanley Young (“Everything Is Dangerous: a Controversy,” National Institute of Statistical Sciences, June 2008, www.niss.org). Fewer than 20% of nonrandomized trials [e.g., observational studies - ed.] replicate; i.e. 80%-90% of epidemiologists’ claims are false.More than $1 billion in grant/tax money flows to institutions with reproducibility problems, Young states. A fundamental flaw in the... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4997503 Sun, 03 Jul 2011 14:13:00 +0100 4997503 http://www.medworm.com/index.php?rid=4992665&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FtFB6CH_fkyo%2F By Tad DeHavenAlmost 600 pages into the 2010 Dodd-Frank Wall Street Reform and Consumer Protection Act is a provision directing the Government Accountability Office to assess the feasibility of the federal government certifying organizations that provide financial literacy. The GAO released its report this week and concluded that “While a federal process for certifying financial literacy providers appears to be feasible, doing so would pose challenges.” The challenges cited by the GAO are generally of the bureaucratic variety: What agency or agencies would be in charge? What criteria would be used? How would oversight be conducted? And most importantly, how much would it cost [taxpayers] to implement and operate a federal process for certifying financial literacy providers? Fortunately... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4992665 Thu, 30 Jun 2011 19:17:43 +0100 4992665 http://www.medworm.com/index.php?rid=4992631&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F06%2Fhospital-system-has-major-computer.html As mentioned on this blog numerous times. Healthcare IT outages never, but never, adversely affect patients in any manner whatsoever:Traverse City Record-Eagle [Michigan - ed.]June 30, 2011 Munson has 4-hour communications failureBy Bill O'Brienbobrien@record-eagle.com TRAVERSE CITY — Munson Healthcare officials are trying to figure out how to avoid a repeat of a four-plus-hour data systems crash and "resultant chaos" that gripped local hospitals and clinics this week.A system failure Tuesday morning shut down computers, telephones, pagers and other telecommunications systems at Munson Medical Center and its Munson Healthcare affiliates in Frankfort and Kalkaska, an incident that administrators described as "unacceptable." [That sounds about right - ed.]Munson officials still aren't su... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4992631 Thu, 30 Jun 2011 18:41:00 +0100 4992631 http://www.medworm.com/index.php?rid=4992632&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F06%2Felectronic-medication-prescribing-magic.html Computers once again are proving not to be the plug-and-play-panacea they've been made out to be in the complex world of medicine. The Magic Bullet Theory of IT-Enabled Transformation once again bites the dust in the real world of medicine:Errors Occur in 12% of Electronic Drug Prescriptions Matching HandwrittenBloombergBy Michelle Fay CortezJun 29, 2011As many as 12 percent of the drug prescriptions sent electronically to pharmacies contain errors, a rate that matches handwritten orders for medicine from physicians, researchers said.An analysis of 3,850 computer-generated prescriptions written over a four-week period found 452 contained errors, including 163 that could harm the patient, according to a report published today in the Journal of the American Medical Informatics Association. ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4992632 Thu, 30 Jun 2011 17:28:00 +0100 4992632 http://www.medworm.com/index.php?rid=4975793&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F06%2Fbabys-death-spotlights-safety-risks.html Two tragic cases.Case #1. See Baby's death spotlights safety risks linked to computerized systems by Judith Graham and Cynthia Dizikes in the Chicago Tribune.A baby died at Advocate Lutheran General Hospital due to an intravenous solution containing a massive overdose of sodium chloride — more than 60 times the amount ordered by the physician. The authors write:Although a series of other errors contributed to the tragedy, its origin — a piece of data entered inaccurately into a computer program — throws a spotlight on safety risks associated with medicine's advance into the information age, a trend being pushed aggressively under health reform.One wonders - what happened to the alerting features, for the tens or hundreds of millions of dollars the hospital spent on health IT?I've als... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4975793 Mon, 27 Jun 2011 15:26:00 +0100 4975793 http://www.medworm.com/index.php?rid=4968494&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-is-it-appropriate-to-disregard-guidelines-in-medical-care%2F2011.06.24 Podcast: In an article appearing last week in the American Heart Journal, investigators concluded that if American doctors would prescribe for their patients with heart failure each of the six therapies which are most strongly recommended in current heart failure guidelines, 68,000 lives per year could be saved. The following (for the interest of the reader, and for the convenience of any attorneys who may follow DrRich’s offerings), is an ordered list of these six proven, life-saving heart failure therapies, along with the number of American lives that could be saved each year if only American doctors would stop grossly under-utilizing them in violation of published guidelines: aldosterone antagonist therapy – 21,407 lives beta blockers – 12,922 lives implantable defibrillators ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968494 Fri, 24 Jun 2011 21:00:47 +0100 4968494 http://www.medworm.com/index.php?rid=5020637&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fcrt-and-icd-implantation-in-difficult-times-following-the-guidelines-providing-evidence.mp4 An examination of the data from controversial recent studies into appropriateness of ICD implantation and cardiac resynchronization therapy underlines the importance of following the guidelines to ensure optimum patient care. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=5020637 Wed, 22 Jun 2011 15:30:00 +0100 5020637 http://www.medworm.com/index.php?rid=4954393&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fcrt-and-icd-implantation-in-difficult-times-following-the-guidelines-providing-evidence.mp4 An examination of the data from controversial recent studies into appropriateness of ICD implantation and cardiac resynchronization therapy underlines the importance of following the guidelines to ensure optimum patient care. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4954393 Wed, 22 Jun 2011 15:30:00 +0100 4954393 http://www.medworm.com/index.php?rid=4960121&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F06%2F22%2Fcultivating-self-compassion%2F When something has gone wrong, when there’s been a mistake made, no matter how small, many people are all too quick to point the finger — at themselves. They flog themselves for any failure, letting their self-esteem bend and bow at the face of disappointments and triumphs. For many, self-esteem is shaky at best. But there’s something you can build that’s more substantial than self-esteem. Something that doesn’t waver and can actually boost your well-being — and your performance isn’t a factor. According to psychologist Kristin Neff, Ph.D, in her book Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind, that something is self-compassion. Being self-compassionate means that whether you win or lose, surpass your sky-high expectations or fall short, you sti... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4960121 Wed, 22 Jun 2011 15:12:04 +0100 4960121 http://www.medworm.com/index.php?rid=4952749&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F06%2Femrupdates-thoughts-on-health-it.html I had posted about my mother's demise at the EMRupdate.com site here where I have written or cross-posted a number of essays over the years. The site's proprietor Nick Harrington of the U.K. replied. In his bio:Managing Director of UK based document management software vendor Ambay Software providing hosting and support to emrupdate.comI recognized a number of familiar themes in his reply.In turn, I replied to his reply as follows:Nick Harrington replied on Mon, Jun 20 2011 10:12 AMDr. Silverstein, We're sorry for your loss. Genuinely. However, I don't think this is the right place for you to start a campaign against EMR. The Healthcare industry is making... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4952749 Tue, 21 Jun 2011 00:28:00 +0100 4952749 http://www.medworm.com/index.php?rid=4911419&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F06%2Fmy-mother-passed-away.html My mother, affected catastrophically by an EHR error last year and the topic of numerous posts here (such as this), passed away yesterday evening.In her memory, a photo of her and me from 1957 I found in her possessions.Betty Silverstein, 1925-2011Her children were always Number One.May she rest in peace, and may my efforts result in others not having to suffer similar mistakes at the hands of IT.-- SS (Source: Health Care Renewal) Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4911419 Tue, 07 Jun 2011 13:28:00 +0100 4911419 http://www.medworm.com/index.php?rid=4893820&cid=t_120514_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2011%2F06%2Fmake-me-daisy.html  Turmoil surrounded by sweet scented lilacs.Dandelion cottons looks like owlet feathers as they wait for the wind.My friend and I go for a long hike and muddy our shoes and legs in the coulees of Pepin County.And I pray, and I pray, and I pray that my life will soon be back to yellow. Bathed in sun. Flowers blooming, and my soul free to accept that gift from Father God.For now, I'll take the yellow that splurges out of the darkness, the buds cheerful against the dark foliage deep.Make me a flower, whose scent pleases you, Lord.Make me better as I become less.Fill all the holes in my soul Satan is diggingwith your love, grace, mercy, peace, long-suffering.  I don't want to be the corrugated metal panel patching up an old factory....we pray for you always, that our God wi... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4893820 Thu, 02 Jun 2011 09:41:00 +0100 4893820 http://www.medworm.com/index.php?rid=4872031&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Fhealthcare-renewal-cited-in-pittsburgh.html Healthcare Renewal was cited in the Pittsburgh Post Gazette today on health IT issues.Specifically, regarding issues I raised at my May 25, 2011 post "Transplant Team at UPMC Missed Hepatitis Result - Suspicious for Health IT Failure?"I have several additional amplifying comments.Doctor, nurse disciplined by UPMCFailed to detect hepatitis C in kidney donated for transplantFriday, May 27, 2011By Jonathan D. Silver and Sean D. Hamill, Pittsburgh Post-GazetteA surgeon and a nurse were disciplined by UPMC for their roles in missing a positive hepatitis C test result in a kidney donor earlier this month that might have stopped the transplant, the hospital system said Thursday.The surgeon was demoted and the nurse suspended, though neither has been identified.In addition, after a discussion with... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4872031 Fri, 27 May 2011 13:12:00 +0100 4872031 http://www.medworm.com/index.php?rid=4873217&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Foptimal-medical-therapy-holds-its-own-in-stich.mp4 . An examination of the "crossover patients" in STICH shows that optimal medical therapy must never be overlooked. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4873217 Thu, 26 May 2011 18:50:00 +0100 4873217 http://www.medworm.com/index.php?rid=4872032&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Ftwelve-hour-health-it-glitch-at.html At "Transplant Team at Univ. of Pittsburgh Medical Center Missed Hepatitis Result" I wrote about a kidney transplant gone bad at UPMC that may have been due to a computer "glitch."Now Allegheny General Hospital in Pittsburgh has suffered a "glitch" that shut down their entire health IT system for approximately 12 hours:Allegheny General Hospital's records system back onlineBy Pittsburgh Tribune-ReviewWednesday, May 25, 2011Last updated: 10:26 pmAllegheny General Hospital's electronic medical records system was online Wednesday afternoon after a morning shutdown caused by a glitch in a vendor's computer software, a spokesman [Dan Laurent] said.... The hospital's system underwent a routine upgrade during the weekend, Laurent said. Staff shut down the system about 5 a.m. Wednesday after noti... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4872032 Thu, 26 May 2011 03:59:00 +0100 4872032 http://www.medworm.com/index.php?rid=4862468&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Ftransplant-team-at-upmc-missed.html A story suspicious for EMR malfunction appeared in the Pittsburgh Post Gazette:Transplant team missed hepatitis result Kidney donor, recipient unaware of virus' presence Saturday, May 21, 2011 By Sean D. Hamill and Jonathan D. Silver, Pittsburgh Post-GazetteThe living donor and recipient of a recently flawed kidney transplant at UPMC are a couple who did not know that the donor, a woman, was hepatitis C positive, and didn't find out until after the kidney was transplanted into the man [which stunningly implies the entire transplant team didn't know, either - ed.], sources told the Pittsburgh Post-Gazette.The woman was tested for hepatitis C prior to surgery, and the results showed she was positive for the virus, but the two people on the transplant team who should have checked the results ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4862468 Wed, 25 May 2011 12:00:00 +0100 4862468 http://www.medworm.com/index.php?rid=4847918&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Fkey-lesson-from-npfit-tony-collins-blog.html ComputerWorldUK.comKey lesson from the NPfIT - The Tony Collins BlogListening to critics is critical to the success of big projects. But has this lesson been learnt?Published 07:56, 20 May 11A US doctor Scot Silverstein, who has an expertise in clinical IT design, says of the NAO report on the NPfIT that the initials should stand for: "National Programme of Failed IT.”He says on the blog Health Care Renewal:"Perhaps the NPfIT (National Programme for IT in the NHS) should be renamed the "National Programme of Failed IT in the NHS." No new acronym will be needed.Read the entire ComputerWorldUK piece by Tony Collins. Some of the excuses and rationalizations described during this programme are simply stunning.This idea, though, I find fascinating:One of the lessons that emerges from disastro... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4847918 Sat, 21 May 2011 01:58:00 +0100 4847918 http://www.medworm.com/index.php?rid=4841389&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Fnational-programme-of-failed-it-in-uk.html In conclusion, the NAO said the system was not providing value for money - something the government rejected.Electronic care records are the key part of the overall £11.4bn NHS IT project.The scheme was launched in 2002 with the aim of revolutionising the way the health service uses technology and also includes developments such as digital x-rays and fast internet connections. It is the third time the NAO has looked at electronic records - and each time the findings have been more damning.http://www.guardian.co.uk/society/2011/may/18/government-urged-to-abandon-nhs-it-programmeThe GuardianGovernment urged to abandon NHS IT programmePolly Curtis, Whitehall correspondentguardian.co.uk, Wednesday 18 May 2011 12.03 BSTThe government is coming under increasing pressure to abandon plans for... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4841389 Thu, 19 May 2011 12:26:00 +0100 4841389 http://www.medworm.com/index.php?rid=4828984&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F16%2Fgood-perfectionism-versus-bad-perfectionism%2F Although perfectionism undoubtedly brings me suffering and pain, I’ve come to appreciate the snobby part of my personality because it also bear gifts, especially over time. For the last three years, perfectionism has placed me in an okay spot in a terrible economy. Had I not invested so many hours into networking and writing blogs the last five or so years, sometimes on top of full-time employment and other responsibilities, I would not have a job right now. And spending a night or two recently with friends of friends I knew back in high school made me proud of all the therapy and recovery I have done since graduating. Had I not held myself to a high standard back then, I wouldn’t have quit drinking at the age of 18, and may still be hitting the bars at night. Perfectionism can even be... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4828984 Mon, 16 May 2011 16:00:07 +0100 4828984 http://www.medworm.com/index.php?rid=4829350&cid=t_120514_180_f&fid=38604&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fmakeitgreat%2F%7E3%2FO-9lBUtkuuY%2F Note from Phil: What follows is a guest post from reader Tim Eyre. It’s a fantastic article and one I should have posted a few weeks ago. Sorry Tim. Sometimes the reason for the delay is unclear to me at the time, but becomes clear after posting it. Hope you’ll forgive me. Enjoy the article everyone! Failure is good. Yes you read that correctly. Forget about what you’ve always heard, thought, or believed. Erase it from your memory. Instead remember this: failure is not a bad thing. Sure, it’s gotten a bad rap over the years. But that’s because most people don’t really understand what failure is. If they did, they would no longer fear it. They would embrace it. Most people fall into a common trap. They define failure only in terms of what it isn’t. Their th... Phil Gerbyshak blogs http://www.medworm.com/rss/comments.php?id=4829350 Mon, 16 May 2011 12:00:00 +0100 4829350 http://www.medworm.com/index.php?rid=4813361&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F11%2Fthe-fear-of-making-mistakes-and-interesting-insights-on-being-wrong%2F My whole life I’ve been terrified of making mistakes. When I was giving a talk about Germany in my sixth grade class and the teacher asked me who the chancellor was, it took me a minute to utter his last name — all the while I was stuttering. When I gave presentations in school, I never veered away from my index cards — not even a word. I made myself memorize the words in their exact order — perfectly. If I fumbled, I was a failure. When I started a job in college, the first time I swept the floor, I took an inordinate amount of time. I was worried that if the manager saw any dirt, she’d think that I wasn’t working hard enough to pick up every speck. When I was accepted to grad school, I thought they could sense my stupidity and lack of skill and send me on my way. (Im... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4813361 Wed, 11 May 2011 12:29:54 +0100 4813361 http://www.medworm.com/index.php?rid=4803009&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F05%2Fhow-hospital-emrs-and-experts-who.html This post is a personal account of a disastrous encounter with HIT by my own mother. This "as it happened" account should put an end to doubts as to the toxic effects that poorly designed and implemented health IT can have on medical care, even on relatively basic issues such as tracking of a mere five common medications.Today is Mother's Day.I weep.It's almost one year to the day when my mother suffered severe and now clearly irreparable cardiac and brain injuries due to an EMR-related screwup in the ED of a large hospital.She spent the entire night last night in an agitated delirium, which is occurring more often now, with me, her son, tending to her needs. Not even strong sedatives helped much. It is only now, this morning at 9:30 AM, that she has finally drifted off to sleep, giving me... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4803009 Sun, 08 May 2011 14:00:00 +0100 4803009 http://www.medworm.com/index.php?rid=4795077&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2F4XTLWXn6G4Q%2F The Dividends of Understanding and Embracing Your Failures No one likes to talk about the dreaded “F” word. No…not that one. The meaning of the word Failure has joined the ranks of words and phrases that traditionally are regarded as lewd or vulgar – to the point that it’s almost taboo to discuss someone’s failures. But in some arenas, the tide may be shifting a bit. Recognizing that innovation comes only from risk taking and that employees will shy away from experimentation if they fear retribution, some companies have begun rewarding employees courageous enough to seek new, creative ways to solve problems. That concept signals a fundamental shift in perspective about what it means to fail. Under this emerging theory, a failure merely represents a bump ... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=4795077 Sat, 07 May 2011 06:21:55 +0100 4795077 http://www.medworm.com/index.php?rid=4794806&cid=t_120514_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F05%2Fventricular-septal-defect-vsd%2F Ventricular septal defect is a not uncommon congenital abnormality that can occur alone or as part of various syndromes. The most common site of a VSD is in the membranous part of interventricular septum. A VSD causes a left-to-right shunt, which can result in pulmonary hypertension and cardiac failure. Historically, VSDs that were clinically significant required open heart surgery, but increasingly, percutaneous procedures done by interventional cardiologists are being used to “plug the hole.” (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4794806 Fri, 06 May 2011 14:00:30 +0100 4794806 http://www.medworm.com/index.php?rid=4794817&cid=t_120514_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F05%2F06%2Fjournal-of-the-american-medical-association-2011-vol-305-no-16%2F This article aims to  evaluate the association between low health literacy and all-cause mortality and hospitalisation among outpatients with heart failure. The article concludes that among patients with heart failure in an integrated managed care organisation, low health literacy was significantly associated with higher all-cause mortality. An NHS Athens password is required to access this article online, alternatively contact the Library for a copy of the article. Filed under: Athens Password, E-Journals, Journals Tagged: Health Care Assessment, Heart Failure, Mortality, Outcome, Patient Education (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4794817 Fri, 06 May 2011 12:14:05 +0100 4794817 http://www.medworm.com/index.php?rid=4794818&cid=t_120514_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F05%2F06%2Fjournal-of-the-american-medical-association-2011-vol-305-no-15%2F The objective of this study was to  develop and validate predictive models for progression of Chronic Kidney Disease (CKD). The article concludes that a model using routinely obtained laboratory tests can accurately predict progression to kidney failure in patients with CKD stages 3 to 5. An NHS Athens password is required to access this article online, alternatively contact the Library to obtain a copy. Filed under: Athens Password, E-Journals, Journals Tagged: Albuminuria, Chronic Kidney Failure, Creatinine, Disease Progression, Glomerular Filtration Rate, Kidney Diseases, Laboratory Techniques and Procedures, Models, Prognosis, Risk Assessment, Statistical (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4794818 Fri, 06 May 2011 11:24:24 +0100 4794818 http://www.medworm.com/index.php?rid=4762728&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fwhen-will-first-class-action-lawsuit-on.html At this post a few weeks ago about FDA (non)regulation of health IT, I observed several salient points:FDA's Chair of the Center for Device and Radiological Health (CDRH) Dr. Jeffrey Shuren, a physician and lawyer, stated that under the Federal, Food, Drug, and Cosmetic Act [that regulates all drug, medical devices, etc. in the United States - ed.] HIT software is a medical device (link to testimony);FDA is aware of HIT risks of injury and death, including specific examples, and issued an internal memo (direct link to memo PDF) taxonomizing these risks in great detail. The memo was publicly divulged by the Huffington Post Investigative Fund; The aforementioned chair of CDRH believes these incidents - including 44 reported injuries and 6 reported deaths - are likely just the "tip of the ice... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4762728 Thu, 28 Apr 2011 17:21:00 +0100 4762728 http://www.medworm.com/index.php?rid=4758708&cid=t_120514_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F04%2F27%2Fjournal-of-the-american-medical-association-2011-vol-305-no-6%2F This article evaluates and examines the eligibility of live kidney donors and their short- and long-term risks are discussed. An NHS Athens password is required to access this article online, alternatively contact the Library for a copy. Filed under: Athens Password, E-Journals, Journals Tagged: Donor Selection, Ethics, Informed Consent, Kidney Failure, Organ Donation, Organ Transplantation, Patient Safety, Surgical Procedures (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4758708 Wed, 27 Apr 2011 10:43:11 +0100 4758708 http://www.medworm.com/index.php?rid=4714741&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-a-patient-who-asks-for-salt-for-his-eggs-could-cost-a-hospital-2-5-million%2F2011.04.14 This was a classic moment of comical clarity that only comes along once a week.  As you may or may not know, starting in 2013, The Medicare National Bank has promised to take back 1% of all  of a hospital’s total Medicare revenue (to increase in future years) if the hospital has a higher 30 day readmission rate for  congestive heart failure, acute myocardial infarction or pneumonia than an as yet undefined acceptable 30 day rate of readmission. What does this mean?  It means if the government decides that 20% is an acceptable rate for congestive heart failure 30 day readmission, and the hospital has a readmission rate of 25%, the hospital will be told to return 1% of all Medicare revenue for the year, not just their heart failure revenue. Let’s use some hypothetical numbers... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714741 Thu, 14 Apr 2011 21:00:00 +0100 4714741 http://www.medworm.com/index.php?rid=4709169&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2F1-toward-meaningful-usability-five-keys.html In a 2011 "White Paper" from a company PatientKeeper entitled "Toward Meaningful Usability: Five Keys to Creating Physician-Centric CPOE" (PDF), an organization whose motto is "Enabling Physicians to Focus on Patients ... Not Technology", I again note a common phenomenon.Certain verboten terms are absent.What might those terms be? More on that in a moment...They speak of "the failure of CPOE":The failure of CPOE to date can be attributed to many factors that ultimately lead to a lack of physician adoption. CPOE systems have historically been designed to support the workflow of the departments responsible for fulfilling the orders rather than the physician workflow around entering orders. As a result, entering orders electronically can take significantly longer than written or verbal orders... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4709169 Wed, 13 Apr 2011 13:14:00 +0100 4709169 http://www.medworm.com/index.php?rid=4696618&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-electronic-medical-records-a-27-billion-waste-of-money%2F2011.04.10 President Obama’s has created an incentive program to encourage physicians to adopt functional Electronic Medical Records.  The program’s $27 billion dollars (funded by President Obama’s Economic Stimulus package) will turn out to be a colossal failure and a waste of money. Twenty seven billion dollars would provide $44,000 for 640,000 physicians. After the bureaucratic infrastructure is built the federal government will be lucky if one third of the money remains for bonuses to physicians. Only 21,000 of 650,000 (3%) of physicians have applied to date. Complex bureaucracies and complicated regulations never save money. These bureaucracies create bigger government, inconsistent policies, more complicated regulations and inefficiencies. The best and cheapest way to create a universall... Better Health blogs http://www.medworm.com/rss/comments.php?id=4696618 Sun, 10 Apr 2011 23:00:40 +0100 4696618 http://www.medworm.com/index.php?rid=4693785&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fstich-focusing-on-the-crossover-patients.mp4 STICH: Focusing on the "crossover" patients. What can we learn from the patients in the STICH trial who crossed over from their original line of therapy (from bypass plus medical therapy to medical therapy alone, and vice versa)? (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4693785 Fri, 08 Apr 2011 16:30:00 +0100 4693785 http://www.medworm.com/index.php?rid=4696592&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fspecial-k-red-berries-mission-hostile.html "You should not have to work around something that is not in the way" - SSThis post can be considered Part 9 of my multi-part series on the mission hostile user experience presented by commercial healthcare IT.Note: Part 1 is here, part 2 is here, part 3 is here, part 4 is here, part 5 is here, part 6 is here, and part 7 is here, and part 8 is here.Special K® Red Berries is one of my favorite cereals.In this context, however, "Special K Red Berries" is a metaphor for cerebral and other hemorrhages caused by health IT getting in the way -- actually obstructing -- physicians ordering emergency medications such as vitamin K given via the fastest route, intravenously.A cerebral hemorrhage at post-mortem (obviously). Note the "red berry." Similarities in appearance to above cereal bowl ironic... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4696592 Tue, 05 Apr 2011 17:36:00 +0100 4696592 http://www.medworm.com/index.php?rid=4684213&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fspecial-k-red-berries-mission-hostile.html "You should not have to work around something that is not in the way" - SSThis post can be considered Part 9 of my multi-part series on the mission hostile user experience presented by commercial healthcare IT.Note: Part 1 is here, part 2 is here, part 3 is here, part 4 is here, part 5 is here, part 6 is here, and part 7 is here, and part 8 is here.Special K® Red Berries is one of my favorite cereals.In this context, however, "Special K Red Berries" is a metaphor for cerebral and other hemorrhages caused by health IT getting in the way -- actually obstructing -- physicians ordering emergency medications such as vitamin K given via the fastest route, intravenously.A cerebral hemorrhage at post-mortem (obviously). Note the big Red Berry.This EHR system, Eclypsis Sunrise Clinical Manager™,... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4684213 Tue, 05 Apr 2011 17:36:00 +0100 4684213 http://www.medworm.com/index.php?rid=4664177&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmitral-valve-regurgitation-caused-elizabeth-taylors-death-could-it-affect-you%2F2011.03.31 I am saddened that Elizabeth Taylor died recently of heart failure. In his appreciation of her, film critic Roger Ebert said in the Chicago Sun-Times, “Of few deaths can it be said that they end an era, but hers does.” She is a star that many of us felt we knew. She was a great actress and a woman of great beauty who was a hard working champion of people with AIDS and always seemed to be a determined person who knew herself. Yet she always had a vulnerable side. So many marriages, so many illnesses, so many, many surgeries, over 40, I’ve read. And then her heart problem developed. Which leads me to talk a little about that problem, mitral valve leakage. The heart’s mitral valve The heart has four chambers and four valves that open to let blood through to the next chamber of th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4664177 Thu, 31 Mar 2011 23:00:00 +0100 4664177 http://www.medworm.com/index.php?rid=4664147&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FvIdkR6So0ek%2F By Neal McCluskeyOver the last few days Jay Greene, the Fordham Institute's Kathleen Porter-Magee, and several other edu-thinkers have been arguing about whether national curriculum standards would destroy a competitive market in education, and a market that already provides the uniform standards Fordham wants Washington to impose. But let's be very clear: We haven't had a real market -- a free market -- in education for a long time. Sadly, I'm afraid Jay started this whole mess, though he certainly knows what a free market in education would look like and I don't think he intended to confuse the issue.  Indeed, he doesn't use the term "free market," but mainly writes about the "competitive market between communities." His argument is that Americans over time picked standardize... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4664147 Thu, 31 Mar 2011 19:04:41 +0100 4664147 http://www.medworm.com/index.php?rid=4664152&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FgmJwZ_hLORU%2F By George Scoville The Obama Doctrine fails to address the limitations of Washington's attempts to shape foreign conflicts. The 2012 Republican presidential field has thus far failed to produce a small-government conservative. FREE E-BOOK: Government Failure: A Primer on Public Choice is available for reading and download (PDF) for a limited time on our website. Republicans and Democrats are quibbling over a measly $61 billion in spending cuts--that's a failure of leadership. Under the failing status quo, Big Sugar wins, and Joe Taxpayer loses. Ian Vásquez, director of Cato's Center for Global Liberty and Prosperity, joined C-SPAN's Washington Journal to talk about the failure of foreign aid: Thursday Links is a post from Cato @ Liberty - Cato Institute Blog (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4664152 Thu, 31 Mar 2011 14:36:18 +0100 4664152 http://www.medworm.com/index.php?rid=4653604&cid=t_120514_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fg_5vLHyT1fE%2F The vast majority of heart failure cases occur in adults aged 65 and older, but a new study in the Archives of Internal Medicine finds that many clinical trials studying the disease exclude older patients. The implication? Most of the meds that are being developed to treat heart disease have not been tested on the very patients who will be taking the drugs. To wit, 64 of 251 trials investigating meds for heart failure, or 25.5 percent, excluded patients by an arbitrary upper age limit. This happened 32.3 percent of the time in the European Union compared with 16.2 percent of trials in the US. Exclusion also was found more often in public institutions compared with private entities - 35.6 percent versus 13.9 percent. Overall, 109 trials, or 43.4 percent, had one or more poorly justified exc... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4653604 Tue, 29 Mar 2011 15:19:44 +0100 4653604 http://www.medworm.com/index.php?rid=4642593&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Felizabeth-taylor-and-understanding-heart-failure%2F2011.03.28 The condition that took Elizabeth Taylor’s life affects millions of Americans. Reports of Elizabeth Taylor’s death focused, as they should, on her life, not on her death from heart failure. But given how common this condition is—the American Heart Association says nearly 6 million Americans are living with heart failure and it kills about 300,000 each year—a little attention to it might be a good idea. What is heart failure? The term “heart failure” is a scary one, conjuring up images of a heart that is suddenly unable to work. In truth, it represents a gradual decline in the heart’s ability to pump enough blood to meet the body’s needs. As the heart weakens, all parts of the body suffer the consequences. (more…) *This blog post was originally published at H... Better Health blogs http://www.medworm.com/rss/comments.php?id=4642593 Mon, 28 Mar 2011 12:00:26 +0100 4642593 http://www.medworm.com/index.php?rid=4696593&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fhow-academic-boneheads-kill-people.html I'm already receiving comments that, regarding Prof. Jon Patrick's detailed exposé of the dangers of ill-suited-for-purpose ED EHR's, Patrick's observations are:... not really valid because they're not peer reviewed; they're just anecdotal. Only an egghead could pen such words.I always get hives immediately after eating strawberries. But without a scientifically controlled experiment with all the right peer review, it's not reliable data. So I continue to eat strawberries every day, since I can't tell if they cause hives.I'd already written about anecdotalist refrains at my Mar. 7, 2011 post "Australian ED EHR Study: Putting the Lie to the Line "Your Evidence Is Anecdotal, Thus Worthless" Used by Eggheads, Fools and Gonifs." In that essay I cite Dr. Patrick himself on "anecdotal evidence"... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4696593 Tue, 22 Mar 2011 14:05:00 +0100 4696593 http://www.medworm.com/index.php?rid=4622206&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fhow-academic-boneheads-kill-people.html I'm already receiving comments that, regarding Prof. Jon Patrick's detailed exposé of the dangers of ill-suited-for-purpose ED EHR's (shall we call them "Electronic Death Records?"), Patrick's observations are:... not really valid because they're not peer reviewed. Only an egghead could pen such words.I always get hives immediately after eating strawberries. But without a scientifically controlled experiment with all the right peer review, it's not reliable data. So I continue to eat strawberries every day, since I can't tell if they cause hives.I'd already written about anecdotalist refrains at my Mar. 7, 2011 post "Australian ED EHR Study: Putting the Lie to the Line "Your Evidence Is Anecdotal, Thus Worthless" Used by Eggheads, Fools and Gonifs."Aside from the fact that eggheads also ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4622206 Tue, 22 Mar 2011 14:05:00 +0100 4622206 http://www.medworm.com/index.php?rid=4615061&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fehr-legible-gibberish-another-example.html My brain-injured mother was admitted to a suburban hospital (recently acquired by the "big hospital" where her EHR-related injuries of May 2010 had occurred) Saturday morning.She was again in a confusional state (delirium) of unknown cause, probably recurrent infection. Of note, almost every time I see their EHRs, I note a problem.This is not the "FirstNet" ED EHR by Cerner forensically analyzed by Dr. Jon Patrick (as I wrote about here), but another ED EHR, "Pulsecheck" by Picis -- a company whose ICU physiological monitoring system I once as CMIO struggled with due to repeated, unexplained crashing.On this ED visit/admission to the satellite I noted a problem with the ED EHR system (the same one that started my mother's travails at the main facility in May 2010, and now in use at the s... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4615061 Mon, 21 Mar 2011 16:42:00 +0100 4615061 http://www.medworm.com/index.php?rid=4658559&cid=t_120514_134_f&fid=35213&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fblogspot%2FYNchP%2F%7E3%2Fj7yiz93YPfE%2Fanemia.html Oh, the things you just keep learning - does it ever end? The kidneys produce erythropoietin (EPO) which stimulates the bone marrow to produce the proper number of red blood cells neeeded to carry oxygen to viatl organs. When the kidneys fail, EPO productions tops. Diseased kidneys don't produce enough of it. Anemia sets in. When hubby was on dialysis, he got daily injections of EPO. But none since coming home. How can you tell if you are anemic? Pull the lower eyelid down. If it is bloody red, then you are not anemic. If it is pale pink or washed out, then you are. Pretty simple, pretty accurate test for anemia. Hubby is seriously anemic and has been since hospital discharge. Not getting any better. He goes to the nephrologist on 4/1 and we will talk to him about EPO injections. ... Wife of a Diabetic blogs http://www.medworm.com/rss/comments.php?id=4658559 Mon, 21 Mar 2011 00:40:00 +0100 4658559 http://www.medworm.com/index.php?rid=4615062&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Freal-medical-informatics-what-does.html At my Mar. 15, 2011 post "What does a "problem list" of typical health IT look like?" I displayed a chart by Jon Patrick at U. Sydney on the ill-suited nature of an American EHR system for use in Emergency Dept. settings. That system had been mandated for rollout in public ED's in the entire Australian state of New South Wales.As it turns out, that chart was just preliminary.A new chart is up entitled "Analysis of Problems Defined by ED Directors", divided into four sections:1. Workarounds and Abandonments (27 elements)2. Functions Lost from the Pre-FirstNet System or Desirable Functions (31 elements)3. Processes with Added Risk to the Integrity of the EMR (11 elements)4. General Problem List - What is the Potential for Resolution? (60 elements)The entire chart can be viewed at this link (... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4615062 Sun, 20 Mar 2011 13:42:00 +0100 4615062 http://www.medworm.com/index.php?rid=4594702&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fupdating-the-aha-s-guidelines-for-prevention-of-cardiovascular-disease-in-women-3.mp4 The recent update to the AHA's effectiveness-based guidelines for prevention of heart disease in women is notable for its refined focus on several issues, including a revised definition of risk, risk during pregnancy, BP control, and understanding diversi (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4594702 Wed, 16 Mar 2011 13:40:00 +0100 4594702 http://www.medworm.com/index.php?rid=4592324&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fwhat-does-problem-list-of-typical.html What does a high level "problem list" of typical health IT look like?Like this, from Prof. Jon Patrick at U. Sydney:This Technology Problem List has been drawn up to collate all the technical problems in the report that have been identified in the Cerner Millenium version used for the FirstNet installations in Emergency Departments in the NSW, Australia.[Link, as I wrote about in my Mar. 2011 post "On an EMR Forensic Evaluation by Professor Jon Patrick from Down Under: More Thoughts" and others - ed.] This is a list of the errors and bugs identified by ED directors in the study published on the 4th March 2011 that seem to have a technical origin, that is we would expect that some change in the underlying technology would solve the problem. The likelihood of resolving the problem is a funct... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4592324 Tue, 15 Mar 2011 14:36:00 +0100 4592324 http://www.medworm.com/index.php?rid=4592328&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fwhy-current-nature-of-healthcare-it.html Apparently Holland is now veering away from a national project for health information exchange. From a researcher at Erasmus University Rotterdam:While failures of IT implementation in the UK and more recently the Cerner implementation in Australia has been dissected by [U. Sydney Professor] Jon Patrick, the Dutch initiative for a national health IT infrastructure for exchanging patient data that would start with a medication record and a summary record is about to be voted down in the upper house (Senate) of the Dutch parliament. It means that the trajectory to get this infrastructure and which lasted thirteen years will grind to a halt. Unfortunately this implementation has been poorly documented in scientific journals (to my knowledge only one paper describing the infrastructure was pub... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4592328 Mon, 14 Mar 2011 13:01:00 +0100 4592328 http://www.medworm.com/index.php?rid=4560203&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Ffuture-pathways-for-e-health-in-nsw.html Prof. Patrick has now added a new section to his report on health IT in NSW Australia, entitled "The Future Pathways for e-Health in NSW." It is available at this link (PDF).It inoculates against most of the 'Ten Plagues' that bedevil health IT projects (such as the IT-clinical leadership inversion, lack of transparency, suppression of defects reporting, magical thinking about the technology, and lack of accountability of the bureaucrats).Emphases mine:In Short Term ( 0-3 months)1. Halt further rollouts of Firstnet or other CIS systems. The current roll-out programs use significant efforts in training staff for a system that is counterproductive to patient well being.2. Complete a full and thorough risk assessment analysis and usability of the software. The CIS report indicates there are a... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4560203 Tue, 08 Mar 2011 13:16:00 +0100 4560203 http://www.medworm.com/index.php?rid=4554596&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fwhat-to-do-about-state-of-ed-ehr-in-nsw.html At my post yesterday "On an EMR Forensic Evaluation by Professor Jon Patrick from Down Under: More Thoughts", I've come down pretty hard on internal and external (i.e., human interface) sloppiness in mission critical IT systems.In my view, the flaws that create randomly-occurring errors, combined with a mission hostile user experience highly and especially inappropriate in the hectic and unpredictable ED environment, turn these systems into slot machines. The jackpot, however, is not wealth. It's injury or death.I've been asked, "So - what to do about the state of the ED EHR in NSW?"Here are some simple initial suggestions:A. For the time being: securing and implementing a paper backup (pen & paper) with scanning and document imaging retrieval system (integrated or standalone) as an 'E... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4554596 Sun, 06 Mar 2011 16:04:00 +0100 4554596 http://www.medworm.com/index.php?rid=4552050&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fon-emr-forensic-evaluation-from-down.html Discussions with ED Directors: Are we on the right track?3.3 Part 3 - Discussions with Software Performance Experts.3.4 Part 4 - Conceptual Data Modelling.3.5 Part 5 - Database Relational Schema and Data Tables.3.6 Part 6 - Coalescing the Analyses of the ER Diagrams, Relational Schemata and Data Tables.3.7 Part 7 - The Integrated Assessment.3.8 Part 8 - Future HIT Regulation Proposals.3.9 Part 9 - Ockham's Razor of Design. Published at the IHI conference, Nov 2010 Washington.I have been reading these sections, and have found the technical sections (parts 4-6) highly informative about a major suspicion I've held for many years.I suspected chaos in the health care IT software engineering process, with inadequate attention to quality, rigor, fine detail, resilience engineering, talent managem... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4552050 Sat, 05 Mar 2011 15:23:00 +0100 4552050 http://www.medworm.com/index.php?rid=4549718&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fthanks-to-wonders-of-ehr-this-premature.html Thanks to the distractions of EHR and the wonders of EHR auto entry, cut and paste etc., this premature baby went to the grave, prematurely:Failures in care alleged after premature birth - $1,000,000 SettlementBy Virginia Lawyers WeeklyPublished: October 18, 2010Tags: Fairfax County Circuit Court, Medical Malpractice, Million-Dollar SettlementsDecedent and his twin sister were born healthy at 27 weeks gestation. Decedent was placed in the neonatal intensive care unit. Six days after birth, a peripherally inserted central catheter (PICC) was inserted into the right axilla and used to infuse nutrition, medication, blood products and lipids.Within 48 hours, the PICC insertion site began to show evidence of compromise. The attending physician gave a verbal order to monitor the arm, but the ord... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4549718 Fri, 04 Mar 2011 16:30:00 +0100 4549718 http://www.medworm.com/index.php?rid=4549719&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fstudy-of-enterprise-health-information.html Discussions with ED Directors: Are we on the right track?3.3 Part 3 - Discussions with Software Performance Experts.3.4 Part 4 - Conceptual Data Modelling.3.5 Part 5 - Database Relational Schema and Data Tables.3.6 Part 6 - Coalescing the Analyses of the ER Diagrams, Relational Schemata and Data Tables.3.7 Part 7 - The Integrated Assessment.3.8 Part 8 - Future HIT Regulation Proposals.3.9 Part 9 - Ockham's Razor of Design. Published at the IHI conference, Nov 2010 Washington.A non-technical but revealing summary from Part 2:Discussions were held with the Directors of 7 Emergency Departments in New South Wales (NSW) public hospitals assessing the impact of the introduction of the FirstNet information system into their Departments. All but one of the Directors has found that th... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4549719 Fri, 04 Mar 2011 15:33:00 +0100 4549719 http://www.medworm.com/index.php?rid=4549779&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F03%2F04%2Fbest-of-our-blogs-march-4-2011%2F Life is a work in progress. When I think about who I was 10 years ago, that girl was barely distinguishable from who stands before me today. Ever read an old journal and feel astonished by who you were? I feel the same way. I was lost, confused and did not know who I was or who I wanted to be. I was a slave to my emotions and my experiences. I let others create the road in front of me and define my worth. While I have grown a lot since then, I am still a work in progress. I don’t know where you are on your journey, but if you are struggling to get to where you want to be in your life, I hope a few of these top posts this week will bring you solace. It takes a lot to get to your goals. You may be dealing with depression, body image issues or struggling with your own self-identity. If ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4549779 Fri, 04 Mar 2011 12:44:20 +0100 4549779 http://www.medworm.com/index.php?rid=4549720&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fwe-are-not-perfect-and-we-are-always.html In response to my post "A Brief Primer on Health IT Problems" which I cross-posted to the site EMRUpdate.com, I received this response from another physician at this link:I engage the so called "IT physician leader", who is non clinical in our hospital system. She told me that this is the "future", even before I could express my concern of work flow disruption with the Cerner system we have. Not realizing that I have an EMR for 11 years. You would think these pundits would ask assistance or input from successful implementers, but they are too arrogant and proud! It is frustrating to say the lease. It takes 2 to 4 times longer to rounds and navigate the system. Then they wonder why the patient satisfaction on their floors waxes and wanes. Priorities shifted to documentation, that makes the ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4549720 Thu, 03 Mar 2011 19:18:00 +0100 4549720 http://www.medworm.com/index.php?rid=4544924&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fwe-are-not-perfect-and-we-are-always.html In response to my post "A Brief Primer on Health IT Problems" which I cross-posted to the site EMRUpdate.com, I received this response from another physician at this link:I engage the so called "IT physician leader", who is non clinical in our hospital system. She told me that this is the "future", even before I could express my concern of work flow disruption with the Cerner system we have. Not realizing that I have an EMR for 11 years. You would think these pundits would ask assistance or input from successful implementers, but they are too arrogant and proud! It is frustrating to say the lease. It takes 2 to 4 times longer to rounds and navigate the system. Then they wonder why the patient satisfaction on their floors waxes and wanes. Priorities shifted to documentation, that makes the ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4544924 Thu, 03 Mar 2011 19:18:00 +0100 4544924 http://www.medworm.com/index.php?rid=4536026&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fcommittee-on-patient-safety-and-health.html In my Jan. 2011 post "Institute of Medicine Committee on Patient Safety and Health Information Technology, and Thoughts on Social Aspects of Health IT Evaluation" I wrote that:The U.S. National Research Council of the National Academy of Sciences issued a report in early 2009 on the state of health IT. That study's report, led in part by pioneers in Medical Informatics G. Octo Barnett and William Stead, was entitled "Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions" (pre-publication PDF available free at this link). The report was announced under the following header:CURRENT APPROACHES TO U.S. HEALTH CARE INFORMATION TECHNOLOGY ARE INSUFFICIENT The insufficiencies were largely in the areas of difficulties with data sharing and integration, deploy... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4536026 Wed, 02 Mar 2011 02:40:00 +0100 4536026 http://www.medworm.com/index.php?rid=4507291&cid=t_120514_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FV7SJ85Z99i0%2F A man, originally from Somalia, is jaundiced and has abnormal LFTs. Can you work out the cause? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4507291 Tue, 22 Feb 2011 00:00:28 +0100 4507291 http://www.medworm.com/index.php?rid=4495203&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmri-safe-pacemakers-available-in-u-s-hospitals-soon-what-it-means-for-heart-patients%2F2011.02.18 This was the Guest Blog at Scientific American on February 16th, 2011. New wave of MRI-safe pacemakers set to ship to hospitals This week Medtronic will begin shipping to hospitals in the United States the first pacemaker approved by the FDA as safe for most MRI scans. For consumers, it is a significant step in what is expected to be a wave of new MRI-compatible implanted cardiac devices. But this is an example of one technology chasing another and the one being chased, the MRI scanner, is changing and is a step ahead of the new line of pacemakers. The pacemaker approved for U.S. distribution is Medtronic’s first-generation pacemaker with certain limitations, while its second-generation MRI-compatible pacemaker is already in use in Europe where approval for medical devices is not as dem... Better Health blogs http://www.medworm.com/rss/comments.php?id=4495203 Fri, 18 Feb 2011 21:00:00 +0100 4495203 http://www.medworm.com/index.php?rid=4455266&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctor-who-attempted-to-have-whistleblowing-nurses-prosecuted-is-put-on-probation%2F2011.02.09 From an AP article in the Dallas-Fort Worth Star-Telegram: AUSTIN — Texas medical regulators on Friday placed on probation a West Texas doctor involved in the unsuccessful prosecution of two nurses who complained anonymously that the physician was unethical and risking patients’ health. The Texas Medical Board technically suspended Dr. Rolando G. Arafiles Jr. but allowed him to continue to practice medicine while on probation for four years if he completes additional training. The board also said Arafiles must be monitored by another physician and submit patient medical and billing records for review. The monitor will report his or her findings to the board. In the mediated order signed in Austin, the board concluded that Arafiles failed to treat emergency room patients properly, did... Better Health blogs http://www.medworm.com/rss/comments.php?id=4455266 Wed, 09 Feb 2011 14:00:20 +0100 4455266 http://www.medworm.com/index.php?rid=4438881&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F02%2Fharsh-farewell-to-david-blumenthal-of_4184.html Well, from me actually, but she agrees with my assessment.I believe one unfortunate "legacy" of Blumenthal's tenure is the near total absence of consideration of HIT risk.Risk to patient life and limb.As I wrote here, the PCAST report itself reflects the same systematic Pollyanna attitude.My comments about the PCAST report are simple and twofold:1. The term "risk" is absent from the PCAST report in the context of risk to patients from clinical IT. Instead, the context is largely about the risk to patients of NOT having health IT.2. The term "safety" is similarly absent in the context of adverse effects of HIT, and only present in the context of how HIT will improve safety, except for one reference (indeed, the match to my search for the term "safety" was in the cited URL itself) ...... I... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4438881 Sat, 05 Feb 2011 00:11:00 +0100 4438881 http://www.medworm.com/index.php?rid=4436717&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F02%2Fharsh-farewell-to-david-blumenthal-of_4184.html Well, from me actually, but she agrees with my assessment.I believe one unfortunate "legacy" of Blumenthal's tenure is the near total absence of consideration of HIT risk.Risk to patient life and limb.As I wrote here, the PCAST report itself reflects the same systematic Pollyanna attitude.My comments about the PCAST report are simple and twofold:1. The term "risk" is absent from the PCAST report in the context of risk to patients from clinical IT. Instead, the context is largely about the risk to patients of NOT having health IT.2. The term "safety" is similarly absent in the context of adverse effects of HIT, and only present in the context of how HIT will improve safety, except for one reference (indeed, the match to my search for the term "safety" was in the cited URL itself) ...... I... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4436717 Sat, 05 Feb 2011 00:11:00 +0100 4436717 http://www.medworm.com/index.php?rid=4436718&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F02%2Fconfusing-heavy-coffee-drinkers-with.html I present a new, true case example of health IT-created problems, with some parallels to this prior health IT information science debacle where I had written:... What manner of amateurs made and approved the decision to map semantically and often medically imprecise, and often deliberately overstated or misused billing codes to diagnoses, and then display the diagnostic terms to a user - ANY user, patient or "learned intermediary" - in an electronic health record?Here are the de-identified details:A clinician participated in a psychiatry team meeting.The patient was in attendance and had dutifully been reviewing the treatment plan and records. The patient was upset that the Axis I diagnoses included “inhalant abuse.”In fact, here’s what the patient's EMR-generated record indicated:�... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4436718 Sat, 05 Feb 2011 00:01:00 +0100 4436718 http://www.medworm.com/index.php?rid=4436958&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2FkYNbI0zoYkw%2F Conclusion This technique has worked for thousands of individuals for hundreds of years. Visualize what you want, feel yourself in possession of it, feel the sense of fulfillment, of happiness and take action as soon as inspiration strikes. This was a guest post by Daniel M. Wood a well-known speaker and writer on Personal Development, Sales Technique and Motivation. Visit his blog Lookingtobusiness.com and download your copy of his free e-book, Double Your Income. Sign up for the PTB newsletter! : Reclaim Your Dream, It’s Time to Come Alive Why You Should Read Personal Development Books (Source: PickTheBrain | Motivation and Self Improvement) PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=4436958 Fri, 04 Feb 2011 06:39:16 +0100 4436958 http://www.medworm.com/index.php?rid=4433058&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F02%2Fdavid-blumenthal-to-resign-as-director.html From NextGov.com - TECHNOLOGY AND THE BUSINESS OF GOVERNMENT Blumenthal Calls It Quits By John Pulley, March 3, 2011 Dr. David Blumenthal, who has pushed the country's health care providers to give up paper files in favor of electronic medical records, announced Thursday that he is stepping down as the country's de facto health IT czar after almost two years on the job. He will return to Harvard University, according to news reports. Blumenthal served as National Coordinator for Health IT during a period of tremendous change. In 2009, Congress allocated billions of dollars to expand the Office of the National Coordinator's authority and to make available incentive funds intended to encourage mass adoption of electronic medical records. The first of those incentives payments were di... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4433058 Fri, 04 Feb 2011 00:12:00 +0100 4433058 http://www.medworm.com/index.php?rid=4429247&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2Fd0H2MKFLGaE%2F Fear is like a toxic poison – it seems you can’t get rid of it by any means and it prevents you from living the life you always wanted to live. I was being “poisoned” with fear for myself and continuously worried about the events that might take place in the future, which included – besides many other things – messing up with my grades or not being able to master the defiances of my life. Even though I wasn’t a scared chicken at all, fear remained a part of my thoughts and often prevented me from falling asleep. Generally speaking I would say that all my worries had one thing in common: the fear of failure. Overcome the fear of failure #1 Having the right mindset about failure When I was about 20 years old, I’ve made an interesting conclusion... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=4429247 Wed, 02 Feb 2011 06:49:27 +0100 4429247 http://www.medworm.com/index.php?rid=4428970&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F02%2Fupdated-reading-list-on-health-it.html This article is a first of its kind, a comprehensive analysis of the liability risks associated with use of clinical IT. The authors point out that the potential benefits of computerization could be substantial, but EHR systems also give rise to new liability risks for health care providers that have received little attention in the legal literature. - Meaningful Use and Certification of Health Information Technology: What About Safety? Sharona Hoffman and Andy Podgurski. Case Research Paper Series in Legal Studies Working Paper 2010-34, October 2010. - Finding a Cure: The Case for Regulation And Oversight of Electronic Health Records Systems, Sharona Hoffman and Andy Podgurski. Harvard Journal of Law & Technology 2008 vol. 22, No. 1 - Emerging Trends in Electronic Heal... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4428970 Wed, 02 Feb 2011 02:39:00 +0100 4428970 http://www.medworm.com/index.php?rid=4424235&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiovascular-care-costs-could-triple-by-2030%2F2011.02.01 Real total direct medical costs of cardiovascular disease (CVD) could triple, from $273 billion to $818 billion (in 2008 dollars) by 2030. Real indirect costs, such as lost productivity among the employed and unpaid household work, could increase 61 percent, from $172 billion in 2010 to $276 billion. Results appeared in a policy statement of the American Heart Association. CVD is the leading cause of mortality and accounts for 17 percent of national health expenditures, according to the statement. How much so? U.S. medical expenditures rose from 10 percent of the Gross Domestic Product in 1985 to 15 percent in 2008. In the past decade, the medical costs of CVD have grown at an average annual rate of 6 percent and have accounted for about 15 percent of the increase in medical spending... Better Health blogs http://www.medworm.com/rss/comments.php?id=4424235 Tue, 01 Feb 2011 18:00:00 +0100 4424235 http://www.medworm.com/index.php?rid=4419112&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F8PbpRgs3Pk8%2F By Tad DeHavenFreshman Sen. Rand Paul (R-KY) has raised the bar in Washington by releasing a bill that would make substantial, specific, and immediate cuts in federal spending. While policymakers on both sides of the aisle have largely paid lip service to stopping Washington’s record run of fiscal profligacy, Paul’s proposal makes good on his campaign promise to seriously tackle the federal government’s bloated budget. Paul’s bill would target $500 billion in cuts for fiscal 2011 alone. While audacious by Washington standards, cutting federal spending by that amount would still leave us with a projected $1 trillion deficit this year. Nonetheless, the federal government’s scope would be dramatically curtailed, which would pay dividends in coming years as the economy is unshackled ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4419112 Mon, 31 Jan 2011 18:49:44 +0100 4419112 http://www.medworm.com/index.php?rid=4414548&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F30%2F5-steps-to-a-more-resilient-you%2F Resiliency is what makes some people able to bounce back after a particularly traumatic or difficult time or stressor in one’s life, while others fall apart. It is a component of positive psychology, in that researchers try and figure out what makes resilient people different than others. And then seeks to help others learn some simple skills that may be able to help build resiliency in one’s own life. There are no secret short-cuts to building greater resilience in your life. Most skills you can learn to help build resiliency are things that are going to take lots of time and lots of practice. Practice is one of the things people often forget when it comes to changing one’s behavior or one’s life. You didn’t become this way overnight. It took years — a... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4414548 Sun, 30 Jan 2011 11:40:39 +0100 4414548 http://www.medworm.com/index.php?rid=4405730&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Forderless-in-seattle-software-glitch.html A commenter yesterday commented that after 25 years in practice, they had one lost [paper] chart (as opposed to an IT systems crash, where every chart is lost temporarily).As coincidence would have it, there's this story in the news:Software glitch shuts down Swedish medical-records systemTuesday, January 25, 2011By Carol M. OstromSeattle Times health reporter Related A four-hour shutdown of Swedish Medical Center's centralized electronic medical-records system Monday morning was caused by a glitch in another company's software, said Swedish chief information officer Janice Newell. There's that word "glitch" again that I see so frequently in the health IT sector when a system suffers a major crash that could harm patients. Why do we not ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4405730 Thu, 27 Jan 2011 04:23:00 +0100 4405730 http://www.medworm.com/index.php?rid=4399473&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fmore-on-electronic-health-records-and.html In conclusion, this new article represents yet another data point challenging uncritical assertions of automatic EHR-created medical improvement.I agree with both the article's authors and those who wrote the critique that more reserch is needed (not more fast-paced implementation).As concluded last year by the National Research Council in a study led by several HIT pioneers:Current efforts aimed at the nationwide deployment of health care information technology (IT) will not be sufficient to achieve medical leaders' vision of health care in the 21st century and may even set back the cause ... In the long term, success will depend upon accelerating interdisciplinary research in biomedical informatics, computer science, social science, and health care engineering. These words should not be ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4399473 Wed, 26 Jan 2011 00:55:00 +0100 4399473 http://www.medworm.com/index.php?rid=4382726&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fmaude-and-hit-risk-mother-mary-what-in.html As I wrote at my last post "Healthcare IT Delirium":The field of health IT has become delirious.On top of an irrational exuberance (see this blog query) largely unsupported by the literature (e.g. here), the technology is experimental, its rollout is a grand national experiment in social re-engineering of medicine, there is no patient informed consent, nobody is in control, and nobody is taking responsibility for regulating the domain despite known risks. The results will very likely reflect the Wild West free-for-all that is now extant.It's worse.Some time ago I posted on a number of cases of health IT malfunction from the FDA's MAUDE (Manufacturer and User Facility Device Experience) database of medical device risks. See posts on MAUDE here and here.MAUDE data represents reports of adver... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4382726 Fri, 21 Jan 2011 15:28:00 +0100 4382726 http://www.medworm.com/index.php?rid=4377537&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fhealthcare-it-delirium.html The delirium surrounding healthcare IT seems to be worsening.In an Aug. 2010 post "EPIC's outrageous recommendations on healthcare IT project staffing" I wrote that health IT company Epic, one of the largest, seemed to not care about healthcare or IT education or experience in its recommendations to hospitals on staffing of safety critical projects (i.e., the implementation of safety critical clinical cybernetic devices):Epic emphasizes that many hospitals can staff their projects internally, choosing people who know the organization. However, they emphasize choosing the best and brightest, not those with time to spare. Epic advocates the same approach it takes in its own hiring: don’t worry about relevant experience, choose people with the right traits, qualities, and skills, they say... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4377537 Thu, 20 Jan 2011 15:15:00 +0100 4377537 http://www.medworm.com/index.php?rid=4372052&cid=t_120514_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F06q9U-Q4HJk%2F aka Trauma Tribulation 008 A 26 year-old male was BIBA after falling off his stationary motorbike at a set of traffic lights. C-spine precautions were removed following palpation of his neck and assessment of his sphincter tone. Initially, his only complaint was pain to his right thumb, presumably from a hyperextension injury. However a detailed [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4372052 Wed, 19 Jan 2011 00:00:30 +0100 4372052 http://www.medworm.com/index.php?rid=4360991&cid=t_120514_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FMXaAOKFQFfs%2F A 20 year-old female had a polypharmacy overdose 36 hours ago. She has had symptoms of GI upset (nausea and vomiting), some anxiety and mild confusion. Her life is in your hands... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4360991 Tue, 18 Jan 2011 00:00:08 +0100 4360991 http://www.medworm.com/index.php?rid=4355706&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fdr-monteith-hit-testimony-to-hhs.html Psychiatrist-medical informaticist Dr. Scott Monteith was a guest blogger on the complications of "Meaningful Use of EHR's" in the Dec. 21, 2010 post "Meaningful Use and the Devil in the Details: A Reader's View."He also testified at the Office of the National Coordinator's Health IT Standards Committee Implementation Workgroup which recently had a meeting, Jan. 10-11, 2010, as I wrote about here.With his permission I am reproducing his testimony to the Committee (which is supposed to also be posted to the meeting website) without further comment. None is needed.Emphases in the original: HIT Testimony in DC January 11, 2011 My name is Scott Monteith, a board-certified psychiatrist and Fellow of the APA from Michigan. I work in private practice and with Community Mental Health (CMH). I also... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4355706 Sun, 16 Jan 2011 21:05:00 +0100 4355706 http://www.medworm.com/index.php?rid=4349479&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fonc-workgroup-document.html A provocative title indeed.The Office of the National Coordinator's Health IT Standards Committee Implementation Workgroup recently had a meeting, Jan. 10-11, 2010.They've posted the testimony and supporting documents here: http://healthit.hhs.gov/portal/server.pt?open=512&objID=1482&&PageID=17128&mode=2 .I've copied & pasted these document links directly from the site, at 12:45 PM EST 1/14/2011:Instructions and Questions for Panelists [PDF - 381 KB] Presenter Bio Sketch [PDF - 549 KB] Paul Kleeberg, MD [PDF - 443 KB] Dan Nelson -Testimony [PDF - 330 KB] Lisa Levine [PDF - 125 KB] CCHIT -Testimony [PDF - 95 KB] Alisa Ray -Testimony [PDF - 219 KB] Patricia Daiker - Bio [PDF - 75 KB] Medhost [PDF - 100 KB] Cerner - Testimony [PDF - 716 KB] John Travis [PPT - 486 KB] Brad ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4349479 Fri, 14 Jan 2011 17:41:00 +0100 4349479 http://www.medworm.com/index.php?rid=4349516&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffda-restricts-acetaminophen-in-popular-pain-medications%2F2011.01.14 This is a guest post from Dr. Mary Lynn McPherson. ********** FDA Restricts Acetaminophen In Popular Pain Medications The Food and Drug Administration (FDA) made an announcement yesterday that affects one of the most common pain medications on the market, and as a consequence may affect countless numbers of the 75 million Americans who experience chronic pain (for perspective, that’s more than the number of people suffering from cancer, heart disease and diabetes combined.) The FDA has asked manufacturers of popular prescription pain medications like Vicodin or Percocet to limit the amount of acetaminophen (also known as Tylenol, or APAP) used in these drugs to no more than 325 milligrams per tablet — the equivalent of one regular-strength Tylenol tablet. The move came because rese... Better Health blogs http://www.medworm.com/rss/comments.php?id=4349516 Fri, 14 Jan 2011 13:00:05 +0100 4349516 http://www.medworm.com/index.php?rid=4343097&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fgoogle-ceo-eric-schmidt-on-healthcare.html At the Jan. 11, 2011 WSJ health blog, in an article entitled "JP Morgan Healthcare: Google’s Schmidt on Open Source and Health IT", Google CEO Eric Schmidt is cited as saying:... One solution to the problem may be to take the electronic-medical record architecture out of the hands of the corporate world, suggested Google CEO Eric Schmidt at the JP Morgan Healthcare Conference last night. “If I were not doing what I’m doing and I wanted to do something in health care … I would go to all of the research universities and would try to figure out where the best, interesting IT software is that can be open-sourced,” he said at a health-IT panel discussion. “My guess is that a platform like that would be remarkably different from the platforms that we are using today,” he said. Firs... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4343097 Thu, 13 Jan 2011 17:14:00 +0100 4343097 http://www.medworm.com/index.php?rid=4338064&cid=t_120514_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FylTLrL6wBdI%2F Yesterday I was attending a conference that had almost nothing to do with EMR. However, in one of my conversations a young girl told me that her dad was a doctor. She went on to tell me how it is all that her dad can talk about her.  He was trying to convince himself why he should ignore the stimulus money and not do EMR. Of course, this part isn’t that interesting since I think we all know many doctors who are doing something similar. What was very interesting was that the daughter of this doctor explained how she was trying to convince her dad why he should do EMR. In fact, she suggested that she might have read my EMR site before because she’d done searches to learn more about EMR so that she could convince her doctor father to use an EMR. This discussion of why you shoul... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4338064 Tue, 11 Jan 2011 18:41:02 +0100 4338064 http://www.medworm.com/index.php?rid=4330968&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fehr-problems-no-theyre-merely.html My mother, who suffered an iatrogenic cerebral hemorrhage in May contributed to by an EMR, fell the other day in the bathroom. Her fall was hard; she struck her back and knocked out one of the mounting posts for the bathroom tissue - completely out of the wall, the wallboard now with a large gaping hole in it.In an elderly person, falls can result in injuries such as this one, a painful hematoma on her back.She went to a local hospital where x-rays were done; aside from a large bruise and hematoma (collection of blood under the skin) over her back at the point of impact, miraculously nothing was broken.At triage I went over her medication list in great detail, ensuring both the data input and the triage printout record of her meds were complete and precise. She went home.The very next day,... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4330968 Tue, 11 Jan 2011 01:53:00 +0100 4330968 http://www.medworm.com/index.php?rid=4318563&cid=t_120514_180_f&fid=38619&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FALifeCoachsBlog%2F%7E3%2FE6fHlz9Aq8s%2F I was just writing an article on New Years Resolutions for my newsletter readers and something crossed my mind that I want to share with you. I’ve deliberately been holding back on sending the newsletter because people that have set New Year Resolutions often don’t start to hit the wall for a week or two as to begin with they are carried along on a wave of enthusiasm and determination As such, I think the advice is more valuable now than when somebody kicks off the new year with high expectations and great intentions and probably wont absorb it. There are a number of reasons goals can, and do fail, and I cover off three of the most important in the newsletter (you can sign up in the box below if you want to know what they are) However, possibly one of, if not the, most common reason, i... Life Coach Blog: The Discomfort Zone : blogs http://www.medworm.com/rss/comments.php?id=4318563 Thu, 06 Jan 2011 20:00:27 +0100 4318563 http://www.medworm.com/index.php?rid=4314221&cid=t_120514_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F6v6OHNUJQ_Y%2F Greetings, everyone. How are you this morning? We trust you feel invigorated as another day gets under way. As usual, we are brewing a delicious cup of stimulation and poking around for interesting items. Heard something fascinating? Send us a note. Meanwhile, we hope your workload is manageable and much gets accomplished. Catch you soon… Pfizer Faces 1,200 Chantix Lawsuits (Birmingham News) Spectrum To Make Biosimilar Of Roche’s Rituximab (Reuters) Roche Wins Wider Approval For Actemra (Bloomberg News) Evidence Links Avastin To Heart Failure In Breast Cancer Patients (HealthDay) EMA Worries Over Foreign APIs (InPharma-Technologist) J&J Files For FDA Approval Of Bloodthinner (Associated Press) Celgene Submits New Applications For Cancer Meds (Reuters) Xoma Inks $505M Diabe... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4314221 Wed, 05 Jan 2011 12:48:44 +0100 4314221 http://www.medworm.com/index.php?rid=4309563&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fblogscan-health-it-debacle-down-under.html From the blog "Australian Health Information Technology" by Dr David More MB, PhD, FACHI:Monday, January 03, 2011NSW Health Has A Full Blown Health IT Failure on Its Hands. As I Predicted in 2006!The Healthelink Project, which was to provide a prototype for a Shared EHR for NSW has essentially imploded. Information provided to this blog confidentially confirms both the number of participants in the project and their information transmission activities have both fallen through the floor over the last 12 months! To protect sources I can’t provide much detail concerning the evidence I have seen, but it is clear and dramatic and confirms what I have been saying for a good while. Sadly HealtheLink is such a badly wounded animal that it really now needs to be helped to pass to a much better pl... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4309563 Mon, 03 Jan 2011 20:50:00 +0100 4309563 http://www.medworm.com/index.php?rid=4302160&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F01%2Fhappy-new-year-2011%2F Happy New Year! May your year be full of the things that bring you the most joy and happiness, whether it be family, success, a new job, or relief from pain — or some combination of all of the above. The staff and family here at Psych Central wish you a very prosperous one in whatever you do. And if you need a little help with your resolutions or making the most of your New Year, please check out our annual New Year’s Guide. Here are the five newest articles to help you with your resolutions this year: 10 Tips for Setting Successful Resolutions That Stick You can make it more likely you’re follow through on your resolutions this year. Here’s how. How New Year’s Goals Give Life Direction (And Keep Fears At Bay)! How do resolutions work to try and help us chan... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4302160 Sat, 01 Jan 2011 06:01:20 +0100 4302160 http://www.medworm.com/index.php?rid=4294711&cid=t_120514_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F12%2F26%2F8-ways-to-pitch-perfectionism%2F Although it can lead to imperfect — or even damaging — consequences, many of us strive for perfection anyway. Procrastination, ironically enough, is one of those unfortunate consequences. “In our pursuit of unreachable standards, we endlessly spin our wheels rather than move forward. In some cases, we never even start. The quest for perfection can be so intimidating that our productivity screeches to a halt,” said Debbie Jordan Kravitz, professional organizer and author of Everything I Know About Perfectionism I Learned from My Breasts. For some people, perfectionism can become all-consuming, so “reaching perfection is all they can see, feel, want or even need,” she said. Fear of failure is part of perfectionism. It stops us from seeking adventure and exploring... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4294711 Sun, 26 Dec 2010 13:57:21 +0100 4294711 http://www.medworm.com/index.php?rid=4281282&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F12%2Funintended-errors-with-ehr-based-result.html As I wrote at "Report of an AMIA special task force on challenges in ethics, safety, best practices, and oversight regarding HIT", articles in the premier journal of Medical Informatics, the Journal of the American Medical Informatics Association (JAMIA) on real and potential downsides of health IT appear to be becoming a trend.Another article just appeared in JAMIA as the result of a study of healthcare IT related errors: "Unintended errors with EHR-based result management: a case series"; Thomas R Yackel and Peter J Embi; JAMIA 2010 17: 104-107; doi: 10.1197/jamia.M3294.The article presents a series of health IT-related errors and categorizes them systematically, and thus adds to our knowledge on the issue of cybernetic clinical test results management. It also makes recommendations for... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4281282 Wed, 22 Dec 2010 21:04:00 +0100 4281282 http://www.medworm.com/index.php?rid=4258809&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F12%2Fnist-provides-healthcare-it-industry.html The National Institute of Standards & Technology (NIST) has published a guide entitled:NIST Guide to the Processes Approach for Improving the Usability of Electronic Health RecordsIt is available free at this link in PDF: http://www.nist.gov/itl/hit/upload/Guide_Final_Publication_Version.pdf (hat tip to an AMIA colleague for posting the URL on an AMIA mailing list.)The NIST was commissioned by HHS/ONC to study Health IT issues such as usability and report on them.I find the publication both welcome, and pitiable.As I started to read ch. 6, for example, I observed material that is suitable for undergraduate computer science instruction:6. User-Centered Design Process in EHRsUser-centered design is a bedrock principle for creating usable systems and devices. [You don't say? - ed.] One of... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4258809 Mon, 13 Dec 2010 12:50:00 +0100 4258809 http://www.medworm.com/index.php?rid=4253096&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F12%2Fnist-provides-healthcare-it-industry.html The National Institute of Standards & Technology (NIST) has published a guide entitled:NIST Guide to the Processes Approach for Improving the Usability of Electronic Health RecordsIt is available free at this link in PDF: http://www.nist.gov/itl/hit/upload/Guide_Final_Publication_Version.pdf (hat tip to an AMIA colleague for posting the URL on an AMIA mailing list.)The NIST was commissioned by HHS/ONC to study Health IT issues such as usability and report on them.I find the publication both welcome, and pitiable.As I started to read ch. 6, for example, I observed material that is suitable for undergraduate computer science instruction:6. User-Centered Design Process in EHRsUser-centered design is a bedrock principle for creating usable systems and devices. [You don't say? - ed.] One of... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4253096 Mon, 13 Dec 2010 12:50:00 +0100 4253096 http://www.medworm.com/index.php?rid=4249040&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FX26ttWF7AY0%2F By Tad DeHavenOver at Downsizing the Federal Government, we focused on the following issues this week: Unfortunately, the president’s Fiscal Commission appears to have operated on the premise that the federal government should continue to do everything it now does. Getting Rep. Jeff Flake on appropriations is a step in the right direction, but his appointment can’t be a token gesture. A new study finds that policymakers needn’t fear spending cuts. House Republican leaders’ support for “Prince of Pork” Hal Rogers to chair the chamber’s appropriations committee is a slap in the face of voters who demanded change in November. Michigan Gov. Jennifer Granholm, whose state’s unemployment rate is almost 13 percent, has advice for Washington on how to c... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4249040 Fri, 10 Dec 2010 21:18:35 +0100 4249040 http://www.medworm.com/index.php?rid=4241951&cid=t_120514_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F2ZAmuszH78k%2F Some may have thought the preemption debate was settled last year by the US Supreme Court, but Johnson & Johnson’s McNeil PPC unit hopes to persuade the justices to take a closer at a case involving the 1999 death of a 16-year-old boy, who had taken its Tylenol Cold med, and a Florida law that does not allow a drugmaker to unilaterally change its product labeling by adding a warning. For those unfamiliar, preemption is the notion that FDA approval of a drug supercedes state law claims challenging safety, efficacy, or labeling. Drugmakers and the FDA unsuccessfully argued last year before the US Supreme Court that preemption exists by maintaining the agency’s actions are the final word on safety and effectiveness. At issue was whether patients can sue a drugmaker through state... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4241951 Wed, 08 Dec 2010 15:15:23 +0100 4241951 http://www.medworm.com/index.php?rid=4233373&cid=t_120514_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F12%2Flooking-in-on-grief.html He left her - this whole earth - early in spring. Her jaw was tight and tears fell silent through all our conversations. We walked down the steep hill in back and cried with her while the children swung on the swings he built, played with the dogs he loved.Summer came and she seemed better, the tears weren't her constant companions any longer. She showed us the garden she somehow managed to plant and we marveled at the pumpkin vines growing thick amongst the weeds. Neighbors mowed her lawn and it seemed like every time we brought her a meal there was one still warm in the fridge, the gift of another helpless friend who brought food instead of words.Autumn. She seemed to be recovering. She talked more about her children and their futures than she did the husband she lost. She seemed to be s... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4233373 Mon, 06 Dec 2010 01:52:00 +0100 4233373 http://www.medworm.com/index.php?rid=4230137&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F12%2Fprofessors-at-harvard-and-nottingham.html In conclusion, I believe this literature review supports the notion expressed in other studies and opinion pieces here and elsewhere that we really need to SLOW DOWN the current HIT stampede, largely promoted by the HIT industry lobby. We need to take the appropriate time to better understand how to "do HIT well" before plunging in as if we actually know what we're doingas well as at my Oct. 2009 post "Washington Post Article: Electronic medical records not seen as a cure-all" where I wrote:... The literature is indeed conflicting, and the need for rigorous scientific study has never been more essential considering the commitment of tens of billions of dollars towards health IT. The time for story telling, marketing based on opinion, name calling, leap-of-faith extrapolations of light year... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4230137 Sun, 05 Dec 2010 18:36:00 +0100 4230137 http://www.medworm.com/index.php?rid=4230158&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-journal-retractions-a-transparency-issue%2F2010.12.05 Interesting case study raised by the Retraction Watch blog. A 2009 journal article in the Proceedings of the National Academy of Sciences (PNAS) – promoted in a news release by the journal and picked up by many news organizations — has now been retracted by the authors. But the journal issued no news release about the retraction — an issue of transparency that the RW blog raises. And you can guess how much news coverage the retraction will get. And this was all over a molecule that could supposedly “make breast tumors respond to a drug to which they’re not normally susceptible” — as the RW blog put it. But it was also a molecule, RW points out, that wasn’t even in clinical trials yet. He or she who lives by the journal news release risks one... Better Health blogs http://www.medworm.com/rss/comments.php?id=4230158 Sun, 05 Dec 2010 16:00:18 +0100 4230158 http://www.medworm.com/index.php?rid=4225716&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2FngcP1mvWf_g%2F Conclusion Decide to take charge of your life and become the success you deserve to be. Don’t let anything or anyone stand in the way of your goals. Do what it takes and learn from every speed bump on the way. If you want to read more articles like this visit http://lookingtobusiness.com I recommend you start with these articles as they are Daniels best on <a href=”http://lookingtobusiness.com”>Sales Technique, Motivation and Success</a>. Don’t Forget To Follow PickTheBrain on Twitter! : Reclaim Your Dream, It’s Time to Come Alive Why You Should Read Personal Development Books (Source: PickTheBrain | Motivation and Self Improvement) PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=4225716 Fri, 03 Dec 2010 06:20:22 +0100 4225716 http://www.medworm.com/index.php?rid=4208623&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Felectronic-health-records-bettering-uptake-and-use.mp4 Despite President Obama's deadline of 2014 for hospitals and practices to adopt electronic health records, uptake has been slow. In our digital age, we will all gain from dropping outdated record practices and adopting electronic records. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4208623 Mon, 29 Nov 2010 17:15:00 +0100 4208623 http://www.medworm.com/index.php?rid=4190284&cid=t_120514_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D100 According to Dr. Richard Solomon, MD, professor of medicine at University of Vermont’s College of Medicine, and a expert in contrast-induced acute renal failure, “CIN is the third most common cause of hospital-acquired renal failure, and among all procedures that utilize contrast media for diagnostic or therapeutic purposes, it affects coronary angiography the most.”  He continued, “Patients with CIN also have a longer stay in the hospital and have are at higher risk for hospital morbidity and mortality.” Keeping a critical diagnostic test from becoming deadly is a challenge, but RenalGuard Therapy, a unique automated process for the prevention of contrast-induced nephropathy (CIN), may be able to help.  While researching a recent white paper, I found that 13% of patients expos... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4190284 Mon, 22 Nov 2010 16:02:32 +0100 4190284 http://www.medworm.com/index.php?rid=4183257&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F11%2Favatar-fails-no-not-cameron-movie-but.html A story "Designed for Efficiency, New Computer Software at Health Dept. Misfires" by The Bay Citizen senior writer Katharine Mieszkowski appeared in the New York Times today regarding San Francisco's Dept. of Public Health."Misfires?"That's a mild term indeed. This story follows a script very familiar to Medical Informatics professionals:Poorly designed and implemented healthcare IT causes clinical and other chaos; Vendor and implementation leaders claims "glitches" and "teething pains" and blame the users for inexperience and/or incompetence; Vendor promises relief in the "next version"; These principals hope it all "goes away" until the system implodes on itself and needs replacement, starting the cycle anew, and/or-The principals hope newspapers stop paying attention to the chaos caused... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4183257 Fri, 19 Nov 2010 14:56:00 +0100 4183257 http://www.medworm.com/index.php?rid=4183249&cid=t_120514_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F11%2F19%2Fnursing-times-2010-vol-106-no-45%2F This article describes a telehealth project in Swansea where patients with heart failure and COPD were provided with telehealth monitoring equipment. Potential economic benefits and patient empowerment are highlighted as positive outcomes from the project. Contact the Library for a copy for this article. Filed under: Journals, Primary Care Tagged: COPD, Heart Failure, Telehealth (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4183249 Fri, 19 Nov 2010 09:49:55 +0100 4183249 http://www.medworm.com/index.php?rid=4172716&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fpetitioning-the-social-security-administration-for-compassionate-disability-for-hf-transplant-and-congenital-heartdisease-patients-3.mp4 The lag between recognition of disability status and receipt of Medicare is 24 months—a long period rife with events for the most seriously ill patients, with costly and tragic consequences. Learn more. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4172716 Tue, 16 Nov 2010 20:30:00 +0100 4172716 http://www.medworm.com/index.php?rid=4172046&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FmgcUL0WIJiU%2F By Caleb O. BrownSen. Mitch McConnell’s quick reversal on the subject of earmarks was a surprise, but that quick, largely symbolic win against profligate spending certainly won’t translate into a more permanent movement without sustained effort. Shortly after McConnell made his speech supporting a “moratorium” on earmarks, I spoke with Matt Kibbe of Freedomworks about turning the enthusiasm for smaller government into that enduring force. He said understanding public choice gives lawmakers a better shot at turning popular anger at government into reductions in its size and scope. Freedomworks recently held orientation sessions for freshmen members of Congress. A primer in public choice was on the agenda. Cato’s Government Failure: A Primer in Public Choice is... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4172046 Tue, 16 Nov 2010 14:08:36 +0100 4172046 http://www.medworm.com/index.php?rid=4172020&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F11%2Femrevent-survey-amateurism-bias-or.html At my post EHRevent.org: Web Site to Collect EHR Safety Reports, I wrote of my questions about a new organization, EHRevent.com, that seems to supercede or compete with the FDA's MAUDE and Medwatch medical device and medication adverse events reporting and analysis services.Reviewing the EHRevent report form on this day (archived here, PDF), I note the following multiple choice question on page 7 (emphasis mine):Notwithstanding the event you are reporting, has the adoption and use of an EHR by your practice added to patient safety, improved care or improved documentation? Select one option.o Yes, definitelyo Likelyo Not sureo No impactA bias and/or survey amateurism is clearly evident in this question. And perhaps something more?Missing is this option:o None of the above; EHR adoption did ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4172020 Tue, 16 Nov 2010 13:53:00 +0100 4172020 http://www.medworm.com/index.php?rid=4164529&cid=t_120514_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FsMX6_NHNJvo%2F Acute Liver Failure in the Emergency Department an EBM Review (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4164529 Sun, 14 Nov 2010 02:00:18 +0100 4164529 http://www.medworm.com/index.php?rid=4152736&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fheartfailure-trials-to-look-for-at-aha-2010-2.mp4 Watch out for the following top trials in heart failure at the AHA Scientific Sessions 2010 (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4152736 Wed, 10 Nov 2010 21:35:00 +0100 4152736 http://www.medworm.com/index.php?rid=4159276&cid=t_120514_107_f&fid=36672&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSciencebaseScienceBlog%2F%7E3%2FZfVMnbGkAHs%2Falcohol-effects-giant-testicles-pennycress-diesel.html An alcoholic FAQ – Aspirin and other drugs prevent the enzyme alcohol dehydrogenase (found in the stomach and liver) from breaking down alcohol, thus slowing the liver’s ability to metabolise alcohol and so it accumulates in your blood faster and has longer-lasting effects, which means you get drunk faster and say drunk longer, but you will have an almighty hangover too (one that aspirin will not cure) The biggest balls of all – The largest testicles by mass as a proportion of body mass are those of the bush cricket. According to behavioural ecologist Karim Vahed who has presumably had a good look, the tuberous bush cricket has testes accounting for 14% of its body mass. Making pennycress pay its way – I'd never heard of this weed until today, but apparently, p... Sciencebase Science Blog blogs http://www.medworm.com/rss/comments.php?id=4159276 Wed, 10 Nov 2010 16:29:19 +0100 4159276 http://www.medworm.com/index.php?rid=4151855&cid=t_120514_107_f&fid=36672&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSciencebaseScienceBlog%2F%7E3%2FZfVMnbGkAHs%2Falcohol-effects-giant-testicles-pennycress-diesel.html An alcoholic FAQ – Aspirin and other drugs prevent the enzyme alcohol dehydrogenase (found in the stomach and liver) from breaking down alcohol, thus slowing the liver’s ability to metabolise alcohol and so it accumulates in your blood faster and has longer-lasting effects, which means you get drunk faster and say drunk longer, but you will have an almighty hangover too (one that aspirin will not cure) The biggest balls of all – The largest testicles by mass as a proportion of body mass are those of the bush cricket. According to behavioural ecologist Karim Vahed who has presumably had a good look, the tuberous bush cricket has testes accounting for 14% of its body mass. Making pennycress pay its way – I'd never heard of this weed until today, but apparently, p... Sciencebase Science Blog blogs http://www.medworm.com/rss/comments.php?id=4151855 Wed, 10 Nov 2010 16:29:19 +0100 4151855 http://www.medworm.com/index.php?rid=4119583&cid=t_120514_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F10%2Fdying-to-be-beautiful-part-ii.html The thing about autumn - this season whose hallmark is death - is that it falls short of our expectations. It cuts short our sun-splashed summers, the boating and vacationing; the harvest is over, and whatever food we've stored from our gardens is it. Often it brings a sense of failure: failure to capitalize on a limitless amount of fun we could have had, work we could have done, yard improvements that languished and friendships we left fallow. In his classic book, Deep Survival: Who Lives, Who Dies and Why, author Laurence Gonzales tells us that our survival - eluding death when the moment beckons - depends mostly on our ability to change our expectations.  If you continue to exist in the old reality - "Holy crap! I am about to die! Here it comes!" - then you probably will do just th... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4119583 Thu, 28 Oct 2010 17:26:00 +0100 4119583 http://www.medworm.com/index.php?rid=4097860&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F10%2Fwhy-i-find-healthcare-it-industry-so.html At "Background On The 'Ecosystem' of Commercial Healthcare IT" I wrote:... In reading about HIT difficulties it is important to understand the “ecosystem” of commercial health IT, that is, the identity and nature of the principal constituents and stakeholders, and their interrelationships. Familiarity with this environment is useful in order to place the social and organizational issues affecting HIT diffusion in the proper context. By implication, I made the case that the commercial HIT ecosystem was far from healthy.Recently at Healthcare Renewal and at another blog I visit, HISTalk, frequented largely by IT industry workers and officials, I've noted an uptick in comments from anonymous commenters that resort to ad hominem, strawman arguments, or other forms of logical fallacy in a f... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4097860 Fri, 22 Oct 2010 12:54:00 +0100 4097860 http://www.medworm.com/index.php?rid=4155940&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fcollaborative-care-in-heartfailure-patients2.mp4 How does patient adherence—to both medications and physician recommendations—work? In her recent study, Dr Lynda Powell sought to understand the potential role of "collaborative care" in improving adherence and outcomes. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=4155940 Wed, 20 Oct 2010 19:25:00 +0100 4155940 http://www.medworm.com/index.php?rid=4082034&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F10%2F21st-century-emr-experiments-screwing.html I was astounded to read the following passage in an interview of the current chief medical information officer at Detroit Medical Center ("DMC") Detroit, MI:DMC tried CPOE in 2003 and said it would regroup and try it again. What lessons were learned from that first attempt? In 2003 we did try at one hospital — a more community-based hospital — on two units. We did it on our rehab unit, the psych unit. I think the first lesson we learned there was that it was really just designed as, or worked out as, an IT project. I mean, it was really IT-led and there wasn’t clinical involvement from the get-go. There wasn’t really a leadership pattern that had physician and nursing components to it. There wasn’t a design phase that included a lot of clinicians. There wasn’t leadership buy-in... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4082034 Tue, 19 Oct 2010 16:23:00 +0100 4082034 http://www.medworm.com/index.php?rid=4077535&cid=t_120514_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F10%2Fletting-go-and-letting-god.html We weren’t originally designed to keep everything in play all the time. Something got broken in us when we left the Garden of Eden. We stopped trusting that God was good and that we were the apple of His eye. We have this suspicious feeling about letting go and letting God take us through the natural course of things.  ~ from (in)Courage, posted by Bonnie GraySometimes God fills your hands so full, you are forced to realize you cannot juggle everything yourself.  Grief fills up your heart until it finally overflows and you cry embarrassing tears in front of people you would never cry with normally (like, say, your doctor).  And then the cup you thought was full of tears is miraculously overflowing with joy, and the laughter leaps out of you even though your sister-in-law i... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4077535 Mon, 18 Oct 2010 16:37:00 +0100 4077535 http://www.medworm.com/index.php?rid=4065353&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FoTBKt6_Pu-Y%2F By Tad DeHavenA study from the American Institutes of Research finds that federal and state governments have wasted billions of dollars on subsidies for students who didn’t make it past their first year in college. The federal total for first-year college drop outs was $1.5 billion from 2003 to 2008. Due to data limitations, the figures are only for first year, full-time students at four-year colleges and universities. Community colleges have even higher drop-out rates, and part-time students or students returning to college are more likely to drop out. Therefore, the numbers in the report are “only a fraction of the total costs of first-year attrition the nation and the states face.” Moreover, it doesn’t include the cost for students who drop out some time after their sophomore ye... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4065353 Wed, 13 Oct 2010 14:50:26 +0100 4065353 http://www.medworm.com/index.php?rid=4055717&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbasic-health-education-not-so-basic%2F2010.10.10 The past two weeks I’ve been the “dayfloat” resident on the cardiology inpatient service. With the 30-hour-shift work “restrictions” placed on medical residents, there has been a need for new systems of care to ensure the safety of newly admitted patients and cardiology dayfloat is one of them. My job is to round with the post-call team, help them get out of the hospital on time, and then take care of their patients through the end of the work day. It’s a fairly easy rotation, as they go, though because I “float” from one team to another without patients of my own, it’s also not the most satisfying. Towards the end of my two week rotation, I was paged by a nurse because a patient’s husband wanted an update on his wife’s condition. Glancing at my “signout” — a on... Better Health blogs http://www.medworm.com/rss/comments.php?id=4055717 Sun, 10 Oct 2010 20:00:29 +0100 4055717 http://www.medworm.com/index.php?rid=4040549&cid=t_120514_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FUg37LV4Smkk%2F By Thomas FireyThe left-wing blogosphere and left-leaning newspapers have spent the past few days joyously incensed over the story of a Tennessee city fire department that allowed a home to burn because the homeowner hadn’t paid his annual fire fee. AlterNet’s Jonathan Holland titled-and-teased his post on the fire: Ayn Rand Conservatism at Work — Firefighters Let Family’s House Burn Down Because Owner Didn’t Pay $75 Fee Talk of limited government is appealing until you see what it actually means in practice: a society in which it’s every man for himself. ThinkProgress’s Zaid Jilani thundered that the fire demonstrates that there are two competing visions of American society: One, the conservative vision, believes in the on-your-own society, ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4040549 Thu, 07 Oct 2010 17:33:57 +0100 4040549 http://www.medworm.com/index.php?rid=4036566&cid=t_120514_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F10%2Fcongestive-heart-failure-signs-symptoms%2F Cheyne-Stokes respiration (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4036566 Wed, 06 Oct 2010 06:17:37 +0100 4036566 http://www.medworm.com/index.php?rid=3998990&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-old-age-be-a-cause-of-death%2F2010.09.24 The Washington Post asks whether “old age” should be reconsidered as a legitimate cause of death for the elderly. Because more people are dying at very advanced ages with multiple system failure, it’s often harder for physicians to pinpoint the specific underlying cause, but using “old age” as a catch-all term could make mortality data less meaningful, the article said. An upcoming revision of the International Classification of Diseases might provide some guidance: “Each revision of the ICD is the right moment to reconsider this question,” the co-head of the ICD’s mortality statistics committee told the Post. (Washington Post) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3998990 Fri, 24 Sep 2010 12:00:00 +0100 3998990 http://www.medworm.com/index.php?rid=3999321&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2FBI-gm3gFE_g%2F Why do so many people fall short of their goals, even when they actively prepare and plot out a course of action?  The answer is surprisingly simple. Our motivations are flawed. Oh, we formulate our plans well enough.  We envision the end results.  We plan our steps out carefully.  But there is one crucial element that we often forget.  And that is our motivation.  Or, more importantly, the fact that our individual motivations are based on words, and that these words have meanings. This probably doesn’t surprise you.  Of course words have meanings.  There are entire dictionaries that prove that fact. But I’m not talking about meanings in the literal sense.  I’m talking about meanings in the personal sense.  For many of us, words carry several layers of contextual meaning an... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=3999321 Fri, 24 Sep 2010 06:16:42 +0100 3999321 http://www.medworm.com/index.php?rid=3993813&cid=t_120514_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F09%2F22%2Fjournal-of-the-american-medical-association-2010-vol-304-no-12%2F This article determines the value of self-management counselling plus heart failure education, compared with heart failure education alone, for the primary end point of death or heart failure hospitalization. An NHS Athens password is required to access this article, alternatively contact the Library for a copy of this article. Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Heart Failure, Patient Counselling, Patient Education, Randomised Controlled Trials (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3993813 Wed, 22 Sep 2010 06:24:52 +0100 3993813 http://www.medworm.com/index.php?rid=3976500&cid=t_120514_87_f&fid=39261&url=http%3A%2F%2Fvactruth.com%2F2010%2F09%2F16%2Fbrain-swelling-and-damage-associated-with-vaccines%2F Catherine Frompovich Vactruth.com 09/16/2010 Brain Swelling and Damage Associated With Vaccines – Inappropriately Labeled Shaken Baby Syndrome Advisory Commission on Childhood Vaccines Meeting Sept. 2-3, 2010, Rockville, MD With all due respect to what’s been presented at this meeting, the Advisory Commission on Childhood Vaccines needs to hear about the unfortunate miscarriage of justice against parents whose children suffer brain swelling vaccine damage and are legally prosecuted by authorities with such charges as Shaken Baby Syndrome (SBS). Munchausen by Proxy (MSBP), Fictitious Induced Illness (FII), Non-Accidental Injury (NAI), Physical Abuse, Failure to Protect, and Child Abuse. Numerous infants and toddlers suffer brain trauma with or without hemorrhages; brain swelling (ed... vactruth.com blogs http://www.medworm.com/rss/comments.php?id=3976500 Thu, 16 Sep 2010 14:25:40 +0100 3976500 http://www.medworm.com/index.php?rid=3973138&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2FcoYRGgQ0Yok%2F Stephen R. Covey is the author of the best-selling book “The Seven Habits of Highly Effective People.” His book has sold more than 15 million copies around the world since it was first published in 1989. Covey believes that success occurs when you align your values with the universal and timeless principles that exist in our world. Covey teaches that values govern people’s behavior, but principles ultimately determine the consequences. Covey has also written several other books including: “First Things First,” “Principle-Centered Leadership,” “The Seven Habits of Highly Effective Families,” and “The 8th Habit.” Covey is currently a professor at the Jon M. Huntsman School of Business at Utah State University. There’s a lot we can learn from Stephen Covey, so without ... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=3973138 Thu, 16 Sep 2010 05:47:49 +0100 3973138 http://www.medworm.com/index.php?rid=3969204&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2Fep8O7HNBpMM%2F Conclusion Your potential is limitless. What you can do is only limited by your belief. Try, try and try again until you find your way and start moving on towards your dreams! If you liked this post and want to read more like it visit LookingToBusiness. Daniel M. Wood writes about Sales Techniques, Motivation and Success . (Source: PickTheBrain | Motivation and Self Improvement) PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=3969204 Wed, 15 Sep 2010 04:42:35 +0100 3969204 http://www.medworm.com/index.php?rid=3954259&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatients-starved-for-time-with-the-doctor%2F2010.09.09 If you’re into health care consumerism, you’ll enjoy my guest blog post at CDHC Solutions magazine. CDHC Solutions focuses on consumer-driven health plans. Consumer-driven plans are a form of “high deductible” health coverage that is more popular than ever. For whatever you want to say about these plans, one thing is clear: They don’t solve the fundamental problem of patients not having enough time with their doctors. Here’s a taste of what I wrote: Researchers have been trying to pinpoint the impact of this time starvation on the quality of medical care, and they’re finding disturbing results. A recent study in the Annals of Internal Medicine found that because of time pressures and related factors, doctors deliver “error-free” care as rarely as 22 percent of the ti... Better Health blogs http://www.medworm.com/rss/comments.php?id=3954259 Thu, 09 Sep 2010 19:00:36 +0100 3954259 http://www.medworm.com/index.php?rid=3946401&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F09%2Fexample-of-inexcusable-health-it-glitch.html An example of an inexcusable health IT "glitch." Reported to FDA MedWatch: The Eclypsis Sunrise Clinical Manager EMR/CPOE is in use at [snip] Hospital.This system appears to have a serious deficiency: an apparent lack of date constraint validity checking when users are seeking information on prior medication orders and administration."BCS", an 84 y.o. white female, was admitted 5/19/10 for cerebrovascular problems (TIA). An iatrogenic cerebral hemorrhage and emergency craniotomy occurred due to failure to reconcile home meds, resulting in an erroneous discontinuation of her heart rhythm medication, and then heparinization due to the resulting atrial fibrillation.Famotidine IV was started prophylactically on admission 5/19 to prevent gastric problems, but was discontinued an... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3946401 Wed, 08 Sep 2010 15:28:00 +0100 3946401 http://www.medworm.com/index.php?rid=3922055&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Fesc-2010-pina-blog.mp4 Two understudied groups were the focus of papers presented in Stockholm that underline our incomplete understanding of biomarkers and of left ventricular hypertrophy in female athletes. (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=3922055 Wed, 01 Sep 2010 12:30:00 +0100 3922055 http://www.medworm.com/index.php?rid=3911651&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F08%2Fcerners-blitzkrieg-on-london-wheres-raf.html In the Battle of Britain in WW2, the Royal Air Force (RAF) heroically repelled a foreign invasion of the UK.The Supermarine Spitfire, key defense tool in the Battle of Britain. (Worked without major glitches.)Now, the invasion is American, and the battlefield is healthcare...I have often said health IT remains an experimental technology. However, the technology is being inexplicably force-fed with a vengeance to hospitals by IT companies and governments, force-fed with respect to the actual evidence of benefit.In the case of the NPfIT in the UK, we have items such as those below from a 2009 government report "The National Programme for IT in the NHS: Progress since 2006 - Public Accounts Committee." Emphases in italics mine: The termination of Fujitsu's contract has caused uncertainty amon... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3911651 Fri, 27 Aug 2010 12:46:00 +0100 3911651 http://www.medworm.com/index.php?rid=3899667&cid=t_120514_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2FnojzfXuNL_I%2F Do you think your life is a failure? Why? Is it because you haven’t accomplished any of your goals? Or because you aren’t financially stable? Don’t have a beautiful home? People can be very dramatic. We’ll stub our toe on the way out the door in the morning, and exclaim “Life sucks!” We’ll create a goal to become a self-made millionaire, won’t work very hard to achieve the goal, and then 2 months later when we discover that our checking account has a balance of $3.24, scream, “I can’t do this!! I’m a failure!” We use the word failure a lot. I’d venture to say we use it too much. And what does this word mean, anyway? What exactly is “failure”? Well, since I don’t know everything (sometimes), let’s consult with the dictionary. failure (n.) – an act or ... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=3899667 Wed, 25 Aug 2010 05:40:56 +0100 3899667 http://www.medworm.com/index.php?rid=3891657&cid=t_120514_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F08%2Fare-computers-in-medicine-narcotic-why.html This article shows the muddled thinking behind the health IT mania. My observation: when you see the word "revolutionary" in the same paragraph as health IT you're dealing with hysterics.The "patient from hell" asks:Why is the road to electronic healthcare so much more rocky than computerising other bits of the economy? Other professions, including bankers, accountants and lawyers, have made the jump, some 30 years after the advent of personal computers. Even musicians, poets, journalists, artists, philosophers and MPs have got up to speed."Even?" Yes, and you can train a dog to fetch a stick, therefore you can train a potato to dance.Why is the road to HIT more rocky than the road to computer poetry or art?Perhaps because the endeavors of clinicians are not like those of a musician or p... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3891657 Sun, 22 Aug 2010 10:48:00 +0100 3891657 http://www.medworm.com/index.php?rid=3882589&cid=t_120514_7_f&fid=38807&url=http%3A%2F%2Fmedia.theheart.org%2Fpodcasts%2FHeart-failure-and-transplantation-with-Dr-Ileana-Pina%2FMedia%2Farbs-and-lungcancer-risk-in-a-new-metaanalysis-by-dr-ike-sipahi-2.mp4 Heart failure and transplantation with Dr Ileana Piña - Cardiologist and heart failure and transplantation specialist, Dr Ileana Piña, from Case Western Reserve University shares her views on cardiology news and events (Source: Blogs@theHeart.org) Blogs@theHeart.org blogs http://www.medworm.com/rss/comments.php?id=3882589 Thu, 19 Aug 2010 19:50:00 +0100 3882589 http://www.medworm.com/index.php?rid=3876601&cid=t_120514_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2Fcharlie-chaplin-on-failure%2F Failure is unimportant. It takes courage to make a fool of yourself. - Charlie Chaplin Post from: BlissTree Charlie Chaplin on Failure (Source: Healthbolt) Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3876601 Tue, 17 Aug 2010 11:00:40 +0100 3876601 http://www.medworm.com/index.php?rid=3872556&cid=t_120514_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-foreign-medical-graduates-doctor-better%2F2010.08.16 Yes, according to a study in today’s Health Affairs. (The full text of the study is available only to subscribers, but Kaiser Health News Daily has a good summary of its findings and links to other news reports.) The study compares inpatient death rates and lengths of stay for patients with congestive heart failure or acute myocardial infarction when provided by U.S. citizens trained abroad, citizens trained in the United States, and non-citizens trained abroad. Treatment was provided by internists, family physicians, or cardiologists. The differences were striking, according to the authors: “Our analysis of 244,153 hospitalizations in Pennsylvania found that patients of doctors who graduated from international medical schools and were not U.S. citizens at the time they entered... Better Health blogs http://www.medworm.com/rss/comments.php?id=3872556 Mon, 16 Aug 2010 14:00:00 +0100 3872556