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 'hospital,'. Tue, 13 Oct 2009 17:54:31 +0100 http://www.medworm.com/index.php?rid=2886362&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fpatient-chest-ct.html Originally published in Journal Watch Emergency Medicine by Richard D. Zane, MD, FAAEM Repeat chest CT angiography scans have a low yield for diagnosing pulmonary embolism. Computed tomography (CT) angiography of the chest is considered the definitive test for pulmonary embolism (PE) in the emergency department. Although CT angiography is readily available, it exposes patients to ionizing radiation and iodinated contrast dye (JW Emerg Med Aug 3 2007). In a prospective study of 675 ED patients who underwent chest CT angiography for the work-up of PE, researchers assessed rates of repeat chest CT angiography. During 5 years of follow-up, 33% of patients underwent repeat chest CT angiography. Of the patients who underwent repeat testing, 22% were women younger than 40. Overall, 5.3% of ind... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2886362 Tue, 13 Oct 2009 15:00:59 +0100 2886362 http://www.medworm.com/index.php?rid=2882963&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Frapid-viral-testing-kids-uris-er.html Originally published in MedPage Today by Todd Neale, MedPage Today Staff Writer Rapid viral diagnostic testing did not reduce the burden of treating children with respiratory symptoms and fever in the emergency department, according to a Cochrane Review meta-analysis. Pooling the results of four trials, researchers found a significant reduction in the use of chest radiography (RR 0.77, 95% CI 0.65 to 0.91), but the reduction was short of the 25% deemed clinically meaningful, according to Quynh Doan, MDCM, of British Columbia Children’s Hospital in Vancouver, and colleagues. There was no effect on the primary outcome — antibiotic use — or on other secondary outcomes such as blood and urine testing, length of ED stay, or postdischarge visits to a primary care physician or ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2882963 Mon, 12 Oct 2009 15:00:15 +0100 2882963 http://www.medworm.com/index.php?rid=2879371&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fprimary-care-doctors-patients-er.html by Edwin Leap, MD One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why. Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency departments provide care to all, regardless of their ability to pay. They do this because of a law called EMTALA, enacted in 1986. The Emergency Medical Treatment and Active Labor Act became law due to the ‘dumping’ of patients from hospital to hospital for inability to pay. It was a good idea, in theory. Prior to EMTALA, very sick individuals or women in act... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2879371 Fri, 09 Oct 2009 19:00:13 +0100 2879371 http://www.medworm.com/index.php?rid=2879372&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fventilating-patients-spread-h1n1-flu-hospitals.html Originally published in MedPage Today by Crystal Phend, MedPage Today Senior Staff Writer Plumes of virus-laden air shooting out from the masks of patients undergoing noninvasive ventilation could put healthcare workers at increased risk for infectious diseases such as the pandemic H1N1 (swine) flu, researchers said. A positive-pressure ventilation mask on a simulated patient yielded a jet of exhaled air extending 2 to 3 feet from the face, according to David S. Hui, MD, of the Chinese University of Hong Kong and Prince of Wales Hospital in Hong Kong, and colleagues. Higher pressure during inhalation increased the size of the plume and the area of the room it would contaminate, they wrote in the October issue of Chest. Although there’s little evidence for the use of this treatment ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2879372 Fri, 09 Oct 2009 17:00:59 +0100 2879372 http://www.medworm.com/index.php?rid=2875932&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fhealth-care-professional-diagnosed-breast-cancer.html A social worker at a Boston hospital, who counsels patients with cancer, discovers that she herself has breast cancer. She tells her compelling story to Better Health’s Val Jones. You can join Val and myself at Blog World Expo 2009 on October 15th in Las Vegas, where we will participate in panel discussions exploring the intersection between blogging and health care. Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:How to provide safe, quality hospital care by increasing transparencyMedical bloggers at Blog World Expo, October 15th, 2009Does a breast MRI have any benefit for patients with breast cancer?A breast cancer survivor on health care reformAre we finding too much breast cancer? (Source: Kevin, M.D. - Medical W... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2875932 Fri, 09 Oct 2009 11:00:47 +0100 2875932 http://www.medworm.com/index.php?rid=2871588&cid=t_270717_87_f&fid=38113&url=http%3A%2F%2Fblogs.consumerreports.org%2Fhealth%2F2009%2F10%2Fcatch-flu-influenza-mask-contamination-sneeze-cough-h1n1.html Hate it when somebody coughs right into your face and eyes? You're not just germ-phobic, that may be the most likely way to transmit influenza, according to a newly published study. Researchers from UC-Berkley’s School of Public Health and the University of Illinois at Chicago’s School of Public Health concluded that close contact spraying of respiratory droplets with the influenza virus carried the greatest risk of infection, followed by hand contact with contaminated surfaces, and inhaling particles carrying the virus. The study was published in Risk Analysis: An International Journal published by the nonprofit Society for Risk Analysis, and used mathematical modeling to examine the theoretical risk of catching an influenza A virus—a type of influenza virus that includes the n... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=2871588 Wed, 07 Oct 2009 17:39:41 +0100 2871588 http://www.medworm.com/index.php?rid=2871619&cid=t_270717_88_f&fid=34729&url=http%3A%2F%2Fallscrubbedup.blogspot.com%2F2009%2F10%2Fhow-to-navigate-hospital-dos-and-donts.html Great article on understanding hospitals, the do's, don'ts, knows and nots.While hospitals can provide a secure refuge when you are seriously ill, remember that hospitals can be scary places! For one thing, the very fact that your doctor wants you to be admitted into hospital means that he thinks you are quite ill and this in itself can generate considerable anxiety! Even worse, hospitals can be very unfriendly places. Not only do hospitals strip you of all your dignity (having to wear a half-open hospital gown which barely covers your body properly does not do much good to your ego!), but also they subject you to painful routines and humiliating rituals performed by a retinue of strangers. Moreover, you could be woken up at any time of the day, (or night), deprived of your privacy, forced... All Scrubbed Up blogs http://www.medworm.com/rss/comments.php?id=2871619 Wed, 07 Oct 2009 16:34:00 +0100 2871619 http://www.medworm.com/index.php?rid=2871810&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FZ3Qe5zM6HCw%2F How big a network will the Health Internet (aka National Health Information Network) be? My BOTE (back-of-the-envelope) calculation is that this network could consist of about 301 million nodes.  Here’s my math (pls. clarify or amplify): 300 million individuals in U.S. 700 K doctors 5 K hospitals 295 K — other B2B healthcare entities Very rough…but I hope you get the point. So let’s put into perspective press releases from Google or Microsoft announcing that they have developed new “partnerships” (i.e.nodes in the network) for Google Health or Microsoft HealthVault. As an example, today Google announced partnerships with APWU Health Plan and Harvard Pilgrim Health Plan. (more…) Article Series - Healthcare Crosses the Chasm to the Network EconomyIntro to a New S... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2871810 Tue, 06 Oct 2009 23:01:41 +0100 2871810 http://www.medworm.com/index.php?rid=2871551&cid=t_270717_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Fbreastfeeding-success-in-the-hospital%2F Here’s another guest post from pediatrician and author Dr. Marianne Neifert. I enjoyed her new book so much that not only did I review Great Expectations: The Essential Guide to Breastfeeding on my blog, I also took the time to post my first-ever review on Amazon.com. Today she talks about how breastfeeding success begins in the hospital: Five Hospital Practices that Extend Your Duration of Breastfeeding Photo by Vedrana Bosnjak Your hospital experience — brief as it may be — can have a powerful impact on your long-term breastfeeding success. Making hospital changes in maternity care practices has been shown to significantly increase breastfeeding initiation and duration rates. The Baby-Friendly Hospital Initiative (BFHI) — launched in 1991– is a worldwide cam... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=2871551 Tue, 06 Oct 2009 20:44:58 +0100 2871551 http://www.medworm.com/index.php?rid=2871504&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fincident-reporting-effective-reducing-medical-errors-increasing-patient-safety.html by Bob Wachter, MD When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons – a focus on bad systems more than bad people, the importance of teamwork, the use of checklists, the value of simulation training – have served us well. But one lesson from aviation has proved to be wrong, and we are continuing to suffer from this medical error. It was an unquestioning embrace of using incident reporting (IR) systems to learn about mistakes and near misses. The Aviation Safety Reporting System, by all accounts, has been central to commercial aviation’s remarkable safety record. Near misses and unsafe conditions are reported... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2871504 Tue, 06 Oct 2009 19:00:19 +0100 2871504 http://www.medworm.com/index.php?rid=2876137&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F10%2F06%2Fsapphire-hospital-emr%2F If you’ve read this blog for any length of time. You know a couple things that I rarely ever do. One is talk about hospital EMR systems (I prefer ambulatory EMR). The other is endorse specific EMR vendors (too many individualized factors). I’m not really going to do either of them here in this post either. However, it might sound like it, so I don’t want people to be confused;-) A few weeks ago, I went to the HIMSS Hittin’ the Streets even in Las Vegas. I’ll admit that my driving motivation for attending the event was to be able to hear Marc Probst speak about EMR and ARRA. Since I inundated you with posts from that talk by Marc Probst, you can safely assume that attending was a great decision. As part of my agreement to attend the event for free, I agreed to ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2876137 Tue, 06 Oct 2009 15:12:08 +0100 2876137 http://www.medworm.com/index.php?rid=2865766&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FJX6LBC4caEY%2F If you’ve read this blog for any length of time. You know a couple things that I rarely ever do. One is talk about hospital EMR systems (I prefer ambulatory EMR). The other is endorse specific EMR vendors (too many individualized factors). I’m not really going to do either of them here in this post either. However, it might sound like it, so I don’t want people to be confused;-) A few weeks ago, I went to the HIMSS Hittin’ the Streets even in Las Vegas. I’ll admit that my driving motivation for attending the event was to be able to hear Marc Probst speak about EMR and ARRA. Since I inundated you with posts from that talk by Marc Probst, you can safely assume that attending was a great decision. As part of my agreement to attend the event for free, I agreed to ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2865766 Tue, 06 Oct 2009 15:12:08 +0100 2865766 http://www.medworm.com/index.php?rid=2865615&cid=t_270717_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F10%2Fboard-of-trustees-or-social-club-for.html We just posted about the unlikely appointment of one Mr Robert K Steel as a trustee of the Hospital for Special Surgery in New York. Mr Steel appears to have no particular expertise or experience in health care, and no special affinity for its values. On the other hand, Mr Steel was briefly the CEO of Wachovia who presided over that company's demise, despite his avowed goal of keeping it independent. Previously, he served as an Under Secretary of the Treasury during Secretary Henry Paulson's controversial bail-out of financial institutions. He also was Chairman of the Board of Trustees of Duke University during the time of the lacrosse scandal, and pledged his full support to the actions of its President (whom he had a personal role in hiring), including those that seemingly put preserving... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2865615 Mon, 05 Oct 2009 20:22:00 +0100 2865615 http://www.medworm.com/index.php?rid=2862424&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fflu-h1n1-influenza-vaccine-recommendations-doctors-health-care-workers.html The following is part of a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP In the Fall of 2009, we physicians should perhaps change the Biblical phrase, “Physician, heal thyself” to “Physician, immunize thyself” and then follow the phrase twice – once for seasonal influenza and once for H1N1. To date, physicians and other health care workers have too often been lax about following this advice, and the past data for immunization of health care personnel against seasonal flu leave much to be desired: only about 40-45 percent of health care personnel are immunized each year, according to the Centers for Disease Control. Equally concerning is the fact that at least 70 percent of health care personnel continue to work despite be... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2862424 Mon, 05 Oct 2009 19:00:25 +0100 2862424 http://www.medworm.com/index.php?rid=2862604&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FNHWsxnws2mA%2F Here’s the big idea: accountable care organizations (ACOs) are about creating accountability. ACOs of various types are being proposed in national health reform legislation. For all you ever wanted to know about ACOs, read How to Create Accountable Care Organizations from the Center for Healthcare Quality and Payment Reform.   I spent an hour and a half poring over the details of this excellent report written by Harold Miller. My mistaken impression has been to focus on the organizational form of ACOs, rather than their objectives.  Organizational form is relevant in understanding ACOs, but primarily as a means toward creating accountability, not the end in itself.  Thus, expect to see many varying types of ACOs emerging based on local needs and characteristics. I initially a... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2862604 Mon, 05 Oct 2009 18:26:29 +0100 2862604 http://www.medworm.com/index.php?rid=2862425&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fsurgical-masks-effective-n95-respirators-prevent-influenza.html Originally posted in Insidermedicine Nurses are as well protected from influenza with a standard surgical mask as with an N95 respirator while caring for febrile patients, according to a randomized trial published in the November 4 issue of the Journal of the American Medical Association. Here are some guidelines for infection control among hospital patients with confirmed or suspected H1N1 influenza, from the Centers for Disease Control and Prevention: • Respiratory hygiene/cough etiquette infection control measures should be implemented at the first point of contact with a potentially infected person • Any patients who have a confirmed, probable, or suspected case of novel H1N1 and present for care at a healthcare facilities should be placed directly into individual rooms and the ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2862425 Mon, 05 Oct 2009 17:00:21 +0100 2862425 http://www.medworm.com/index.php?rid=2862445&cid=t_270717_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F10%2Ftrustee-of-what-caliber-for-hospital.html The Hospital for Special Surgery in New York, a prestigious institution focused on orthopedics and rheumatology, closely affiliated with Weill Cornell Medical College, just announced its newest trustee, whose qualifications for the position turn out to be just a wee bit curious. Here they are as described by the press release:He is a former CEO of WachoviaHospital for Special Surgery announced today that Robert K. Steel, former President and Chief Executive Officer of Wachovia Corporation, has been named a member of the hospital's Board of Trustees.Steel facilitated Wachovia's merger with Wells Fargo to create the second-largest retail brokerage in the country.Before then, he served in the Treasury DepartmentPrior to running Wachovia, Steel served in the U.S. Treasury Department as Under S... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2862445 Mon, 05 Oct 2009 17:00:00 +0100 2862445 http://www.medworm.com/index.php?rid=2862426&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2F1918-flu-pandemic-increase-risk-heart-disease.html Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent Men who were in utero during the peak of the 1918-1919 flu pandemic were at increased risk of heart disease when they reached their 60s, 70s, and 80s, researchers said. In those men, the rate of heart disease was more than 23% higher than among those whose mothers were not pregnant during the pandemic’s virulent phase in the fall of 1918, according to Caleb Finch, PhD, of the University of Southern California, and colleagues. The main factor in the increase was a 32.7% rise in the rate of ischemic disease, Finch and colleagues reported online in the Journal of Developmental Origins of Health and Disease. The 1918 pandemic was the most deadly on record, with mortality estimated as high... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2862426 Mon, 05 Oct 2009 15:00:20 +0100 2862426 http://www.medworm.com/index.php?rid=2862439&cid=t_270717_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F05%2Fnursing-times-2009-vol-105-no-38%2F This article describes the implementation of a specialist community team working with support from acute services to manage COPD patients at home. Introduction of this service has resulted in a sustained reduction in hospital admissions over one year. Posted in Current Awareness, Journals Tagged: Community Services, COPD, Hospital Admissions, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2862439 Mon, 05 Oct 2009 07:10:25 +0100 2862439 http://www.medworm.com/index.php?rid=2858610&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fanalysis-senate-finance-committee-health-care-reform-bill.html Originally posted in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent The Senate Finance Committee finished work on its healthcare reform bill in the wee hours of Friday morning, paving the way for a committee vote next week. After considering hundreds of amendments, the committee is now waiting for a cost-estimate from the Congressional Budget Office (CBO) before it takes a final vote to report the bill to the full Senate. “I have never felt more proud because, tonight, we take another step toward putting this country on a path to a healthy future,” said Sen. Max Baucus (D-Mont.), chairman of the committee. window.onload = function () { var q = (document.URL); document.getElementById("mptplayer").src += q; } The president issued a statement followin... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2858610 Sat, 03 Oct 2009 19:00:55 +0100 2858610 http://www.medworm.com/index.php?rid=2876140&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F10%2F03%2Fhis-emr-buying-seminar%2F As you know, I try to save my simpler posts for the weekend when less people are reading. Although, I do tend to ramble on occasion. Thankfully I type reasonably fast. In some of my EMR readings of late I came across something that sounds similar to what I’ve talked about doing for EMR. They call it an EMR Buying Seminar. Sure, there have been a ton of EMR seminars lately. In fact, I did an EMR presentation in Austin myself. However, what struck me about this seminar is that it said it was the 10th annual EMR Buying Seminar. That’s a lot of years. Of course, the thing I like least about this seminar is that it’s focused on hospital EMR systems. If you’ve read here much, you know I’m more of an ambulatory EMR kind of guy. Certainly there’s a lot of cross ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2876140 Sat, 03 Oct 2009 15:28:53 +0100 2876140 http://www.medworm.com/index.php?rid=2857464&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FOvdFmZQEe9o%2F As you know, I try to save my simpler posts for the weekend when less people are reading. Although, I do tend to ramble on occasion. Thankfully I type reasonably fast. In some of my EMR readings of late I came across something that sounds similar to what I’ve talked about doing for EMR. They call it an EMR Buying Seminar. Sure, there have been a ton of EMR seminars lately. In fact, I did an EMR presentation in Austin myself. However, what struck me about this seminar is that it said it was the 10th annual EMR Buying Seminar. That’s a lot of years. Of course, the thing I like least about this seminar is that it’s focused on hospital EMR systems. If you’ve read here much, you know I’m more of an ambulatory EMR kind of guy. Certainly there’s a lot of cross ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2857464 Sat, 03 Oct 2009 15:28:53 +0100 2857464 http://www.medworm.com/index.php?rid=2857378&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fhealth-care-reform-analysis-insurance-hospital-executive.html by Marie Cooper I have been in senior executive management in both managed care and a major hospital system. I find the hysteria over “reform” bitterly amusing because it is so misdirected. The real problem with health care in America? Greed, indifference and incompetence, pure and simple. But not in the places everyone is pointing. Insurer side Insurance companies have to maximize their revenue because they answer to their boards. They are in no rush to fix claims systems that make copious errors and delay payments to providers. There are hundreds of claims processing software programs out there. Some are acceptable, some are useless. None are really good or efficient. And there is the human error factor. A careless mistake by an apathetic claims processor can create payment p... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2857378 Sat, 03 Oct 2009 11:00:22 +0100 2857378 http://www.medworm.com/index.php?rid=2855500&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fmayo-clinic-opposes-public-plan-dissonance-facing-progressive-health-reformers.html Health reformers often cite the Mayo Clinic as a model for how all medical practices should look like. It’s often mentioned by the President, and indeed, studies do back up their claims of higher quality, lower cost, care. But in a recent piece from the Washington Post, some are questioning whether the stellar results from the Mayo are due to demographics. The Mayo Clinic has a very low Medicaid patient population, perhaps because they make these patients pay a premium to use the hospital’s services. To me, the most telling statistic is that Mayo Clinic outposts in other areas of the country, like Jacksonville and Phoenix, have spending rates comparable to local hospitals. In any case, there’s a bit of a dissonance for progressive reformers who espouse the Mayo way. The ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2855500 Fri, 02 Oct 2009 11:00:17 +0100 2855500 http://www.medworm.com/index.php?rid=2851694&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F10%2Fsurgery-1930s.html Some seriously cool silent videos showing what surgery was like in the 1930’s. Removal of a tuberculoma from the brain: Caesarean birth, in the pre-WWII era: (via Wired and MedGadget) Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:Brain surgery in a dayC-sections and individual insuranceRIP VBAC?Changing genders, without surgeryScheduled for knee surgery, had a brain operation instead (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2851694 Thu, 01 Oct 2009 11:00:15 +0100 2851694 http://www.medworm.com/index.php?rid=2846301&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Funnecessary-testing-er.html Plenty, if you ask the people most familiar with the situation, the emergency physicians themselves. According to a survey from Emergency Physicians Monthly , many tests performed in the ER are deemed unnecessary to good patient care. Here’s how doctors responded to the following question: “Given that in a typical shift of eight hours you see an average of two patients per hour (16 patients/shift), could you have eliminated any of the following tests and/or treatments without compromising the quality of care? If so, how many of each?” As you can see, laboratory tests and CT scans comprised the greatest proportion of unnecessary tests. It’s been well-debated on this blog as to why, but one reason is that there’s a mentality that a wide net has to be cast, so ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2846301 Wed, 30 Sep 2009 11:00:50 +0100 2846301 http://www.medworm.com/index.php?rid=2846396&cid=t_270717_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F09%2Fcould-health-care-help-fund-2016.html With the recent report in Crain's Chicago Business that disclosed that health care costs in Chicago are 25% above those in nearby cities, the use of health care to help fund the 2016 Olympics might not be as far fetched as it sounds. While is it convenient for journalists and policy pundits to constantly point fingers at doctors who order too many tests as the sole cause of the explosion in health care costs, we must not forget other reasons our health care costs in Chicago might be uniquely situated to assist in that process. It is an inconvenient truth that the city of Chicago has the highest total sales tax of all major U.S. cities. It is also one of the most complex. 10.25% is levied on all non-perishable goods purchased, while 2% is levied on qualifying food, drugs, medicines and medi... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2846396 Wed, 30 Sep 2009 10:32:00 +0100 2846396 http://www.medworm.com/index.php?rid=2846302&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fhospice-doctors-relying-symptom-scores-assess-pain.html by Eric Widera, MD A recent issue in The Lancet included an article entitled “The Death of Ivan Ilyich and pain relief at the end of life.” This is a thought provoking article focused on the question of whether there is overuse of pharmaceuticals to treat various forms of suffering in hospice and palliative medicine. The authors argue that a good death, as seen through their interpretation of The Death of Ivan Ilyich, may include physical and existential suffering. Tolstoy’s character finds redemption in his suffering; he remains conscious through the agony of a prolonged and painful death and ends up with a greater understanding of life. The authors further argue that such a moment of clarity may no longer occur if we rely on practices that promote complete freedom from suffering t... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2846302 Tue, 29 Sep 2009 19:00:01 +0100 2846302 http://www.medworm.com/index.php?rid=2842546&cid=t_270717_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F09%2Fi-dont-know-why-im-in-hospital.html Continuing to tweak my thoughts about doctor-patient diagnostic discordance (i.e. doctor says: she's in the hospital for X; patient says: my doctor told me I'm in the hospital for Y), this time for the International Conference on Communication in Healthcare to be held Oct 4-7 in Miami Beach. I will be heading to the sukkah, not to the surf (I'm arriving 10/5 if anyone wants to look me up), but I am looking forward to it nonetheless. I'm also working on an application for an AHRQ grant on the same topic so I can reproduce my Bellevue pilot study at the Johns Hopkins Hospital. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2842546 Tue, 29 Sep 2009 15:41:00 +0100 2842546 http://www.medworm.com/index.php?rid=2842440&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fprovide-safe-quality-hospital-care-increasing-transparency.html Paul Levy is the CEO of Boston’s Beth-Israel Deaconess hospital, and one of the nation’s foremost patient safety advocates. He blogs at Running a hospital, where he openly talks about the various issues facing a major academic institution. Increasing transparency, such as shining a light on medical errors and hospital infection rates for instance, can provide an effective way to confront each of these issues, so patients can benefit. Better Health’s Val Jones produced a 3-part video series interviewing Mr. Levy, where he sheds some insight behind his patient safety endeavors. Well worth watching. You can join Paul, Val, and myself at Blog World Expo 2009 on October 15th in Las Vegas, where we all will participate in panel discussions exploring the intersection between ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2842440 Tue, 29 Sep 2009 11:00:54 +0100 2842440 http://www.medworm.com/index.php?rid=2838868&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Freasons-doctors-practice-defensive-medicine.html Here’s a simple chart that sums it all up. Apologies for the small type. As The Happy Hospitalist writes, “Some doctors and patients may be willing to experience some anxiety for the unknown. But most won’t, especially since neither party is directly paying for the testing. This selfish interest is rooted in moral hazard, at the expense of national economic security.” And the bottom line today practice climate is, for doctors, always be in the top row. Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:Why do doctors practice defensive medicine?And you wonder why doctors practice defensive medicineDoctors leaving private practice, and where to go nextSupport balance billing; How doctors lose money; Findi... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2838868 Mon, 28 Sep 2009 11:00:51 +0100 2838868 http://www.medworm.com/index.php?rid=2838869&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fpoll-doctors-nurses-vaccinated-seasonal-flu-h1n1-influenza.html It’s been shown that flu shots reduce the spread and severity of influenza. But despite CDC guidelines recommending that all health care professionals receive both the seasonal and H1N1 influenza vaccine, a significant number of physicians and nurses plan to decline the shots. Data from the CDC show that only 40 percent of health care workers receive the seasonal flu vaccine. Reasons include fear of side effects, including the perception that the dead virus contained in the vaccine can cause disease. This is false, as is the belief that physicians and nurses are “too healthy” to become infected. A UK survey says that 50 percent of doctors and a third of nurses do not plan on taking the H1N1 vaccine. Some point to the 1976 incident where a swine flu vaccine caused Guillain... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2838869 Sun, 27 Sep 2009 19:00:31 +0100 2838869 http://www.medworm.com/index.php?rid=2836153&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fletting-premature-infant-die-considered-health-care-rationing.html by an anonymous NICU nurse There is a medical controversy brewing over in England that is threatening to invade the United States. Ms. Capewell, a 23-year old British mother, is claiming English doctors let her 21 5/7 week infant die, only because they were following national perinatal guidelines. If only he was born at 22 weeks, she insists, they would have tried everything to save him and admitted him to the neonatal intensive care unit (NICU). According to British perinatal guidelines, the age of viability of infants is set at 23 weeks gestation. Ms. Capewell states the guidelines had robbed her son of a chance of life. Following her experience, she has set up a web page called Justice for Jayden, urging a change in the British legislation. She is petitioning that all infants born befor... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2836153 Sun, 27 Sep 2009 11:00:55 +0100 2836153 http://www.medworm.com/index.php?rid=2834226&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fbulk-excessive-medical-care-happen-er.html by Michael Kirsch, MD The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other viruses believing that something beneficial was being done for them. We can’t expect a patient to know if a CAT scan a physician orders is medically necessary. From a patient’s perspective, a test is medically necessary if the doctor orders it. However, physicians, with professional training and experience, know wheth... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2834226 Fri, 25 Sep 2009 19:00:55 +0100 2834226 http://www.medworm.com/index.php?rid=2832090&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Freduce-risk-medical-errors-patient-handoffs.html One of the consequences of capping resident work-hours is increasing the frequency of patient hand-offs. In a recent column in The New York Times, surgeon Pauline Chen cites a somewhat frightening statistic that during a course of a typical 5-day hospitalization, patients “are passed between doctors an average of 15 times.” And residents sign over patients several hundred times during the first few weeks of training. One interesting solution would be to model physician hand-offs on how nurses do it. When nurses hand-off patients at the end of shift, it’s often in a quiet, undisturbed room. Contrast that to doctors, where patient hand-offs are performed quickly, often interrupted by pages. Indeed, according to Vineet M. Arora, a physician who studies the effects of patien... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2832090 Fri, 25 Sep 2009 11:00:43 +0100 2832090 http://www.medworm.com/index.php?rid=2832251&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FtVXihMwiuC0%2F Dr. Don Storey and I spoke at the at The Forum 09 conference in San Diego earlier this week. The DMAA publication “The Continuum” had an excellent writeup of our enthusiastically received presentation.  Here’s a copy of our PowerPoint slides… HITECH Health IT Legislation: Opportunities for the DMAA Community View more presentations from vincek. and here’s DMAA’s writeup: Helping physicians and hospitals meet the “meaningful use” criteria for federal support for health information technology under recently passed legislation represents a keen opportunity for the population health management industry, presenters at this session said yesterday. Vince Kuraitis, JD, MBA, of Better Health Technologies, LLC, and Don Storey, MD, of RMD Networks, presented a look at the evolut... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2832251 Fri, 25 Sep 2009 01:54:42 +0100 2832251 http://www.medworm.com/index.php?rid=2832092&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fradiologists-communicating-mammogram-results-patients-doctors.html by an anonymous radiologist I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur. I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both laughable and insulting. Percutaneous biopsy has become standard of care for all breast lesions that are visible by imaging. Involving a surgeon in the decision-making process typically adds more than a week to the process of diagnosis, and as the writer of the blog suggests, this is not a pleasant interlude for any patient. Even th... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2832092 Thu, 24 Sep 2009 19:00:06 +0100 2832092 http://www.medworm.com/index.php?rid=2828133&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fsuffering-patients-find-psychiatrists.html “Psychiatrists may be the last batch of physicians who are still granted a luxurious amount of time with patients.” So says Maria, a psychiatrist who blogs over at intueri. And because time is so undervalued without our health system, some doctors relying on psychiatrists to counsel patients in the hospital. She cites an example with surgeons, saying that “it is entirely unfair to both the patient and the psychiatrist for the surgeon to completely emotionally ‘turf’ the patient.” Are surgeons better off letting psychiatrists, who may have more experience in the area, guide patients through times of suffering? Or are they, in Maria’s words, asking he psychiatrists to have a doctor-patient relationship for them? In the end, it comes down to how time ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2828133 Thu, 24 Sep 2009 11:00:17 +0100 2828133 http://www.medworm.com/index.php?rid=2828134&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fmedical-technology-making-doctors-relevant.html by Edwin Leap, MD It happens over and over. I call a surgeon about a patient with abdominal pain. ‘Well, what’s the white count?’ ‘Normal.’ ‘Did you get a CT Scan?’ ‘Yes, and it was normal. But they just look uncomfortable.’ ‘Sounds like nothing for me to do. Call the hospitalist.’ It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if the neck CT is clear. Maybe, just maybe, they’re right! Maybe medicine can be reduced to that place; if the test is negative, the physician is unnecessary. Well, the other physician. The important physician, not the emergency medicine doc. We always have to examine the patient. We, the v... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2828134 Wed, 23 Sep 2009 19:00:08 +0100 2828134 http://www.medworm.com/index.php?rid=2823905&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fpatients-reject-evidencebased-medicine.html Newsweek’s Sharon Begley pens an excellent piece on why Americans will reject evidence-based medical decisions. She opens with a vignette, which every emergency physician should be familiar with: A 4-year-old suffers minor head trauma, perhaps from falling off a swing and hitting her head on the ground. She is dazed, and although she doesn’t lose consciousness her worried parents—visions of subdural hematomas and concussion dancing in their own heads—rush her to the local emergency room, expecting that the doctors there will immediately do a CT scan. The data, however, suggests that a head CT will not improve care in these cases, and, “in more than 99.9 percent of the cases, the rules accurately predicted which ones did not have a serious brain injury and could theref... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2823905 Wed, 23 Sep 2009 11:00:35 +0100 2823905 http://www.medworm.com/index.php?rid=2823907&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fprotect-abdominal-aortic-aneurysms.html by Mark Adelman, MD While diseases like prostate cancer and heart disease have become household concerns, abdominal aortic aneurysms (AAA), the 10th leading cause of death in men age 55 and older, have been overshadowed by more prominent diseases for far too long. It’s time we pull back the curtain and take a closer look at this serious disease and how it can be both detected and prevented. An AAA, which is one of the conditions associated with vascular disease, is a bulge that develops in the body’s main blood vessel, the aorta. As the aneurysm expands within the aorta, the chances of it rupturing increase. However, AAAs generally develop without noticeable symptoms. Often times, people do not realize they have an aneurysm until it ruptures, giving the disease its “silent killer” ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2823907 Tue, 22 Sep 2009 19:00:06 +0100 2823907 http://www.medworm.com/index.php?rid=2820152&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fhomebirth-advocates-continue-support-doctor-convicted-sexual-exploitation.html Amy Tuteur calls sexual exploitation “the most egregious violation of professional conduct that any obstetrician-gynecologist can commit.” And in that context, she details an interesting scenario brewing in California. Stuart Fischbein is an obstetrician that’s widely hailed in homebirth circles, writing a book and being a foremost advocate of homebirths. Unfortunately for him, he also exercised some poor judgment, as detailed in this newspaper report: He called her “sweet pea,” held her hand and warned her about moving too fast with her fiancee. What began as flirtation morphed into an affair that was twice consummated. Even before the relationship dissolved into angry phone calls, a lawsuit, a criminal complaint, therapy and wounds that changed lives, there ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2820152 Tue, 22 Sep 2009 11:00:31 +0100 2820152 http://www.medworm.com/index.php?rid=2814360&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fhospitals-deal-disruptive-physician-behavior.html by Mark N. Simon, MD What can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans in attendance. He also saw that it took a number of individuals to get Blount off the field and into the locker room. Kelly was now faced with one of the most difficult decisions any leader will face. What was he to do with a valuable member of the team whose behavior was clearly unacceptable? Blount was beginning his senior season with the university. He had been named to the watch list for the D... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2814360 Sun, 20 Sep 2009 19:00:09 +0100 2814360 http://www.medworm.com/index.php?rid=2812364&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fbias-analyzing-data-slow-lines.html by Paul Levy Here’s an excerpt from a lovely little book by John D. Barrow called One Hundred Essential Things You Didn’t Know You Didn’t Know; Math Explains the World. This selection has a great lesson about statistical inference. The chapter is entitled, “Why does the other queue always move faster?” You will have noticed that when you join a queue at the airport or the post office, the other queues always seem to move faster. When the traffic is heavy on the motorway, the other lanes always seem to move faster than the one you choose. Even if you change to one of the others, it still goes slower. In fact, the reason you so often seem to be in the slow queue may not be an illusion. It is a consequence of the fact that on the average you are usually in the sl... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2812364 Sun, 20 Sep 2009 11:00:15 +0100 2812364 http://www.medworm.com/index.php?rid=2812401&cid=t_270717_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F09%2Fwhich-is-it-self-referral-or.html A series of fines have been levied in New Jersey for various fraudulent practices that might have a chilling impact on the way hospital systems do business:The doctors -- Ravindra Patel of Scotch Plains, Jasjit Walia of Edison and Rakesh Sahni of Rumson -- agreed to pay a combined $960,000, representing twice the annual salaries they received from the University of Medicine and Dentistry of New Jersey, according to Ralph J. Marra, acting U.S. attorney for New Jersey. Lawyers for the cardiologists were unavailable for comment last night.Federal law prohibits doctors from accepting payments in exchange for referring patients. Beginning in 1996, authorities say University Hospital began trying to increase the number of cardiac procedures it performed by offering salaries to doctors in private... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2812401 Sun, 20 Sep 2009 09:29:00 +0100 2812401 http://www.medworm.com/index.php?rid=2859104&cid=t_270717_136_f&fid=39027&url=http%3A%2F%2Fwww.lrdlc.dreamhosters.com%2F2009%2F09%2Fwhen-cancer-killed-grandma%2F I’d like to expand on what I wrote in this post, particularly about my grandma. I didn’t write enough about how her death affected me. She was diagnosed with pancreatic cancer  when she was 85 and I was 15. It’s been said that type of cancer is one of the most excruciating and lethal. (R.I.P., Mr. Swayze) Let me backtrack… my granny was Manuela. She insisted we call her Manuelita, though. She didn’t want to hear any of that “abuelita” or “grandma” business. She was short, stocky, feisty, and incredibly rugged for her age. She lived with my family since before I was born. In a sense, she was a second mom. They both ran the show while Dad was off working. Dad, Mom, and Manuelita: they were the bosses of us 5 kids. Manuelita & me Manu... Cancer, life, and me blogs http://www.medworm.com/rss/comments.php?id=2859104 Fri, 18 Sep 2009 22:26:07 +0100 2859104 http://www.medworm.com/index.php?rid=2800507&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F09%2F15%2Fhealthcare-data-sharing-in-emr-software%2F Healthcare data sharing is one of the hottest topics when talking about the importance of EMR software. Some people call it healthcare data portability. One of the problems I have with these discussions is that everyone has different goals for why they want to share the information. Here’s a partial list of reasons people may want to share healthcare data between various EMR respositories (in no particular order): Clinical data sharing for reimbursement purposes Quality data sharing for broader research goals Quality data sharing to meet ARRA requirements/reimbursement Data shared for continuity of care between providers There are probably other reasons to have EMR software be able to share clinical data. However, you get the basic point. There are a lot of reasons why people want ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2800507 Tue, 15 Sep 2009 15:45:59 +0100 2800507 http://www.medworm.com/index.php?rid=2796529&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F3EdpSrRccHA%2F Healthcare data sharing is one of the hottest topics when talking about the importance of EMR software. Some people call it healthcare data portability. One of the problems I have with these discussions is that everyone has different goals for why they want to share the information. Here’s a partial list of reasons people may want to share healthcare data between various EMR respositories (in no particular order): Clinical data sharing for reimbursement purposes Quality data sharing for broader research goals Quality data sharing to meet ARRA requirements/reimbursement Data shared for continuity of care between providers There are probably other reasons to have EMR software be able to share clinical data. However, you get the basic point. There are a lot of reasons why people want ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2796529 Tue, 15 Sep 2009 15:45:59 +0100 2796529 http://www.medworm.com/index.php?rid=2796677&cid=t_270717_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FMqic5OSjAPw%2F MRSA is short for methicillin-resistant Staphylococcus aureus, a bacteria that is resistant to certain types of antibiotics, including methicillin, oxacillin, penicillin and amoxicillin. Most infections occur in the hospitals or health care setting where people’s immune systems are naturally weaker (called healthcare-associated or HA-MRSA). Another type of MRSA can infect healthy people in the community (called community-associated or CA-MRSA), and this bacteria causes a serious form of pneumonia and skin infections. But this breaking news is rather surprising – researchers combing the beaches along the state of Washington found MRSA in the sand at the shoreline! The type of Staph found in 10 public beaches were similar to those acquired from hospitals, but there are no local hospita... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=2796677 Mon, 14 Sep 2009 21:24:25 +0100 2796677 http://www.medworm.com/index.php?rid=2793098&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Ftiger-woods-medical-futility-endoflife-care.html by Michael Kirsch, MD Consider this hypothetical vignette. Tiger Woods accepts my challenge to play 18 holes. Obviously, the gallery would be packed with golf enthusiasts who would cancel job interviews, vacations and even worship services in order to witness this historic competition. Spectators would be permitted to place bets at even money. Perhaps, my mother would bet on me, but no other sane person would. They would properly conclude that even my best performance against Tiger’s worst would be inadequate. There is nothing I could do to change the outcome. All of my efforts would be futile. Futility cannot be proved with mathematical certainly. After all, Tiger could develop acute appendicitis on the fairway and have to forfeit. He could be arrested. Lightning could strike. Killer be... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2793098 Mon, 14 Sep 2009 15:00:36 +0100 2793098 http://www.medworm.com/index.php?rid=2790249&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fviolence-emergency-department-promote-er-safety.html by Patricia B. Allen, MBA, RN What would you differently tomorrow if you had a violent episode in your emergency department today? Violence in the ED is a growing and alarming phenomenon. A recent survey conducted by the Emergency Nurses Association (ENA) revealed that 25 percent of the RN respondents report experiencing physical violence more than 20 times in the past three years and 20 percent of the respondents revealed encountering verbal abuse more than 200 times in the past three years. A recently released article by the Journal of Nursing Administration discusses – and supports – the results of the ENA survey. ED Violence is a serious threat that needs immediate attention. ED nurses and physicians are on the front lines of aggression, violence and abuse from patients, famili... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2790249 Sat, 12 Sep 2009 19:00:23 +0100 2790249 http://www.medworm.com/index.php?rid=2790321&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fqn6AlRE1xgg%2F By Vince Kuraitis and Steven Waldren MD, MS.  Dr Waldren is Director of the Center for Health Information Technology at the American Academy of Family Practice (AAFP). Two issues have rightfully surfaced front and center in the public’s understanding of HITECH Act implementation: ” definition of “Meaningful Use” of EHRs, and ” definition of “certification” process for EHRs …and we applaud the progress of the workgroups and the HIT Policy Committee in addressing these issues constructively. However…a THIRD issue lurks – “Data harmonization at the expense of data liquidity“, or put another way – “misplaced pursuit of one (and only one) language at the expense of practical communication.” On August 20, the HI... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2790321 Sat, 12 Sep 2009 18:18:03 +0100 2790321 http://www.medworm.com/index.php?rid=2781959&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fpatient-dies-doctors-fail-communicate-operating-room.html by Jerry I. Meyers, Esq. Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication. Several years ago, a female client about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided. This was to be a one-day inpatient hospital procedure and was associated with little to no risk. As a part of the procedure, however, a prophylactic antibiotic was to be administered. Unfortunately in this particular case, when the antibiotic (Cefotan) was administered the patient suffered a sudden cardiac arrest. This cardiac arrest resulted from a rare but well-known allergic reaction to this antib... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2781959 Thu, 10 Sep 2009 15:00:13 +0100 2781959 http://www.medworm.com/index.php?rid=2781960&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Froutine-brain-mri-lead-incidental-findings.html by Nancy Walsh, Contributing Writer, MedPage Today Almost 3% of healthy, asymptomatic people who underwent MRI brain scans showed incidental abnormalities in a recent study, leading researchers to express concern about about psychological and medical fallout from these increasingly popular screenings. In meta-analysis of MRI brain scans, the prevalence of neoplastic incidental findings was 0.70% (95% CI 0.47 to 0.98), while the prevalence of non-neoplastic findings was 2% (95% CI 1.1 to 3.1), according to Zoe Morris, MD, of Western General Hospital in Edinburgh, and colleagues. The combined prevalence of neoplastic and non-neoplastic abnormalities, excluding markers of cerebrovascular disease, was 2.7%, with a number needed to scan of 37, the researchers reported online in the British Medi... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2781960 Thu, 10 Sep 2009 13:00:07 +0100 2781960 http://www.medworm.com/index.php?rid=2781961&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fcritically-ill-baby-lead-posttraumatic-stress-disorder-parents.html Parents who have a critically ill infant can exhibit symptoms later on similar to those who have been through war. And indeed, this article in The New York Times draws parallels between the neonatal intensive care unit (NICU) and a warzone, “with the alarms, the noises, and death and sickness.” Infants in the NICU can cause the parents to experience multiple traumas, starting with a premature birth, where many of the problems stem from. And the potential for bad news hangs over them on a daily, if not hourly, basis. According to a recent study, “The post-traumatic stress may take the form of nightmares or flashbacks. Sufferers may feel panic every time a beeper goes off in the intensive care unit, or they may avoid the trauma by not visiting the unit or by emotionally d... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2781961 Thu, 10 Sep 2009 11:00:12 +0100 2781961 http://www.medworm.com/index.php?rid=2782124&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FrzJiYQ9ydd4%2F by Glen Laffel MD, PhD Many of us have enjoyed a few good minutes of fun having our fortunes told by soothsayers who claim they can predict our future based on patterns of tea leaves in a cup or the playing cards we’ve pulled from a deck. We pay a few dollars for the entertainment and if the fortune teller is skilled, we are temporarily impressed by his “insight.” But once we leave the carnival, we come back to our senses. Fortune-tellers can’t predict the future. With its latest announcement, the Certification Commission for Healthcare Information Technology (CCHIT) appears to have entered the fortune telling business. And if information provided on blogs published by its founders is to be believed, some EHR vendors plan to have their fortunes told by the former EHR certification... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2782124 Wed, 09 Sep 2009 21:43:16 +0100 2782124 http://www.medworm.com/index.php?rid=2778338&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fpatient-satisfaction-influence-physician-compensation.html One bane of emergency physicians are patient satisfaction scores, which some hospitals use in part to determine physician salaries. Often times, if patients are denied, say, opioid medications, they’re more likely to give low scores, which the hospital administration can then use to penalize doctors. Of course, this creates an incentive to give patients everything they want, sometimes to the detriment of good medicine. But Shadowfax, an emergency physician-administrator, delves deeper into how his group uses these scores, and finds that, in most cases, low scores were correlated with valid patient complaints. Long waiting times and whether the medical staff listened to patients, for instance. He goes on to detail his hospital’s turnaround, which required cooperation with hospit... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2778338 Wed, 09 Sep 2009 11:00:30 +0100 2778338 http://www.medworm.com/index.php?rid=2774567&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Felderly-patients-admitted-hospital.html 95-year old patients who go to the emergency department, more likely than not, will get admitted to the hospital. But is that always what’s best for the patient? Emergency physician Graham Walker suggests not. He notes, correctly, that, “the group with the highest odds of having something seriously wrong with them are probably also the most likely to have something go wrong with them while they’re in the hospital.” Indeed, hospital complications, like iatrogenic infections and falls, contribute to the morbidity and mortality of hospitalized elderly patients. Combine this with the fact that 90% of Americans surveyed want to die at home, but 80% die in an institution. How about a simple discussion with both the patient and family about their wishes to be admitted? If no f... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2774567 Tue, 08 Sep 2009 11:00:23 +0100 2774567 http://www.medworm.com/index.php?rid=2772478&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fmozart-teach-suberbugs-antibiotic-resistance.html by Maya Sequeira Composer Wolfgang Amadeus Mozart’s death in 1791 has long been a mystery, but a new study published in the Annals of Internal Medicine suggests that it was, of all things, a common strep infection that killed the maestro at the age of 35. Researchers speculate that Mozart contracted the strep infection—easily treatable today—from a fellow musician who had been hospitalized at a crowded military hospital in Vienna. It’s not difficult to imagine that strep would rage in a dirty hospital in the 18th century. But a 2008 report from Lancet Infectious Diseases says that crowded, understaffed hospitals worldwide remain breeding grounds for antibiotic resistant infections such as Methicillin Resistant Staphylococcus Aureus (MRSA). The strep infection that killed Mozart is ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2772478 Sun, 06 Sep 2009 19:00:45 +0100 2772478 http://www.medworm.com/index.php?rid=2770082&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fdrama-tpa-stroke-threehour-window.html by Doctor Grumpy Before telling this story, I’m going to have to lay some background for my non-medical readers. The most obscene word in English, in my opinion, has three letters and is an acronym. It’s tPA (it stands for Tissue Plasminogen Activator). This drug gets a lot of press as a “clotbuster.” It has the potential to break down clots and reverse a stroke. That potential, however, has a dark side. By breaking down clots it can also cause catastrophic bleeding into the brain. As a result, I’m not a fan of this drug. I use it very judiciously, with a solid understanding by the family and patient of what they are getting into. It can lead to both great rewards and serious complications. Compounding this is the fact that the drug must be given within three hours o... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2770082 Sun, 06 Sep 2009 11:00:19 +0100 2770082 http://www.medworm.com/index.php?rid=2768611&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Feroentgen-iphone-choose-xray-scan-mri-diagnostic-test.html The following is a sponsored guest post by Constantine Brocoum, a radiologist in Concord, NH. I have personally used eRoentgen, and recommend the product without reservation. by Constantine Brocoum, MD Like most inventions, eRoentgen was developed to respond to a need. As a practicing radiologist, I take frequent calls from primary care providers who need assistance in choosing the smartest way to diagnose their patients’ illnesses. They often need help choosing between a CT or MRI. Should intravenous contrast be used? Are there alternatives if a patient is allergic to the contrast? These are some of the many questions that clinicians are confronted with every day. This inspired me to provide an easier way for them to get needed information quickly without having to reach a radiologist ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2768611 Sat, 05 Sep 2009 11:00:14 +0100 2768611 http://www.medworm.com/index.php?rid=2765947&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Famericas-hospitals-list-affect-patient-outcomes.html by Charles Bankhead, Staff Writer, MedPage Today A news magazine’s rankings of top-rated hospitals for heart failure care did not include many hospitals that performed at least as well as the ranked centers, according to a comparison of the magazine’s list and government data. Hospitals that made the U.S. News & World Report list had a better 30-day mortality than those who didn’t make the cut, but 30-day readmission rates did not differ between ranked and unranked hospitals, a multicenter team of investigators concluded. Mortality and readmission rates varied widely among the 50 hospitals on the magazine’s list and the 4,700 hospitals that did not make the list, the investigators reported in the September issue of Circulation: Cardiovascular Quality and Outcom... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2765947 Fri, 04 Sep 2009 13:00:45 +0100 2765947 http://www.medworm.com/index.php?rid=2765950&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F09%2Fhospitalists-provide-quality-patient-care-lowest-cost.html by Bob Wachter, MD Much has been made of the superior performance – on both cost and quality – of integrated health care organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated history, few believe that the rest of us – namely the docs and hospitals that provide the bulk of American health care – can quickly achieve such seamless integration, even if the perfect bill emerges from the Congressional sausage factory. And it’s increasingly clear that the perfect bill will not be coming out of Washington this year. Is hope lost? Is it possible to create tighter integration between hospitals and doctors without a legislative Attaboy? Can health care organizations and physicians be incented to ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2765950 Thu, 03 Sep 2009 19:00:23 +0100 2765950 http://www.medworm.com/index.php?rid=2761833&cid=t_270717_87_f&fid=36050&url=http%3A%2F%2Fwww.blisstree.com%2Fbreastfeeding123%2Fhome-births-safer-for-low-risk-pregnancies%2F It surprised me to see a DVD copy of the documentary “The Business of Being Born” available at one of my local county libraries. I put it on hold for 25 cents (have I mentioned how I think the public library is one of the best inventions ever?!), picked it up a few days later, and finally got to watch it with my husband the other night. The movie completely spoke to my disappointing experiences with hospital births and my very satisfying home birth. I wish everyone — pregnant or not, male or female — would watch the movie! The problem is that the type of people drawn to the movie in the first place already believe the viewpoint presented there and the movie is preaching to the choir! Those who don’t already share the viewpoint that home birth is a wonderful, s... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=2761833 Thu, 03 Sep 2009 03:26:14 +0100 2761833 http://www.medworm.com/index.php?rid=2747902&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fpatients-leaving-hospital-medical-advice.html by Michael Smith, North American Correspondent, MedPage Today The number of people who check out of hospitals against medical advice has grown dramatically, according to the Agency for Healthcare Research and Quality. In 2007, the agency said, inpatient care ended that way 368,000 times, accounting for 1.2% of all hospital stays, compared with only 264,000 such discharges a decade earlier. That 39% increase is markedly higher than the 13% increase in all other hospital stays during the period from 1997 through 2007, the agency noted in a statistical brief. The finding is based on data from the agency’s Healthcare Cost and Utilization Project 2007 Nationwide Inpatient Sample. On average, hospital stays that ended in discharge against medical advice were about 2.7 days (versus 5.1 da... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2747902 Mon, 31 Aug 2009 13:00:17 +0100 2747902 http://www.medworm.com/index.php?rid=2747903&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fwealth-information-takes-attention-patient.html by Abraham Verghese, MD This month I am the attending physician overseeing an internal medicine team, one of four such teams that admit patients to my teaching hospital. It’s a great time to be an attending physician. I have seasoned interns who in just a few weeks will be junior residents, and I have even more seasoned senior residents on their way to entering practice or entering subspecialty training. The team feels very efficient. What always strikes me when I come back to being on the in-patient wards is the mountain of data that exists on each patient. It’s a surprise every time, a feeling analogous to revisiting Bombay or Madras after years of being away and finding that a city you did not think could get more congested, has done just that. For example, if we admit to ou... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2747903 Mon, 31 Aug 2009 11:00:36 +0100 2747903 http://www.medworm.com/index.php?rid=2748082&cid=t_270717_131_f&fid=35008&url=http%3A%2F%2Fscienceroll.com%2F2009%2F08%2F30%2Fsearching-and-comparing-hospital-websites%2F In the future of healthcare, we can access any kind of information we need for our health management. When we have  a medical condition, usually it’s not that easy to find the best hospital for the best treatment. WebMD has an interesting tool, Medica. You choose a diagnosis or procedure, give an explanation, choose a city and it helps you find hospitals that might be of your interest. Ed Bennett updated his custom Google Custom Search Engine with over 2,800 hospital websites. It’s very useful when you want to find hospitals and centers that are focusing on a specific medical condition. (Source: ScienceRoll) ScienceRoll blogs http://www.medworm.com/rss/comments.php?id=2748082 Sun, 30 Aug 2009 18:40:41 +0100 2748082 http://www.medworm.com/index.php?rid=2745503&cid=t_270717_97_f&fid=35606&url=http%3A%2F%2Fwww.theangriestpharmacist.com%2F2009%2F08%2F30%2Fpharmacy-optimization-with-enterprise-re-engineering-my-disdain-thoughts-and-call-to-arms%2F P.O.W.E.R. — (n. – ENG) Pharmacy Optimization With Enterprise Re-engineering. It’s okay. It hasn’t hit my area yet, but my fellow citizens aren’t stupid. They are asking what it is, what my thoughts are, and what they should do. [Again, you have my word that I do *NOT* work for Walgreens -- at all...] Anyway, my marquee is exactly as I said it would be (Yes, heart included): Your Rx Filled RIGHT HERE by OUR Pharmacist ♥ It’s going over good. Some people know and they like it. Others don’t know and they ask…so I’m starting the word of mouth of all the rumblings and grumblings. All the fodder I need is on the Student-Doctor Network or other various message boards. Everyone has a problem. No one has stated, supported, backed, and pushed ... The Angriest Pharmacist blogs http://www.medworm.com/rss/comments.php?id=2745503 Sun, 30 Aug 2009 08:32:23 +0100 2745503 http://www.medworm.com/index.php?rid=2744037&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Frelationships-lost-medicine-hospitalists-partly-responsible.html by Edwin Leap, MD An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that God has a great sense of humor. See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them more often than you might imagine. After all, our hospital is ‘the only game in town.’ There are some patients I know quite well, and thus I know with reasonable accuracy who is sick and who isn’t, based on how they looked or behaved before. It doesn’t always work, but frequently it does. Which brings me to trends in primary care. I don’t know if I’m really a primary care provider ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2744037 Sat, 29 Aug 2009 11:00:38 +0100 2744037 http://www.medworm.com/index.php?rid=2789017&cid=t_270717_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F08%2Fsaving-money-byop.html * bleeeeep bleeeeep bleeeeep *It was 11:57PM on the alarm clock last night. I peeled my head from the pillow and felt my heart racing from the adrenaline surge that usurped by Stage IV REM sleep. I fumbled for the pacer and pressed the button. Glorious silence ensued as I caught my breath. Reading the pager, I noticed it was the nurse caring for my patient calling. I dialed the phone."This is Doctor Fisher. I'm returning Sally's call (not her real name).""Just a moment."Some cheesy commercial played in the background with some canned music that I had heard a thousand times before. 'Damn, why don't they just play some soft classical music?' I thought to myself. Just then, a voice answered."This is Sally...""Sally, Dr. Fisher, returning your call...""Yes, Mr. Faachamatacheesedip is having tr... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2789017 Fri, 28 Aug 2009 19:34:00 +0100 2789017 http://www.medworm.com/index.php?rid=2741315&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fincreasing-radiation-exposure-patients-ct-scans-imaging-tests.html by Kristina Fiore, Staff Writer, MedPage Today Imaging procedures can expose patients to high cumulative doses of radiation, researchers say. In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of Emory University in Atlanta, and colleagues. They published their findings in the Aug. 27 issue of The New England Journal of Medicine. “Our finding that in some patients, worrisome radiation doses from imaging procedures can accumulate over time underscores the need to improve their use,” Dr. Fazel and colleagues wrote. In an accompanying editorial, Michael S. Lauer, MD, of the National Heart, Lung, and Blood Institute,... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2741315 Fri, 28 Aug 2009 13:00:12 +0100 2741315 http://www.medworm.com/index.php?rid=2744169&cid=t_270717_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2009%2F08%2Fus-hospital-websites.html Tara Calishain and her diverse service specialty called Research Buzz provides a link to a new Google Custom Search Engine specific to hospital websites in the U.S., 2800 of them at current count.For specifics, please see her website/blog entry: click here (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=2744169 Fri, 28 Aug 2009 12:50:00 +0100 2744169 http://www.medworm.com/index.php?rid=2741493&cid=t_270717_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2009%2F08%2Fus-hospital-websites.html Tara Calishain and her diverse service specialty called Research Buzz provides a link to a new Google Custom Search Engine specific to hospital websites in the U.S., 2800 of them at current count.For specifics, please see her website/blog entry: click here (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=2741493 Fri, 28 Aug 2009 12:50:00 +0100 2741493 http://www.medworm.com/index.php?rid=2741441&cid=t_270717_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2Fa36XduxD3Rs%2F Alright, George Clooney fans out there, time to get your get well cards and positive energy flowing. Turns out George broke his hand while staying at his pad in Italy. I know what you’re thinking… will he still be able to wave to the fans? Yes. His doctor joked that he was giving George “30-40 years more to live, and no live animals were harmed during the wrapping of the hand.” (Sounds like George had just the right doctor to suit his personality, doesn’t it?) Rumors fly that perhaps George broke his hand while riding a motorcycle (because he did have that accident a couple years ago where his cycle collided with a car), but it turns out George simply closed the car on his hand. Ouch! We’re sending out our love, Mr. Clooney! Image: Zuma Press ... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2741441 Fri, 28 Aug 2009 11:53:36 +0100 2741441 http://www.medworm.com/index.php?rid=2741369&cid=t_270717_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D7801 The Malay Mail ran this report Why Gleneagles could not admit child CHEONG is flabbergasted that his son, suspected of having contracted the Influenza A (H1N1) virus, was turned away by a private hospital. He took his son to the Gleneagles Intan Medical Centre on Jalan Ampang in the morning of Aug 13, where initial tests showed the boy to be positive for the H1N1 virus. After the result was known, CHEONG said, the hospital refused to admit his son. He was instead was given prescription to buy the medication. The CEO gave the explanation ..hospital did not turn away the child who was brought to its Accident and Emergency Department at 1.39am on Aug 13. “Our attending doctor found the child’s body temperature to be 37.9 degrees Celsius. “Without further delay, the doctor did a rapid te... Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=2741369 Thu, 27 Aug 2009 23:00:00 +0100 2741369 http://www.medworm.com/index.php?rid=2741456&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FJVbaWzgJhJI%2F These guys really don’t get it, and they need to be called on the carpet, taken to the woodshed, or pick your own favorite cliche. The Federation of American Hospitals (FAH) sent a letter to Dr. David Blumenthal (National Coordinator for Health IT) arguing that “Meaningful Use” funding should not be tied to achievement of quality measures.  The FAH is the trade association for for-profit hospitals; the letter is dated August 26 and a copy is available on the HealthHombre website, with a deserved hat tip. First, let me concede that they make a reasonable point on p. 3 when they say “Under it’s framework, the Policy Committee has recommended that HHS should adopt a measure for 2013 requiring a 10 percent reduction in preventable admissions from 2012 to qualify as a meani... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2741456 Thu, 27 Aug 2009 20:16:29 +0100 2741456 http://www.medworm.com/index.php?rid=2859108&cid=t_270717_136_f&fid=39027&url=http%3A%2F%2Fwww.lrdlc.dreamhosters.com%2F2009%2F08%2Fmy-foundation%2F I’m a newbie dad (about 7 years experience so far). Each day that goes by I am reminded of the strength and determination of one man: My father. He started out as a newbie dad once. He had five kids in all: 3 girls and 2 boys. He was poor, but I didn’t really know it or feel it. He worked his ass off in a factory. His children could have gone to public school for free, but he knew the value of education, so each one of them attended private schools through high school. His income went to food, rent, school, and clothes. He was also a young father. He wasn’t perfect by any means (but in my memory he comes damn close), but still he worked for all of us: Mom, Grandma, May, Jess, Thani, Alan and I. I see his sacrifice in retrospect and frankly, it floors me. Then one day he w... Cancer, life, and me blogs http://www.medworm.com/rss/comments.php?id=2859108 Thu, 27 Aug 2009 19:38:16 +0100 2859108 http://www.medworm.com/index.php?rid=2741318&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fnew-troponin-tests-to-better-diagnose-a-heart-attack.html by Crystal Phend, Senior Staff Writer, MedPage Today A generation of new, more sensitive troponin assays has improved hospitals’ ability to diagnose a heart attack to a point as early as the time of emergency department presentation, two separate studies affirmed. In one multicenter study, a sensitive troponin I assay had an early diagnostic accuracy of 96%, compared with conventional troponin T’s 85%, Stefan Blankenberg, MD, of Johannes Gutenberg University in Mainz, Germany, and colleagues found. A second blinded comparison revealed significantly higher accuracy at presentation with all four sensitive cardiac troponin assays studied than with the standard assay (95% to 96% versus 90%). Both studies appeared in the Aug. 27 issue of The New England Journal of Medicine. The ma... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2741318 Thu, 27 Aug 2009 17:00:24 +0100 2741318 http://www.medworm.com/index.php?rid=2737680&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fwhy-does-it-take-so-long-to-get-a-medical-license.html by Doctor T, MD As a newly minted physician, having graduated residency three years ago, I would like to tell you my frustrations with the system that I had no idea I was getting into. I am a board-certified pediatrician. I have had no complaints filed against me, and zero malpractice claims. I worked briefly in Arizona providing hospital care, then received more training in pediatric critical care, and have moved on to California. Every state I have practiced in requires me to re-submit my college transcripts, medical school transcripts, USMLE test scores, documentation from my residency programs, and board-certification scores, along with personal references. This process can take time. Although I submitted my application in February 2009, I am still waiting for a California license, for... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2737680 Thu, 27 Aug 2009 13:00:43 +0100 2737680 http://www.medworm.com/index.php?rid=2737681&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Ftreating-fournier-gangrene-or-necrotizing-fasciitis-of-the-male-genitals.html Fournier gangrene one of the nastiest infections you’ll ever see. General surgeon Jeffery Parks details a case, complete with a vivid CT scan: Dr. Parks takes us behind the scenes in treating the condition, which requires rapid surgical debridement. “There’s nothing fancy about this surgery,” he writes. “You cut and debride until all the necrotic fat and skin and muscle is gone. It leaves a horrible wound. Sometimes you have to divert stool with a colostomy to facilitate clean wound care post-operatively.” He provides some other clinical clues to the condition, including, a markedly high white count, a low blood pressure, “popping” or crackling sounds under the skin, otherwise known as crepitus, and extreme pain. It’s a condition I wo... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2737681 Thu, 27 Aug 2009 11:00:16 +0100 2737681 http://www.medworm.com/index.php?rid=2733984&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fwould-you-rather-have-an-older-or-younger-trauma-surgeon.html Turns out, it may not matter. According to a recent study from the Archives of Surgery, when it comes to trauma surgery, the mortality rate of trauma causes handled by “novice” surgeons - those just out of residency - did not differ appreciably from those handled by more experienced doctors. As reported by ABC News (under the somewhat melodramatic headline, “In the ER, Baby-Faced Doc Is No Death Sentence”), whether the hospital is organized, or not, plays a more important role. Jay Doucet, a surgeon cited in the piece, compares the findings to fighter pilot performance, saying, “”Let’s say you have a highly trained fighter pilot, but you send him against a tough enemy, flying an obsolete aircraft in a disorganized air force … what outcomes ca... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2733984 Wed, 26 Aug 2009 11:00:13 +0100 2733984 http://www.medworm.com/index.php?rid=2734038&cid=t_270717_87_f&fid=34872&url=http%3A%2F%2Fwww.blisstree.com%2Fhealthbolt%2Fleaving-hospital-against-medical-advice%2F Would you leave the hospital before your doctor says you are ready? It’s not something that I’d do. But according to the Agency for Healthcare Research and Quality, it’s becoming a common occurence as more and more people check out against medical advice. In fact, in 2007 368,000 patients walked out on their doctor. So why did they leave? Turns out that the majority of those who left were uninsured or on Medicaid.   They were also more likely to be… Male: Men left hospital against advice at a rate of 1.5 per 1,000 population, compared with 0.9 for 1,000 women. In contrast, women were more likely to be inpatients, at a rate of 102.8 per 1,000, compared with 91.5 for men. Younger than other patients: The average age those who left against advice was 46 years, compared with 58 year... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=2734038 Tue, 25 Aug 2009 23:51:35 +0100 2734038 http://www.medworm.com/index.php?rid=2727354&cid=t_270717_133_f&fid=35096&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAutismVox%2F%7E3%2FdyVQIWg1i1g%2F Adult autism is bound to become a huge topic in coming years, and several institutions are moving to anticipate the need. Massachusetts General Hospital is creating a program to provide specialized medical care to adults with autism. The hospital expects to receive $29 million to help add “a major adult component to its pediatric autism program,” allowing the the hospital to expand services for children with autism. The hospital notes, not that many parents of the adult autistic needed to hear it, that some doctors are hesitant or unsure how to talk to and examine adult autistic patients. *   *    * Photo courtesy of gadgetdude (flickr.com) Arizona State University has added a master’s program in special education. Officials at the school claim that one of the motiv... Autism Vox blogs http://www.medworm.com/rss/comments.php?id=2727354 Sun, 23 Aug 2009 20:58:06 +0100 2727354 http://www.medworm.com/index.php?rid=2719776&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fjp_2OUrAwoQ%2F   “We need to make care linkages a core competency of American health care.”  George Halvorson, Chairman and CEO, Kaiser Foundation Health Plan, Kaiser Foundation Hospital   There’s a double meaning to the title of this new series: Healthcare Crosses the Chasm to the Network Economy At the level of technology, it’s a reference to Geoffrey Moore’s bestselling business/technology book — “Crossing the Chasm”. The Chasm here is the huge gap between early adopters of technology and mainstream users. The book describes the process of bringing specific technologies into mainstream usage. At the level of clinical care, its a reference to the landmark 2001 report by the Institute of Medicine — “Crossing the Chasm”.  Here, the Chasm is a reference to the quality/safety... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2719776 Fri, 21 Aug 2009 01:09:37 +0100 2719776 http://www.medworm.com/index.php?rid=2716029&cid=t_270717_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F6T0CFfGv18Q%2F I hear of so many people who were either given the wrong medication or had a medical professional treat them poorly. When they tried to speak up, they were shut down. I’ve had this happen myself. You’re sick, oftentimes on medication, and yet to have to remain alert because the people helping care for you either don’t care or aren’t aware of what you need. A new article on CNN said that as many as “98,000 people die in U.S. hospitals each year as a result of medical errors.” CNN asked nurses what they would advice to patients on having a stay that is healthy. They reiterated that if something doesn’t seem right, you should speak up. Again, while I agree with this advice, it doesn’t always work. You’ll get shut down by the hospitals wor... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2716029 Thu, 20 Aug 2009 11:19:22 +0100 2716029 http://www.medworm.com/index.php?rid=2715878&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fthe-consequences-of-doing-everything-in-end-of-life-care.html by Marya Zilberberg, MD, MPH Fear-mongering about health care reform killing grandma really burns me: I have delivered “everything”, I know what “everything” looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma, but the rest of us too. Here is what I mean. When I was in practice I cared for critically ill patients. I loved the ICU for its complex physiology and its palpable human dimension. Unfortunately, my practice afforded me many opportunities to understand the pain and frequent futility of interventions to prolong life without regard to its quality. Often the intensivist is first to address end-of-life issues. In a typical scenario, an elderly patient is hospitalized with pneumonia. The ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2715878 Wed, 19 Aug 2009 19:00:54 +0100 2715878 http://www.medworm.com/index.php?rid=2712288&cid=t_270717_131_f&fid=35008&url=http%3A%2F%2Fscienceroll.com%2F2009%2F08%2F18%2Ftop-20-hospitals-on-twitter-and-youtube%2F Ed Bennett is probably the most famous hospital web manager nowadays and he maintains lists that are more than interesting. Now he published two lists. One about the most popular hospitals on Twitter ranked by the number of followers. And another one about the most popular hospitals on Youtube ranked by the number of subscribers. Do you remember which US hospital I have featured for plenty of times? Of course, Mayo Clinic that is also on the top of both of the lists. Ves Dimov from Clinical Cases and Images had some comments on this. He wrote “There are a few surprises since the ranking definitely does not much the list of America’s Best Hospitals published every year by the U.S. News & World Report” Here is a slideshow about the web 2.0 coverage of Mayo Clinic I shar... ScienceRoll blogs http://www.medworm.com/rss/comments.php?id=2712288 Tue, 18 Aug 2009 20:56:24 +0100 2712288 http://www.medworm.com/index.php?rid=2712037&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fis-reducing-medical-errors-similar-to-improving-transportation-safety.html According to a recent op-ed, Jim Hall, former chairman of the National Transportation Safety Board, says, “Because American medicine accepts error as an inevitable consequence of treatment, our hospitals, insurers and government do little to respond to unnecessary deaths. If we are to address the problem in a serious manner, we must first change this culture.” But a simple solution to reduce medical errors may be elusive, says emergency physician Graham Walker. He comments that the human body is significantly more complex than the transportation industry, writing, “I feel like there’s many more that can go wrong with humans–not just the patient, but also the multiple humans taking care of the patient.” He also points out the unintended consequences of striving f... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2712037 Tue, 18 Aug 2009 15:00:07 +0100 2712037 http://www.medworm.com/index.php?rid=2709070&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fwhen-it-comes-to-health-care-reform-winners-and-no-losers.html And that’s precisely what’s obstructing any meaningful reform. Princeton economist Uwe Reinhardt talks about how the American people wants to have their cake and eat it too, and devises an “all-American wish list” of what ideal reform should look like to the American public. It includes such items as, “Cost-effectiveness analysis should never be the basis of any coverage decision by public or private third-party payers in health care, for to do so would put a price on human life — which, in America, unlike everywhere else, is priceless,” and, “Americans have a moral right to life-saving and potentially highly expensive medical care, should they fall critically ill, even if they are uninsured and could not possibly pay for that care with their own... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2709070 Tue, 18 Aug 2009 11:00:43 +0100 2709070 http://www.medworm.com/index.php?rid=2699695&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fno1LFrhNDCM%2F by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system.  We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included: Patient Centered Medical Homes (PCMHs) Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs) Payer Disease/Care Management Programs Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come State/Regional Chronic Care Programs (e.g., Colorado, Pennsylvania, Improving Performance in Practice) Accountable Care Organizations — the n... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2699695 Thu, 13 Aug 2009 20:41:48 +0100 2699695 http://www.medworm.com/index.php?rid=2699544&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fa-borderline-admission-from-the-er-or-not.html A woman on Medicaid is newly diagnosed with lung cancer in the emergency department. Although medically stable, should she be admitted to facilitate the coordination of the care she will require? That’s a question emergency physician Jesse Pines asks in a recent WSJ op-ed. In the end, despite the resistance of the admitting hospitalist, he admitted the patient. Dr. Pines writes that, “Without expert help, arranging a timely, multi-step outpatient work-up for something serious can be a full-time job even for patients with private insurance. For those with Medicaid, it’s an even greater challenge. Some doctors will not treat Medicaid patients, which pays less than private insurance, and those who do often have long waiting times for appointments.” He notes, correctly,... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2699544 Thu, 13 Aug 2009 19:00:53 +0100 2699544 http://www.medworm.com/index.php?rid=2699809&cid=t_270717_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2F6PvCOl2D3Xc%2F It’s tough enough for a family to have someone suffer from a genetic disorder but to have three in the family is just heart-breaking. And that’s what the Shaffer family from Oregon is going through as their three young sons are treated for a rare genetic condition that affect the nervous systems (video). Two 8-year old twins and their younger brother have leukodystrophies (adrenoleukodystrophy or ALD), a disorder that causes damage to the membrane (myelin sheath) that surrounds nerve cells in the brain. Adrenoleukodystrophy is commonly inherited as an X-linked (or sex-linked) trait, as the gene is located on the X-chromosome and passed from mother to her children. If the mother is a carrier (say XX for one abnormal allele), then she will pass that defective gene to all her sons (XY).... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=2699809 Thu, 13 Aug 2009 16:33:18 +0100 2699809 http://www.medworm.com/index.php?rid=2695312&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fshould-advance-directives-be-stored-online-on-google-health.html It was recently announced that Google Health, a popular personal health record, will allow patients to store their advance directives. Emergency physician Graham Walker calls the initiative an “epic fail,” and illustrates some real-life problems of the idea. While it is generally thought that making one’s health information available electronically to medical personnel is a reasonable idea, doing so with advance directives may not be. Especially in the emergency department where patients often are unable to give a cogent history. Dr. Walker notes that, “Our critically ill patients are usually so critically ill they’re not able to be speak, or they’re altered, or too somnolent to be thinking correctly, let alone be able to type and remember their login to Google ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2695312 Wed, 12 Aug 2009 15:00:57 +0100 2695312 http://www.medworm.com/index.php?rid=2691437&cid=t_270717_87_f&fid=38113&url=http%3A%2F%2Fblogs.consumerreports.org%2Fhealth%2F2009%2F08%2Fyou-never-know-whats-coming-for-ya.html I finally saw the movie The Curious Case of Benjamin Button this weekend and woke to a bright morning thinking the movie’s refrain “You never know what’s coming for ya.” So I was primed for the unexpected as I read the troubling content on Dead By Mistake, a site that features the results of a Hearst investigative report on medical errors. The site’s most compelling feature is the set of 30 profiles and heart wrenching photos of lives lost unexpectedly under circumstances that certainly seemed preventable. This new content echoes the report we released in May as part of our Safe Patient Project.  Our report, To Err is Human—To Delay is Deadly, looks at specific infection-preventing practices state by state and the status of legislation to make hospital ... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=2691437 Tue, 11 Aug 2009 20:21:19 +0100 2691437 http://www.medworm.com/index.php?rid=2691436&cid=t_270717_87_f&fid=38368&url=http%3A%2F%2Fwww.aannet.org%2Ffiles%2Fpublic%2FAPN_template.pdf As the nation focuses on how to cut the cost of so-called health care reform, maybe it’s time to pay attention to demonstrated methods for improving care while reducing costs that are not yet supported by Medicare and other payers. We cannot afford the system we have and changing it should be on the top of the agenda for anyone who wants to extend coverage of health care to all and improve health outcomes. For example, many readers of this blog will have had the experience of being a patient or family caregiver for someone who is older and has multiple chronic health problems that periodic become acute and require hospitalization. Once discharged from the hospital, the patient and caregiver often feel at a loss for how to manage some of the problems that can arise even within hours of di... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2691436 Tue, 11 Aug 2009 13:42:39 +0100 2691436 http://www.medworm.com/index.php?rid=2688599&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Frobert-ricketson-and-the-surgical-screwdriver-medical-malpractice-case-the-medical-records-revisited.html Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient’s back. This is his account of the ordeal. by Robert Ricketson I am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious “medical blogs” and Google hits that have effected my entire life. I no longer practice medicine nor would I ever consider it again. I have erred, I admit, but I can no longer tolerate the degree of misrepresentation of facts and distortion of truths. I would like the opportunity to relate what actually happened at Hilo Medical Center in 2000 and the subsequent events at Queen’s Medical Cen... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2688599 Tue, 11 Aug 2009 11:00:05 +0100 2688599 http://www.medworm.com/index.php?rid=2681989&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FEHAHY8k71iI%2F Google Health…please stick around….but please also get your stuff together. Over the past few days, several of my respected colleagues have written excellent blog posts essentially asking “Does Google Health have life?” Scott Shreeve — CLEAR! Shocking Google Health Back to Life John Moore — Is Google Health Irrelevant? Will Crawford — Future of Google Health I share their observations and sentiments.  I see Microsoft HealthVault as a serious business strategy while Google Health is more like a hobby (one of probably hundreds at Google). Are there reasons Google should stick around healthcare? Absolutely!  Off the top of my head, I can think of five: Google brings unique competencies to health care information seeking. Google Health is doing a good job on a sho... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2681989 Fri, 07 Aug 2009 22:36:01 +0100 2681989 http://www.medworm.com/index.php?rid=2671060&cid=t_270717_136_f&fid=36469&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fespeciallyheather%2FEH%2F%7E3%2FikAroPw0y6g%2F When I saw my name on His name, I didn’t quite grasp the true meaning behind the name Jehovah Jireh- I knew that it meant “He will provide”, but I didn’t quite grasp that through the sobs. And then it hit me: Jehovah-jireh was the place in the land of Moriah where God told Abraham [...] (Source: Especially Heather) Especially Heather blogs http://www.medworm.com/rss/comments.php?id=2671060 Wed, 05 Aug 2009 12:51:39 +0100 2671060 http://www.medworm.com/index.php?rid=2670767&cid=t_270717_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2009%2F08%2F04%2Fits-world-breastfeeding-week-more-hospitals-have-been-added-to-the-baby-friendly-list-and-a-word-on-judgment%2F It’s World Breastfeeding Week, and Women’s eNews has a piece up about new additions to the list of Baby-Friendly Hospitals, facilities which meet 10 criteria demonstrating a commitment to improve institutional breastfeeding policy, training and practices. The criteria are 10 breastfeeding-focused steps outlined by UNICEF/WHO, including helping mothers initiate breastfeeding, allowing “rooming in,” and other practices. The complete list of 83 qualifying U.S. facilities is available from the Baby-Friendly Hospital Initiative. Now, whenever this particular week rolls around, there are inevitably a flood of posts on breastfeeding, especially about how women who can’t or won’t breastfeed experience harsh judgment from others. With so many cultural and workpl... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=2670767 Wed, 05 Aug 2009 00:16:15 +0100 2670767 http://www.medworm.com/index.php?rid=2670761&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F08%2Fshould-er-doctors-be-immune-from-medical-malpractice.html Emergency physicians are forced by EMTALA  to treat everyone who comes through the ER doors. Should these cases be exempt from medical malpractice? The Happy Hospitalist argues that the standard of care within the community sets an unreasonable bar. Consider this situation, for instance: The [problem] I see in today’s malpractice environment is the irrational standard of care that has been established, not by science, but rather by the fear of the lawsuit itself. Everyday of my life I see head CTs ordered on patients with drug overdoses because they are acting funny. Should that be the standard of care? Of course not. Is it? Yes. He appears to support a bill recently introduced in Ohio where “physicians would have qualified civil immunity while working in emergency rooms and b... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2670761 Tue, 04 Aug 2009 15:00:28 +0100 2670761 http://www.medworm.com/index.php?rid=2671094&cid=t_270717_150_f&fid=38374&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FJl3Mf2vW2Yw%2Fonline-hospital-ratings.html (Source: ePharma Summit) ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=2671094 Tue, 04 Aug 2009 14:38:00 +0100 2671094 http://www.medworm.com/index.php?rid=2667553&cid=t_270717_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2009%2F08%2Ficd-10-implementation.html Lisa Eramo has written a piece for HealthLeaders Media about ICD-10 implementation issues and timelines. The article is available online: Providers May Need Four Years to Implement ICD-10.[snippet]"Industry experts have repeatedly said that ICD-10 implementation must begin immediately in order for hospitals, health plans, and vendors to meet the October 1, 2013 compliance deadline. But now there is detailed evidence to prove it."[snippet] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=2667553 Mon, 03 Aug 2009 21:10:00 +0100 2667553 http://www.medworm.com/index.php?rid=2663593&cid=t_270717_46_f&fid=38787&url=http%3A%2F%2Fmsf.ca%2Fblogs%2Fphotos%2F2009%2F08%2F03%2Fnigeria%2F Photo: Misha Friedman Port Harcourt, Nigeria - July 2007 In the oil-rich Niger delta in southern Nigeria, the struggle for revenue and power has resulted in violent clashes fueled by a complex dynamic among various groups. In the heart of the Diobu in Port Harcourt is Teme hospital where MSF set up a trauma center in November 2005. More than 200 Nigerian and international staff provide free emergency medical care to victims of trauma, including gunshots, stabbings, burns, and life-threatening road accidents. (Source: MSF Blogs) MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=2663593 Mon, 03 Aug 2009 11:43:40 +0100 2663593 http://www.medworm.com/index.php?rid=2664008&cid=t_270717_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F9FbayybjEJQ%2F                 Economists call it “The Penguin Problem”  — No one moves unless everyone moves, so no one moves.  The role of user expectations is crucial in getting penguins to move off of ice floes and in the successful adoption of new network technologies.  I’ll cover two main points in today’s essay: How “The Penguin Problem” Helps Explain Low EHR (electronic health record) Adoption To-Date How Recent Federal Actions Are Setting Higher Expectations for EHR Adoption The Penguin Problem and Low EHR Adoption To-Date While not the only factor, the role of user expectations is a crucial element in explaining the adoption of new network technologies. Harvard Business School Professor Tom Eisenmann explains: (more…) Tags: business model, care management... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2664008 Sun, 02 Aug 2009 23:37:24 +0100 2664008 http://www.medworm.com/index.php?rid=2657569&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fare-drive-thru-ers-the-future.html Finding a way to decompress crowded emergency departments is imperative. Over at Stanford Hospital, doctors there have come up with one novel tool: the so-called “drive-thru ER.” Patients literally don’t have to get out of their cars to receive medical care. This is especially relevant in the current era of pandemic flu, since patients can use their own cars to reduce the risk of contaminating others. So, how does it work? Here’s a description of the concept in action: The volunteer patients made their way through the drive-thru triage as though they were being seen at the emergency room. As cars entered the parking garage, patients registered and were given paperwork. They then drove through one of two lines and stopped at the first station, triage, where nurses ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2657569 Fri, 31 Jul 2009 11:00:24 +0100 2657569 http://www.medworm.com/index.php?rid=2653857&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FJiGzgIr2hbA%2F This weekend I had the delightful experience of spending time hanging out in the hospital as my wife gave birth to our third child. All went well and baby and Mamma are doing well. Of course, having this fanatical EMR background that I do, I couldn’t help bet spend many moments considering on the impact of an EMR at the hospital. Certainly I was watching as the nurses spent a lot of their time at the computer entering in all sorts of granular data about what was happening in our room. It was interesting to watch how laborious it was for them to enter everything. I could see many of them dreading that part of the job. However, the thing that hit me most was that the computer was so rarely in the middle of my wife and baby’s care. At all of the most important points the computer ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2653857 Wed, 29 Jul 2009 15:24:11 +0100 2653857 http://www.medworm.com/index.php?rid=2648935&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fare-patients-refusing-doctors-who-no-longer-do-hospital-work.html As the numbers of hospitalists increase, more primary care doctors are no longer doing hospital rounds. Communication problems can arise from this, as discharge summaries and other hospital notes often are not transferred back to the outpatient physician in a timely manner, if at all. And indeed, some patients are unhappy with this trend, and prefer to choose doctors who both have an outpatient clinic and perform hospital duties. As internist Robert Centor says, “Patients are smart. They understand the value of having a physician who knows them well.” However, blame the current fiscal environment that influences physician behavior as a major reason why the hospitalist profession is thriving. It is likely that the doctor, or “comprehensivists” as Dr. Centor calls the... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2648935 Wed, 29 Jul 2009 11:00:17 +0100 2648935 http://www.medworm.com/index.php?rid=2645245&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fdid-michael-jacksons-doctor-give-propofol-a-possible-cause-of-death-for-the-king-of-pop.html Things are looking increasingly bleak for Dr. Conrad Murray, Michael Jackson’s personal physician. Reports are circulating that the powerful anesthetic propofol, also known by its trade name Diprivan, was found in the singer’s body. According to ABCNews, “the autopsy of Michael Jackson found the powerful anesthetic propofol, as well as several prescription drugs, in his system, and law enforcement sources say that investigators believe their final report will list the propofol as a ‘contributing factor’ in his death.” Dr. Murray has consistently denied that he had given drugs like Demerol or Oxycontin, but has remained suspiciously quiet about propofol. And indeed, sources say that Dr. Murray administered the drug 24 hours before the singer’s deat... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2645245 Tue, 28 Jul 2009 03:35:45 +0100 2645245 http://www.medworm.com/index.php?rid=2648982&cid=t_270717_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D7511 I notice many young kids in hospital unsupervised running around hospital doing crazy things. Parents are nowhere to be seen or even if nearby seem oblivious to their little terrors. One day I heard giggling in the ward and I saw a couple of young ones maybe 4-5 years old placing their hands on freshly painted railing guards on the wall and delighting in their “paw prints”. Aside from damaging hospital property and being a nuisance to ward staff and other patients, kids sometimes face real dangers. Hospitals are a hazardous place for kids. You have patients with infectious diseases - open TB, H1N1 and what not - and multi-resistant germs abound. But there can be real horror stories like what Jimbo just related. This is not an isolated incident as it has happened elsewhere befo... Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=2648982 Mon, 27 Jul 2009 23:00:00 +0100 2648982 http://www.medworm.com/index.php?rid=2639618&cid=t_270717_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2FBtIPxLvl6xg%2F Sometimes going into the hospital can expose you to all kinds of deadly disease and germs that you wouldn’t normally have crossed paths with. Such is the case for Madison, Wisconsin area patients who were told that they may have been exposed to Creutzfeldt-Jakob disease due to contaminated instruments. Creutzfeldt-Jakob disease symptoms “include rapidly progressing dementia, with death often coming within a year.” University Hospital says there is an “extremely low” risk that developed after it was confirmed that one woman had the disease. While the instruments used on the woman were sterilized, some health officials believe it is not enough to kill this deadly disease. The instruments, who were also used on 53 neurosurgery patients, have now been discarded. ... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2639618 Sun, 26 Jul 2009 12:02:01 +0100 2639618 http://www.medworm.com/index.php?rid=2634326&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fcan-paging-the-wrong-doctor-harm-patients.html One of the more frustrating hospital experiences is trying to reach either the doctor on call, or the covering physician, outside of business hours. And reaching the wrong doctor happens more often than you think. According to a recent study from the Archives of Internal Medicine, “14 percent of in-hospital pages were sent to the wrong physician when that physician was off duty and out of the hospital.” That’s a lot. Many times, the reason is communication. Various physician groups have complicated call schedules, and fail to adequately inform either the nursing staff or the hospital. And worse, of these erroneous pages, “15 percent were marked as emergencies, warranting an immediate reply, and 32 percent were marked urgent, meaning a response was needed within an h... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2634326 Thu, 23 Jul 2009 15:00:29 +0100 2634326 http://www.medworm.com/index.php?rid=2625934&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fthe-unintended-consequences-of-preventing-patient-falls.html When it comes to preventing Medicare’s so-called “never” events, sometimes the solution is worse than the problem. I wrote about it last year in the USA Today, saying, “While withholding payment for inexcusable medical mistakes is a sensible concept, Medicare’s decision to penalize hospitals for more nuanced complications raises the bar too high. You cannot regulate perfection.” And preventing patient falls has nuance written all over it. The New England Journal of Medicine recently wrote as much, noting that as much as we’d like to prevent falls (via Dr. RW), there is no reliable evidence showing that it can be done. Worse, unintended consequences will rear its ugly head: If hospitals are scrutinized for the occurrence of falls, the natural tendency w... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2625934 Tue, 21 Jul 2009 15:00:22 +0100 2625934 http://www.medworm.com/index.php?rid=2616668&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fpoll-is-easy-patient-access-to-the-medical-record-a-good-idea.html Boston’s Beth Israel-Deaconess Hospital is engaging in a year-long project called OpenNotes, which will look at what happens when patients are given real-time unrestricted access to their medical chart. HIPAA gives patients the legal right to access their medical records, but actually getting them is often a slow, laborious process. This project will give patients access to their electronic record immediately following an office visit. Is this a good idea? Having easy access to their physicians’ notes could help patients remember what was discussed during the appointment. But many physicians are wary. Some physicians anticipate that patients will be worried and confused by medical jargon they don’t comprehend, and that doctors will have to spend time translating their notes into ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2616668 Mon, 20 Jul 2009 11:00:16 +0100 2616668 http://www.medworm.com/index.php?rid=2611148&cid=t_270717_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F07%2F16%2F2009-2010-u-s-news-world-report-best-u-s-hospital-rankings%2F Today, U.S. News & World Report issued its 2009-2010 rankings of the best U.S. hospitals for adults. The University of Texas, M.D. Anderson Cancer Center is rated #1 in cancer treatment; Brigham and Women’s Hospital is rated #1 in gynecology; and Johns Hopkins is rated #1 overall based upon all medical specialties. If you would like [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2611148 Fri, 17 Jul 2009 00:14:29 +0100 2611148 http://www.medworm.com/index.php?rid=2611117&cid=t_270717_131_f&fid=35008&url=http%3A%2F%2Fscienceroll.com%2F2009%2F07%2F16%2Fa-modern-hospital-website%2F John D. Halamka is an exceptional health blogger and Chief Information Officer and Dean for Technology at Harvard Medical School. He just blogged about the new website of Beth Israel Deaconess Medical Center. I know I always use Mayo Clinic as a perfect example about how to create a proper web 2.0 coverage for a hospital, but this one is another good example. Halamka blogged about the features as well: Blogs – Uses a SiteCore provided blogging module Chat – a commercial application called Cute Chat from CuteSoft. BIDMC TV (news and information videos produced by BIDMC)- Hosted by BrightCove. Medical Edge (videos about innovation produced by BIDMC)- Hosted by BrightCove. Podcast Gallery – Hosted on BIDMC servers. Health Quizzes – created using a commercial applicat... ScienceRoll blogs http://www.medworm.com/rss/comments.php?id=2611117 Thu, 16 Jul 2009 19:39:13 +0100 2611117 http://www.medworm.com/index.php?rid=2594402&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fwhy-are-hospitals-offering-nurses-free-plastic-surgery.html Is there pressure for nurses to look more like models? The answer appears to be yes, in Prague. Citing an article in The New York Times, plastic surgeon Chris Hess (via Better Health) notes that nurses in that region are “under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.” And according to this Czech nurse, “We were always taught that if a nurse is nice, intelligent, loves her work and looks attractive, then patients will recover faster.” I’m not sure about the data behind that, but in that society, offering free plastic surgery appears to be no different from giving away a car or a vacation. Despite the nursing shortage affecting patient care in many other countries, it appears to be a desperat... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2594402 Mon, 13 Jul 2009 11:00:36 +0100 2594402 http://www.medworm.com/index.php?rid=2594403&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fshadowfax-on-the-kevinmd-live-qa-tuesday-july-14th-at-1030pm-eastern.html Emergency physician Shadowfax will be my next guest on the Live Q&A. Blogging over at Movin’ Meat, Shadowfax is the pseudonym of an emergency physician in the Pacific Northwest. His blog posts are a combination of cogent health care reform analysis and opinion, commentary from the administrative side of medicine, and fascinating ER cases. He recently had a piece on health care reform published in The New York Times’ Room for Debate blog, entitled, Shift Pay Away From Specialists. Here’s your chance to ask him questions about life and practice in an American emergency room. Just click the window below on Tuesday, July 14th at 10:30pm Eastern. I’ll open the forum a few hours prior to the start time so you can begin posting your questions. Shadowfax on the KevinMD Li... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2594403 Sun, 12 Jul 2009 23:00:44 +0100 2594403 http://www.medworm.com/index.php?rid=2591442&cid=t_270717_87_f&fid=34872&url=http%3A%2F%2Fwww.blisstree.com%2Fhealthbolt%2Fhospital-care-varies-across-nation%2F In this study, researchers reviewed three years of experience (July 2005 to June 2008) of Medicare fee-for-service patients with heart failure and heart attack at almost 5,000 hospitals across the nation. Examining the records of nearly 600,000 heart attack admissions and more than 1 million heart failure admissions, they calculated the 30-day death and readmission rates and found: The average 30-day death rate for heart attack was 16.6 percent and the average rate of heart attack readmission was 19.9 percent. The average 30-day death rate for heart failure was 11.1 percent and 24.4 percent for readmission.   Heart failure death rate ranged from 6.6 percent to 19.8 percent. Readmission for heart attack ranged from 15.3 percent to 29.4 percent. Readmission for heart failure ranged from 1... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=2591442 Fri, 10 Jul 2009 21:14:02 +0100 2591442 http://www.medworm.com/index.php?rid=2859117&cid=t_270717_136_f&fid=39027&url=http%3A%2F%2Fwww.lrdlc.dreamhosters.com%2F2009%2F07%2Fdeath-of-a-dream%2F Surgery #1 was 1987. Once I recovered from the drug-induced haze and made my way out of the physical therapy labs (around 7-8 years old), I had seen far too many medical staff. Yet, since they were all around me and concerned about me, naturally it made me curious about them. It was simply fascinating. Overwhelming, but fascinating for a kid brain. Example thought process as a kid in a hospital: Who’s that lady? Why’s she got a mask on her head? Stetho-what? Heh, look at the dumb clown print on that guy’s shirt! How come so many of them have silly shirts? What are those cards hanging from everyone’s neck? What is that giant piece of metal? Is this a dungeon? Whoa I’m on a moving bed. Why don’t they use any orange or yellow lights around here? Everything ... Cancer, life, and me blogs http://www.medworm.com/rss/comments.php?id=2859117 Fri, 10 Jul 2009 20:25:08 +0100 2859117 http://www.medworm.com/index.php?rid=2588160&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fhow-soon-should-patients-receive-their-test-results.html And should you assume that no news is good news? The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent. That’s almost a quarter of abnormal test results from that center that patients were never notified about. Talk about a malpractice time bomb waiting to go off. Of course, practices with electronic medical records have the lowest rate of missed notifications, but interestingly, practices that combined paper charts and EMRs fared the worst of all. Doctors receive hundreds of lab and x-ray reports, along with consultant letters and hospital admission notes and discharge summaries, ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2588160 Thu, 09 Jul 2009 19:00:04 +0100 2588160 http://www.medworm.com/index.php?rid=2588318&cid=t_270717_117_f&fid=36026&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Fzimney-health-and-medical-news-you-can-use%2Fdiprivan-propofol-and-michael-jackson%2F Although Diprivan is widely used every day in hospitals and surgery centers across the United States, very few people, outside of medical personnel, were familiar with it or had even heard of it prior to its being found in Michael Jackson’s home after his untimely death. And while we still don’t yet know if it was related in any way to his death, many people want to know more about Diprivan and what its potential effects might have been. I worked for ICI, now Astra Zeneca, the pharmaceutical company that originally developed Diprivan, in the mid-80s during the time it was being prepared for market launch. I was part of the team helping to train the sales people who would later be selling the product. But Diprivan was unlike any product previously sold by these representatives b... Dr. Z's Medical Report blogs http://www.medworm.com/rss/comments.php?id=2588318 Thu, 09 Jul 2009 16:48:47 +0100 2588318 http://www.medworm.com/index.php?rid=2580205&cid=t_270717_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F07%2Fny-state-legislator-pleads-guilty-to.html We have posted about cases in which hospitals or academic medical centers hired legislators to promote their political agendas. In one case in 2006, a former Rhode Island state legislator pleaded guilty to selling his influence to a local medical center, which submitted to a deferred prosecution agreement, and whose CEO was later convicted of conspiracy and fraud. (This conviction has been appealed.) In another case in 2008, a former New Jersey state legislator was convicted of fraud for selling his influence to a state health care university and academic medical center, which also had been operating under a deferred prosecution agreement.The latest version of this type of scandal appeared towards the end of last month in the New York Times:Saying that he knew his 'conduct was illegal and ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2580205 Tue, 07 Jul 2009 21:11:00 +0100 2580205 http://www.medworm.com/index.php?rid=2580239&cid=t_270717_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FKqYn0C3m22o%2Fdont-forget-hiipa-privacy-rules.html As we move towards EMR’s, the ability to know who has looked at the medical record may get more and more in trouble. While we are all curious about our friends, neighbors, and celebrities (local or global), it is important to respect each others privacy. This local Arkansas story shows the importance of this respect. Hospital emergency room coordinator Candida Griffin, patient account representative Sarah Elizabeth Miller and Dr. Jay Holland, a family doctor who worked part time at the hospital, each face up to a year in prison and $50,000 fine if convicted of the misdemeanor charge. I would hope that all three of the people listed above would have “known better.” When this story broke earlier this week, the staff in the OR and I had a nice discussion on who gets HIPAA training ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2580239 Tue, 07 Jul 2009 15:32:22 +0100 2580239 http://www.medworm.com/index.php?rid=2859128&cid=t_270717_136_f&fid=39027&url=http%3A%2F%2Fwww.lrdlc.dreamhosters.com%2F2009%2F07%2Fmy-deepest-darkest-fantasy%2F This fantasy was born in a hospital room, while I was lying in recovery after the first major surgery. It started with a prayer.  I asked God with ALL my heart to “please make cancer into a real life demon.” I begged with God over and over.  I wanted cancer to be a physical being outside of my own body. I would have dreams where God granted me that wish. I would find myself (still a boy) with a shield and sword. Then I imagined myself walking up a steep mountain. Anger was my motivation. At the top of the mountain, I’d imagine a cave entrance.  Inside lurked the cancer demon.  I’d call him out and ask for a fight. Then this dragon/gollum/beast/demon would come stalking out. In this fantasy I did not show or feel any fear. Only anger. I dropped my shield and swor... Cancer, life, and me blogs http://www.medworm.com/rss/comments.php?id=2859128 Mon, 06 Jul 2009 17:52:47 +0100 2859128 http://www.medworm.com/index.php?rid=2570322&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fer-homeopathy-style.html Classic. (via Dr. Val) Related Posts:ICU wooWhen homeopathy takes holdMedicare already rations careAnother example of how homeopathy risks livesHomeopathy and placebo controlled studiesPosted at KevinMD.com. Stay updated and subscribe or follow me @KevinMD on Twitter. (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2570322 Fri, 03 Jul 2009 15:05:46 +0100 2570322 http://www.medworm.com/index.php?rid=2570534&cid=t_270717_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FKqYn0C3m22o%2Fdont-forget-hiipa-privacy-rules.html As we move towards EMR’s, the ability to know who has looked at the medical record may get more and more in trouble.   While we are all curious about our friends, neighbors, and celebrities (local or global), it is important to respect each others privacy.  This local Arkansas story shows the importance of this respect. Hospital emergency room coordinator Candida Griffin, patient account representative Sarah Elizabeth Miller and Dr. Jay Holland, a family doctor who worked part time at the hospital, each face up to a year in prison and $50,000 fine if convicted of the misdemeanor charge.   I would hope that all three of the people listed above would have “known better.”  When this story broke earlier this week, the staff in the OR and I had a nice discussio... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2570534 Thu, 02 Jul 2009 12:14:24 +0100 2570534 http://www.medworm.com/index.php?rid=2570326&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fdid-propofol-or-diprivan-kill-michael-jackson.html As predicted, the details surrounding the singer’s death continue to get more bizarre. Recent reports have stated that the powerful anesthetic Diprivan, generically known as propofol, was found in the singer’s house. Apparently, according to a nurse, Jackson “was begging for the powerful sedative to help him get over insomnia.” There are zero circumstances where propofol should ever be used for insomnia. This medicine is used for general anesthesia or to sedate patients in the intensive care unit who are intubated and on a ventilator. In fact, patients have to be monitored very closely when on the drug because the risk of respiratory arrest is so high. And that’s why I find it incredible that, again according to reports, Jackson had “claimed to have rec... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2570326 Wed, 01 Jul 2009 19:54:38 +0100 2570326 http://www.medworm.com/index.php?rid=2570327&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F07%2Fwhy-removing-the-tax-breaks-for-non-profit-hospitals-could-be-dangerous.html It’s because of the unintended consequences, of course. In their regular column in Slate, physicians Zachary Meisel and Jesse Pines talk about the recent attention that non-profit hospitals are garnering. The problem is this. Many are acting like for-profits, and in some cases, have been caught mistreating the uninsured and those who are on Medicaid. So, when money is tight, you hear stories like this one a few weeks ago in the Boston Globe, which takes another shot at their favorite target, Partners HealthCare. But threatening the tax breaks of non-profit hospitals can backfire. For instance, they can simply respond by simply cutting their losses and declaring themselves for-profit. And the results would be disaster to patients. Indeed, as Drs. Meisel and Pines write, “By disc... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2570327 Wed, 01 Jul 2009 19:00:45 +0100 2570327 http://www.medworm.com/index.php?rid=2561353&cid=t_270717_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2FUpfBMCGn-84%2F When someone comes in for treatment to the hospital, you’d like to believe that they won’t be back in for the same condition. However, readmission are a huge problem in hospitals today. Elderly and chronic disease patients account for a large part of readmission, but it can really happen to anyone. The reasons why someone would need to come back days or weeks later for the same condition can vary. We’ve all seen someone sent home from the hospital far too early. Add that to poor communication with health care staff and “trouble getting a prompt doctor’s appointment after discharge” and you’ve got a lot of patients in need of additional care. How to correct this? One suggestion has been a pay system that rewards quality. When patients are treated a... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2561353 Tue, 30 Jun 2009 22:14:35 +0100 2561353 http://www.medworm.com/index.php?rid=2556111&cid=t_270717_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F06%2Fdishonest-paramedics.html May be safer than an ambulanceI was called to see Mrs Johnson today. She is 78, lives with her husband, and suffers from COPD which is troublesome but stable. The details on the call request were "bad diarrhoea". She was, as always, apologetic when I arrived. But she looked unusually frail. Her husband said she was not drinking. She had had the diarrhoea for two days. Yesterday, Sunday, she was so bad that her son called an ambulance. I looked at the paramedic report. The box next to "Refused hospital admission" was ticked, and the form was signed by Mrs Johnson.I asked Mr & Mrs Johnson why she had refused to go to hospital. They both looked baffled. They had not refused admission. The paramedics had told her that it was the weekend, that the hospital was short staffed (true - it is al... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2556111 Mon, 29 Jun 2009 18:54:00 +0100 2556111 http://www.medworm.com/index.php?rid=2552987&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F06%2Fpatients-die-when-doctors-dont-talk-to-one-another.html Poor communication in medicine can kill. I wrote a piece a few years ago on the issue (What we have in health care today is a failure to communicate), and fellow primary care doctor Rob Lamberts revisits the topic in a recent post. In fact, he goes one further, saying not only does it cost money, “It kills. Patients have died because of this.” Hospitals and emergency rooms rarely have access to primary care records, and in turn, primary care offices usually have trouble receiving discharge summaries from inpatient admissions. This leads to fragmented care, repeated tests, and gaps in the patient record. Dr. Rob points out a strange irony, saying, “we live in a time where communication is easier than ever before and when information is easily accessed. Through my blog, Fac... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2552987 Mon, 29 Jun 2009 11:00:20 +0100 2552987 http://www.medworm.com/index.php?rid=2517188&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F06%2Fhow-did-michael-jackson-die-and-the-medicine-behind-sudden-cardiac-death.html Michael Jackson is dead at age 50. I’ve received several e-mails to comment on this story, but there’s really too few details to go on. I’m sure more will emerge in the near future. According to news reports, emergency medical services were called to his home in Los Angeles, where he was found in presumed cardiac arrest. CPR was performed, and he was rushed to UCLA Medical Center, which was about six minutes away. Other reports stated that he was training for a new show, opening in London next month, and had recently undergone a thorough and complete physical exam. He apparently was given a clean bill of health. It’s being reported that he died from sudden cardiac death, which according to the American College of Cardiology, is defined as, “the sudden cessati... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2517188 Fri, 26 Jun 2009 02:55:23 +0100 2517188 http://www.medworm.com/index.php?rid=2510723&cid=t_270717_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F06%2Ften-things-i-know-about-bellevue.html 1. The closets that are always open across from the chemistry lab have signs that say "THESE DOORS MUST NOT BE LEFT OPEN."2. Cocaine for sale!3. There is only so much Valium in the hospital, and in a night with a lot of alcohol withdrawers, Bellevue just might run out. Then - the apocalypse. Or some other benzodiazepine, whatever.4. What happens on the eighteenth floor, stays on the eighteenth floor.5. During my intern year I got sick of people mistaking Bellevue, New York's oldest public hospital, for a psychiatric institution. Now I know the truth: Bellevue is a psychiatric institution which just happens to have a lot of medical beds too.6. Sure you don't need to call an inpatient dermatology consult very often, but when you do, are they ever wrong?7. No, the patient doesn't speak (Spani... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2510723 Thu, 25 Jun 2009 02:04:00 +0100 2510723 http://www.medworm.com/index.php?rid=2553117&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F23%2Feasy-to-justify-ehr-implementation-at-hospitals%2F Many people have been arguing that it’s an easier process for hospitals to be able to justify the implementation of an EHR thanks to the new EHR stimulus money. Even more important might be the 5% penalty for not implementing an EHR. There’s no doubt that there’s a lot of money at stake in a large hospital system that has 100+ practices. You can do the math: number of providers x $44,000 = A lot of money. However you also have to add to that amount the penalties which is basically: Medcare reimbursement x 5% = Even more money. I’m certain that every hospital in the US is keeping a close eye on these developments. Even large group practices have some of the same financial equations with just a little bit smaller scale. What I think most people are forgetting is that ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2553117 Tue, 23 Jun 2009 15:07:19 +0100 2553117 http://www.medworm.com/index.php?rid=2523205&cid=t_270717_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F1KLKfZNhjgg%2F Many people have been arguing that it’s an easier process for hospitals to be able to justify the implementation of an EHR thanks to the new EHR stimulus money. Even more important might be the 5% penalty for not implementing an EHR. There’s no doubt that there’s a lot of money at stake in a large hospital system that has 100+ practices. You can do the math: number of providers x $44,000 = A lot of money. However you also have to add to that amount the penalties which is basically: Medcare reimbursement x 5% = Even more money. I’m certain that every hospital in the US is keeping a close eye on these developments. Even large group practices have some of the same financial equations with just a little bit smaller scale. What I think most people are forgetting is that ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2523205 Tue, 23 Jun 2009 15:07:19 +0100 2523205 http://www.medworm.com/index.php?rid=2609181&cid=t_270717_46_f&fid=38787&url=http%3A%2F%2Fmsf.ca%2Fblogs%2Fphotos%2F2009%2F06%2F23%2Fcongo-6%2F Photo: Roger Job Kenya Kamalondo health center, Lubumbashi - August 1999 A man fans his pregnant wife in the maternity ward where the fans are no longer working. (Source: MSF Blogs) MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=2609181 Tue, 23 Jun 2009 14:36:38 +0100 2609181 http://www.medworm.com/index.php?rid=2510147&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F06%2Fsteve-jobs-received-a-new-liver-and-the-ethics-surrounding-his-transplant.html Orac, a general surgeon who blogs at Respectful Insolence, writes the most comprehensive entry I’ve seen thus far on Apple’s Steve Jobs’ liver transplant. For those interested in the medicine behind the transplant, go and read his post in its entirety. I’d like to highlight some of the potentially questionable ethics surrounding the case. For one, there is the question why Mr. Jobs, who lived in California, had his transplant done at a Tennessee hospital. As reported by The Wall Street Journal, it was because the waiting list in that state was 46 days, far lower than the national average of 306 days. Orac asks how many others in need of a transplant would have had to means to travel to a state with shortest waiting time, and although “what Jobs did is not ill... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2510147 Mon, 22 Jun 2009 17:56:33 +0100 2510147 http://www.medworm.com/index.php?rid=2609182&cid=t_270717_46_f&fid=38787&url=http%3A%2F%2Fmsf.ca%2Fblogs%2Fphotos%2F2009%2F06%2F22%2Fhaiti-4%2F Photo: Cristina De Middel Cité Soleil, Haiti - June 2007 In one of the city’s most violent areas, Cité Soleil, MSF operates the 75-bed Choscal Hospital and primary healthcare centre in Chapi. More than 3,000 consultations are carried out monthly, including maternal and child healthcare and surgical consultations. (Source: MSF Blogs) MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=2609182 Mon, 22 Jun 2009 12:28:44 +0100 2609182 http://www.medworm.com/index.php?rid=2522916&cid=t_270717_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2F%3Fp%3D7284 I read with interest this letter someone wrote to Malaysiakini. We do sympathise with the writer on the loss of his or her loved one, but there are some things the writer brought up which I feel need clarification from the medical point of view. Every time we admitted her, the doctor would take some blood sample to check her condition. In total, so much blood was taken from her and not a drop was ‘returned’, so much so that her body became skeletal Taking Blood samples are not going to make one “skeletal” and indeed will not make an adult anaemic. The doctor didn’t see it fit to put her inside the ICU even though she was clearly dying. ICU is for those who need intensive care , not necessarily for those who are dying. It is possible that the writer’s mother was... Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=2522916 Sat, 20 Jun 2009 23:00:00 +0100 2522916 http://www.medworm.com/index.php?rid=2510454&cid=t_270717_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2006%2F06%2Flunchtime-phone-call-from-godson.html A lunchtime phone call from a godson.He qualified as a doctor last year. He has just coming to the end of his F1 year. He wants to be a surgeon. A properly trained surgeon. There are a total of 41 F1s in the region in which he works. Twenty of them (he knows for certain, there may be more) are applying for jobs in Australia. He is one of them.Doctors in AustraliaAustralia is enthusiastically welcoming our newly qualified doctors. In fact, it is actively recruiting them. It will not pay them as much as they will get paid here, but it will treat them decently, train them properly, and offer them a stimulating career. Many are going. Doctors.net is full of adverts such as this.Why is it happening? What is to be done?++++++++++This brilliant take on NHS bureaucracy gives some of the answers : ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2510454 Sat, 20 Jun 2009 17:15:00 +0100 2510454 http://www.medworm.com/index.php?rid=2510150&cid=t_270717_85_f&fid=34587&url=http%3A%2F%2Fwww.kevinmd.com%2Fblog%2F2009%2F06%2F10-president-obama-posts-you-may-have-missed.html With entries dating back to 2004, here are 10 classic blog posts on President Obama: 1. How the primary care doctor shortage threatens Obama’s health reform plan 2. The Obama health care summit, and did the President offer any clues to the upcoming health reform effort? 3. Is Physicians for a National Health Program the biggest threat to Obama’s health reform plan? 4. Did Obama provide any health care clues in his inaugural address? 5. How Obama’s health reform will hurt Canada 6. Do we really want Obama to quit smoking? 7. Expect more primary care work under an Obama health plan 8. Is an Obama presidency a threat to Catholic hospitals? 9. A pediatrician resigns after calling Obama “evil incarnate” 10. Will Obama resist the radical left? Related Posts:Migrating to WordPre... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=2510150 Sat, 20 Jun 2009 11:00:18 +0100 2510150 http://www.medworm.com/index.php?rid=2473257&cid=t_270717_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F06%2Fjunior-hospital-doctors-are-incompetent.html Junior hospital doctorThose GPs who wake up in the morning listening to the Today programme on Radio 4 are used to the medical stories that always start, or contain, some criticism of GPs. We don’t know this, we don’t know that, we need more training, we are overpaid, we are lazy and so on. It is deeply depressing and saps morale.The medical story this morning was different. It was precise and to the point. British junior hospital doctors are incompetent, inexperienced, negligent fools who are allowing patients to die of acute renal failure, an illness that is eminently treatable if only it is promptly diagnosed. “It can be diagnosed at the bedside with a simple blood test” suggested the egregious twat of an academic who was clearly enjoying his two minutes of perceived fame on the... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2473257 Thu, 11 Jun 2009 14:51:00 +0100 2473257 http://www.medworm.com/index.php?rid=2469490&cid=t_270717_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F06%2Fhospital-doctor-rises-from-ashes.html Hospital Doctor is much missed. It was the best of the many medical magazines that one found in the mess, in the coffee room, the dining room and the library. Now, some of the Hospital Doctor staff have risen, phoenix like, from the ashes to present "Hospital Dr" on the internet.HospitalDrWell worth a look. (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2469490 Wed, 10 Jun 2009 12:06:00 +0100 2469490 http://www.medworm.com/index.php?rid=2469535&cid=t_270717_105_f&fid=36987&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FIvorKovicMd%2F%7E3%2FTkMry_7qqcA%2F The Apple Worldwide Developers Conference (WWDC) is taking place in San Francisco right now. On the first day Apple introduced the new iPhone 3G S. They also continued their tradition of presenting some interesting upcoming applications. AirStrip Technologies has presented its new medical app called Critical Care. I really don’t have any comments at this moment other than WATCH THE VIDEO IT WILL BLOW YOUR MIND! AirStrip CRITICAL CARE features include: Virtual Views – Remote, virtual real-time monitoring of live cardiac rhythm strips and other waveform data such as pulse oximetry, end tidal CO2 and peak ventilator pressures. Strip Zooming – The zoom feature maintains relative size of waveforms and the background grid allows for easy assessment and measurements. Automated Calipe... Ivor Kovic, M.D. blogs http://www.medworm.com/rss/comments.php?id=2469535 Wed, 10 Jun 2009 10:26:51 +0100 2469535 http://www.medworm.com/index.php?rid=2609187&cid=t_270717_46_f&fid=38787&url=http%3A%2F%2Fmsf.ca%2Fblogs%2Fphotos%2F2009%2F06%2F09%2Firaq-2%2F photo: Siavash Maghsoudi September 2008 Hassan, 43, was driving his taxi in Bagdad, Iraq, when a bomb exploded. He underwent surgery with the MSF team in Mehran, in neighbouring Iran, and he is now getting follow-up treatment in Amman, Jordan. (Source: MSF Blogs) MSF Blogs blogs http://www.medworm.com/rss/comments.php?id=2609187 Tue, 09 Jun 2009 11:36:43 +0100 2609187 http://www.medworm.com/index.php?rid=2458162&cid=t_270717_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F07%2Fa-secret-a-disability-a-journey-into-the-unknown%2F The best documentaries, said one creator of that art form after a recent screening in Baltimore, reveal something that is outside the experience of those watching the film. His words resonated for me. For the past several years, I have immersed myself in the life of someone I never knew, someone whose daily routine couldn’t have been more different than mine. She was my aunt, and she was a family secret. More precisely, she was my mother’s secret. Mom never talked about having a sister, and only after Mom’s death did the first wisps of her secret come into the light. Her name was Annie Cohen. She had physical and mental disabilities that came to define her and her existence. I know now, based on medical records unearthed from a mental hospital, that Annie wanted nothing m... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2458162 Sun, 07 Jun 2009 12:00:01 +0100 2458162 http://www.medworm.com/index.php?rid=2452750&cid=t_270717_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F481itp1enA0%2F I’m all for hospitals showing patients how to eat healthy, but a farmer’s market right on the premises? That’s the case for some hospitals. One CNN article says that “The concept of farmers markets at hospitals is not entirely new, but it has started to spread — to places like Mount Sinai Medical Center in New York, University of California San Francisco Medical Center in California, and the Vanderbilt Medical Center in Nashville, Tennessee.” I used to work in a hospital kitchen, and it was interesting to cook our meals and talk to the patients and staff about what we had made and why. I suppose having a farmer’s market takes that a step further, where the hospital ends up showing patients what kind of foods to buy. What do you think? Would you at... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2452750 Wed, 03 Jun 2009 20:17:13 +0100 2452750 http://www.medworm.com/index.php?rid=2441451&cid=t_270717_97_f&fid=35606&url=http%3A%2F%2Fwww.theangriestpharmacist.com%2F2009%2F05%2F30%2Ftheres-a-kick-me-sign-on-pharmacys-back%2F I guess we’re the flavor of the month as the douchbags and assholes are coming out of the woodwork to take a cheap shot at our lovely profession. A loyal reader, known only as Bond, sent me the link to an article titled, “The Great Drug Switcheroo.” This piece of shit article published by “Prevention Magazine” (which has been around since the 50’s). The tagline is, “Your pharmacist may be changing your medication without your knowledge–and what you don’t know could hurt you. Here’s how to stay safe.” Once again, the man behind the counter in the white coat is trying to KILL you — not trying to help you achieve optimal results from your drug therapy. It begins with a story of a lady diagnosed with epilepsy who had troub... The Angriest Pharmacist blogs http://www.medworm.com/rss/comments.php?id=2441451 Sat, 30 May 2009 05:46:57 +0100 2441451 http://www.medworm.com/index.php?rid=2442326&cid=t_270717_133_f&fid=37107&url=http%3A%2F%2Fwww.aspieweb.net%2Fpsych-ward-old-asylum-lake%2F Yesterday my fiance and I went to a place a few miles down the road of me called Asylum Lake four our hopefully what would be daily jog.  Asylum lake is an absolutely beautiful place, complete wilderness inside a bustling city - but it has a history, a history that is heavy in suffering, rumor [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=2442326 Sun, 24 May 2009 07:38:13 +0100 2442326 http://www.medworm.com/index.php?rid=2441289&cid=t_270717_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F05%2Fhealthsouths-digital-hospital-from-era.html The trial for a civil law-suit against Richard Scrushy, the former CEO of for-profit rehabilitation hospital chain HealthSouth, is currently in progress. One bit of testimony provided a reminder about how supposed "innovations" in health care are uncritically accepted. As reported by the Birmingham (Alabama, US) News:HealthSouth Corp. Chief Executive Jay Grinney has concluded his testimony in the Richard Scrushy civil trial, ending with a devastating critique of the so-called 'digital hospital.''It was a very bad business decision that made no sense,' Grinney said of the half-completed Scrushy brainchild on U.S. 280 he inherited when he took over in 2004.Ending his sixth hour of testimony over two days, Grinney said the hospital had an original budget of $200 million, and that much had alr... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2441289 Wed, 20 May 2009 20:11:00 +0100 2441289