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 'insights:'. Wed, 21 Jul 2010 10:59:23 +0100 http://www.medworm.com/index.php?rid=3767122&cid=t_355769_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F07%2F19%2Fintroducing-the-therapist-within%2F I’m pleased to introduce The Therapist Within, a blog about psychotherapy by Gabrielle Gawne-Kelnar. Gabrielle is a psychotherapist who comes to us from Sydney, Australia, and I’m hoping her perspective from a different country and culture on psychotherapy will bring us new insights into the therapy process and the different ways it is practiced. But I’ll let Gabrielle speak for herself: A central part of my work as a therapist is a belief that everyone has their own answers, and their own unique solutions to the challenges in their lives, hidden somewhere inside them — it’s just that sometimes these answers can be hard to see. So, together, we’re embarking on a kind of quest here. A quest for questions. For curious keys that might help unlock some of the answer... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3767122 Mon, 19 Jul 2010 10:00:49 +0100 3767122 http://www.medworm.com/index.php?rid=3662934&cid=t_355769_150_f&fid=38374&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2Fzlg1Vf05_d8%2Fabbott-bayer-glaxosmithkline-pfizer.html Consumer healthcare brands and over the counter medicines are a multi-billion dollar industry. Brand marketers at leading pharmaceutical companies are charged with ensuring their brand pops off the shelf and into the shopper's basket. Understanding consumer and shopper needs is at the heart of delivering the right medical solutions in the right way.Join Abbott Laboratories, Bayer Healthcare, GlaxoSmithKline & Pfizer Consumer Healthcare and over 400 other best-in-class brands and retailers at the industry's most respected shopper insights event -Shopper Insights in ActionJuly 11-14, 2010, Marriott Downtown Magnificent Mile, Chicago, ILDownload the brochureFeatured Consumer Healthcare Perspectives include:Understanding Trip Segmentation & Shopper Insights to Increase Conversation &am... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=3662934 Mon, 14 Jun 2010 18:15:00 +0100 3662934 http://www.medworm.com/index.php?rid=3648598&cid=t_355769_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F06%2F10%2Fintroducing-the-creative-mind%2F We were sorry to see Susan K. Perry of our Writer’s Mind blog leave after only a few short months blogging with us. By all accounts, people enjoyed her blog and I know I learned something about writing from her insights. But producing new and interesting blog entries week after week can sometimes be more work than people realize. (Trust me, I understand!) But as they say, when one door closes, another one opens. With that, I’m pleased to introduce our new blog on psychology and creativity, The Creative Mind, with Douglas Eby. The Creative Mind will explore some of the main emotional and psychological topics that can affect how well or how freely creative people are able to express themselves. Douglas hopes to cater this blog to both professionals and to anyone who may want to f... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3648598 Thu, 10 Jun 2010 15:30:41 +0100 3648598 http://www.medworm.com/index.php?rid=3633622&cid=t_355769_147_f&fid=39202&url=http%3A%2F%2Fnicolaziady.wordpress.com%2F2010%2F06%2F05%2Fcompetitive-research-tools%2F The tools below are used to determine how much traffic your competitors get and which search terms send them the most traffic. Alexa: Gives you traffic trends for competing websites Compete.com: Track and compare competitors with free site metrics for the top 1,000,000 web domains Google Search Insights: Compare search volume patterns across specific regions, categories, and time frames Xinu: Free competitive analysis tool that provides PageRank, backlinks, site age, social bookmarking and link data (Source: Nicola Ziady) Nicola Ziady blogs http://www.medworm.com/rss/comments.php?id=3633622 Sat, 05 Jun 2010 23:40:41 +0100 3633622 http://www.medworm.com/index.php?rid=3545401&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2Fkgad-z4FyX0%2Fwhy-i-am-campaigning-for-dr-martin.html I believed in him before and I still believe in him now. If there's anyone "healthy" enough to be called a senator, that would be Dr. Martin Bautista, our Dr. Balikbayan. Why? I still believe that the "health" ills of this country could be better addressed with no less than a physician at the legislative forefront. Dr. Bautista's grasp of our health issues (like over population, health care reform) is unequaled. A fact that is borne out of him being a physician and having been exposed relentlessly to the social and health ills of this country vis a vis his training and yes, his stethoscope. Some would ask, will Dr. Bautista  be able to perform at par with other senators tackling other legislative issues in the senate? If you have seen Dr. Bautista talk or debate (on TV and on air) o... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3545401 Sat, 08 May 2010 05:48:00 +0100 3545401 http://www.medworm.com/index.php?rid=3479626&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2F6eFu2mZYqFM%2Fwhy-i-am-for-government-funded.html Yes. I am for a "universal" health care in the Philippines. Universal health care for all Filipinos? I cannot think of anyone not wanting a "secured" (meaning easily accessible, convenient, and efficient) health care coverage especially at the point of need. Majority (except US until, recently) of developed nations have some sort of universal health care system that protects its citizens.Look at their health indicators as a result of this. All points to a 'healthier' population. Simplistic, yes, but then personally I think health care should be that way. Everyone, every citizen should have access to an affordable, efficient and effective health care system Consider our alternative, our status quo. Access to health care in the Philippines is almost always concentrated on urban communiti... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3479626 Sat, 17 Apr 2010 06:34:00 +0100 3479626 http://www.medworm.com/index.php?rid=3435012&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FOlwfWp37u4Y%2Frelaunching-rejuvinated-season-two-blog.html Six months ago we were poised to rejuvenate season two of TBR. Some of us actually did submit articles for inclusion but it never went beyond my draft. Sorry for that, my mistake actually.  I thank all those who gave an article for that bungled season two. My apologies, to all of you. I miss the blog rounds. Everyone else I talked to seem to miss our blog rounds. Even some of my non medical friends miss it too.  Heck they were actually reading our blogs!  The New Blog Rounds Season 2 logo To make amends for that, and to revive our thirst for more blogging action, I, together with some blogging MDs are re-launching Season Two of TBR. No fanfare, just pure blogging indulgence on stuff that affects our lives, our patients and the world we live in as physicians. I'm sure we al... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3435012 Sat, 03 Apr 2010 10:39:00 +0100 3435012 http://www.medworm.com/index.php?rid=3350222&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2Fp9Ix57VA-Ns%2Fsome-peculiar-filipino-health-habits.html Filipinos in general,  have some peculiar, health and physician consulting habits  It's an observation many of us (physicians) noticed even before my generation of medical professionals. Surprisingly, we somehow developed  an adaptive, physician-patient working environment that is "attuned" to such behavioral peculiarities. Even if sometimes, they are as annoying as fascinating as they can be!  Some words of caution though and a bit of a "disclaimer". I'm pretty sure these are not unique to my set of patients nor to my field of specialty. Also, I am not saying these habits are trademarks or are unique to every Filipino patient out there. There are plentiful of exceptions and there are probably a hundred more similarities with another nationality. Certainly, I don't wan... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3350222 Wed, 10 Mar 2010 14:34:00 +0100 3350222 http://www.medworm.com/index.php?rid=3335256&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FoBCBJmnIwlg%2Funceremonious-unseating-of-up-pgh.html Here is one concise analysis of the UP-PGH Directorship issue from the former dean of the UP College of Law, Raul Pangalangan. Original article can be read here in his column in the inquirer.net.  Unceremonious unseating of UP PGH director By Raul Pangalangan Philippine Daily Inquirer First Posted 22:39:00 03/04/2010 I AVOID writing about faculty intramurals in the University of the Philippines, preferring to talk instead about the more benign politics of murders, massacres and wars. However, the recent unceremonious ouster of a sitting hospital director smacks too much of Malacañang-style politics that writing about it, come to think of it, is just like writing about President Macapagal-Arroyo. On Dec. 18, 2009, the university’s Board of Regents appointed Dr. Jose Gonzalez as th... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3335256 Fri, 05 Mar 2010 02:46:00 +0100 3335256 http://www.medworm.com/index.php?rid=3322306&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FXsMDe2gAH4Q%2Fup-medicine-college-council-resolution.html RESOLUTION OF THE COLLEGE COUNCIL OF THE UP COLLEGE OF MEDICINE ON THE APPOINTMENT OF THE DIRECTOR OF THE PHILIPPINE GENERAL HOSPITAL UNIVERSITY OF THE PHILIPPINES MANILA Whereas the University of the Philippines Board of Regents in its 1252nd meeting on December 18, 2009, appointed Dr. Jose Castillo Gonzales as Director, Philippine General Hospital, University of the Philippines Manila from January 1, 2010 to December 31, 2012; Whereas Dr Jose Gonzales took his oath of office as Director of Philippine General Hospital, University of the Philippines Manila before the BOR Chair on December 21, 2009 and before the UP Manila Chancellor on January 7, 2010; Whereas Dr. Jose Gonzales has already served as PGH director and has performed responsibly since January 4, 2010 with honor , integrity a... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3322306 Tue, 02 Mar 2010 06:53:00 +0100 3322306 http://www.medworm.com/index.php?rid=3316066&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2F2Ew7bYZWjBA%2Fstatement-of-indignation-laban-up-pgh.html The PGH Director controversy continues to heat up with sudden twist and turn of events that will for the first time in so many years, fire up into a UP Manila/ UP-PGH wide constituency (Laban-PGH Movement) barricade tomorrow morning, March 1, 2010.  I'm publishing a copy of this Indignation Statement here verbatim. Chronology of events that led to this controversy will also be published in my succeeding posts. On the historic day of Feb 25 and the 24th anniversary of the People's Power Revolution, the UP Board of Regents under the dark clouds of a walk out by the student, alumni, faculty and staff regents and a dismissed temporary restraining order against a decision to remove the student regent Chari Banez, declared null and void a board decision that appointed an already functioning... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3316066 Sun, 28 Feb 2010 13:01:00 +0100 3316066 http://www.medworm.com/index.php?rid=3243727&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FwRlfc9df75o%2Fyou-are-always-captain-of-your-ship-and.html The legal, ethical and aged (almost wise, but not quite) captain of the ship medical adage always stand true in any physician led health team. This autocracy is no more apparent anywhere else than that inside a surgical theater orchestrated by a feel god surgeon. I will not contest that Machiavellian theater governance (will write another post for that) but focus instead one ghastly annoyance that hound surgeons both inside and outside the OR once in a while. This: You are always the captain of your ship but oftentimes, you need to be a bosun too!I'm not sure if this is unique to any not so lovely practice environment but often something has to be done (short of putting a gun inside your mouth)  un-captainly in order to stop a captain's sinking vessel. Take this one anecdote shared b... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3243727 Thu, 04 Feb 2010 01:46:00 +0100 3243727 http://www.medworm.com/index.php?rid=3239502&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FwRlfc9df75o%2Fyou-are-always-captain-of-your-ship-and.html The legal, ethical and aged (almost wise, but not quite) captain of the ship medical adage always stand true in any physician led health team. This autocracy is no more apparent anywhere else than that inside a surgical theater orchestrated by a feel god surgeon. I will not contest that Machiavellian theater governance (will write another post for that) but focus instead one ghastly annoyance that hound surgeons both inside and outside the OR once in a while. This: You are always the captain of your ship but oftentimes, you need to be a bosun too!I'm not sure if this is unique to any not so lovely practice environment but often something has to be done (short of putting a gun inside your mouth)  un-captainly in order to stop a captain's sinking vessel. Take this one anecdote shared b... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3239502 Thu, 04 Feb 2010 01:46:00 +0100 3239502 http://www.medworm.com/index.php?rid=3243728&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FIcvjO4TqjMI%2Fironic-absurdities-for-bonedoc.html Last night when I was reading Bongi's blog (Other Things Amanzi), I came across his brutally hilarious (but freakishly realistic) post on (his sort of) "surgical principles". Bongi is a general surgeon based in South Africa and though I see striking similarities between our "surgical worlds", I found the guy's witty and humorous ways of narrating his surgically bugged life, intriguingly interesting. Anyhow I'm particularly inspired (nah, copycat) by his post on how he came up with "his principles". Not that I subscribe to all of  these but most went straight out of his operating theater making it egoistically fascinating for us surgeons and surgeons neck peckers. The one thing that strike me most was this "flat" referral to his bloody (or organically graphic) reality and how he finds ... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3243728 Thu, 04 Feb 2010 01:13:00 +0100 3243728 http://www.medworm.com/index.php?rid=3171818&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FNhWR5BlAwRk%2Fshould-you-give-your-cellphone-numbers.html In the few years I have been into practice, giving mobile contact number to a certain set of patients improved doctor-patient interactions and reduced overheads in the clinic.  In several provinces here in the Philippines where landlines are nonexistent,  the advent of mobile phones and SMS technologies provided easier and faster communication between physicians and their patients. Those that live in places away from their physician's clinic reported a reduction in their  unnecessary clinic visits and ER consults. The perceived overall health care cost reduction (especially with the SMS technology ) is felt not only by patients but also by physicians who find it easier to decongest their very busy clinic schedules. On the other hand, some doctors has had a bad experience aft... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3171818 Wed, 13 Jan 2010 16:11:00 +0100 3171818 http://www.medworm.com/index.php?rid=3167043&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FNhWR5BlAwRk%2Fshould-you-give-your-cellphone-numbers.html In the few years I have been into practice, giving my mobile contact number to a certain set of patient population proved to be beneficial in facilitating a reduction in health care cost.  In several provinces here in the Philippines, where landlines are nonexistent, cellphone calls and or SMS will be a great alternative for patients. These patients were appreciative of the fact they can contact their physicians easily. Those that live in places away from my clinic reported reduction in their  unnecessary clinic visits and ER consults. There seem to be an overall cost reduction , especially with the SMS technology nowadays, with giving away your mobile contact number to your patients. On the other hand, some doctors reported harrowing experience when they gave their mobile numbe... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=3167043 Wed, 13 Jan 2010 16:11:00 +0100 3167043 http://www.medworm.com/index.php?rid=3167198&cid=t_355769_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F01%2F12%2Fintroducing-the-therapy-soup-blog%2F As our regular readers know, we’re big supporters of psychotherapy. When you look at the research into what works for most common mental disorders, psychotherapy has decades’ worth of data supporting its effectiveness (in many of its various forms). Yes, medications are often a valuable adjunct treatment for mental health concerns, but for the vast majority of them, people should almost always be in therapy as well (or had a course of it in the past). So it’s with our pleasure to welcome our latest blogger to the Psych Central family, Richard Zwolinski. Richard is an author and therapist, and his blog Therapy Soup will discuss all issues of psychotherapy and the therapeutic process, demystifying it and helping to answer your questions about it. Richard Zwolinski, LMHC, CA... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3167198 Tue, 12 Jan 2010 18:23:18 +0100 3167198 http://www.medworm.com/index.php?rid=2912123&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2Fc36mQUPlsjw%2Fsocial-networks-and-physician.html In the recent years we've seen the rise of physician bloggers and physicians in social networks like Facebook, Tweeter, Multiply, online medical community like Recomed , Linked In or such online conferencing tools like Skype. While what constitute "sociable" data (those that can be shared or not shared on these networks) remains gray and debatable, this rising trend will continue for quite sometime at least in the first world countries I believe. Still, some physicians (especially in developing countries) isn't taking advantage of these social networks and online health care tools to develop their practice and improve patient care. Obviously there are distinct advantage and disadvantages for physicians getting involve on these social networks. The recent suggestion of charging patients ... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2912123 Wed, 21 Oct 2009 04:30:00 +0100 2912123 http://www.medworm.com/index.php?rid=2894453&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FGN3MqC6us9A%2Ftownhouse-blogging-will-it-be-for-real.html Here's a spin of my epic reawakening.When I started blogging about health care issues a year ago, I restricted my so called "online journal" to personal nuances that rarely touch anything substantial beyond my own epidermis. It was easier back then, having to simply blurt out personal experiences in order to keep the curiosity of my readers. It was this curiosity that enabled some readers a window into the often chaotic and enigmatic life of medical students, physicians, residents and the tears and glitter that came with our job. Grey's anatomy, Scrubbs and House MD entertained more viewers rather than offering realistic solutions to health care debacles. But they did succeed in bringing health care personnel into some different form of popularity.When I stumbled on foreign medical blogs t... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2894453 Wed, 14 Oct 2009 12:42:00 +0100 2894453 http://www.medworm.com/index.php?rid=2576491&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2F6xYB-xQWiJs%2Fover-counter-drug-store-dispensing.html The one good thing about going to the drug stores and buying medication incognito is that somehow, you'll get a glimpse of what some other sick people is buying without being stereotyped niceties of an inside the clinic patient-doctor interactions. Here are some of the sales lady - buyer overheard conversations that shocked me: Customer: "Miss ano maganda gamot sa trankaso?"(Miss what's a good medication for flu?) Saleslady:" Decolgen, trangkaso man kaha." (Decolgen, you got flu, right?) Customer:" Three times a day na sya ano?"( Three time a day?) Saleslady:"Yes". Customer: "Unsa, maayo nga antibiotic para sa trangkaso?"(Any antibiotic for flu?) Saleslady: "Konsulta sa mo sa duktor nay." (Consult a doctor first) Customer: "Cge, katong Decolgen na lang ako-a, tatlo ka buok. Ug isa ka Es... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2576491 Tue, 07 Jul 2009 07:37:00 +0100 2576491 http://www.medworm.com/index.php?rid=2510051&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2Fy3au7tCrICQ%2Fphilippines-enroute-to-mc-allen-health.html This article became a must read for Obama and his White House staff. I think the Philippines can also learn from these insights. While we preoccupy much of our debates over two spectrum of health care delivery (poor vs rich ) present in the cities, we do not exactly know the vast number of "in between" that reside in the rural areas.The Mc Allen phenomena is not unique to Texas. While those in the tertiary centers of health (e.g. Manila, Cebu, Davao) presumably get better access to quality health care system, the fee based system we have limits this quality health care to those who can afford it. Of greater concern are those poor Filipinos in the rural areas, where not only that they don't have access to better quality healthcare, they'll have to shell out more than their counterparts in ... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2510051 Wed, 17 Jun 2009 04:40:00 +0100 2510051 http://www.medworm.com/index.php?rid=2477200&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2F7PIEm99CTfg%2Fif-youre-young-and-wealthy-you-probably.html This study will probably be more "skewed" to the right among its Filipino users, as IPhone prices here in the Philippines are only affordable to the savvier, wealthier crop of professionals. Let's see what happens with the iPhone price cuts that Apple is offering these days. (Source: The Orthopedic Logbook) The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2477200 Sun, 14 Jun 2009 15:20:00 +0100 2477200 http://www.medworm.com/index.php?rid=2472240&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FvXekbdmatc0%2Fhigh-cost-of-hospitalization-in.html I'm not talking about top quality health care that is available to those who can afford. I'm not even compounding the issue with other factors such as health insurance system and access to medical care. Not even the extensive use of public health facilities by the poorest 30% of the Filipino population. I'm talking about this patient's words Doc, di nalang ako magpapaadmit sa ospital kahit kelangan. Di ko po kaya ang gastusin" (Doc, I don't want to be admitted in the hospital  even if its needed. I can't afford the expense)-Indang Her words not only rang the current "cost" of being a "poor" sick here in the Philippines but of frustration and disgust for having been a victim of a doubly whammy - that of being a poor and getting sick here in the Philippines. The findings of a study to... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2472240 Fri, 12 Jun 2009 13:57:00 +0100 2472240 http://www.medworm.com/index.php?rid=2452276&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FCp8zmXrlj0M%2Fi-hate-gunsthey-kill-my-courage.html "Patay na si Mingoy.Nabaril sya sa uma" (Mingoy is dead. He was shot while he was in the farm)- text message on Joy's phone. This SMS shocked me and Joy. It took us a while to regain our composure. Returning back from a hearty lunch with my cousins earlier we immediately talked about what to do next. Joy called nanay on the phone and told them not to go to the farm anymore as the "assailants" may still be lurking there. We then proceeded to the hospital where the body was brought in. We were all too late. Mingoy is dead. Mingoy is dead on arrival when he was brought into the hospital. His body is in the morgue when we arrived there. Talking to the first few people who saw and brought him to the hospital and to the investigating officers on the scene, it seems like he died from an "acciden... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2452276 Thu, 04 Jun 2009 14:09:00 +0100 2452276 http://www.medworm.com/index.php?rid=2447694&cid=t_355769_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F01%2F9-more-things-i-learned-in-high-school%2F Inspired by Therese Borchard’s 11 Things I Learned in High School, I wanted to share a few things I learned from my own high school experiences. I had many good times while in school, as well as my share of bad. But so many of the learning experiences we have in high school really can stick with us for years to come, teaching us about the ways of the world, life, friends and relationships. 1. Believe in your own abilities. So many times, we’re led to believe we’re not as good as we should or could be. And yet each and every one of us has unique abilities, talent and skills. No matter what others might tell you, believe in your own abilities, even when you feel unsure of yourself. 2. Things aren’t as bad as they seem. Things often seem worse than you’ve ever fe... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2447694 Mon, 01 Jun 2009 14:57:42 +0100 2447694 http://www.medworm.com/index.php?rid=2404915&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2Fov1Qf8EfpdQ%2Fare-there-any-electronic-medical-record.html I've been looking for an EMR that will suit my practice for two years ago. So far, for the few EHRs I tried, none really came close to servicing a community type of orthopedic practice. I'm still figuring out what to include in my evaluation per se but most of them is acking on some basic features. Here are the basic requirements for an EMR to work in a community based orthopedic practice: It should be free for all to use and upgraded via a community supported open source software. EMR migration for most,  is all about cost. If the cost is expensively prohibited, I might as well stay with our "manual" clinic operations. I should be easy to use, both for the MD and the clinic staff. No matter how "hi tech" the system would be if my college level clinic assistant don't know how to us... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2404915 Wed, 13 May 2009 15:49:00 +0100 2404915 http://www.medworm.com/index.php?rid=2263001&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FWu_cvmV5Zu8%2Fis-there-such-thing-as-blue-vs-red-pill.html "Lost".That's the best word to describe my general feeling the day after my graduation. I don't know where to start my medical career. There weren't any practical road maps to take on. I say practical because it's frustrating trying to figure out the nitty-gritty of establishing a practice on your own! Despite swallowing voluminous medical information and bombardments of idealism sans borders, I'm still lost in the opportunities in front of me. Regurgitating medical facts you learn in the lecture halls and clinics is not an easy thing to do. Those facts I learned (and still learning it) the hard way. The great enlightenment so far focused on two things- that career decisions solely depend on principles, values and capabilities and that you will be entirely responsible for whatever outcome... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2263001 Fri, 13 Mar 2009 09:36:00 +0100 2263001 http://www.medworm.com/index.php?rid=2169321&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FJpl_3Nk-Mdc%2Fweb-and-health-20-what-is-web-20-to-us.html I've been asked several times by colleagues and friends alike what do I get from blogging and joining social networks as a physician-surgeon. My honest to goodness answer was, I'm dabbling at web 2.0 tools to enhance my practice, my delivery of health care and sometimes, earn from sponsored ads.I get blank stares when I mentioned web 2.0 but the words "earn" seem to catch astute ears. I usually don't get enough talking time to expound on this, especially with the web 2.0 and health 2.0 part. Thus, I am making a series of posts to elucidate what web 2.0 is to us physicians and how is it changing the medical practice and our delivery of health care. (Forget the earning part, the web is replete with how-tos on this topic) I must warn physicians reading these series of posts, that even if I t... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2169321 Thu, 05 Feb 2009 04:18:00 +0100 2169321 http://www.medworm.com/index.php?rid=2169319&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FXT5jgMwFO7E%2Fban-all-forms-of-fireworks.html That's all the solution to the injuries inflicted by all forms of fireworks. The year in and year out reports of firecracker injuries dropping significantly by the year, under the present regulated law on "responsible" use of firecrackers, is hogwash. I have read that kind of news since I was in third grade, through my med school, and even after my orthopedic residency. Still, how many hands and fingers have we amputated each year? How many lives are still to be taken before we say, "Stop this crack!" It's always too late to cry (and too hard by the way) when you wipe your tears with an amputated hand, mind you. The question really boils down to why our legislators could not pass a legislation and the government imposing a total ban on all form of firecrackers. Is it the taxes they pay? T... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2169319 Fri, 09 Jan 2009 03:17:00 +0100 2169319 http://www.medworm.com/index.php?rid=2090927&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F506827646%2Fban-all-forms-of-fireworks.html That's all the solution to the injuries inflicted by all forms of fireworks. The year in and year out reports of firecracker injuries dropping significantly by the year, under the present regulated law on "responsible" use of firecrackers, is hogwash. I have read that kind of news since I was in third grade, through my med school, and even after my orthopedic residency. Still, how many hands and fingers have we amputated each year? How many lives are still to be taken before we say, "Stop this crack!" It's always too late to cry (and too hard by the way) when you wipe your tears with an amputated hand, mind you. The question really boils down to why our legislators could not pass a legislation and the government imposing a total ban on all form of firecrackers. Is it the taxes they pay? T... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2090927 Fri, 09 Jan 2009 03:17:00 +0100 2090927 http://www.medworm.com/index.php?rid=2510052&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FzIKX3Y1hXQY%2Fsuperdocs-and-super-patients.html I've seen these type of patients( commonly called a freeloader) since I was a neophyte in the practice of medicine- in the corridors, the cafeteria, the laboratory, at Wendys, or even at the malls(yes, MDs got to the malls too, sometimes). The common profile of such patients is someone you know or got acquainted to, not long ago or through another known person. The ambush interrogation is a classic "guerrilla consult" aimed (intentionally or unintentionally) at defying conventional ethics and procedures to get an MD consult on something the patient felt so "urgent. By some cultural and social magnet, you give in to the pleading, even if you felt the "problem" may not be closed to an emergent case by some medical standards. You come up with your most empathic diagnosis and advice in such a... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2510052 Wed, 07 Jan 2009 09:58:00 +0100 2510052 http://www.medworm.com/index.php?rid=2087996&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F505169519%2Fsuperdocs-and-super-patients.html I've seen these type of patients( commonly called a freeloader) since I was a neophyte in the practice of medicine- in the corridors, the cafeteria, the laboratory, at Wendys, or even at the malls(yes, MDs got to the malls too, sometimes). The common profile of such patients is someone you know or got acquainted to, not long ago or through another known person. The ambush interrogation is a classic "guerrilla consult" aimed (intentionally or unintentionally) at defying conventional ethics and procedures to get an MD consult on something the patient felt so "urgent. By some cultural and social magnet, you give in to the pleading, even if you felt the "problem" may not be closed to an emergent case by some medical standards. You come up with your most empathic diagnosis and advice in such a... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2087996 Wed, 07 Jan 2009 09:58:00 +0100 2087996 http://www.medworm.com/index.php?rid=2510053&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FFHdsBMXYvMY%2Febola-virus-reston-strain-in-hogs.html Frankly, to some degree, I am. Had it not been for an item in one newspaper and Google Health Maps, I would have left this story to the epidemiologist and infectious disease experts and enjoy Pacquiao's glamorous boxing stints. But this news pinched an area of my curiosity. Pigs in three Philippine hog farms have been found infected with the Ebola Reston virus, a strain not harmful to humans, officials say.-9News Australia This strain of Ebola virus (Reston) was previously known to infect monkeys and Department of Agriculture secretary Arthur Yap assured Filipinos this Ebola strain is non pathogenic to humans. However, following the news items "anchored" on the Philippines' Google health map location, suggest that much is still unknown of this Ebola strain. Where is the reservoir host o... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2510053 Thu, 18 Dec 2008 13:08:00 +0100 2510053 http://www.medworm.com/index.php?rid=2054915&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F488683342%2Febola-virus-reston-strain-in-hogs.html Frankly, to some degree, I am.Had it not been for an item in one newspaper and Google Health Maps, I would have left this story to the epidemiologist and infectious disease experts and enjoy Pacquiao's glamorous boxing stints. But this news pinched an area of my curiosity.Pigs in three Philippine hog farms have been found infected with the Ebola Reston virus, a strain not harmful to humans, officials say.-9News AustraliaThis strain of Ebola virus (Reston) was previously known to infect monkeys and Department of Agriculture secretary Arthur Yap assured Filipinos this Ebola strain is non pathogenic to humans.However, following the news items "anchored" on the Philippines' Google health map location, suggest that much is still unknown of this Ebola strain.Where is the reservoir host of this s... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2054915 Thu, 18 Dec 2008 13:08:00 +0100 2054915 http://www.medworm.com/index.php?rid=2510054&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Forthologbook%2F%7E3%2FS6WiF6CzMCs%2Fsms-remote-controlled-orthopedic.html This interesting news caught my attention just today. A British doctor volunteering in DR Congo used text message instructions from a colleague to perform a life-saving amputation on a boy.- BBC News HealthIt is not unusual for surgeons to refer to other surgeons for guidance on opinions regarding some cases they do. Some are personally being coached by more experienced surgeons actually. Residents in training are actually required to refer and if necessary ask the help of a consultant in all surgeries they are doing. And intra operative referrals, especially on emergency cases, is not uncommon. But I have yet to hear an actual surgery being remotely controlled via text messaging, step by step. These surgeons, from Medecins Sans Frontieres (MSF) in Rutshuru have done it. If we believe th... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2510054 Tue, 09 Dec 2008 04:45:00 +0100 2510054 http://www.medworm.com/index.php?rid=2036316&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F479186555%2Fsms-remote-controlled-orthopedic.html This interesting news caught my attention just today. A British doctor volunteering in DR Congo used text message instructions from a colleague to perform a life-saving amputation on a boy.- BBC News HealthIt is not unusual for surgeons to refer to other surgeons for guidance on opinions regarding some cases they do. Some are personally being coached by more experienced surgeons actually. Residents in training are actually required to refer and if necessary ask the help of a consultant in all surgeries they are doing. And intra operative referrals, especially on emergency cases, is not uncommon. But I have yet to hear an actual surgery being remotely controlled via text messaging, step by step. These surgeons, from Medecins Sans Frontieres (MSF) in Rutshuru have done it. If we believe th... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036316 Tue, 09 Dec 2008 04:45:00 +0100 2036316 http://www.medworm.com/index.php?rid=2036314&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F447142256%2Flessons-from-pulpit-my-mbs2-summit.html E-health 2.0 Since I started a medical blog (The Orthopedic Logbook) , I've been very enthusiastic on bringing on Web 2.0 and health together in marriage, so that the medical blogging community in the Philippines will have a distinct voice undiluted by mainstream media. The powers of Web 2.0 has this potential of revolutionizing health care and health care delivery systems in the country. In my upcoming posts, I will be tackling Web 2.0 and how Filipino physicians can take advantage of this promising tool to efficiently and effectively deliver quality health care to our fellowmen. Amazing Feat My Mindanao blogging community experience and how the forerunners of this very vibrant group in the blogosphere made me really gasps at the powers of Web 2.0 and blogging. The recent Mindanao Bloggin... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036314 Sun, 09 Nov 2008 05:17:00 +0100 2036314 http://www.medworm.com/index.php?rid=1906161&cid=t_355769_147_f&fid=35750&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHealthCareVox%2F%7E3%2F430050209%2Fmaking_sense_of_social_media_d.html Recently, I have been increasingly focusing on how health organizations can use the reams of information available to them via social networks, blogs and other social technologies for business critical purposes.  While the concept of mining online data is well established, many are still having trouble linking this information to business processes.  Specifically, there is a lot of room for improvement in how this data is being used by the health industry to: -Help executives answer questions that impact business over the long term-Accelerate decision-making -Predict outcomes -- especially as they relate to marketing communications initiativesI believe that successfully utilizing social media data requires one to visualize information  in order to quickly identify trends and... HealthCareVox blogs http://www.medworm.com/rss/comments.php?id=1906161 Thu, 23 Oct 2008 22:20:46 +0100 1906161 http://www.medworm.com/index.php?rid=2036313&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F423212680%2Fi-was-crying-dry.html (Disclaimer: All names and characters in this story were deliberately changed to protect the privacy of the patient concerned. If you felt the story was referring to you or someone you know, you are wrong.) "Hepe, you might want to go the ward now." The nurse on duty 's voice on the phone, sound a little bit gloomy. I just came down from assisting a junior for an OR that extended to almost 12 midnight and I barely touched "the bean bag" to rest. My team wasn't on duty that night. "Bakit hepe?" (Hepe, is our pet calls for male residents and male nurses in the wards, sort of brotherly respect). "Nag code si Nanay Delia..Ikaw yung hinanap nya..." For a moment, I don't know what to think of or how to react to this news. I immediately ran to the wards and joined the code team doing ACLS on Na... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036313 Thu, 16 Oct 2008 16:32:00 +0100 2036313 http://www.medworm.com/index.php?rid=2036312&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F423289881%2Fhow-to-find-best-physician-in-your-area.html Do you have any health concern needing attention? How should one actually go about looking for the "best doctor" if you need medical advice? Such questions only come up to the minds of most Filipinos during medical emergencies were choices are usually limited. I frequently end up seeing patients who have been through a number of physicians but don't have any idea about what they just went through or why.Thus, patients and relatives end up in a dissatisfying doctor-patient relationship or  worst, end up in the arguing courts rather than quality medical service. Not that I am better than the rest, but certainly such predicament put so much pressure on the MD and patients alike that quality service to patients suffer most. Here's some tips I can give to patients or parents when they're... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036312 Fri, 10 Oct 2008 13:24:00 +0100 2036312 http://www.medworm.com/index.php?rid=2036311&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F410378283%2Fsome-horrendous-claims-of-herbal.html It's not only irritating to hear horrendous "cure all" claims of some food supplements manufacturers and advertisers about their "drug" but the lack of advertisement control also nauseates me to no end. The sickening charade of food supplements jumping out of nowhere and claiming to heal all kinds of human afflictions thinkable (just so they can corner the poor man's pocket) is staggering to say at least. Taking these supplements at advertisement value is already one big step to your sick bed. Deceiving someone with false hopes and killing the patient in the process is another "crime" worthy of harakiri. (Photo taken from Science Blogs.) In almost everyday that I listen to the radio, some airtime (at times lasting a full 15 minute!) is spent on miracle cure throttled by exaggerated person... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036311 Fri, 03 Oct 2008 15:19:00 +0100 2036311 http://www.medworm.com/index.php?rid=1759843&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F09%2F03%2Fintegrating-emrs-with-reference-labs%2F There are many issues associated with connecting physician offices running EMRs into a hospital or reference lab. In prior postings we’ve covered: The use of standard vocabularies or terminologies such as LOINC. The challenges of using HL7 Orders and HL7 Results in a standard way — typically via profiling such as ELINCS profile (also described here). Communications infrastructure — using a VPN with a real-time, always-on connection or using a asynchronous method such as web services. Why do I mention this topic? Because it is “readers write” day over at HIS-Talk and there is some excellent discussion about many of these topics. Selected quotes: I think the labs agree [more standard integration] needs to happen, but just don’t want to invest in it. It is ve... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1759843 Thu, 04 Sep 2008 02:36:10 +0100 1759843 http://www.medworm.com/index.php?rid=2036309&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F382156613%2Fclosing-pandoras-box-mandatory-return.html According to ancient Greek mythology, Pandora opened the "box" (actually a jar which Zeus entrusted but forebode her to open) because of one uncontrollable urge-curiosity. The opening of Pandora's box released all "human evils" kept inside the jar by Zeus, except one human trait. (Pandora's Box Painting by JW Waterhouse) In one striking parallelism, the current brain drain of professionals is rooted in one analogous reason. Better financial and professional opportunities abroad fueled the curiosity of homegrown professionals to go on an exodus and opened the lid of our Pandora's box. No other profession suffered more scrutinizing eyes than what physicians received in this brain drain phenomenon . Believing that this mandatory return of service will close the exodus of professionals from ... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036309 Thu, 28 Aug 2008 13:47:00 +0100 2036309 http://www.medworm.com/index.php?rid=2036307&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F369971823%2Fis-there-shortage-of-physicians-in.html The World Health Organization (WHO) use these core health indicators to determine the status of health and healthcare delivery systems in a particular country. One of these indicators directly concern me as a Filipino physician. It actually scares me the most. Is there a shortage of physicians in the Philippines? To answer this question, I tried searching available statistics in the net, evaluated the credibility of these sources and studied the parameters in understanding these statistics. The results surprised me more than being confused some more. Take a look at this graphical presentations and their sources. A graph representing the estimated number of physician(s)per 1,000 Filipinos from 1960 to 2002 (Source the WHO and reproduced here) The same data noted the following trends:Fo... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036307 Wed, 20 Aug 2008 10:03:00 +0100 2036307 http://www.medworm.com/index.php?rid=1704678&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F08%2F13%2Fmassachusetts-hospitals-must-have-cpoe-by-2012-and-cchit-certified-ehrs-by-2015%2F Massachusetts recently passed a law requiring hospitals and certain other organizations to use interoperable electronic health applications. One key part of the story is that, by law, the systems must be CCHIT Certified. There is good, broad coverage at FCW.com. As is typical with such programs, the hope is to contain health care costs while boosting quality, transparency, and access to healthcare. What does this have to do with interoperability? One of the sections (#37) of this law states that by the year 2015 hospitals and community health centers will be required to use interoperable electronic health records (EHR) in order to renew or obtain a license to operate in Massachusetts. Another section (#36) says that by 2012 these entities will be required to use computerized physician orde... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1704678 Thu, 14 Aug 2008 11:48:01 +0100 1704678 http://www.medworm.com/index.php?rid=2036303&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F350020436%2Fpraying-before-undergoing-heart.html CONCLUSIONS: Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of receiving intercessory prayer was associated with a higher incidence of complications.Take note of their conclusions. In a predominantly catholic country like ours, I think our bishops would not be very happy with this. Unless they come up with another similar randomized multicenter study disproving this same results!Uh what the!Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medi... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036303 Wed, 30 Jul 2008 01:27:00 +0100 2036303 http://www.medworm.com/index.php?rid=2036299&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F335077607%2F3g-iphone-and-what-physicians-can-do.html I'm not about as techie doc as anyone here, but for those physicians ogling for the new 3G iPhone, here's what you can possibly do with this gadget according to Dean Giustini, at Open Medicine Blog1. Listen to medical podcasts or videocasts;2. View patient charts;3. Search PubMed; Google scholar; the web4. Phone 911 for emergencies; 'code' response in hospitals;5. Monitor patients; using PocketTweets (Twitter for your iPhone) Here's the big list (Grand Rounds Vol 4 number 40) of what physicians can do (or not do) with 3G iPhone and medical softwares for it compiled by Dr. Penna!All seem to be dependent on the availability of highspeed, reliable, uninterrupted net service and access to an electronic healthcare database in the hospitals. None of these two however is within a mile of my pract... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036299 Mon, 14 Jul 2008 12:16:00 +0100 2036299 http://www.medworm.com/index.php?rid=2036298&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F335040608%2Fensuring-e-mail-security-in-clinical.html Tired of deleting spam on your email's inbox? That's nothing compared to what happens when confidential information is "fished" out from those email messages sent over the net!No one is more horrified of this than physicians who use emails to send confidential information across the net. Yes, losing confidential information tru e-mail is as devastating as losing patients. Or worse, losing our careers.That is what Dr. David Kreindler is trying to avoid when he wrote this article "Email security in clinical practice: ensuring patient confidentiality" published in Open Medicine Vol 2 No 2 2008.And since it is impossible to strip the email of confidential personal (or patient's) information (the primary reason your sending that email in the first place) he gave a step by step advice on how to ... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036298 Mon, 14 Jul 2008 11:11:00 +0100 2036298 http://www.medworm.com/index.php?rid=2036295&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F329480276%2Fwrong-side-of-surgery-which-site.html Although rare, wrong site surgery happens even to the most able and busy OR team such as in this hospital. Imagine the horror of both the OR team and the patient discovering the closure stitches in the normal side after the procedure. But thats another story.What I'm a bit surprised is how the hospital administration managed to "rectify" the error and came out with better policies to prevent future incidents like this to happen. Their CEO even blogged about it, so the whole community would know about the lapses, the steps taken to correct it, and prevent further "errors" to happen in the same way.I can help but wonder if most of our health institutions here in our country have the same attitude towards wrong site surgery and medical errors. A universal protocol for wrong site surgery has b... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036295 Tue, 08 Jul 2008 03:14:00 +0100 2036295 http://www.medworm.com/index.php?rid=2036294&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F327874276%2Flow-gender-awareness-for-physicians.html Quite a number of studies showed that differences in gender awareness exist in the health care industry. However, this is not limited to professionals on the opposite side of the arguing fences, but also within professionals of the same gender. Consider this;"Ms. applicant A, considering this is a very "masculine" dominated training program and specialty, do you have any other training program in mind, that you applied for also and which is more "feminine" that would fit your built?"- Female Interviewer B I don't know if the interviewer was just "sensitive" enough to "enlighten" the applicant further by giving her options, but its pretty obvious such question is consequential to the bias created by a less gender sensitive workplace.But what is gender awareness in the first place? Here is o... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036294 Sun, 06 Jul 2008 02:35:00 +0100 2036294 http://www.medworm.com/index.php?rid=2036292&cid=t_355769_83_f&fid=38215&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Forthologbook%2F%7E3%2F320473038%2Fsex-in-clinics-directors-cut.html Nope, it's not what you think! But The Blog Rounds Fifteen Edition will tackle gender sensitive issues in medicine, on being a physician and on one's specialty!Head on to Manggy's blog, No Special Effects, host to this interesting round of blog posts, to get a clear idea of what I'm talking about. His call for articles is already up here.For those unaware yet, The Blog Rounds is a biweekly compilation of the best in Philippine's medical blogosphere, written by physician bloggers (or medically inclined bloggers) and hosted on a participating blogger's weblog. Archives and edition schedules ( plus the host blogger) are listed here. The next edition of TBR will be up this Tuesday, July 8, 2008 7am PST.Physicians and medically inclined bloggers interested in joining this blog carnival, please ... The Orthopedic Logbook blogs http://www.medworm.com/rss/comments.php?id=2036292 Thu, 26 Jun 2008 11:47:00 +0100 2036292 http://www.medworm.com/index.php?rid=1512317&cid=t_355769_109_f&fid=35677&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FBrainBasedBusiness%2F%7E3%2F310390477%2Faction_awakens_a_university.html Science is shedding light on how brains learn best through doing and how to transform complex concepts into doable actions. Yet when higher education ignores the wonders of acting on or applying ideas … entire education systems soon struggle from flawed visions. Have you seen it happen?If you agree that practice leads to excellent performances … you’d likely also concur that learning should be the clarion call to apply or act out dynamic insights. Do universities in your area spike or stunt learning?To act on a good idea … is to wire the human brain’s plasticity to do more of it … and to do it better.  Toss multiple intelligences into the mix … and you up the ante for golden applications that draw from hidden or unused talent. How so? Ima... BrainBasedBusiness blogs http://www.medworm.com/rss/comments.php?id=1512317 Thu, 12 Jun 2008 14:09:45 +0100 1512317 http://www.medworm.com/index.php?rid=1385475&cid=t_355769_158_f&fid=36018&url=http%3A%2F%2Fcaregiversbeacon.blogspot.com%2F2008%2F04%2Fhow-to-say-it-with-seniors-closing.html At Aging Parents Insights , author, speaker and educator David Solie recently discussed "what to do about aging parents who have little or no savings but refused to discuss any aspect of their 'money issue'." He explains that to elders the lack of money means a lack of control, and offers strategies for adult children who are dealing with this type of situation.In another article on his website titled "Reframing and Signaling: Communicating Tough Choices to Aging Parents" David Solie gives concrete, detailed suggestions for this. I especially like the part where he says to "The goal is to signal that you get it." In communication skills classes I took in college we were taught how important it is to the speaker for the listener to acknowledge that you grasp the situation. If the speaker do... The Caregiver's Beacon - Resources, Links, Ideas, News blogs http://www.medworm.com/rss/comments.php?id=1385475 Sat, 19 Apr 2008 18:25:00 +0100 1385475 http://www.medworm.com/index.php?rid=1072491&cid=t_355769_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F195629667%2F After a long run of quarterly spending growth, the reported spending for DTC advertising fell 7.1 percent in the third quarter to $1.13 billion, according to DTC Insights, which cites data released this week by Nielsen Monitor-Plus. The decline represented “reported” dollars of $86 million. (For the first nine months of 2007, the reported spending data shows an increase of 2.6 percent to $3.85 billion.) The shift in the third-quarter DTC spending hit network television hard, DTC Insights writes. According to Nielsen data, network TV saw its DTC ad dollars fall 10.1 percent in the quarter to $314.5 million (a drop of more than $35 million). As a result, the firm notes that cable TV surpassed network as the market-share media leader for DTC in the period (28.9 percent market share for c... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1072491 Wed, 05 Dec 2007 17:53:02 +0100 1072491 http://www.medworm.com/index.php?rid=835418&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F31%2Femr-interfacing-best-practices%2F The demand for healthcare interfaces with Electronic Medical Records (EMR) is increasing. This increase is due to the rising adoption of EMR systems, emerging clinical healthcare data standards (HL7, CCR, CDA, CCD, ELINCS), and increasing interoperability requirements, such as CCHIT (Certification Commission for Healthcare Information Technology). To achieve the most effective and efficient EMR connectivity, the following steps should be included in the process: Understand workflow:  Define the workflow within your organization and between your organization and the organization with the EMR system Document requirements:  Define the data requirements of your systems and the EMR in which you will be exchanging patient information Implement interfaces:  Build the interfaces to facilitate ... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=835418 Fri, 31 Aug 2007 16:03:52 +0100 835418 http://www.medworm.com/index.php?rid=832538&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F30%2Fhow-widely-adopted-is-hl7%2F HL7 is extensively adopted within the healthcare community. The HL7 family of standards has been under development since the late 1980s and represents the de facto method of moving clinical healthcare data. To clarify, the term “HL7″ can mean many different things based on who asks the question. However, when most people say “HL7″ they mean the “HL7 2.X messaging standard.” A much smaller number of people mean HL7 3.X, CCOW, EHR, CCD, CCR, CDA, etc. If we use the common definition of HL7 (HL7 2.X), it is fair to say that most hospital-based clinical software applications support HL7. “Support” in this context means that they can send or receive a subset of the HL7 2.X messages. Specifically, a typical software application will use between fiv... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=832538 Thu, 30 Aug 2007 16:24:31 +0100 832538 http://www.medworm.com/index.php?rid=818764&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F23%2Fpoint-to-point-interface-vs-interface-engine-in-healthcare%2F A healthcare environment typically has multiple systems that need to be interfaced. From the HIS to the RIS to the LIS, these systems all need to be able to exchange data via HL7. While most of these systems today have an HL7 interface, these interfaces are not compatible out of the box.  There is no plug-and-play interfacing in the world of HL7 today.  When one of these systems needs to send data to another, there usually will need to be some modifications to the message structure that is sent. This is because these applications all speak a ‘custom’ version of HL7.  In order to successfully interface the applications, one of two things has to happen.  One or both vendors will need to make customizations to their applications and/or their interfaces to be able to send and rec... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=818764 Thu, 23 Aug 2007 22:32:03 +0100 818764 http://www.medworm.com/index.php?rid=803568&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F16%2Fgetting-started-with-your-hl7-interface%2F A majority of clinical applications today have the ability to interface via HL7, or as we say, they can ’speak’ HL7. The problem is that HL7 is a flexible standard, and it is typically customized by each vendor to fit the specific needs of their application. When you need to build an interface between two independent systems, it is helpful to know where to start and what information you should gather from each vendor to begin the project. Ask For: HL7 Specifications - Each vendor should be able to supply an inbound and outbound HL7 specification for their application. The quality of these documents will vary greatly from vendor to vendor. These documents will allow you to do a gap analysis (see below) between the two systems. Sample Messages - Regardless of the quality of th... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=803568 Thu, 16 Aug 2007 15:25:30 +0100 803568 http://www.medworm.com/index.php?rid=797901&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F13%2Fwhat-is-cdisc%2F Clinical Data Interchange Standards Consortium (CDISC) is a data standards group focused on the interchange of clinical information within the pharmaceutical market. Specifically, CDISC is very aligned with the needs of clinical trial data exchange as it relates to clinical research workflow. CDISC is related-yet-separate from HL7 proper. While CDISC has mapped their data model (ODM) onto HL7’s reference information model (RIM), CDISC also stays neutral and makes mention of (or even provides mapp mappings to) other standards such as ISO, CEN, and other approaches from international organizations. As mentioned in their mission statement, this scope can be expanded to a full “motherhood and apple pie” version like so: The mission of CDISC is to develop and support global, p... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=797901 Tue, 14 Aug 2007 04:07:55 +0100 797901 http://www.medworm.com/index.php?rid=792808&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F10%2Fhow-do-hl7-and-xml-coexist-in-clinical-interfacing%2F There are a number of ‘new’ healthcare standards that are beginning to be implemented in clinical interfacing today. Acronyms such as CCR, CDA, and CCD are becoming common words in everyday interfacing discussions. While most interfaces today are using the HL7 2.x encoded format, these new standards are choosing to use XML as their message format. The healthcare standards are new, but the idea of using XML to transmit clinical information has been around for a long time. In fact, the HL7 organization actually publishes a set of XML schemas for rendering HL7 version 2 messages in an XML format. This format is more commonly known as HL7 2.XML. While this HL7 2.XML format is not widely used, these other XML based standards are beginning to be implemented by vendors and asked for b... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=792808 Fri, 10 Aug 2007 22:26:47 +0100 792808 http://www.medworm.com/index.php?rid=777590&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F08%2F03%2Fstreamline-the-billing-workflow-with-hl7%2F Healthcare billing departments are dependent on getting accurate information in a timely manner to meet its goals: increasing cash flow and decreasing operational costs. The challenge is getting the data from multiple systems and even multiple facilities. Many manual methods such as faxing, printing, scanning, etc. are used to facilitate the information gathering. Getting the needed patient demographics and charge capture data can be accomplished using HL7 interfaces*. (*Note that interfaces are dependent on an application’s ability to speak HL7, or produce or consume data in an electronic format.) HL7 integration presents the opportunity to streamline processes and share information quickly between systems. For example, in a hospital setting, if the laboratory adds on an additional ... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=777590 Fri, 03 Aug 2007 21:12:58 +0100 777590 http://www.medworm.com/index.php?rid=742562&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F07%2F18%2Felincs%2F The EHR-Lab Interoperability and Connectivity Specification (ELINCS) specification provides a profile that refines (or constrains) “standard” HL7 messages to moving lab results from reference labs to physician offices. Like IHE, the ELINICS profile constrains the generic HL7 standard to a specific set of use cases. In addition the ELINICS standard provides business rules that must be followed between the trading partners. Such rules are outside the scope of the base HL7 standard. ELINCS is part of the 2007 CCHIT Ambulatory Interoperability requirements. Note that sometimes this standard is misspelled as e-links or elinks. Resources for ELINCS: Accelerating EMR Interoperability with ELINCS: Streamlining Lab Connectivity to Physician EMRs ELINCS Standard: Laboratory Results to E... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=742562 Wed, 18 Jul 2007 20:29:15 +0100 742562 http://www.medworm.com/index.php?rid=716472&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F07%2F05%2Fmedical-device-interfacing%2F Last week the joint workshop on HCMDSS (High Confidence Medical Devices, Software, and Systems) and Medical Device Plug-and-Play (MD PnP) held a conference on medical device interfacing. The meeting was entitled, “Improving Patient Safety through Medical Device Interoperability and High Confidence Software.” Tim Gee, who is the Principal Consultant over at Medical Connectivity Consulting, wrote up an interesting “raw notes summary” of one of the panel discussions: Clinical Need for Interoperability Interesting quotes in his post: “Hospitals today are not safe – if you go into the hospital, take someone with you. One of the biggest problems is that technology advancement has outstripped the infrastructure (how the technology is deployed and used) to ensure sa... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=716472 Thu, 05 Jul 2007 22:19:09 +0100 716472 http://www.medworm.com/index.php?rid=708772&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F07%2F02%2Form-vs-rde-for-hl7-pharmacy-orders%2F When designing an HL7 interface to send pharmacy orders from a clinical application to a pharmacy system, it can sometimes be a challenge to determine which HL7 message type to use to send different types of information. Since both ORMs and RDEs can be used to send pharmacy orders, the question sometimes arises as to whether one should use ORM or RDE for pharmacy orders. Either approach is valid. Ultimately the question is not “Should I use ORM or RDE for pharmacy orders?”, but rather “Do my sending and receiving applications support exporting and importing of ORMs, RDEs or both for pharmacy orders?” Some vendors may choose to only export/import pharmacy orders as ORMs with additional segments or Z-segments as needed, while other vendors may choose to support expo... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=708772 Mon, 02 Jul 2007 15:39:12 +0100 708772 http://www.medworm.com/index.php?rid=660439&cid=t_355769_111_f&fid=34725&url=http%3A%2F%2Fnursesean.com%2F%3Fp%3D534 My first thought was, “I have been incredibly jinxed with urine output lately!” It was getting to the point where I was more surprised if my patients actually peed an appropriate amount. The doctors were getting used to my frequent pages begging for boluses for my dry patients. Yes, my patient’s urine output was only 200cc for the entire shift. I resigned myself to this fact after about ten minutes of manipulating and milking the tube, and falling short only of pushing on my patient’s bladder and begging. I had no choice, it was time to call the doctor for another bolus. What luck! The doctor was standing by the nursing station flirting with the young nurses. Granted, he his young and devastatingly handsome, but do the girls really need to giggle like that? I hesitantly walked ov... Nurse Sean blogs http://www.medworm.com/rss/comments.php?id=660439 Wed, 06 Jun 2007 09:48:05 +0100 660439 http://www.medworm.com/index.php?rid=637968&cid=t_355769_87_f&fid=34865&url=http%3A%2F%2Fwww.thecancerblog.com%2F2007%2F05%2F25%2Fcutting-remarks-a-surgeons-blog%2F Filed under: All Cancers, Blogs, Books, SurgerySidney M. Schwab, M.D., the author of Surgeonsblog, is a mostly retired general surgeon. With his blog, his intention is to inform, entertain, and possibly educate the reader about the life and loves of a surgeon. He also has written a book, Cutting Remarks; Insights and Recollections of a Surgeon. It's about his surgical training in San Francisco in the 1970s, aimed at the lay reader with the goal of entertaining with good stories, informing with understandable details of surgical anatomy, procedures, and diseases. Here is a little taste of what you can find on the Surgeonsblog --good stuff! If there's such a thing as mild OCD, I think I have it. For a surgeon, I'd say that's generally a good thing. In my practice, I was pretty obsessive ov... The Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=637968 Fri, 25 May 2007 04:00:00 +0100 637968 http://www.medworm.com/index.php?rid=611661&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F14%2Fwhy-use-an-hl7-engine%2F There are two primary methods of moving clinical data in a hospital or clinic: Point-to-point interfacing, which provides a direct connection between exactly two applications Interface engine interfacing, which provides a way to leverage a set of interfaces between many applications The presence of an HL7 interface engine in a healthcare environment gives more control to an organization and saves money and time by: Reducing the required number of export and import endpoints Allowing for reuse of data between applications Providing an easier method to interface a new or replaced application Providing the ability to monitor the entire system at one time Providing the ability to proactively notify interested persons using visual display and e-mail, when problems arise Facilities that use ... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=611661 Tue, 15 May 2007 02:42:18 +0100 611661 http://www.medworm.com/index.php?rid=587451&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F03%2Frene-spronk-on-where-is-hl7-deployed-or-used-across-the-world%2F Rene Spronk from Ringholm is a former co-chair of the HL7 Marketing committee and a very active participant within the HL7 community. He offered up his view on “where in the world are the HL7 users” in response to my posting earlier this week about who uses HL7. Given that I deeply appreciate both Rene’s HL7 work and his opinion, I wanted to place his entire response in a new posting so it would not get lost in the RSS shuffle. It is true that this mainly depends on what one decides to count. The HL7 Marketing committee established that 30% of the global HL7 membership is located in the US, and about 45% in Europe. Which doesn’t necessarily mean the distribution of implementations is the same. The 80% figure in terms of users (organizations that use HL7 interfaces) loo... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=587451 Fri, 04 May 2007 03:28:20 +0100 587451 http://www.medworm.com/index.php?rid=587452&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F03%2Fattendance-at-the-hl7-meeting-somewhat-lower-than-hoped%2F Although the final numbers are not yet announced, it appears that attendance at the May 2007 HL7 Working Group Meeting in Cologne, Germany will reach a total of approximately 375 people over the course of the week. This is a bit lower than a typical meeting where there are between 400 and 550 attendees. The lower turnout contributed to the conference not meeting the hotel room block requirements. The good news is that I did not hear anyone indicate that committee work was held up by the lower turnout. Some argued that fewer people actually made things go faster! There was some discussion and conjecture about why attendance was lower at the Cologne meeting. Several ideas were floated, and I think they all contributed towards the lower turnout - for example, ”overseas travel” sp... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=587452 Thu, 03 May 2007 22:46:09 +0100 587452 http://www.medworm.com/index.php?rid=587455&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F05%2F02%2Fwhere-is-hl7-deployed-or-used-across-the-world%2F This week I’m at the May 2007 HL7 Working Group Meeting in Cologne, Germany. Although I travel extensively, almost all my travel is typically within the United States. Thus, dropping into a country with a culture and environment so different than my own has me deeply thinking about the international community of “real” users of HL7. I ran an informal survey to see if my thoughts about HL7’s use would be in line with other HL7 experts. Background: As you probably know, HL7 is a family of international standards that are endorsed by or used within many countries. The HL7 standards — be them older V2.X messaging, new 3.X messaging, CDA/CCR/CDA, etc — reflect input from many realms. This internationalization of HL7 has been on-going since the early 2000s. Th... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=587455 Wed, 02 May 2007 12:18:26 +0100 587455 http://www.medworm.com/index.php?rid=549639&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F04%2F17%2Fhl7-z-segment-questions-and-answers%2F On a previous HL7 Z-Segment post, a reader responded with two questions. Outlined below are the questions and my answers. HL7 Question 1: Can I insert a Z-segment anywhere in the HL7 message or can I only place the Z-segment at the end? HL7 Answer:  You can place the Z-segment anywhere in the HL7 message. There is no rule in HL7 that dictates where a Z-segment should be located in a message. One popular approach is to insert the Z-segment in the message so it is grouped with similar information contained in the message. For example, if you are storing insurance specific data, you may want to create a ZIN segment and place it in the insurance group in your message directly after the IN3 segment.  Another approach is to place any Z-segments at the end of your message, so systems that are... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=549639 Tue, 17 Apr 2007 23:26:19 +0100 549639 http://www.medworm.com/index.php?rid=538994&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F04%2F12%2Fimprove-your-tat-with-hl7%2F Turn Around Time or TAT. An important concept for many radiology practices or any healthcare institution.  An article entitled Are Your Physicians Happy? appeared in RT Image in 2004. Granted, it was several years ago, but the article highlights the importance of understanding key radiology processes, knowing the cycle time of each process, and identifying the “weak” areas. The workflow discussion and approach is still valid today, especially if the objective is to improve TAT. What has changed today is that many radiology practices and diagnostic imaging centers have begun to realize how the HL7 standard and interface engine solutions can take TAT to the next level.  We wrote a white paper entitled Rethinking Radiology Workflow which illustrates how steps in a process c... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=538994 Thu, 12 Apr 2007 14:30:38 +0100 538994 http://www.medworm.com/index.php?rid=508111&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F03%2F28%2Fcreating-an-electronic-medical-community-productively%2F In a recent issue of Advance Magazine for Health Information Executives, Brian Moreau with Henry County Health Center wrote an article entitled IT Performance Excellence. The article highlights how a hospital with limited resources can easily and effectively connect various applications together - CPSI, GE Centricity PACS, and GE Centricity EMR - to: Improve workflow Extend reach to physicians Enhance patient focus We are proud to have Henry County Health Center as a customer, because they represent how combining the right approach with the right solutions can enhance hospital operations while strengthening relationships with patients and physicians. (Source: NeoTool Healthcare IT Blog) NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=508111 Wed, 28 Mar 2007 19:39:21 +0100 508111 http://www.medworm.com/index.php?rid=464210&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F02%2F08%2Felincs-standard-laboratory-results-to-emrs%2F The EHR-Lab Interoperability and Connectivity Standards (ELINCS) is a national data standard for transmitting results from a Laboratory Information System (LIS) to an Electronic Medical Record (EMR) or Electronic Health Record (EHR) system. The ELINCS messaging specifications seems to be a practical, real-world approach to solving the application level problem of electronic lab results. ELINCS simplifies and normalizes only the lab results, which are the most valuable piece of data to the physicians. Furthermore, it supports the information required by CLIA (Clinical Laboratory Improvement Amendments) for lab reporting to clinicians.  The ELINCS standard is based on the HL7 v2.4 messaging standard, specifically, the result message, ORU. It greatly reduces the complexity of the generic H... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464210 Thu, 08 Feb 2007 14:33:49 +0100 464210 http://www.medworm.com/index.php?rid=464211&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F02%2F01%2Fack-message-real-world-scenario%2F In my last two posts - acknowledgement (ACK) message definition and Original Mode ACK, it is important to remember that not every system will handle acknowledgments the same way. You will interface with systems that send you HL7 messages and do not wait for a response of any kind prior to sending the next message. In this scenario, your system will not be able to send back acknowledgment messages. This type of message delivery is never recommended. Also, not all systems will review the values that are placed in MSA-1. So even though your application may be setup to send back an AE value in MSA-1, if you fail to receive a message, there is no guarantee that the sending system will review this value. Why is this important? Consider this scenario: Your lab application is setup to send back a ... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464211 Thu, 01 Feb 2007 22:54:53 +0100 464211 http://www.medworm.com/index.php?rid=464212&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F02%2F01%2Fack-message-original-mode-acknowledgement%2F In an earlier post on HL7 acknowledgement (ACK) messages, I highlighted the important value of ACKs and defined the concept of original mode acknowledgement. A sending application should review each response and verify three things:   1.   The response is an HL7 formatted message. To do this, the application simply needs to review the format of the response that was received and verify that it appears to be formatted in a typical HL7 pipe-and-hat format.   2.   The response is a positive HL7 ACK. To verify this, the application needs to review the MSA segment of the ACK message. MSA-1 will contain the acknowledgment status of the message. Below are the typical values you will find in this field: • AA - Application Accept • AE - Application Error • AR - Application... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464212 Thu, 01 Feb 2007 22:54:06 +0100 464212 http://www.medworm.com/index.php?rid=464213&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F02%2F01%2Fhl7-ack-messages-guaranteed-message-delivery%2F The HL7 2.5 standard defines close to 500 different message types. While some are only used occasionally, almost all HL7 interfaces will incorporate the H7 acknowledgment (ACK) message. An HL7 ACK message is used to insure that HL7 messages are delivered from system to system without being lost. Like any technology company, occasionally we have our own internal IT problems to deal with. This week it happened to be our mail server. For a period of time, we were not receiving any external e-mail, but we were unaware of the problem until a customer called us to let us know his e-mail had bounced. Once we were aware of the problem, fixing it was trivial. This got me thinking about the way HL7 messages are delivered, and the importance of HL7 acknowledgment messages. In the clinical world... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464213 Thu, 01 Feb 2007 22:53:51 +0100 464213 http://www.medworm.com/index.php?rid=464215&cid=t_355769_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F01%2F26%2Fpatient-data-matching-with-hl7-messages%2F More independent reference laboratories and imaging centers are connecting to their referring community of physicians by creating interfaces between their Laboratory Information System (LIS), Radiology Information System (RIS), and the physician’s Electronic Medical Record (EMR) system. In their efforts to create a seamless process of transmitting electronic results, they typically find challenges in various aspects of interfacing. One example of the issues that arise is the requirement by the EMR to match on specific patient information. This requirement translates to a lab or diagnostic imaging center that they must include specific information, as identified by the EMR, within the HL7 result message (ORU) to send the reports electronically. As with any interface, the issues and so... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=464215 Sat, 27 Jan 2007 00:00:28 +0100 464215