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 'integration'. Sat, 03 Sep 2011 01:56:38 +0100 http://www.medworm.com/index.php?rid=5130658&cid=t_138355_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fcan-competition-and-integration-co-exist-in-a-reformed-nhs%2F Scan or Click to go to King's Fund website to download 'Can competition and integration co-exist in a reformed NHS?' Title: Can competition and integration co-exist in a reformed NHS? The Skinny: King’s Fund report that addresses the fundamental question of whether competition and integration can co-exist and considers the role that different bodies, especially the NHS Commissioning Board and Monitor, will play within a new system. The NHS Commissioning Board and Monitor must: develop bundled payment mechanisms so that commissioners can contract for packages of care from different providers allow flexibility for local innovation – regulations and guidance from both are critical access to specialist procurement support for clinical commissioning groups is vital ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130658 Mon, 15 Aug 2011 14:00:21 +0100 5130658 http://www.medworm.com/index.php?rid=4882968&cid=t_138355_139_f&fid=38879&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FVirologyBlog%2F%7E3%2FpvidiGD_uZ4%2F The novel human retrovirus XMRV has been associated with prostate cancer and chronic fatigue syndrome. The nucleotide sequence of XMRV isolated from humans indicates that the virus is nearly identical with XMRV produced from a human prostate tumor cell line called 22Rv1. This cell line was derived by passage of human prostate tumor tissue in nude mice. Sequence analyses reveal that the genomes of these mouse strains contain two different proviral DNAs related to XMRV. These viral genomes recombined to produce XMRV that has been isolated from humans. XMRV was originally isolated from a human prostate cancer in 2006, and subsequently associated with ME/CFS. The human cell line 22Rv1, which was established from a human prostate tumor (CWR22), produces infectious XMRV. An important question is... virology blog blogs http://www.medworm.com/rss/comments.php?id=4882968 Tue, 31 May 2011 14:45:14 +0100 4882968 http://www.medworm.com/index.php?rid=4709468&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F04%2Fsensory-integration-research-who-is-it.html This article is another factor analysis study that has to be considered in the context of a number of other studies including Ayres (1989) original cluster and factor analyses that went into SIPT standardization, Mulligan's 1998 and 2000 cluster and factor analyses, and the critically appraised topic written by Davies and Tucker (2008). I'm not sure how many street level practitioners read cluster and factor analysis studies but I don't think that most people put this on top of their reading list. I think this is because we don't spend a lot of time educating practitioners on these methods and what they mean. I personally think that these statistical models are interesting but I also understand that they have a serious fundamental flaw in that they are based on heuristic models of interpre... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4709468 Thu, 14 Apr 2011 03:46:00 +0100 4709468 http://www.medworm.com/index.php?rid=4676907&cid=t_138355_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2011%2F04%2F03%2Femr-integration-for-medical-devices-the-basics%2F Medical device manufacturers in markets that have managed to resist creating connectivity solutions are facing increased pressure from providers adopting EMRs. I mean, what’s the use of automating the EMR if users have to write down numbers read from medical device displays and then manually type them into the EMR? That’s certainly not “automation.” This feature is already a required and necessary feature in some device markets, and rapidly becoming a necessity in many other device markets. Manufacturers in this situation (needing an interface to EMRs for clinical documentation) often come to me with a plethora of questions. Before we get started, let’s frame the discussion. In this post you will be introduced to a framework for clinical documentation connecti... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=4676907 Sun, 03 Apr 2011 18:08:23 +0100 4676907 http://www.medworm.com/index.php?rid=4664300&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FB9uML3xGuUk%2F Let me try to get you in the right frame of mind to read one of the most remarkable white papers in a long time: Better to BEST: Value Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations — released yesterday by the Commonwealth Fund, Dartmouth Institute, and PCPCC. Having been a debater in high school and then trained as a lawyer, my default mode of thinking is to be critical: “Hey, Vince, how ya doin’? Great day isn’t it?” “Well, …err…maybe, maybe not…actually, here’s 14 reasons why not.” My wife and friends kindly tell me that this personal quality can be insufferable, and if you’ve ever met a lawyer you know what I’m talking about. My internal defense mechanism against my inner-critical brain is simply to... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4664300 Thu, 31 Mar 2011 14:48:23 +0100 4664300 http://www.medworm.com/index.php?rid=4554337&cid=t_138355_139_f&fid=38879&url=http%3A%2F%2Ftraffic.libsyn.com%2Ftwiv%2FTWiV123.mp3 Hosts: Vincent Racaniello, Alan Dove, and Rich Condit On episode #123 of the podcast This Week in Virology, Vincent, Alan, and Rich talk about XMRV integration sites in prostate tumor DNA, the decline effect and scientific method, and the first virus of Caenorhabditis nematodes. Right click to download TWiV #123 (67 MB .mp3, 93 minutes). Subscribe to TWiV (free) in iTunes , at the Zune Marketplace, by the RSS feed, by email, or listen on your mobile device with the Microbeworld app. Links for this episode: Analysis of XMRV integration sites from human prostate cancer (Retrovirology) Integration site preference of XMRV (J Virology) The Decline Effect and the Scientific Method by Jonathan Lehrer (New Yorker) Why most published research findings are false (PLoS Medicine) Cochrane Rev... virology blog blogs http://www.medworm.com/rss/comments.php?id=4554337 Sun, 06 Mar 2011 19:12:02 +0100 4554337 http://www.medworm.com/index.php?rid=4535789&cid=t_138355_139_f&fid=38879&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FVirologyBlog%2F%7E3%2FdhFAXLKovhg%2F Integration of retroviral DNA into the cellular genome is essential for the production of new infectious particles. A strong argument that the novel human retrovirus XMRV is not a laboratory contaminant is the finding that viral DNA is integrated in chromosomal DNA of prostate tumors. Nucleotide sequence analyses of 14 integration sites in prostate tumor DNAs from 9 different patients previously revealed the expected viral sequences linked to human DNA. But two of these integration sites are identical to those found in a prostate tumor cell line infected with XMRV. A search of the nucleotide sequence database with the previously identified XMRV integration site sequences revealed that 2 of the 14 sequences (from 2 patients) were identical to two XMRV integration sites in DU145 cells. This... virology blog blogs http://www.medworm.com/rss/comments.php?id=4535789 Wed, 02 Mar 2011 04:08:00 +0100 4535789 http://www.medworm.com/index.php?rid=4455410&cid=t_138355_132_f&fid=35006&url=http%3A%2F%2Fnsaunders.wordpress.com%2F2011%2F02%2F09%2Falgorithms-running-day-and-night%2F Warning: contains murky, somewhat unstructured thoughts on large-scale biological data analysis Picture this. It’s based on a true story: names and details altered. Alice, a biomedical researcher, performs an experiment to determine how gene expression in cells from a particular tissue is altered when the cells are exposed to an organic compound, substance Y. She collates a list of the most differentially-expressed genes and notes, in passing, that the expression of Gene X is much lower in the presence of substance Y. Bob, a bioinformatician in the same organisation but in a different city to Alice, is analysing a public dataset. This experiment looks at gene expression in the same tissue but under different conditions: normal compared with a disease state, Z Syndrome. He also notes ... What You're Doing Is Rather Desperate blogs http://www.medworm.com/rss/comments.php?id=4455410 Wed, 09 Feb 2011 03:41:21 +0100 4455410 http://www.medworm.com/index.php?rid=4450288&cid=t_138355_87_f&fid=38368&url=http%3A%2F%2Fbit.ly%2FfY2q28 By Mary Grealy. There’s no question that, if we’re ever to have effective health reform in this country, improving our healthcare delivery system has to come through a public-private partnership. One of the key elements of the Affordable Care Act is the creation of the Center for Medicare and Medicaid Innovation (CMMI), an entity that will be charged with evaluating concepts for healthcare delivery reform and then putting into action demonstration projects that have the potential to improve healthcare quality and increase cost-efficiency. Fortunately, much of this ground is already being broken in the private sector.  Throughout the country, hospitals, pharmaceutical companies, medical device manufacturers, group purchasing organizations, insurers, distributors and other health sector... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4450288 Tue, 08 Feb 2011 13:24:20 +0100 4450288 http://www.medworm.com/index.php?rid=4355913&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F01%2Fnew-study-on-si-effectiveness-but.html Just a quick couple thoughts as I got a few emails asking me to comment on an article in the new AJOT. The study people are interested in is Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. (linked for those of you who have access). The study found that both intervention groups demonstrated significant improvements toward goals on the Goal Attainment Scale, but the SI group demonstrated more significant improvement than the FM group. Also, the SI group displayed significantly fewer autistic mannerisms than the FM group as measured by a sub test of the Social Responsiveness Scale.One of the nicest features of this study is that the researchers completed a series of fidelity measures on the interventions. This is a big step forward... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4355913 Sun, 16 Jan 2011 18:30:00 +0100 4355913 http://www.medworm.com/index.php?rid=4309239&cid=t_138355_139_f&fid=38879&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FVirologyBlog%2F%7E3%2FbeReX4M3uAY%2F A strong argument that the novel human retrovirus XMRV is not a laboratory contaminant is the the finding that viral DNA is integrated in chromosomal DNA of prostate tumors. Why does this result constitute such strong proof of viral infection? Establishment of an integrated copy of the viral genome – the provirus – is a critical step in the life cycle of retroviruses. Proviral DNA is transcribed by cellular RNA polymerase II to produce the viral RNA genome and the mRNAs required to complete the replication cycle. Without proviral DNA, retroviral replication cannot proceed. To produce proviral DNA, the retroviral RNA genome is converted to a double-stranded DNA by the viral enzyme reverse transcriptase. This step occurs in the cytoplasm. Specific and efficient insertion of�... virology blog blogs http://www.medworm.com/rss/comments.php?id=4309239 Tue, 04 Jan 2011 14:00:33 +0100 4309239 http://www.medworm.com/index.php?rid=4294781&cid=t_138355_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F12%2F21%2Fwatch-for-emr-company-consolidation-but-not-emr-software-consolidation%2F I’ve regularly talked about my belief that there isn’t just one major EMR market. Instead, I firmly believe that there are a number of EMR markets that are divided by clinic size, medical specialty, and possibly even location. In fact, there’s likely even other factors. There are just far too many EHR companies for this to not be the case. I think this was also well illustrated in this blog post on Kevin MD about the “Perfect EMR Traits.” Here’s the perfect EMR trait #1: Perfect EMR Trait #1: The ideal medical record would be tailored to the specific needs of a clinician, only exposing them to portions of the record which are relevant to their work. Knowledge within healthcare is rapidly changing. Possibly more so than another other industry. Techniques ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4294781 Tue, 21 Dec 2010 19:24:58 +0100 4294781 http://www.medworm.com/index.php?rid=4265683&cid=t_138355_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fw5-DbLn6GR4%2F By Daniel IkensonIf you want to understand how global integration and cross-border investment have left U.S. trade policy in need of a new purpose, check out today’s Wall Street Journal article about the Apple iPhone’s complex production-supply chain.  (And then see this analysis for more depth and detail.) The story is both testament to the benefits of globalization and the latest indictment of a decrepit international trade flow accounting system that nourishes misleading trade skeptics and misinforms policy. Following in the footsteps of a groundbreaking and widely-cited 2007 UC-Irvine study, which disaggregated the components of a Chinese-assembled Apple iPod and assigned its constituent value to the companies and countries responsible for their production, two researchers at the ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4265683 Thu, 16 Dec 2010 21:20:10 +0100 4265683 http://www.medworm.com/index.php?rid=4294784&cid=t_138355_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F12%2F16%2Fsecure-fax-services-and-emr%2F I’ve tried every way imaginable to get away from having to fax things and as hard as I try, it’s just really hard to replicate the beauty of a simple fax to someone. We could talk about the reasons that faxes are so effective and successful (like everyone has a unique identifier…a phone number), but suffice it say that we’re going to be stuck using faxes for a long time to come. Of course, if you read this and you’re in healthcare then you know the love hate relationship with faxing and how faxing is an essential part of every clinic. Previously, I’ve talked about the value of a fax server in a clinic that uses an EMR. Many EMR companies are even integrating some sort of fax service into their EMR offering. This is beautiful and any EMR company that does... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4294784 Thu, 16 Dec 2010 18:15:27 +0100 4294784 http://www.medworm.com/index.php?rid=4134196&cid=t_138355_147_f&fid=39273&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FJTJukTRLr80%2Fintegration-is-key-for-effective.html Recently at One-to-One Media, they looked at the effectiveness of integrated marketing efforts. While print is still an important part any marketing campaign, the effective integration of digital marketing into this plan will result in more views. It will also allow your potential customers to customize their experience and ultimately make them more likely to say yes to your product. By allowing individuals to choose which platform they engage with you on, you can better customize their data to fit their needs. Across all platforms, mobile is the one that is growing the fastest. The ePharma Summit has a number of sessions dedicated to integrating social media into the traditional media mix. Event Co-Chair Joe Shields, Product Director at Pfizer will be presenting on “Hyperintegration in... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=4134196 Wed, 03 Nov 2010 15:29:00 +0100 4134196 http://www.medworm.com/index.php?rid=4125105&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FfzA8zEEyTkY%2F The September issue of Wired magazine and an article in last Sunday’s New York Times illustrate a central debate in technology circles. The debate is not new — it’s being going on for two decades — but it has newfound vibrancy. The essence of the debate is about competing tech/business models: walled gardens vs. the open world wide web (web).   vs.   The debate is highly controversial and nuanced. There are “experts” on both sides. My point today is not to take sides (although I’ll admit my canine partiality to the open web), but rather: to point out that the debate is occurring  to explain what the discussions are about to suggest that competition between walled gardens vs. the open web is creating healthy competition and providing consumers with great choi... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4125105 Tue, 02 Nov 2010 00:30:33 +0100 4125105 http://www.medworm.com/index.php?rid=4045174&cid=t_138355_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FnFDx5RhqYO0%2F While at the AAFP conference recently, I saw a company called PhoneTree that I found interesting. They essentially take care of all the automated calling for the doctors office. I was a bit surprised that a company like this is still around. Is there still a market for narrowly focused products like this? I know that many EHR vendors have integrated these types of features into their PMS and EMR software. The other problem I had with this company was that they only have a one way interface for calling. Basically, you dump a csv file out from your scheduling system and they make the calls. However, there’s no method of getting the data back to the EHR software so you can know who confirmed and who didn’t in your EHR. Seems like a no brainer feature to me, but seemed to barely be... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4045174 Thu, 07 Oct 2010 07:26:24 +0100 4045174 http://www.medworm.com/index.php?rid=4025795&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F10%2Fsensory-integration-more-evidence-that.html There are quite a few opinion pieces in this blog about the state of sensory integration as a model for occupational therapy - the reader is particularly referred here and here for quick background if needed.Continued evidence that occupational therapists have lost control of the 'sensory integration' narrative can be found in the October 2010 Scientific American Article by Nancy Shute entitled "Desperation drives parents to dubious autism treatments."Sensory integration therapy is described in the article as ranging from "wrapping children in blankets or placing them in a hug machine to having them play with scented clay..." They also note in the article that this intervention costs families up to $200 per hour or $6000 per year. Sensory integration is listed in a chart as Temptations: Du... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4025795 Sat, 02 Oct 2010 13:07:00 +0100 4025795 http://www.medworm.com/index.php?rid=3776361&cid=t_138355_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FowncvYq992w%2F By Neal McCluskeyExplicit, forced racial integration of the public schools is almost completely a thing of the past, buried in part by broad distaste for it among Americans of all races who had grown tired of the conflict, coercion, and plain inconvenience it often caused, as well as numerous Supreme Court rulings sharply curtailing it. But coerced integration has not gone away: Proponents of engineering racial integration have turned to income as the basis for assigning kids to schools, with the goal of achieving greater socio-economic — and, in the process, racial – balance. To listen to some proponents of coerced integration by class, this new focus is a clear social and educational success. To illustrate the success, in All Together Now: Creating Middle-Class Schoo... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3776361 Wed, 21 Jul 2010 18:29:14 +0100 3776361 http://www.medworm.com/index.php?rid=3762821&cid=t_138355_139_f&fid=38879&url=http%3A%2F%2Fwww.twiv.tv%2Fvincent.mp3 Hosts: Vincent Racaniello, Dickson Despommier, Alan Dove, Rich Condit, and Welkin Johnson On episode #91 of the podcast This Week in Virology, Vincent, Dickson, Alan, Rich and Welkin discuss the nature, origin, and evolution of endogenous retroviruses (ERVs), and the recent finding of endogenous filovirus genomes in mammals. Download TWiV #91 (64 MB .mp3, 89 minutes) Subscribe to TWiV (free) in iTunes , at the Zune Marketplace, by the RSS feed, or by email, or listen on your mobile device with Stitcher Radio. Links for this episode: Welkin blogs at Small Things Considered Constructing primate phylogenies from ancient retrovirus sequences (PNAS) Filoviruses are ancient and integrated into mammalian genomes (BMC Evol Biol) Synthetic cells: Momentous breakthrough or ethical morass? (To The ... virology blog blogs http://www.medworm.com/rss/comments.php?id=3762821 Sun, 18 Jul 2010 04:41:39 +0100 3762821 http://www.medworm.com/index.php?rid=3629894&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F06%2Fparent-questions-auditory-intervention.html Dear Dr. Alterio:I read your article on Tomatis and other auditory integration programs. My son has autism, and we are midway through a program that uses a form of Tomatis. Their company is called {REDACTED}.My gut is telling me that this may be a scam, but as a concerned parent with a child with Autism I'll admit that I am easy prey. During one visit the instructor (I now question whether she was an OT) told me that my son fell asleep during the session. I asked how long he was asleep, and she said about 45 minutes (the session was only 80 minutes long). She then proceeded to tell me that that was ok, because he had the head phones on during that time. Anyway, before I sink another $4k into this program, I would be interesting in knowing if you've heard anything about this facility, as we... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3629894 Fri, 04 Jun 2010 05:00:00 +0100 3629894 http://www.medworm.com/index.php?rid=3599504&cid=t_138355_109_f&fid=36089&url=http%3A%2F%2Fthesituationist.wordpress.com%2F2010%2F05%2F26%2Fracial-prejudice-in-real-estate-markets%2F Here is another segment from John Quinones excellent ABC 20/20 series titled “What Would You Do?” — a series that, in essence, conducts situationist experiments through hidden-camera scenarios. This episode asks, “what would you do if you attended a real estate open house where only certain people were welcome?” (and includes analysis from social psychologist John Dovidio). * * * * * * It has been over 50 years since the Black, middle-class Myers family moved into all-White Levittown.  You can watch the landmark (32-minute) documentary depicting reactions to the Myers moving into Levittown below. * * * * * * Finally, here is a 1991 ABC Primetime story on the “nature of today’s prejudices.” The documentary follows “two men (equal in ... The Situationist blogs http://www.medworm.com/rss/comments.php?id=3599504 Wed, 26 May 2010 15:49:12 +0100 3599504 http://www.medworm.com/index.php?rid=3592410&cid=t_138355_150_f&fid=38374&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FNG7qrycqa-A%2Fmulti-channel-pharma-marketing-event.html The Multi Channel Pharma Marketing Event agenda is now ready for download! Brought to you by the producers of the ePharma Summit, the Multi Channel Pharma Marketing Event is the ONLY industry event focused on breaking down internal silos to achieve channel integration and maximize return on engagement. In order to compete, pharma companies are forced to rethink their approach as traditional sales and marketing techniques have been rendered inefficient and ineffective. Download the brochure today to find out more. (Source: ePharma Summit) ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=3592410 Mon, 24 May 2010 13:00:00 +0100 3592410 http://www.medworm.com/index.php?rid=3420759&cid=t_138355_150_f&fid=38374&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FFBvzapWXCW8%2Fofficial-call-for-papers-multi-channel.html (Source: ePharma Summit) ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=3420759 Tue, 30 Mar 2010 13:00:00 +0100 3420759 http://www.medworm.com/index.php?rid=3416388&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F03%2Frole-of-occupational-therapy-for.html Behavioral problems in children are sometimes difficult to solve. Caregivers and even professionals often search for what I call an 'easy button' to solve complex problems. I have always believed that using a general systems methodology prevents the inappropriate reduction of complex system problems to single-point causes.Human beings are meaning-making creatures, however, and that causes us to sometimes reduce complex data into single-points even though it doesn't make sense to do so. As an obtuse example - if you ask the average person what caused the shuttle Challenger to explode they will tell you that it was Morton Thiokol and faulty O-rings. Although that is true, it is more true that there were other factors including cold temperatures, design errors, lack of redundancy, and flawed ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3416388 Mon, 29 Mar 2010 15:22:00 +0100 3416388 http://www.medworm.com/index.php?rid=3408575&cid=t_138355_132_f&fid=35006&url=http%3A%2F%2Fnsaunders.wordpress.com%2F2010%2F03%2F26%2Fbiomart-and-biomart%2F I’ve been vaguely aware of BioMart for a few years. Inexplicably, I’ve only recently started to use it. It’s one of the most useful applications I’ve ever used. The concept is simple. You have a set of identifiers that describe a biological object, such as a gene. These are called filters. They have values – for example, HGNC symbols. You want to retrieve other identifiers – attributes – for your objects. You can use BioMart as a web application called MartView. However, R users should check out the biomaRt package, part of the Bioconductor suite. Here’s a couple of examples. Example 1: fetch Ensembl gene identifiers given HGNC symbols Let’s start with a simple example. You have a CSV file in which one of the fields is a HGNC symbol (w... What You're Doing Is Rather Desperate blogs http://www.medworm.com/rss/comments.php?id=3408575 Fri, 26 Mar 2010 07:23:18 +0100 3408575 http://www.medworm.com/index.php?rid=3302304&cid=t_138355_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F616ciamU-w8%2F By José PineraThe Maastricht Treaty requires countries in the eurozone not to exceed a public debt of 60% of GDP. Well, now almost all of them have an official debt exceeding that ceiling. But the situation is immensely worse because European states also have huge, and largely hidden, unfunded liabilities arising from their pension and health systems. According to a 2009 study by my colleague Jagadeesh Gokhale, the true debt of the 25 European countries is, on average, 434% of GDP. And the treaties that underpin European integration do not say a word about such debt. Greece’s true debt is 875% of GDP and its current problems are just the first act of the coming fiscal bankruptcy of Europe. In my 2004 essay “Will the Pension Time Bomb Sink the Euro?”, I concluded that... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3302304 Tue, 23 Feb 2010 17:27:26 +0100 3302304 http://www.medworm.com/index.php?rid=3189437&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F01%2Ffolk-taxonomies-and-sensory-processing.html This article effectively demonstrates how professional training and item wording can strongly impact the way that different diagnosticians interpret common behavioral attributes.When people think that a disorder is present I believe that it is most important to begin with actually determining if there is a functional behavioral problem that is interfering with ability to carry out everyday tasks. That can help us avoid falling into the trap of labeling every nuanced form of trait or characteristic difference that people may express. Humans are natural 'meaning-makers' and we don't advance the cause of understanding our patient's concerns unless we improve our ability to become armchair anthropologists about our own professional culture.It might be interesting to write a blog post and call ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3189437 Tue, 19 Jan 2010 16:50:00 +0100 3189437 http://www.medworm.com/index.php?rid=3067331&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F12%2Fquestions-about-aotas-response-to.html The National Autism Center published a comprehensive National Standards report regarding evidence-based practice guidelines for children and young adults who have autism. The report is an excellent summary of research about intervention methods and effectiveness. It was particularly interesting to me that this report referenced and hoped to expand on the New York State Early Intervention Clinical Practice Guidelines for autism spectrum disorders which of course is a document that is familiar to many of the families in my geographic area. The NYS guidelines were published ten years ago so an update to include new research was needed.The new report focuses on quantitative studies and in this sense some important occupational therapy literature may not have met the inclusion criteria. There h... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3067331 Mon, 07 Dec 2009 19:37:00 +0100 3067331 http://www.medworm.com/index.php?rid=3048289&cid=t_138355_132_f&fid=35006&url=http%3A%2F%2Fnsaunders.wordpress.com%2F2009%2F12%2F02%2Fhas-our-quest-for-completeness-made-things-too-complicated%2F In my opinion, yes. Let me elaborate. My current job is very much focused on “data integration”. What this means is that we have a large amount of diverse data from different “-omics” experiments: microarrays, protein mass spectrometry, DNA sequencing – really, whatever you like, but it’s all aimed at answering the same question. Namely: which of these biological entities (transcripts, proteins, metabolites) are markers for various human disease states? Somehow, we have to pull all of these data into a common framework so that it can be analysed using statistics. The problem: whilst a lot of effort has gone into designing schema and ontologies that describe the individual data types, less effort has been applied to the question: what do all these things... What You're Doing Is Rather Desperate blogs http://www.medworm.com/rss/comments.php?id=3048289 Wed, 02 Dec 2009 02:38:06 +0100 3048289 http://www.medworm.com/index.php?rid=2977615&cid=t_138355_180_f&fid=38610&url=http%3A%2F%2Fwww.productivity501.com%2Fintegration-is-more-important-than-features%2F237%2F I am working with a client that has about 10 employees. They are starting to hit a wall when it comes to productivity. While each of their systems have a bunch of nice features, none of them integrate with each other. As a result, they spend most of their time moving information back and forth. The more their business grows, the slower their back office processes become. Here is an example: when someone buys something from the online store, that information has to be manually entered into the accounting software. The customer information must be manually entered into the customer relationship management system. If a customer gets a refund, the accountant handles the refund, but then the information must manually be entered in the online store to adjust the inventory levels. While all of t... Productivity501 blogs http://www.medworm.com/rss/comments.php?id=2977615 Mon, 09 Nov 2009 18:00:41 +0100 2977615 http://www.medworm.com/index.php?rid=2793256&cid=t_138355_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F09%2F10%2Femr-integration-with-cisco-ip-phones%2F One of the lunch demos I saw at the EHR Stimulus tour was a demo of the integration of a Cisco IP phone with an EMR. I’ll admit that they are VERY brave souls to try and do a demo like this since it’s just prone to problems. Demos are always that way. Plus, I think you can get the picture of what’s happening without seeing it. At least I could have and everyone else that couldn’t probably just saw all the configuration and thought it was too complex to even consider. That part aside, there were a couple of things that were intriguing about the demo. First, as they said, it’s interesting to see how hardware can really affect and interact with your EMR. That’s an interesting concept that I think is worth exploring a lot more. Second, if setup correctly the... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2793256 Thu, 10 Sep 2009 15:30:36 +0100 2793256 http://www.medworm.com/index.php?rid=2724982&cid=t_138355_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FXuRlPtb2jEQ%2F Conclusion I think we’re going to see a lot more little services like this pop up. I think a number of them could be very beneficial if they’re integrated or used alongside a great EMR. The other good part is that it seems like using stand alone services like this one will still allow you to be considered a “certified EHR” and possibly receive some of the $36 billion of EMR stimulus money. Now, just to provide some background on this specific company, here’s a copy of the email I received about how ePatientHistory came about: As a web developer, professionals seeking online solutions that make sense for their particular business often approach my company for advice. A local physician recently asked if I could develop online patient registration and payment se... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2724982 Sat, 22 Aug 2009 16:44:37 +0100 2724982 http://www.medworm.com/index.php?rid=2699695&cid=t_138355_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=2879564&cid=t_138355_123_f&fid=39035&url=http%3A%2F%2Fwww.liddlekidzblog.com%2F2009%2F05%2Fmassage-for-children-with-autism.html For children with Autism, massage may provide relaxation, stress reduction and calm muscle spasms. Over time, touch therapy also helps the child to become more accustomed to tactile stimulation and aides in body awareness. Often by incorporating massage therapy into daily routines, children with Autism experience decreased issues with sleeping. Research has demonstrated that this type of intervention may promote more on-task and social relatedness behavior during play, they show less erratic behavior, and are more attentive after receiving massage therapy. This safe, nurturing touch, along with regular sensory integration, is beneficial in reducing inattentiveness, touch aversion and withdrawal.Read more about The Benefits of Massage for Children with Autism (Source: Liddle Kidz Infant ... Liddle Kidz Infant and Pediatric Massage Blog blogs http://www.medworm.com/rss/comments.php?id=2879564 Mon, 25 May 2009 16:41:00 +0100 2879564 http://www.medworm.com/index.php?rid=2354138&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F04%2Ftwenty-years-of-sipt-where-do-we-go.html Standardized tests are periodically discarded or updated because the normative group that the test was developed around may have changed characteristics. I am unaware of any 'industry standards' regarding the life expectancy of standardized tests; rather, professionals in a field tend to come to consensus about the relative usefulness of tests on their own. I would be interested in knowing what other therapists think about the Sensory Integration and Praxis Tests - which were published in 1989.I became certified in the administration of these tests seventeen years ago. At first I found them highly useful but the more I gave the tests the more I understood the limitations. Now it has gotten to a point where I do my best to discourage people when they ask for this test - not just because of ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2354138 Tue, 21 Apr 2009 16:34:00 +0100 2354138 http://www.medworm.com/index.php?rid=3599520&cid=t_138355_113_f&fid=34633&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheHealthcareItBlog%2F%7E3%2FSsNc6IQycU0%2Fgartner-group-s-take-on-health-intelligence-and-amalga-uis.aspx Recently we worked with Gartner Group on a webcast outlining the issues that healthcare provider organizations face when it comes to data integration and how solutions such as Amalga UIS 2009 can help address these issues and provide organizations with more tools and better ability to view, analyze and act upon information that they already own, but rendered inaccessible by the silos in which it’s locked. The twenty minute long webcast features: GG’s Dr. Tom Handler and Vi Shaffer, two of our customers Brad Kappalman and Dr. Mark Smith (Medstar WHC) and Kim Pemble (WHIE), Jon Handler and Peter Neupert. The webcast is available at this address. Enjoy! (Source: The Healthcare IT Blog) The Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=3599520 Thu, 16 Apr 2009 19:46:38 +0100 3599520 http://www.medworm.com/index.php?rid=2302558&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F03%2Fmonday-morning-spaghetti.html In 11th grade I took a computer programming class - computers were brand new technology at the time and the teacher knew little more than the students so it was definitely a wide open frontier. The computer was an excellent tool in that programming forced my adolescent brain into a type of linear and logical thinking pattern that I still find useful today.The teacher often had us work in pairs on larger projects and I had an excellent programming partner. We regularly challenged ourselves with writing complex programs and we were sometimes over-ambitious. One particularly complex program we attempted was to write a 'Blackjack" program. I remember how excited we were when we got the cards to print correctly on the screen. This was high-end stuff for a couple of high school kids hacking away... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2302558 Mon, 30 Mar 2009 17:44:00 +0100 2302558 http://www.medworm.com/index.php?rid=2272569&cid=t_138355_113_f&fid=34621&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthcareGuy%2F%7E3%2FnutFSkpaL3M%2F503 Given all the attention being given to healthcare IT these days (especially because of the stimulus bill), many of my readers were wondering how to get into the market (jobs, contracts, etc). I asked Sarah Scrafford, who regularly writes on the topic of pharmacy technician online programs, to tell us what she’s seeing these days. Here’s what she had to say about the healthcare IT job market. There’s an inherent satisfaction in working in the healthcare field – you feel fulfilled because you’re helping people get better and get over ailments that get them down. But on the flip side, you’re exposed to suffering and pain on a continuous basis, and for some people, this leads to a great deal of stress. If you want to remain in the healthcare sector and yet avoid all the hardships ... The Healthcare IT Guy blogs http://www.medworm.com/rss/comments.php?id=2272569 Mon, 16 Mar 2009 21:59:14 +0100 2272569 http://www.medworm.com/index.php?rid=2261921&cid=t_138355_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F03%2F10%2Frtw-matters%2F My copy of the weekly update from RTW Matters has arrived with some great new articles for people working in the field of helping others return to work. If you haven’t been there before, head on over to take a look at the free stuff, then if you’re excited by it, think about subscribing. It’s well worth it with some of the most prominent researchers and workers in the field contributing from their experience. Some of the articles this week: Comparing Australian and New Zealand rates and duration of durable and non-durable RTW over time Early intervention and good communication: everyone’s responsibilities. The top points from the Dr William Shaw interview. oh, and yes there’s one from me! New Zealand’s Bronnie Thompson looks at the next steps back to wo... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2261921 Tue, 10 Mar 2009 05:13:53 +0100 2261921 http://www.medworm.com/index.php?rid=2234622&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F03%2Fsensory-integration-how-occupational.html I am working with a student who is completing a literature review on the concept of fidelity in sensory integration. At the same time I am completing a book chapter on entrepreneurship and today came to an interesting perspective on the state of sensory integration theory and practice models. Reality dictates that people purchase goods and products and will pay for them based on some value formula. Occupational therapists have famously made references to the value of their services - from Mary Reilly's belief that OT could be one of the great ideas of 20th century medicine to the more recent AOTA branding campaign on how OT helps people live life to its fullest. If both of these statements were true people would be flocking to seek out and pay for our services. Is this the case? Certainly ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2234622 Tue, 03 Mar 2009 17:11:00 +0100 2234622 http://www.medworm.com/index.php?rid=2276203&cid=t_138355_133_f&fid=35124&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Faspergerwoman%2F%7E3%2FK_WzXMUFZic%2Fautism-and-immigrationintegration.html While I watch another tv discussion program on Integration of Foreigners in our society I can not help to get annoyed by this subject. I wish there was an equal amount of money and media attentions spent on autism matters. In my homecountry The Netherlands one of the main issues in general and political discussions is about how to deal with Integration of Foreigners Issues. There are many foreign employees working here. They were asked to come here and do our dirty jobs during the sixties and seventies. They contributed not only in the our prosperity but have also created a culture of their own. Many people from Turkey and Maroc, especially elder man and imported brides- do only speak their own language. For years the foreigners could, due to our policy, just live their own life in our cou... The Art of Being Asperger Woman blogs http://www.medworm.com/rss/comments.php?id=2276203 Sat, 28 Feb 2009 20:57:00 +0100 2276203 http://www.medworm.com/index.php?rid=2217939&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F02%2Fcentral-convolutions-to-itch-and.html Convolutions have always been interesting to me - and that is the way that I have always tried to understand the complexities between itch and scratch. I think I slept through any references to Fourier analysis that I was ever exposed to though so I am kind of weak on applying a mathematical model to the problem - even though I think that is the best way to consider the relationship.This is why I am an occupational therapist and tend to keep myself in application/behavioral analysis - because as soon as I dunk my head into the literature of molecular pain I start to get a little lost. I find some solace in the knowledge that even the molecular pain people are still figuring it out though.Itch and pain are oddly connected. Histaminergic systems seem to be square mediators between these two ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2217939 Wed, 25 Feb 2009 19:06:00 +0100 2217939 http://www.medworm.com/index.php?rid=2211210&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F8CNlOodxzOM%2F We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians. A breakthrough study quantifies just how complex and challenging care coordination really is.  The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination : We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs to coordinate care with 229 other physicians working in 117 different practices…. The number of peers was greater for physicians treating patients with higher chronic illness burden, who may benefit the most from coordination. My m... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2211210 Thu, 19 Feb 2009 00:12:52 +0100 2211210 http://www.medworm.com/index.php?rid=2580298&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F8CNlOodxzOM%2F We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians. A breakthrough study quantifies just how complex and challenging care coordination really is.  The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination : We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs to coordinate care with 229 other physicians working in 117 different practices…. The number of peers was greater for physicians treating patients with higher chronic illness burden, who may benefit the most from coordination. My m... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580298 Thu, 19 Feb 2009 00:06:43 +0100 2580298 http://www.medworm.com/index.php?rid=2190554&cid=t_138355_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F02%2F16%2Fcan-blogging-make-you-happier%2F According to researchers in Taiwan, the answer is “Yes.” The researchers (Ko & Kuo, 2009) administered a 43-item self-report survey to 596 college students who were mostly between ages 16 and 22 and female (71 percent). The college students were young adults who had blogging experience, and specifically with blogging for the purpose of keeping a personal journal. The researchers found support for deeper self-disclosure from bloggers resulting in a range of better social connections. These included things such as a sense of greater social integration, which is how connected we feel to society and our own community of friends and others; an increase in social bonding (our tightly knit, intimate relationships); and social bridging — increasing our connectedness with peo... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2190554 Mon, 16 Feb 2009 15:41:19 +0100 2190554 http://www.medworm.com/index.php?rid=2145022&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2009%2F01%2Fdevelopmental-attention-and-visual.html Caveat lector: This post presents more questions than it does answers. It may also be appropriate to ignore all this theorizing and file this separately under 'Kids say the darnedest things.'A colleague asked me to review one of her cases because the child was presenting with some peculiarities. This four year old child's main difficulties are that he is 'overly sensitive,' as well as having some functional problems with attending skills and fine motor coordination. The parent perceives the child as 'different.' This could be underscored by the child's recent statement of "Do you hear my eyes blinking?" and reporting that watching his father's eyes blink sounded differently than the sound of his own eyes blinking.I am aware of the concept of synesthesia - and believe that most of what I ha... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2145022 Thu, 29 Jan 2009 19:52:00 +0100 2145022 http://www.medworm.com/index.php?rid=2053855&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F12%2Fempirical-vs-innate-knowledge-in.html I received an email from the Sensory Processing Disorder Foundation about today's NY Times article discussing the process of how disorders are included in the DSM.The email expressed excitement that awareness of sensory processing disorder was growing. I think that awareness of any problems that children have that can impact their ability to function is good - but I remain unconvinced that we are anywhere near ready for DSM inclusion of sensory processing disorder, if such a unitary disorder even exists. I have blogged about this topic before here.As the title of this entry suggests, my primary sticking point is the problem of empiricism vs. innatism. Empirical analysis suggests a process where there is NO prior knowledge and everything learned is written upon the 'blank slate' of consciou... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=2053855 Thu, 18 Dec 2008 23:51:00 +0100 2053855 http://www.medworm.com/index.php?rid=2046785&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Fone-way-for-rdf-to-help-a-bioinformatician-build-a-database-s3db.html%3F_c%3Dfeed-rss This post is part of the PLoS One syncroblogging day, as part of the PLoS ONE @ Two birthday celebrations. Happy Synchroblogging! Here's a link to the paper on the PLoS One website. Biological data: vitally important, determinedly unruly. This... Read and post comments | Send to a friend (Source: Systems Biology & Bioinformatics) Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=2046785 Thu, 18 Dec 2008 08:34:11 +0100 2046785 http://www.medworm.com/index.php?rid=2033141&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Fadding-informative-metadata-to-bioinformatics-services.html%3F_c%3Dfeed-rss [This post has also been copied across to my researchblogging-friendly wordpress site (now completely defunct except for my research blogging efforts, as Vox doesn't play nicely with their aggregator software)]. Carole Goble and the other auth... Read and post comments | Send to a friend (Source: Systems Biology & Bioinformatics) Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=2033141 Fri, 12 Dec 2008 15:22:43 +0100 2033141 http://www.medworm.com/index.php?rid=2027020&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Fthis-site-now-listed-in-nature-blogs-and-the-reason-behind-my-keyword-choices.html%3F_c%3Dfeed-rss Last week when scanning through Friendfeed, someone mentioned Nature Blogs. A number of my friends and fellow friendfeeders (1,2,3,4,5,6,etc.) already have their blogs registered there. I took the plunge and submitted my request last week, and thi... Read and post comments | Send to a friend (Source: Systems Biology & Bioinformatics) Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=2027020 Thu, 11 Dec 2008 08:03:23 +0100 2027020 http://www.medworm.com/index.php?rid=1905890&cid=t_138355_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2008%2F10%2Fwhile-real-doctors-prescribe-placebos.html Results of a survey published in the British Medical Journal (BMJ) indicate that "about half of the surveyed internists and rheumatologists reported prescribing placebo treatments on a regular basis." Most often they prescribe harmless vitamins and over the counter analgesics."Furthermore," say the researchers, "physicians who use placebo treatments most commonly describe them to patients as a potentially beneficial medicine or treatment not typically used for their condition; only rarely do they explicitly describe them as placebos" (see "Prescribing 'placebo treatments': results of national survey of US internists and rheumatologists").In contrast, fake doctors on TV, like Gregory House, the protagonist of the hit TV medical drama House, was caught prescribing Lupron off-label for hypogo... Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=1905890 Fri, 24 Oct 2008 18:21:00 +0100 1905890 http://www.medworm.com/index.php?rid=1876820&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F10%2Fauditory-interventions-trip-down-rabbit.html I posted two and a half years ago about problems with a lack of evidence for the Wilbarger intervention methods. In that post I included a link to http://www.sensorydefensiveness.com/ which at the time was allegedly sponsored by Pat Wilbarger. Now that website curiously redirects and links to a mirror page for Valerie Dejean and The Spectrum Center, which is now located in New York. Apparently they used to have a center in Maryland, but according to documents from the Maryland Board of Occupational Therapy Practice, it is a matter of public record that a Valerie Dejean surrendered her license to practice for several reasons including:use of the Tomatis Electronic Ear which has been banned by the FDAuse of unlicensed persons to practice occupational therapyfraudulent billing practicesI prev... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1876820 Tue, 14 Oct 2008 18:18:00 +0100 1876820 http://www.medworm.com/index.php?rid=1871352&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F10%2Fsensory-processing-characteristics-of.html ConclusionThe research that has been completed on CRPS provides useful information for occupational therapists to consider when investigating sensory modulation disorders. This literature review and exploratory study demonstrates that there is justification for continuing to study the possible relationship between disorders that share common sensory processing factors as they have a significant impact on people’s occupational function.References:Apkarian, A.V., Thomas, S., Krauss, B.R. and Szeverenyi, N.M. (2001). Prefrontal hyperactivity in sympathetically mediated chronic pain. Neuroscience Letters, 311, 193-197.Ayres, A.J. (1979). Sensory integration and the child. Los Angeles: WPS.Baron, R. & Wasner, G. (2001). Complex regional pain syndromes. Current Pain and Headache Reports, 5... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1871352 Sat, 11 Oct 2008 23:21:00 +0100 1871352 http://www.medworm.com/index.php?rid=1859507&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Ftwo-journal-special-issues-big-data-and-semantic-mashups-for-bioinformatics.html%3F_c%3Dfeed-rss Both of these special issues are worth a look, as some of the papers look pretty interesting. I'll spend a little time in a later post on any articles I find particularly relevant. Semantic Mashup of Biomedical Data Special Issue of the Journal... Read and post comments | Send to a friend (Source: Systems Biology & Bioinformatics) Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=1859507 Tue, 07 Oct 2008 12:55:42 +0100 1859507 http://www.medworm.com/index.php?rid=1825843&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F09%2Fwordless-special-exposure-wednesday_23.html If this continues, I shall sell his bed!It is white wood.A cheap trade in return for a very obvious free fall drop in tactile defensiveness.I also have a few words to share on my "Alien" site called "A Glut of Starving Brains."If you like what you read, send it to someone in 'need.' (Source: Whitterer on Autism) Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1825843 Wed, 24 Sep 2008 06:59:00 +0100 1825843 http://www.medworm.com/index.php?rid=1806826&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F09%2Ftime-for-more-name-changing.html Juliet:"What's in a name? That which we call a roseBy any other name would smell as sweet."There is a history of name changes in describing sensory integration problems. People have probably heard:SI disorderSID (sensory integration dysfunction)DSI (Disorder of sensory integration)SPD (Sensory processing disorder)You can check here for someone's blog entry on the issue. The SPD Foundation (formerly KID Foundation) has mostly scrubbed references on its website to the words that are no longer in vogue. That is helpful, particularly since they are seeking DSM-V recognition of SID/DSI/SPD.Have I used enough initialisms and acronyms in this entry yet?Now we have a companion problem in that there are multiple meanings for the concept of a 'sensory profile.' I was googling some information on the... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1806826 Fri, 19 Sep 2008 02:18:00 +0100 1806826 http://www.medworm.com/index.php?rid=1759843&cid=t_138355_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=1717129&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F08%2F18%2Fhospitals-creating-their-own-networks%2F There used to be a saying that “all politics is local,” meaning that how to get elected or get things done was at the local level. This was the idea behind a post several months ago entitled All Healthcare Integration is Local. While there are many grand initiatives happening (from IHE to HIEs to RHIOs, etc.), the actual integration work is happening with several leading health care entities. The local approach is taking hold with hospitals and their efforts to connect to the referring physician community without a RHIO-type effort. In a recent Health Data Management article entitled The Hospital as the Network Hub, the telling statement is:  “The hotbed of networking activity in health care today involves hospitals linking with their referring physicians, not broader... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1717129 Mon, 18 Aug 2008 22:02:04 +0100 1717129 http://www.medworm.com/index.php?rid=1705269&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F08%2Feffectiveness-of-howdahug-seat-in.html Conclusions: Preschoolers need to develop attending skills so that they can meaningfully participate in typical classroom activities including circle time. Children who are this age have many distracting behaviors that impact their ability to attend. Children who have disabilities may have confounding factors that cause development of attending skills to be impaired. Preschool-aged children were given the HowdaHUG seat and their ability to attend during circle time was measured. Because the study was completed in the natural environment there were many factors that were unable to be controlled for that influenced the children’s ability to attend. Some of the children demonstrated some improved attending in the seats while other children’s attending skills were unaffected by the seats. ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1705269 Thu, 14 Aug 2008 15:31:00 +0100 1705269 http://www.medworm.com/index.php?rid=1704678&cid=t_138355_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=1655420&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F07%2F25%2Fhl7-dates-and-times%2F Moving dates and times between systems via HL7 has two primary challenges: Clock skew/drift — the systems don’t agree on the definition of “now” Time zones — the systems differ in their offset from UTC/GMT While both problems are easy to understand, the two challenges are solved in very different ways. Here is a summary of each problem: Clock Skew or Clock Drift: Systems exchanging data “almost agree” on the current date and time — but not quite. For example, the RIS system thinks it is 4:15pm while the registration system thinks it is 4:17pm. Time Zone: The receiver of a message needs to know if the dates and times in the message are using the same time zone as the receiver or a different one. e.g., a radiology clinic based in Tucson rec... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1655420 Fri, 25 Jul 2008 20:13:52 +0100 1655420 http://www.medworm.com/index.php?rid=1655421&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F07%2F25%2Fhl7-time-zone-qualification%2F Both HL7 V2.x and V3.x support complex date structures. In the real world most V2.x messages are encoded using the local time on the system that generates the message. In addition, many interfaces do not support the concept or use of time zone. This can be a big challenge when building interfaces and often site-to-site negotiation is required should the data moving across the interface need interpretation in another facility in a different time zone. Said another way, historically HL7 messages were “always local” within a hospital or clinic. As the scope of using these messages pushes to regional or national level, the time zone is much more critical. In addition, the challenge of time zones directly applies even at the local level when daylight savings time kicks in and out. A... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1655421 Fri, 25 Jul 2008 16:34:59 +0100 1655421 http://www.medworm.com/index.php?rid=1478048&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F05%2Fprickly-pairs.html After a long career in the Navy, my parents decided to buy a house and remain in one place. It was a three story terraced Victorian house and I loved it before the ink was dry on the contract. At the back of the house, leading to the tiny strip garden, was what my mother called ‘the conservatory.’The conservatory was a four foot square arrangement of glass and wooden shelves, an entrance way or exit, a distance of three paces. The previous owners has neglected to remove some of their plants from this area, predominantly "cacti." They were a dull grey, with lots of prickles but otherwise quite unremarkable, apart from the single startling iridescent "bloom" stuck on the side like an afterthought. I stroked it to make sure that it wasn’t plastic, as the 1970’s were the heyday of fake... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1478048 Thu, 29 May 2008 20:10:00 +0100 1478048 http://www.medworm.com/index.php?rid=1473008&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F05%2Foccupational-therapy-and-macabre.html This is a blog entry for Halloween, but I just couldn't wait.My daughter was recently assigned some Edgar Allan Poe to read - and I immediately assumed it would be one of his most famous poems or short stories. I was surprised to find that she was assigned one of his more esoteric stories which of course caused me to launch into a lecture on the state of education today, blah blah blah - you know, the kind of story that makes teenage daughters roll their eyes.I told her that additionally it was important to read 'classic' Poe and referred her to "The Raven" and "Annabel Lee" and "The Tell Tale Heart" and "The Fall of the House of Usher." Then I thought I better read them all again myself so I can talk to her about what I just asked her to read. It had been years since I picked up Edgar Al... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1473008 Wed, 28 May 2008 03:30:00 +0100 1473008 http://www.medworm.com/index.php?rid=1467904&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F05%2Fassociations.html We all make associations all the time, where we connect one event or set of circumstances with another. I associate the arrival of Summer with sun burn, turning puce and spending many a happy hour peeling off strips of dead snake skin from my arms. I associate the holidays with Christmas pudding, hidden silver shillings to break teeth and a visit to the dentist. Some of the connections we make are faulty but they’re hard to shift once they’ve been experiencing. We learn through our unique experiences.Teaching autistic children can be difficult because their motivations differ so greatly from the average child. It is because of this that frequently we need to use motivators that many other parents disapprove of quite strongly. Most people are on board with giving a child a piece of cand... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1467904 Sun, 25 May 2008 17:02:00 +0100 1467904 http://www.medworm.com/index.php?rid=1418714&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F05%2Fnew-sensory-research-for-children-who.html Below is a feed I picked off of ScienceDaily - reporting on a study that was presented at the recent AOTA conference. I wish that more information was available - and I was unable to attend conference this year. I'll have to reserve most of my comments because I just need more information. I am encouraged by the apparent rigor of a double blind design - but wondering if they just used the Sensory Profile as a pre-post measurement. I'll try to find out and post more... Here is the newsfeed:Autistic Mannerisms Reduced By Sensory TreatmentScienceDaily (2008-04-27) -- Children with autistic spectrum disorders who underwent sensory integration therapy exhibited fewer autistic mannerisms compared to children who received standard treatments. Such mannerisms, including repetitive hand movements o... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1418714 Sat, 03 May 2008 13:53:00 +0100 1418714 http://www.medworm.com/index.php?rid=1401389&cid=t_138355_133_f&fid=35096&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAutismVox%2F%7E3%2F278391714%2F Mid-70s weather last week and Charlie’s still wearing his blue fleece jacket with the hood pulled far over his head, or his fleece vest with the zipper all the way zipped, or his fleece gloves (which, having survived several turns in the washing machine, are decidedly un-fleecy). He’s not been wanting to shed his winter gear at the end of April because, for the past several months, it’s become his routine to wear all those items whenever he goes out. There’s another reason besides the strong force of habit for why Charlie has been keeping his fleece “armor” on. Charlie—-like seemingly every person on the spectrum I’ve known—seems to take in sensory data (sounds, sights, smells, textures, tastes, even the quality of the air) in ways that... Autism Vox blogs http://www.medworm.com/rss/comments.php?id=1401389 Sat, 26 Apr 2008 18:13:02 +0100 1401389 http://www.medworm.com/index.php?rid=1380565&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F04%2Fbrotherly-love-dream-on.html “I am be like!”“Really! What do you like dear?”“I bin dun like dah cream!”Oh no! Don’t tell me ‘bin dun’ is back to haunt us again, one of this pre-emptory terms equivalent to ‘er.’ I look at my little neophobe and his 15 foods. Verily the child doth lie through his little wonky baby teeth. “Indeed!” Oddly enough he picks up on my tone of skepticism, as does his brother, who dives in to defend, encourage and elucidate.“Yeah Mom we are have ice-cream in school today.”“Ice-cream!” So much for the ‘healthy food in school policy,’ that didn’t last a whisker. “How come you had ice-cream?”“Coz it was Tim’s birthday.”“Ah.”“It wuz a birthday treat.”“Nice explaining dear. Surely he didn’t eat ice-cream?” I ask over his brother's head i... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1380565 Fri, 18 Apr 2008 02:45:00 +0100 1380565 http://www.medworm.com/index.php?rid=1363689&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F04%2F09%2Fhl7-sample-messages-always-the-best-way-to-go%2F Despite previous warnings, I recently committed a cardinal interfacing sin when working on an HL7 integration project. Upon kicking off a large project involving several applications with which we’re interfacing, I requested both specifications and sample HL7 messages from the vendor. The specifications came right away; the sample messages unfortunately did not. Rather than making a big deal out of the messages and insisting that we get them prior to interface construction, I dove right in to perform a gap analysis based on the specifications that we were furnished in order to determine the incompatibilities between the systems involved. After carefully identifying the mappings required to transform the HL7 messaging such that it would satisfy each system’s specs, the interfaces we... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1363689 Wed, 09 Apr 2008 22:09:02 +0100 1363689 http://www.medworm.com/index.php?rid=1319810&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F03%2Fwhen-is-tantrum-not-tantrum.html Jennifer stomped into my office, hair askew and wet socks flapping around her toes. "I hate my shoes and I don't care about the seven day rule!"Jennifer is 9 years old and has severe regulatory difficulties - a psychologist has provided the label of ADHD. She has accompanying motor incoordination, complicated by her generic lack of persistent attention to much of anything other than the Winx Club. As a result she has a hard time learning in school and socializing appropriately with her peers. She has been coming to see me privately for a few months now because she has been discharged from the school program - I am still not sure I understand why. That's another post, I suppose.She has made some good progress with improving her posture, learning to control her body to maintain a sitting pos... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1319810 Fri, 21 Mar 2008 15:17:00 +0100 1319810 http://www.medworm.com/index.php?rid=1304937&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F03%2F14%2Fovercoming-the-barrier-to-particpating-in-ihe%2F Since it’s inception in 1998, IHE (Integrating the Healthcare Enterprise) has embarked on a commendable mission to “improve the way computer systems in healthcare share information.” Over the past 10 years the initiative has made great strides in standardizing the implementation of not-so-confining “standards” such as HL7. In so doing IHE has developed a plethora of integration profiles across a dozen or so clinical and operational domains, from Cardiology and Radiology to Patient Care Devices and IT Infrastructure.  These profiles take a lot of the interpretation and guesswork out of the implementation of the underlying standards and thus make the messages transmitted between clinical information systems much more consistent and predictable, at least amongst supporting systems... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1304937 Fri, 14 Mar 2008 22:10:13 +0100 1304937 http://www.medworm.com/index.php?rid=1286191&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F03%2F07%2Fpatient-reports-directly-to-emrs%2F A recent article in Radinformatics highlighted the radiology workflow of one of our customers - EPIC Imaging. The article is entitled Look, No Hands: Reports Go Directly to Referrer EMRs.  As the title implies, the article is about how EPIC Imaging implemented an electronic means to connect with various referring physician practices and send patient reports quickly, efficiently, and accurately. John Griffith is the CIO at EPIC Imaging, and he and his team have taken the initiative to solve the radiology workflow and operational challenge. A few highlights from the article: Addressing Physician Requirements:  “The physicians wanted the reports to show up automatically in each patient’s electronic medical record (EMR). They wanted to open the patient’s EMR and have the report... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1286191 Fri, 07 Mar 2008 19:57:19 +0100 1286191 http://www.medworm.com/index.php?rid=1233285&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F02%2Fcomplementary-abilities-and-word.html I drive the boys home, a pal and my son, the very verbal and the not so much so. A match made in heaven. They are as different as chalk and cheese but they share the same label. They have little in common yet they are a perfect foil for one another. Mine is a head taller yet a year younger, but I'm not really interested in chronology or inches. I watch them in the corner of the rear view mirror. My son examines the inside of his pal’s ear, the one closest to him, both pal and ear, that is to say. “Your ear……” he fizzles out.“What about my ear?” he asks looking straight ahead. My son sticks his finger tip in his friend’s ear, tentatively. “Don’t do that, you’ll make me deaf and then I won’t be able to hear ever again,” he responds factually, without reproach.“Oh.... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1233285 Thu, 14 Feb 2008 23:49:00 +0100 1233285 http://www.medworm.com/index.php?rid=1226781&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F02%2Fwordy-wednesday-sense-of-smell.html “A floor plan? You don’t know anything about architecture do you?”“What I know about architecture could be written on the back of a postage stamp.”“So why to we have a picture of a floor plan then?”“Just think of it as a map, put you in the picture as we go from A to B, so you can get your bearings.”“Fair enough. We start at A?”“The sitting room, but we never really use it. It’s just an extra piece of space like a corridor.”“Why am I interested in this?”“Because he can’t go in there.”“Why not?”“Because it smells.”“Dare I ask what it smells of?”“We don’t know. We can’t smell it. I know! Maybe we should start in E, the half bathroom.”“He can’t go in there because it smells?”“Spot on.”“Bathrooms often smell.”“This is... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1226781 Tue, 12 Feb 2008 19:24:00 +0100 1226781 http://www.medworm.com/index.php?rid=1221368&cid=t_138355_107_f&fid=36698&url=http%3A%2F%2Fminingdrugs.blogspot.com%2F2008%2F02%2Fpipeline-pilot-student-edition.html As posted by Richard Compton on CCL.net provides SciTegic (part of Accelrys) a student version of Pipeline Pilot (PLP), which is free for academics ! I seriously like the thinking of those SciTegic guys, they are sharp, critical, and very trendy. This is a good starting point for having a hell of a discussion about science. Smart move, which is following the integration principle !This shows another fantastic example of a smart licensing strategy, which will probably always be critically discussed in the drug design area? Just recently there was a discussion on CCL and I commented on it. Anyway, this particular case will support science and allows scientists integrating their tools on a global level. Furthermore it allows sharing tools with industrial partner without forcing them creating ... Mining Drug Space blogs http://www.medworm.com/rss/comments.php?id=1221368 Sun, 10 Feb 2008 23:26:00 +0100 1221368 http://www.medworm.com/index.php?rid=1218555&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2008%2F02%2Fdo-you-believe.html One of the best questions that people ask me is if I 'believe' in sensory integration. I haven't really answered that directly, so I will try. I am motivated to do so because I just got the question again today - and I don't want to post the comments that were left because there was too much identifying information - and the person did not leave an email. So I hope the commenter sees the response here.I suppose that people see my commentary and questioning about sensory processing and the need for evidence as being 'critical' or 'unbelieving' in the diagnosis. I commented recently about the concept of 'fidelity' when talking about sensory integration because one of the problems is that it is being so poorly defined by so many groups, including researchers. Even our 'state of the art' asses... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1218555 Fri, 08 Feb 2008 18:22:00 +0100 1218555 http://www.medworm.com/index.php?rid=1217912&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F02%2F08%2Fwhat-if-there-was-an-election-on-healthcare-standards%2F By now, you may have had enough of primaries and election results. What if, however, we applied the primary election process to healthcare standards? What would happen?  Just as there are factions the political candidates are trying to pull together to win, they probably have not seen as many factions as there are in healthcare standards. There is a major faction called the HL7 Standards, but emerging factions are getting noticed which are XML related - from Continuity of Care Record (CCR) to a faction-within-a faction, that is, HL7 V2, HL7 V3, HL7 Clinical Document Architecture (CDA), and HL7 Continuity of Care Document (CCD). We don’t need new healthcare standards. We just need to enforce the ones we have. What about the X12, DICOM, NCPDP, LOINC, and SNOMED factions? And, l... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1217912 Fri, 08 Feb 2008 16:02:10 +0100 1217912 http://www.medworm.com/index.php?rid=1212272&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F230455340%2F I’ve written a lot recently about Medicare Health Support (MHS).  We are learning a lot from MHS about what DOESN’T work with the frail, elderly Medicare population.   But, what DOES work?   One key lesson emerging from MHS is the need to integrate and engage physicians and other local care providers…easier said than done.   MHS is just one of many experimental approaches being tried by Medicare.  Other approaches include the medical home model, Medicare Advantage plans, Special Needs Plans (SNPs), P4P, and a variety of other Medicare demos and pilot projects.  I’ve been critical of Medicare’s lack of transparency lately, but I applaud their innovation and experimentation.   While we definitely don’t have all the answers, I’d like to bring your attent... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1212272 Wed, 06 Feb 2008 18:42:16 +0100 1212272 http://www.medworm.com/index.php?rid=1177662&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F01%2F25%2Fcomparing-hl7-messages-to-hl7-documents%2F For those who have been involved with the HL7 Standards over these past decade, there has been a slow evolution to expand the standards, change the approach (i.e., HL7 V2 to HL7 V3), and include clinical documentation. Healthcare integration initiatives are benefiting from the changes, but confusion rises as to the differences and the growing complexity. One question that arises is:  what is the difference between HL7 messages and HL7 documents? Outlined below is quick review of differences. HL7 Messages:  HL7 messaging is usually a real-time flow of patient and clinical information. They convey current information about a patient, including updates to admissions or discharges (ADT), orders for tests (ORM), and test results (ORU). The more current the data, the more relevant it is in th... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1177662 Fri, 25 Jan 2008 21:08:23 +0100 1177662 http://www.medworm.com/index.php?rid=1158346&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F218365191%2F Last week I did the major annual tune-up of my presentation on Disease Management Megatrends for the MCOL Future Care Web Summit.  I’m pleased to share a copy of the PowerPoint presentation with you, and I hope you find it useful and provocative.  You can view and/or download a copy here (6MB).  This version contains 77 slides, which would be about the length I’d use for a 3 hour workshop; you’d see a more compact version for a conference keynote, Board summary, or management strategy session. fyi, the DM Megatrends are: MAGNITUDE: We are just scratching the surface of chronic disease challenges. INTEGRATION:  The 50 year tide is shifting toward integration, away from specialization. MEDICARE: While Medicare has endorsed the need for chronic disease management, disappointing ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1158346 Thu, 17 Jan 2008 17:50:01 +0100 1158346 http://www.medworm.com/index.php?rid=1154073&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F217342986%2F My colleague and friend Dr. Jaan Sidorov has recently started a blog — Disease Management Care Blog.  Check it out and add it to your RSS feed.  Jaan is eminently qualified to write on the topic — he spent 25 years at Geisinger Health System in Pennsylvania as a practicing physician and as an executive, and he just ended a term on the board of DMAA—the Care Continuum Alliance (formerly Disease Management Association of America). Jaan’s sense of humor and articulateness shine through in his latest posting “Are Integrated Delivery Systems really all that?” He presents a Top 10 list of “why IDS’ could always remain the health care solution of the future”. Jaan, it’s worth splitting a hair here. Let’s clarify who we’re talking about when saying “an integra... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1154073 Wed, 16 Jan 2008 00:55:49 +0100 1154073 http://www.medworm.com/index.php?rid=1150710&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2008%2F01%2Fcurse-of-socks.html On the first day of term, on the first day of school I was destined for an afterlife in heaven. This was directly due to my snowy white, knee length socks. Each was secured in place with a thick elastic garter above the calf that cut off all blood circulation. The cuff was neatly turned now with perfect symmetry. It is a well know fact that one’s personal appearance in the neat, tidy and clean department, has a direct correlation with the condition of your soul, or so I was led to believe.The second week at school showed that I was winging my way to a completely different destination. This was due to my inability to keep my immaculate socks free from grass stains and dirt. Their general grubbiness could not be eradicated by my inadequate hand laundering skills in cold water with the aid ... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1150710 Mon, 14 Jan 2008 19:52:00 +0100 1150710 http://www.medworm.com/index.php?rid=1146633&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Fwww.mcol.com%2Fpodcasts%2Ffuture08%2Fkuraitispodcast08.mp3 Over the past week I’ve been doing a major tune-up of my presentation on Disease Management Megatrends for the annual MCOL Future Care Web Summit.  More typically, DM Megatrends is 45–90 minute presentation with accompanying PowerPoint slides. As part of the Web Summit, the good folks at MCOL asked me to do a short podcast on highlights of this presentation. They’re allowing me to share it with you… click here to save or listen to the podcast. fyi, the DM Megatrends are: MAGNITUDE: We are just scratching the surface of chronic disease challenges. INTEGRATION:  The 50 year tide is shifting toward integration,  away from specialization. MEDICARE: While Medicare has endorsed the need for chronic disease management, disappointing results from recent demo projects make future dir... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1146633 Sat, 12 Jan 2008 00:53:14 +0100 1146633 http://www.medworm.com/index.php?rid=1136810&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F01%2F08%2Fthe-benefits-of-improving-your-healthcare-billing-operations%2F Healthcare integration plays a critical role in streamlining billing workflow. As highlighted in an earlier post, the HL7 Standard and HL7 messaging facilitates a more effective data flow. Healthcare billing departments are dependent on getting accurate information in a timely manner to meet their goals, such as increasing cash flow and decreasing operational costs. Getting the needed patient information and charge capture data can be accomplished using HL7 interfaces. Automating your environment with HL7 interfaces leads to many tangible and intangible benefits for your billing facility including: Increased accuracy with reduced manual entry Increased Turn Around Time (TAT) with data flowing to billing in near real time Decreased paper records storage and office space with electronic dat... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1136810 Tue, 08 Jan 2008 18:35:42 +0100 1136810 http://www.medworm.com/index.php?rid=1130965&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2008%2F01%2F04%2Fhl7-messages-in-healthcare-billing-environments%2F Every healthcare environment bills for services provided. The goal of billing is to increase reimbursement in a timely fashion. How does the HL7 Standard help in this endeavor? Automating clinical data delivery through HL7 interfaces provides accurate information quickly to the billing department. When transferring patient’s billing information through HL7 messaging, it is helpful to know some of the key segments in which to find the data. PID: Patient Information PV1: Visit Information (DOS) FT1: Financial Transaction IN1: Insurance Information IN2: Additional Insurance Information IN3: Additional Insurance Info, Certification GT1: Guarantor AUT: Authorization Information A better understanding of the HL7 messages used in various billing environments may help demonstrate the possibl... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1130965 Fri, 04 Jan 2008 20:17:17 +0100 1130965 http://www.medworm.com/index.php?rid=1108580&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fdownload%2Fvideos%2FFast15-Radiology-Workflow-and-HL7.wmv The technology used in imaging centers and radiology practices is rapidly evolving. These technology changes affect both the front-end and back-end radiology workflows. The front-end workflows are affected by ever changing imaging and modality technology advancements while the back-end workflows are affected by advancements in information technology (IT). Keeping up with the changes can be a challenge. The focus of this blog is the IT back-end radiology workflow changes. The goal of healthcare IT is to make all the systems work smoothly together or interoperate for organized, seamless data flow. The first step to achieving such goals is to understand your current workflow. In an example imaging center, the workflow might be: Schedulers enter orders manually on the radiology information s... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1108580 Thu, 20 Dec 2007 23:47:09 +0100 1108580 http://www.medworm.com/index.php?rid=1079703&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F12%2F07%2Fhow-manual-is-your-billing-workflow%2F Many radiology practices are focusing on various radiology workflows to understand how to improve turn around times or increase efficiencies. Austin Radiological Association (ARA) focused on their billing workflow and highlighted their approach and success in a recent article entitled ARA Floats an Automated Billing Process… And Inhales.  In the imagingBiz.com article, ARA discussed the old process and stated “We would touch each radiology report approximately six times to manually key demographics and charge transactions into the billing system.” They went on to describe the completely manual nature of their billing workflow that involved lots of people, pens, and paper. By focusing on the workflow and determining best practice approach on how to automate it, ARA implemen... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1079703 Fri, 07 Dec 2007 15:59:11 +0100 1079703 http://www.medworm.com/index.php?rid=1072415&cid=t_138355_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D470 This post has been forming itself in my head ever since I went to both a DD self-advocacy conference and MIT within the same week last May. I’ve just for whatever reason not had the chance to actually write it. I really enjoyed spending time at MIT. People there accepted me more or less as I was, and accepted a lot of other disabled people as well. In fact, their entire Human 2.0 symposium, that happened while I was there, dealt with the fact that disabled people get a lot of technology before other people do, and was about how technology that could enhance everyone’s lives was being developed specifically for disabled people all the time. At some point there, I had a bad migraine and needed to lie down. They allowed me to lie down backstage under a table. I expressed fear over... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=1072415 Thu, 06 Dec 2007 01:09:29 +0100 1072415 http://www.medworm.com/index.php?rid=1186404&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2007%2F11%2Fintervention-for-adults-who-have.html I received this email today, and I thought it was a great question:I am an adult who has Sensory Integration problems that were diagnosed three years ago. I also have central auditory processing disorder and was recently diagnosed with Asperger's. I have had some OT in the past for the SI difficulties, and was wondering if you knew of services for adults with these problems.++++++++++++++++++++++++++++++++++++++++++Sensory integration refers to an 'unseen' process that has not yet been clinically defined - people have suggested that it may be a neurochemical problem, or perhaps a neuromigrational problem, or perhaps something else entirely. However, occupational therapists are claiming that it is SOMETHING that has to do with neurological processing - a lot of current research is looking a... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1186404 Wed, 28 Nov 2007 20:18:00 +0100 1186404 http://www.medworm.com/index.php?rid=1054791&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F11%2F27%2Fpdf-attachment-in-hl7-message%2F It is possible to send a PDF file inside of an HL7 message. However, it is not a simple “encode and send” process as there are many moving pieces that allow a document file to be moved across an HL7 interface. The key question is not what the HL7 standard says about document encoding or even what the interface engine can do with the document. Rather, the focus should be on how the PDF file will be delivered to and from the source and destination application and how the target application will display the document. The options to move a PDF document include sharing the PDF via a file system (network shared drive), sending the file via HL7 as an ED (encapsulated data) data type, or including a URL to the PDF file via an RP (reference pointer) datatype. The complexity of each solu... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1054791 Tue, 27 Nov 2007 16:36:37 +0100 1054791 http://www.medworm.com/index.php?rid=1028171&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F11%2F15%2Fpacs-administrator-responsibilities%2F An Imaging Economics article - The Purview of the PACS Administrator - highlights the critical components of a PACS Administrator’s role that impacts radiology workflow. It is a great article because it outlines many of the key knowledge and work activities required to be an effective PACS Administrator. More than ever, PACS Administrators contribute significantly to defining, enabling, and refining radiology workflow. Key Knowledge of a PACS Administrator. DICOM is always the healthcare standard people think about when radiology workflow is mentioned. Today, the knowledge required has expanded to include the HL7 Standard. HL7 integration is the standard that facilitates the data flow between the various applications (e.g., RIS, HIS, EMR, PACS, etc.) and streamlines the workflow... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1028171 Thu, 15 Nov 2007 14:08:30 +0100 1028171 http://www.medworm.com/index.php?rid=1019135&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F11%2Fcant-swim-chuck-em-in-deep-end.html I chat to my "chum" via e-mail, about our families and how their reactions are so pivotal to our own well being. The issue of the extended family, as opposed to the tiny autism unit has great repercussions. Unless families are geographically and perhaps psychologically close, it can be difficult to translate the message, to explain how autism impacts the day-to-day minutiae of life. What hits home for me, is her reference to the fact that we, as parents, give the impression that "we’re coping." It puts me in mind of a visit home to England, over a year ago now.Because we were in England there was the inevitable dose of rain. My youngest son does not ‘do’ rain. Rain is a curse from on high to torture the tactile and sensory challenged child. For many an autistic child, their emotion... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=1019135 Sat, 10 Nov 2007 19:15:00 +0100 1019135 http://www.medworm.com/index.php?rid=1009390&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F11%2F06%2Fbridging-the-device-divide%2F During a recent stay at a very well respected Dallas area hospital that saw my wife and I welcome our first child into the world, I was reminded that the “Device Divide” that separates the vast majority of healthcare providers’ medical device data from the rest of their clinical information network is not limited to just small to medium-size hospitals. Given the fact that the hospital is part of a large statewide chain and would likely be labeled as cutting edge from a technological standpoint, I was somewhat surprised to see a nurse come in every 2-3 hours to dutifully record my wife and son’s vitals in a paper chart. I’m sure that information was re-entered into an EMR at some point, but I couldn’t help but wonder how often the data gets transposed or forgotten. That experien... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1009390 Tue, 06 Nov 2007 21:02:15 +0100 1009390 http://www.medworm.com/index.php?rid=3710645&cid=t_138355_113_f&fid=34633&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheHealthcareItBlog%2F%7E3%2F8EpzS4x_pMs%2Fgetting-started-with-hl7-version-3-and-biztalk-server-2006-r2.aspx After a long gestation period we have finally published the HL7 v3 and BizTalk whitepaper: Getting Started with HL7 v3 and BizTalk Server 2006 This paper provides developers with an overview of HL7 version 3 Messaging (HL7 v3) concepts, how to build HL7 v3 solutions with Microsoft® BizTalk® Server 2006, and how to convert message format from HL7 v3 to HL7 Version 2 Messaging (HL7 v2). Given all the different nuances of HL7 v3, it is somewhat difficult for Microsoft to build a "product", but we're definitely committed to supporting the development of solutions based on HL7 v3 messaging standard on the Microsoft platform. Over the past years we worked very closely with HL7 to make sure that XML best practices and Web Services were included in the development of the standard and at the same... The Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=3710645 Wed, 31 Oct 2007 22:47:47 +0100 3710645 http://www.medworm.com/index.php?rid=1186408&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2007%2F10%2Fsensory-issues-are-not-really-that.html People are easily confused whenever someone talks about sensory integration or sensory processing, mostly because of confusing messages that are sent by occupational therapists regarding these issues.Confusion is evident in the public but it is also interesting evident among occupational therapists and researchers as well. There have been some recent efforts to address this confusion by initiating conversation about 'fidelity' in sensory integration research. This means that when someone claims that a study is about sensory integration that it REALLY is about sensory integration. I encourage people to look at the Sensory Integration Global Network website; it has a lot of good information that helps to clearly define the concept of sensory integration.However, it is also important to under... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1186408 Wed, 31 Oct 2007 15:28:00 +0100 1186408 http://www.medworm.com/index.php?rid=979154&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F10%2F25%2Femr-certification-the-right-approach%2F A recent Physicians Practice article entitled Technology: Should Your EMR Be Certified? provides an interesting give-and-take on the Electronic Medical Record (EMR) CCHIT certification process. The Certification Commission for Healthcare Information Technology - CCHIT - is a private organization that offers a voluntary certification process for EMR vendors. To achieve certification, the vendors must complete tasks in 40 categories (the article highlights all 40 categories). The features and functionality tested are general in nature, but the plan is to introduce certification for specialty areas, including emergency medicine, cardiovascular, etc. With over 200 EMR vendors, finding the right solution for a physician practice was challenging, so the certification process provides a qualit... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=979154 Thu, 25 Oct 2007 15:00:50 +0100 979154 http://www.medworm.com/index.php?rid=970047&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F10%2F22%2Fmonitoring-and-alerting-for-hl7-interfaces%2F As you read this, do you know the status of every clinical interface in your environment? Unfortunately, a common answer to this question may be, “I have not received a call from anybody, so everything must be fine.”  What needs to be monitored in HL7 messaging? Some examples include: Guaranteed message delivery ACK vs NACK No response Connection status Started Connected Messages moving Messages backlogged Errors in message processing Invalid HL7 structure Invalid message data Database interaction issues Machine issues (e.g., hard drive space) The question remains:  Do you know the status of every clinical interface in your environment? What if you could answer this question confidently and say, “Yes, I know my interfaces are all running without an issue?&#... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=970047 Mon, 22 Oct 2007 13:33:59 +0100 970047 http://www.medworm.com/index.php?rid=933996&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Fof-gelml-and-mfo.html%3F_c%3Dfeed-rss A couple of papers from here at Newcastle University have appeared over the past couple of weeks. Here's a summary of them both. Data Standards From "An Update on Data Standards for Gel Electrophoresis" in Practical Proteomics Issue 1, Septembe... Read and post comments | Send to a friend (Source: Systems Biology & Bioinformatics) Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=933996 Mon, 08 Oct 2007 12:05:48 +0100 933996 http://www.medworm.com/index.php?rid=915065&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F09%2Fno-free-lunch-and-certainly-not-dinner.html Of course we knew immediately. At 11:45 and we were pleasantly weary after far too much good company and more than a drop of wine. The baby sitter left, almost scurried and there is was, right next to the three toothbrushes, right next to the coffee maker, obvious and white and large and unused and still folded. He legged it upstairs and I pouted at the pull-up. Another baby sitter crossed off the list, another load of laundry coming my way.When he reappears I can hardly see my knight in his non-work attire, as he is a mobile laundry pile, covered in six feet of soggy duvet, sheet, mattress cover, pillow, pillow cover and duvet cover, a royal flush.“Is he alright?”“Ooo yes. Happy as a Lark, soggy as a………very soggy person.” It is late.“I’ll put the first load on and go an... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=915065 Sat, 29 Sep 2007 17:27:00 +0100 915065 http://www.medworm.com/index.php?rid=904569&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F09%2Ftwits-you-nit-wit.html I think very hard. I need to work out what country in the world will be enjoying Wednesday whilst it is only Monday night here? I give up. I need to find a way of expanding time so that I won’t look like an idiot for posting Wordless Wednesday on a Monday night. Fortunately, I have a very scientific brain, so this should be easy to solve. I decide to insert a scalpel in the world, pole to pole and add another semi circle of extra globe. The result is a ripple ball, with extra mountains and valleys and a few tectonic plates bumping into each other. I am not entirely happy with the result and I’ve only bought myself 12 hours. What else? Aha. Double the size of the globe and magically I have gained 24 hours. Brilliant! I may also have saved the world from global warming with one executiv... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=904569 Tue, 25 Sep 2007 18:56:00 +0100 904569 http://www.medworm.com/index.php?rid=873761&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F09%2Ffish-or-fowl.html It’s definitely a kid thing, I think I can be confident in asserting that distinction. I’ve never seen or read about any adult doing it. I don’t think it’s an autism thing. I think it’s a sensory thing, which usually amounts to faulty wiring somewhere along the system. That said, because adults don’t do it, this must mean that whatever it is, disappears as you grow up. Perhaps you feel the same way, but find better ways of dealing with the matter? I need grown ups to tell us, let us in on the secret. It’s an odd thing to watch, but not a pleasant thing to observe. You can sort of see it happening but for some reason, you’re not able to stop them doing it, at least not in time. The child sits before the bowl of food. It can be any kind of food but something that in theory,... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=873761 Sat, 15 Sep 2007 02:17:00 +0100 873761 http://www.medworm.com/index.php?rid=858259&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F09%2F10%2Fvariations-of-the-hl7-orur01-message-format%2F If you’ve been in healthcare integration for any amount of time, you’ve probably seen an HL7 ORU^R01 message. As we like to say at NeoTool, if you’ve seen one HL7 message, you’ve seen one. This is especially true in the case of an ORU^R01 message. The following example illustrates some possible variations to this message. Scenario: An imaging center (IC) is receiving some order messages (ORM^O01) from 2 external hospitals for which they complete the orders and send back transcribed reports (ORU^R01) in an HL7 standard format. The IC is also completing their own internal orders, and the resulting reports need to be routed to their internal PACS system. Overall, there are 4 separate systems involved. In the world of HL7 messaging, this often means there will be 4 cust... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=858259 Mon, 10 Sep 2007 15:51:02 +0100 858259 http://www.medworm.com/index.php?rid=841627&cid=t_138355_113_f&fid=34633&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FTheHealthcareItBlog%2F%7E3%2F152309367%2Fhealth-connection-engine-whitepapers-now-live.aspx We just published two (2) Health Connection Engine whitepapers: Introduction to The Microsoft Health Connection Engine: This whitepaper provides an overview of the Health Connection Engine (HCE), including the major concepts and the service-oriented architecture (SOA) principles applied within HCE. The paper also discusses possible use scenarios for the HCE from an architectural perspective, highlighting how HCE components and connected systems can be deployed in different combinations to match each scenario. This paper is intended to be read by an architect charged with the definition and implementation of integration solutions within a healthcare domain (XPS, PDF). Developing a Health Connection Engine (HCE) Adapter: This whitepaper provides an introduction to the design and development ... The Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=841627 Wed, 05 Sep 2007 00:57:20 +0100 841627 http://www.medworm.com/index.php?rid=838774&cid=t_138355_113_f&fid=34652&url=http%3A%2F%2Fwww.neotool.com%2Fblog%2F2007%2F09%2F04%2Ftop-100-most-wired-hospital-henry-county-health-center%2F In this post, we interviewed Brian Moreau, IT Director, Henry County Health Center. Henry County Health Center was recently recognized as being one of the Top 100 Most Wired hospitals in the US by Hospitals & Health Networks magazine. Below is the interview with Brian. What was the evaluation process to become one of the ‘most wired’ hospitals? Henry County Health Center raised its hand to participate in the 2007 Most Wired Survey and Benchmarking Study sponsored by released Hospitals & Health Networks magazine. It is a detailed study that covers how Henry County Health Center uses information technology to address five key areas:  safety and quality, customer service, business processes, workforce, and public health and safety. What was it that motivated you to undertake t... NeoTool Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=838774 Tue, 04 Sep 2007 13:08:28 +0100 838774 http://www.medworm.com/index.php?rid=835418&cid=t_138355_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_138355_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_138355_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=816601&cid=t_138355_113_f&fid=34633&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FTheHealthcareItBlog%2F%7E3%2F146995098%2Fms-hug-techforum-biztalk-accelerator-for-hl7.aspx Straight from the horse's mouth, Stuart Landrum, Program Manager for the BizTalk Accelerators gave an overview of the new features for the Accelerator for HL7 2.0(A4HL7) in BizTalk 2006 R2. Here they are: New Accelerator Licensing! Support for HL7 v2.5 Support of international characters Support for ordered messaging Enhanced MLLP persistent connection management HL7 Schema Generation Tool BizTalk Mapper behavior enhancements: HL7 v2: Preserving the Order When Mapping a Repeating Sequence Group HL7 v3: Accommodating Schemas with Large Footprints Licensing A little piece of information that might have gone unnoticed is that with the R2 release of BizTalk, all the Accelerators (HL7, HIPAA, Swift, RosettaNet) are going to be free and included in the box! Yes, read again, free. This added to ... The Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=816601 Wed, 22 Aug 2007 16:54:06 +0100 816601 http://www.medworm.com/index.php?rid=803568&cid=t_138355_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_138355_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=795141&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F08%2Fsun-tiptoe-through-tulips.html One of our ongoing campaigns, is to continue to try and expand junior’s diet. Currently, he eats 17 foods. [translation = jolly annoying but more commonly referred to as neophobic] Ideally I would wish for our family to enjoy a meal together in the evening, but that dream may be a while away yet. For the time being I am more than satisfied with a lesser deal. The lesser deal these days is for everyone to be at the table together, for a period of time. The time period is vague. [translation = more than a minute fits the bill] When I say ‘at’ the table, this is because I don’t expect anyone to really sit, in the conventional meaning of the term. [translation = hunkered down, kneeling, draped, or in close proximity to a chair, are all good enough]At first, this might see quite a low b... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=795141 Sun, 12 Aug 2007 22:27:00 +0100 795141 http://www.medworm.com/index.php?rid=792808&cid=t_138355_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_138355_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=756747&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F07%2Fdanger-lurks-around-every-corner.html I take my youngest autistic son to the supermarket with me. [translation = grocery store] To say that such an errand was akin to punishment, would be an understatement, but I am out of options today. Like most children, shopping is one of his least favourite activities, [translation = me too!] but malnutrition is but one missing meal away.I have carefully chosen an alternative store. This alternative store, has one overwhelming advantage over it’s competitors, one that the store owners are probably blissfully unaware of. The shop has electric doors, which are the bane of many a parent’s life. [translation = they’re open, they’re closed, hop in, hop out, get in the way off all customers who arrive or leave, as they are invisible, chortle merrily throughout] However, in this particul... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=756747 Wed, 25 Jul 2007 00:58:00 +0100 756747 http://www.medworm.com/index.php?rid=742562&cid=t_138355_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=1186414&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2007%2F07%2Fplatos-response-to-state-of.html I received my "certification" to administer and interpret the Sensory Integration and Praxis Tests in 1992. I believe that the test battery was published in 1989 so it was still fairly new at the time I was certified. At that time there was a certification examination that you had to pass. I don't know how psychometrically sound the SII program was - but they claimed that it was a certification program. SII never wanted me to 'recertify' though - which is a little scary.In the past twenty years the Sensory Integration and Praxis Tests have not been updated and there are no new norms. I have never heard of an occupational therapist talking about the Flynn Effect or heterosis so I don't know if anyone believed that there is a useful lifespan of an assessment tool. Some OTs still use the old ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1186414 Mon, 16 Jul 2007 21:50:00 +0100 1186414 http://www.medworm.com/index.php?rid=716472&cid=t_138355_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_138355_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=674473&cid=t_138355_113_f&fid=34633&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FTheHealthcareItBlog%2F%7E3%2F124886225%2Fhealth-connection-engine-2-1-1-released-to-codeplex.aspx We have released version 2.1.1 of the Health Connection Engine to CodePlex. The release addresses a few issues we identified in setup and the Deployment Guide and some security and performance warning raised by FxCop. From the project description: "The Health Connection Engine facilitates the interoperability between these multiple systems by abstracting the interfaces used to connect them and by providing a rich and extensible adapter framework." As usual we welcome any feedback you might have on HCE. We're thinking about the next version and the two topics that came up in our heads are support for WCF and integration with the Microsoft ESB Guidance. What do you think? (Source: The Healthcare IT Blog) The Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=674473 Thu, 14 Jun 2007 18:50:00 +0100 674473 http://www.medworm.com/index.php?rid=674474&cid=t_138355_113_f&fid=34633&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FTheHealthcareItBlog%2F%7E3%2F123367080%2Fsummary-report-for-nhin-prototypes.aspx If you pay any attention to what's happening in the U.S. around the National Health Information Network (NHIN) you certainly have seen that the U.S. Department of Health and Human Services has posted another RFP for more prototypes to test what was done last year in the 4 prototypes and in HITSP. At the same time they are making available a Summary Report on NHIN Prototype Architectures. As you probably also know (in case you don't I'm telling you now), Microsoft was part of the CSC/Connecting for Health (the U.S. one) consortium. I have talked about this in the past here and here If you did not have any plans for the weekend, now you do :-) (Source: The Healthcare IT Blog) The Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=674474 Sat, 09 Jun 2007 00:02:47 +0100 674474 http://www.medworm.com/index.php?rid=659002&cid=t_138355_122_f&fid=35065&url=http%3A%2F%2Feideneurolearningblog.blogspot.com%2F2007%2F06%2Fsensory-processing-sensory-integration.html The New York Times has an article on sensory processing disorders and interviews Dr. Lucy Miller. It's a reminder of how far the field needs to go to improve recognition of disturbing sensory behaviors. Excerpt: "...now this subculture wants membership in mainstream medicine. This year, for the first time, therapists and researchers petitioned the American Psychiatric Association to include “sensory processing disorder” in its influential guidebook of disorders, the Diagnostic and Statistical Manual. Official recognition would bring desperately needed research, they say, as well as more complete coverage for treatment, which can run to more than $10,000 a year. But many psychiatrists, pediatricians, family doctors and school officials fear that if validated, sensory processing disorder... Eide Neurolearning Blog blogs http://www.medworm.com/rss/comments.php?id=659002 Tue, 05 Jun 2007 07:01:00 +0100 659002 http://www.medworm.com/index.php?rid=629287&cid=t_138355_132_f&fid=35011&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fmndoci%2F%7E3%2F118313819%2F At the Bio-IT World conference earlier this year, Robin Spencer, Chief Idea Management Officer (don’t you love titles like that) and senior research fellow at Pfizer, gave a keynote entitled Drug Discovery 2.0: From Push to Pull. Talk titles like that carry a lot of weight in these parts. That his talk drew from Science Business further piqued my interest. So what was the talk all about? In two words - Idea Management. Or to be more precise, about new approaches to idea management for the pharma/biotech industry to be really successful. Spencer, channeling Gary Pisano argues that the life science business inherently lacks some of the features that lead to success in other industries, notably, scale, predictability and control. Then, and this is the part I love, Spencer says that what... business|bytes|genes|molecules blogs http://www.medworm.com/rss/comments.php?id=629287 Mon, 21 May 2007 04:21:46 +0100 629287 http://www.medworm.com/index.php?rid=611661&cid=t_138355_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=602049&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Fnewcastle-university-technical-report-cisban-dpi.html A Technical Report for the School of Computing Science of Newcastle University was released last month describing the CISBAN DPI, an implementation of the FuGE Milestone 3 STK. You can find and download that technical report here:http://www.cs.ncl.ac.uk/research/pubs/trs/abstract.php?number=1016 The Abstract follows:The Centre for Integrated Systems Biology of Ageing and Nutrition has developed a Data Portal and Integrator (CISBAN DPI) that is based on the FuGE Object Model and which archives, stores, and retrieves raw high-throughput data. Until now, few published systems have successfully integrated multiple omics data types and information about experiments in a single database. The CISBAN DPI is the first published implementation of FuGE that includes a database back-end, expert and s... Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=602049 Thu, 10 May 2007 17:22:01 +0100 602049 http://www.medworm.com/index.php?rid=587451&cid=t_138355_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_138355_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_138355_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=688697&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F113474741%2F Al Lewis, one of the founding fathers of DM, has shaped the face of the DM industry probably more than other any single individual. (This is all fine unless you happen to be the person whose face is being shaped by Al.) Al has been unabashedly pro-DM.  Until now.  Al writes in a recent article in Managed Healthcare Executive: Disease management as we now define it may be on its last legs, though no one knows it yet. The Disease Management Purchasing Consortium has noticed that the savings in all but a few diseases doesn’t offset the costs, and nowhere does it generate the level of return on investment (ROI) that some people think they are getting. But fear not, Al foresees a new DM: (more…) Share This 4 Comments At May 2, ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=688697 Wed, 02 May 2007 00:18:27 +0100 688697 http://www.medworm.com/index.php?rid=549639&cid=t_138355_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=688702&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F109853298%2F The 1990’s experiment around development of integrated delivery systems (IDSs) mostly did not take root. This experiment was primarily about financial integration — doctors joining with hospitals so that they could together contract with health insurers for capitated reimbursement, hospitals starting their own health plan, or hospitals buying physician practices as a way of guaranteeing a future base of patients and revenues. The systems and processes needed jointly to manage financial and clinical risk were an afterthought; information technology was not yet far enough advanced to offer integrated clinical solutions.  One of the lessons learned was that financial integration alone was insufficient for success. There is still a largely unexplored s... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=688702 Tue, 17 Apr 2007 20:43:07 +0100 688702 http://www.medworm.com/index.php?rid=538994&cid=t_138355_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=1186417&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2007%2F04%2Fupdate-of-therapeutic-listening.html As promised, I wanted to review some of the articles in the current (March/April 2007) issue of the American Journal of Occupational Therapy. Since I have gotten some emails and blog comments asking me about the Hall & Case-Smith study (see reference below) I thought that this would be a good article to begin discussing.I was excited to see a study on this intervention technique because I have been hesitant in the past to fully embrace 'therapeutic listening.' In my opinion there is not adequate evidence to support promoting this technique so I was interested to see if this new study would change my mind.I believe that the authors should be commended for initiating this inquiry, but I also believe that their conclusions are far overstated. There are several fundamental flaws in their desig... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1186417 Mon, 09 Apr 2007 16:35:00 +0100 1186417 http://www.medworm.com/index.php?rid=688709&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F106979686%2F Mathematica Research has just released a report: The Evaluation of the Medicare Coordinated Care Demonstration: Findings for the First Two Years.  It’s not pretty. Section F of the Executive Summary is entitled “Synthesizing the Findings: What Works, and What Doesn’t”.  That section begins: Given that few of the programs have shown convincing evidence to date of reducing beneficiaries’ need for hospitalizations and saving money or of improving the quality of care received, there is relatively little assessment that can be done yet of  what works.[xxxii] The Medicare Coordinated Care Demonstration (MCCD) is one of a series of Medicare demonstration projects that have been going on for a decade.  Many of these projects relate to chroni... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=688709 Fri, 06 Apr 2007 00:22:24 +0100 688709 http://www.medworm.com/index.php?rid=1186418&cid=t_138355_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2007%2F04%2Ftying-some-loose-ends.html This article isn't directly assessing the effectiveness of a 'brushing program' but it does look at the issues of 'prescribing' a program that is potentially intrusive to a family's normal occupational routines.Dr. Segal makes some critical observations including "Although therapists should continue to educate parents about this intervention, it is important that they keep in mind that parents' lives may not revolve around occupational therapy and the child who needs this particular intervention." The question then is: How ethical is it to prescribe some type of intervention program that is fundamentally disconnected and in fact is disruptive to the normal flow of activity within a home? One could argue that chemotherapy and radiation interventions for cancer are maximally disruptive to no... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=1186418 Thu, 05 Apr 2007 16:55:00 +0100 1186418 http://www.medworm.com/index.php?rid=522163&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F04%2Foral-defensiveness-once-bitten-twice.html This is one feature of my youngest son. On the whole, he refuses all ‘new’ foods. A few of years back, my older son, who is also autistic, had a play date with his chum, a typically developing twin. This fully verbal child had energy, enough to spark my child into action. There were few words between them as they spent the majority of their time wrestling. [translation = roughhousing.] These two five year olds ‘played,’ until snack time, when all four came to the table. At this time junior only "ate three things," but we seem to have been working on this forever.Very occasionally, approximately once or twice a year, he would snatch food from someone else’s plate, stuff it in his mouth and then promptly spit it out again, with accompanying screams.The friend immediately noticed t... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=522163 Wed, 04 Apr 2007 16:12:00 +0100 522163 http://www.medworm.com/index.php?rid=688717&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F105031782%2F Just in case this particular item hasn’t yet reached the top of your own “to read” pile, let me bring to your attention recent testimony to the Senate Finance Committee on Medicare Payment of Physician Services. The testimony was presented on March 1 by Byron Thames, MD, an AARP Board member. With over 35 million members, AARP is the leading nonprofit, nonpartisan membership organization for people age 50 and over in the United States. Here are my take-away points from Dr. Thame’s testimony: AARP recognizes that addressing care coordination is a critical issue in health care payment reform AARP is on the fence about who should do care coordination AARP could have an influential role in payment reform (more…) Share This 2 Comments At March 29, 2007, Rand... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=688717 Wed, 28 Mar 2007 23:23:21 +0100 688717 http://www.medworm.com/index.php?rid=508111&cid=t_138355_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=502985&cid=t_138355_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2007%2F03%2Fearly-days-6-its-all-relative.html [From way back when]Junior son and I have arrived early at school to pick up his brother from his Special Education Day Class, now that he is in First Grade. We're early because it allows him to adjust to the 'new surroundings,' even though it's been a few weeks now. It helps to be first because then additional people arrive gradually. We need to avoid the deluge of a crowd. Another mother and her child are also waiting outside the same door. We join her on the bench and I smile. It’s reciprocated. I make sure that junior is on the far side of the bench, as far away from her and her son as is physically possible. My son doesn’t look at the other mother, nor her child. He might notice if it was a baby, but toddlers are in the same category as dogs and cats, small creatures that are unpr... Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=502985 Mon, 26 Mar 2007 23:03:00 +0100 502985 http://www.medworm.com/index.php?rid=688718&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F104564841%2F “In theory, there is no difference between theory and reality. In reality, there is.”  Yogi Bera Out-of-the-box thinking is good; out-of-touch thinking is not. Dr. Porter and Teisberg’s (PT’s) recent article in JAMA “How Physicians Can Change the Future of Health Care” is disappointing, unrealistic and dangerous. Disappointing: Please Answer the Challenges About Why Your Theory isn’t Workable Unrealistic: Money Does Matter a Lot Dangerous: Measuring Process in Health Care Does Add Value Whatss so seductive about their writing is that about 90% of it makes a great deal of sense; however, the other 10% doesn’t, and this 10% is foundational to their thinking. (more…) Share This 6 Comments At March 28, 2007, Gordon Norman, MD, MBA; Alere ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=688718 Mon, 26 Mar 2007 21:59:56 +0100 688718 http://www.medworm.com/index.php?rid=490872&cid=t_138355_132_f&fid=35011&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fmndoci%2F%7E3%2F103577468%2F Via Techmeme I found this short post by Dave Winer in which he quotes Peter Rip The Web today still resembles MS-DOS more than MS-Windows. Every website is an island, an island that knows nothing about any other website. This is no different than the world before the Windows Clipboard. All 640KB of memory was available to whatever application was running. The point of integration was the User. As it is today. This quote really hits home. With exceptions the world of biological information is exactly that, an island. The integrated web of information is a misnomer. Just because Google indexes the web doesn’t make it integrated. So how does this change? That’s why I am intrigued by the semantic web, Freebase, microformats, etc. In the software business we talk about about develop... business|bytes|genes|molecules blogs http://www.medworm.com/rss/comments.php?id=490872 Thu, 22 Mar 2007 16:11:54 +0100 490872 http://www.medworm.com/index.php?rid=688719&cid=t_138355_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F103188176%2F Translation — Today’s blinding flash of the obvious (BFO): How can you expect pay-for-performance (P4P) programs in Medicare to work with out a designated physician quarterback (QB)? Please allow me to elaborate. P4P programs are based on two assumptions: Patients are assigned to a physician or a practice that will have primary responsibility for their care, and That a meaningful fraction of the care physicians deliver is for patients from whom they have primary responsibility Wouldn’t you expect that this would be problematic for older (Medicare) patients who see multiple doctors over time? How can you assign accountability for performance to one doctor when the patient is seeing a number of doctors for a number of care episodes? (That’s the BFO part for me.)... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=688719 Wed, 21 Mar 2007 00:46:39 +0100 688719 http://www.medworm.com/index.php?rid=485533&cid=t_138355_132_f&fid=35028&url=http%3A%2F%2Flurena.vox.com%2Flibrary%2Fpost%2Fbeta-release-cisban-data-portal-and-integrator.html The Centre for Integrated Systems Biology of Ageing and Nutrition has developed a Data Portal and Integrator (CISBAN DPI) based on Milestone 3 of the Functional Genomics Experiment (FuGE) Object Model (FuGE-OM), and which archives, stores, and retrieves raw high-throughput data. We are pleased to announce that the CISBAN Data Portal and Integrator is now available in a public sandbox version. Please note that this release is still at an early beta stage, and any data you may upload to the server may be deleted at any time. You will need a logon to access this database, which you may request from the helpdesk. This is a low-level of security that will only serve to prevent anonymous load on the database and to keep your sandbox area separate from others. For more inform... Systems Biology & Bioinformatics blogs http://www.medworm.com/rss/comments.php?id=485533 Fri, 16 Mar 2007 16:40:12 +0100 485533