Indian Medicine

When Bill Ventres and his colleagues published their paper last year on this topic - I was impressed, but for some reason I didn't write about it here or forward a link to all of my colleages as I should have done. Bill presented the paper at this year's STFM - and of course he uploaded his powerpoint to FMDRL. Required reading.

A few days ago I made a comment about how the building blocks were there to pull together some "mashups" in medical practice.   I said it wasn't rocket science.   Here's a short description of how I solved a real-life problem in my practice.  Problem: Dr Reider isn't as well organized as he could be.  Duh.  this is a common problem in healthcare.  Physicians work too much - we'd much rather spend time with our patients than at our desks reviewing paperwork, writing notes, etc.  Perhaps I'm worse than many others.  So be it.  Not going to change this old dog.  Sometimes I'm not scheduled to see patients in the office (yes - I have too many jobs - but let's keep on track here!) but I agree to see someone anyway.  Perhaps I am on the phone with someone who tells me that they can't get an appintment to see me for a few weeks .. and I say "well, Bob .. how about we see each other at 8:30 next Tuesday?"  So Bob gets scheduled .. and next Tuesday rolls around and Bob shows up .. but I'm not there because I forgot.  oops.  Office calls me.  I rush to the office .. see Bob.  All is well.   We hope. My attempt @  human solution was to have the office staff look @ tomorrow's schedule .. see if there are patients scheduled to see me on a day that I'm not usually "in" - and call to remind me.  Short version: this didn't work.  Enter technology: Requirements: The system will be able to determine when the provider is scheduled to see a patient on a day that he is not otherwise scheduled to see patients. The system will be able to cause the provider to be reminded about the appointment(s) with enough warning to be able to be in the office on time - yet not so early (1 week) that he will forget. The system should - if possible - be able to add the appointment(s) to his calendar in google calendar, 30Boxes, or Outlook. Implementation: I'm using the webservices that I created for our Misys Vision practice management system to get the information about the scheudle.  Easy.  Scheduled Task that runs on the server @ 6 PM GetSchedule("JMR",BeginDate,EndDate)  .. in this case - I get 1 day - tomorrow. I parse the data and decide if it's a "usual" day or a day I'm not supposed to be in If # rows returned > 4 .. End If $ rows returned < 4 .. then it's probably not an "in-office" day - so let's keep going Push the data to Google's API - to add an event for each visit Sending: BeginTime, EndTime, no patient identifier, description "patient scheduled" The scheduled visit is now on my google calendar.  I can now receive an alert from google via SMS .. or sync with my PDA, outlook, 30Boxes, etc.  Easy.  Google this - there are so many options these days .. from SyncML free solutions - to commercial products.   Perhaps that topic deserves another post ...

This note in the Lancet (sorry - free registration required) tells a compelling story about the state of our Homeland security.  I'll admit I've never seen a Seton .. so I would have been just as confused as the Homeland security physician (did you know we had homeland security physicians?)

Matt's Article in Health-IT World got a nice little article on social networking in healthcare.  It's a good little review of what's out there.  I'm not convinced that this stuff is going anywhere.  Physicians have too little time ...

Today Enoch reviews PFW. As usual, Enoch "gets it." I've been involved with the project for a long time - and it has been a privilege to be involved in something so substantive. In some ways - PFW serves one of the original goals that medical blogs were trying to reach: reviews of (and pointers to) important medical news on a regular basis. The "regular basis" is an important differentiator between weblogs and a professional he developed and provided resource such as PFW. There is no expectation that a blogger make a post every single day. On the other hand, a product such as PFW fields a reputation as a reliable new source by providing news and information on a daily basis. Sometimes this is a true challenge, since there have been days in which there is clearly a dearth of truly important medical news. It's interesting to see that medications gape has discovered and increased logs in the past 6 or 12 months. I remember when Steve Hoffman was there and Steve single-handedly motivated the company to provide RSS feeds well before most people knew what RSS feeds were. It even 18 months ago, it was hard to get Netscape to understand how powerful weblogs could be as a way to build and maintain readership. And this is why PFW still differs quite a bit from weblogs: We provide important medical information in it claim, concise, well written summary that is deliver daily via e-mail or RSS. There is (by design) very little editorial opinion expressed about the content. In a conversation about the project with the neck a few months ago when I was in San Francisco, and when he pointed out that the discussion around the content may be just as informative or important for readers. He maybe right, but there is no reason that PFW can't serve as the nidus of such a discussion that takes place elsewhere. For example, this story about salmeterol reminds us of the dangers of this long acting beta agonist when used incorrectly. I'm still not convinced that salmeterol is a dangerous drug inherently. salmeterol (like any medication) should be used carefully and appropriately. From my perspective, the article (and the previous warnings about salmeterol) or more about asthma than this medication. Asthma is a very serious illness and we need to understand that beta agonists (either short-acting or long acting) only treat the symptoms of this disease. Just as no one would expect albuterol two "cure" asthma, salmeterol plays no role in reducing inflammation as would corticosteroids or theophylline. The staff editors and physician editorial board members of PFW discuss (by conference call) each article twice before publication. These conversations are often robust and educational for all involved, and sometimes I wish that the readership had access to some of the content of our discussions. Yet if we remain focused on our goal of providing concise, well written summaries, perhaps the medical "blogosphere" will serve the function of creating and maintaining a forum for discussion of these important topics.