The Patient is handed the tablet...

APP.COM - END OF THE PAPER TRAIL | Asbury Park Press Online
I really happen to like this story as it shows even a novice, a patient who has never used a tablet before, had no issues with adding his patient information. The physician is really seeing his return on investment here as this is also saving him or a member of his staff all the duplicate entry efforts if this had been done on paper. This physician and the patient are both enjoying the tablet and working towards better health care. Software can be created to make this work with an EMR. The patient was also relieved in not having to fill out a large chunk of paperwork as well! BD

So, when he walked into Dr. Mukaram Gazi's office in Lakewood, he expected to be asked to fill out extensive paperwork with a pen.

Instead, he was handed a tablet PC and a stylus — initiating an administrative technology that allows electronic prescribing of medications and makes for a near-paperless world for physician.

"It is really very easy to do," said Rotondo, tapping away on the small computer screen. "You just follow the directions and answer the questions. If a new system like this gets medications to you quickly and helps save lives, I am all for it."

Industry Exec at HIMMs adds humor to the role of hospital CIOs and advice for CEOs

Modern Healthcare Online
"If you're a CIO, this will be a particularly painful next hour," Garets promised.

On the topic of benchmarking, Garets said CEOs want to compare their organization to its competitors, but Garets suggested that CIOs should not compare their hospital with other healthcare operations—because "what do they know?" Instead, they should compare their organization with companies in other industries known for their effective use of IT—like Fed Ex and Disney.

Glaser mentioned how FedEx customers can track where their package is and now, with the proper IT system, healthcare consumers can track where their laboratory specimen is.
In "the Art of Stalling" segment, Glaser gave tips on how to prevent a CEO's bad idea from becoming reality while making it look you're working on it.

QuickBooks Contact Synch for Outlook

QuickBooks Contact Synch for Outlook
Last week I posted an article about free accounting software from Microsoft and the competition continues with Quick Books allowing synchronization for Outlook. If your version of Quick Books is 2005 or above, it looks like it will work for you, along with being current on all the latest Microsoft updates. BD

  • QuickBooks 2005, 2006, and 2007 (must be installed and registered)
  • Microsoft Outlook (2000, 2002, 2003, and 2007)
  • Microsoft Windows XP, Windows 2000, or Windows Vista including the latest service packs. Go to http://office.microsoft.com/en-us/officeupdate/default.aspx to check for and download updates.

Neochroma mobile projector blows up cellphone screens - Engadget

Neochroma mobile projector blows up cellphone screens - Engadget
Interesting look at a new mobile phone projector. With all the information being ported to a cell phone today, this small project appears to make it possible to project to the size of a 19 inch monitor. BD

Having trouble sleeping?

More Than 20,00 People Worldwide Now Use SLEEPTRACKER® For a Better Start to the Day
Interesting new item designed by a sleep physician...BD
Atlanta, GA (PRWEB) February 28, 2007 -- Innovative Sleep Solutions' unique sleep-monitoring and wake-up device, SLEEPTRACKER®, is now helping more than 20,000 people worldwide wake up feeling refreshed. With the appearance of a standard wristwatch, SLEEPTRACKER monitors the wearer's sleep patterns to detect the best possible waking time - allowing the wearer to wake up more refreshed and alert from a light sleep stage.

SLEEPTRACKER has normal watch features including time, day, date and standard alarm settings, as well as a snooze function. It is water-resistant, has a night-glow feature and carries a one-year warranty. SLEEPTRACKER is available for $149.00 at Sleeptracker.com and has a 30-day money back guarantee.

Microsoft Office 2003 Apps Hit with New Crash Bugs

PC World - Microsoft Office 2003 Apps Hit with New Crash Bugs
One more warning about Word and Excel.....BD

"A remote attacker may exploit this vulnerability by presenting a malicious WMF file to a victim user," said Symantec's report on the Office 2003 flaw. "The issue is triggered when the application is used to insert the malicious file into a document."

Specially crafted WMF (Windows Metafile) image files were the root of a major attack in late 2005 and early 2006 that was launched from hundreds of malicious Web sites and compromised thousands of PCs. This bug seems to be different from the 2005/2006 vulnerability.

Attacks using either vulnerability require users to download malicious files from a Web site or open them when they arrive as e-mailed file attachments.

FDA Approves Cymbalta(R) For Treatment Of Generalized Anxiety Disorder

FDA Approves Cymbalta(R) For Treatment Of Generalized Anxiety Disorder: "
Eli Lilly and Company (NYSE: LLY) announced today that the U.S. Food and Drug Administration (FDA) has approved the antidepressant Cymbalta(R) (duloxetine HCl) for the treatment of generalized anxiety disorder (GAD), a condition that affects more than 6.5 million American adults in a given year.(1) Because GAD presents with a variety of symptoms, it can be difficult to diagnose(2) and may have a negative impact on a person's ability to function properly in work, family and social situations.(3)"

MercuryNews.com | 02/26/2007 | Study: Patients favor doctors that use electronic medical records

MercuryNews.com | 02/26/2007 | Study: Patients favor doctors that use electronic medical records

Doctors looking to attract new patients may want to buy an electronic medical record system because a new survey slated to be released Monday found that a majority of consumers said the technology plays a role in their selection of a physician.

The good news for doctors is that patients may offset the cost of such a purchase: Fifty-one percent of consumers said they would be willing to pay for the service if the price was reasonable.

Microsoft CEO Keynote Speaker at HIMMS

Modern Healthcare Online: "'Healthcare is the single-largest industry in the world, and yet we don’t see quite the same level of standardization in the healthcare industry that we do in the manufacturing industry,' he said. 'The needs of the providers simply have not been met.'

Making sense of the information, not just storing and retrieving it, will be the challenge of the future, one that healthcare software developers must meet.
"
"Healthcare is the single-largest industry in the world, and yet we don’t see quite the same level of standardization in the healthcare industry that we do in the manufacturing industry," he said. "The needs of the providers simply have not been met."

Making sense of the information, not just storing and retrieving it, will be the challenge of the future, one that healthcare software developers must meet.

First-Time Generic Approvals: Focalin, Valtrex, Hydrodiuril

Medscape Medical News 2007. © 2007 Medscape

February 16, 2007 — The US Food and Drug Administration (FDA) has approved first-time generic formulations for dexmethylphenidate HCl tablets in the treatment of attention-deficit/hyperactivity disorder, valacyclovir HCl tablets for the treatment of genital herpes and shingles, and hydrochlorothiazide 12.5-mg tablets for the treatment of edema and hypertension.
Generic Dexmethylphenidate HCl Tablets (Focalin) for ADHD
On January 29, the FDA approved first-time generic 2.5-, 5-, and 10-mg formulations for dexmethylphenidate HCl tablets (made by Teva Pharmaceuticals USA; brand name Focalin, made by Novartis Pharmaceuticals Corp).
Dexmethylphenidate tablets are indicated for the treatment of attention-deficit/hyperactivity disorder in patients aged 6 to 17 years.
Generic Valacyclovir HCl Tablets (Valtrex) for Genital Herpes, Shingles
On January 31, the FDA approved first-time generic formulations for valacyclovir HCl 500-mg and 1-g tablets (made by Ranbaxy, Inc; brand name Valtrex, made by GlaxoSmithKline).
Valacyclovir is indicated for the treatment/suppression of genital herpes in immunocompetent individuals and for the suppression of recurrent genital herpes in HIV-infected patients. It also may be used for the treatment of herpes zoster (shingles).
Generic Hydrochlorothiazide 12.5-mg Tablets (Hydrodiuril) for Edema, Hypertension
On January 23, the FDA approved a first-time generic 12.5-mg formulation for hydrochlorothiazide (HCTZ) tablets (made by Mylan Pharmaceuticals, Inc; brand name Hydrodiuril, discontinued by Merck and Co, Inc).
The FDA notes that although generic formulations of HCTZ 12.5-mg capsules were previously approved, the current approval represents the first for generic tablets in this strength.
HCTZ is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy; and for use alone or with other agents for the management of hypertension. It has also been found useful for edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure.
You may need to log in for the story below.
http://www.medscape.com/viewarticle/552375_print

Microsoft Acquisition of Medstory

Microsoft Demonstrates Further Commitment to Healthcare Market With Planned Acquisition of Web Search Company: Medstory’s intuitive technology designed to improve access to health information and empower consumers to make better-informed health decisions.

The site has a nice format for searching and brings a lot of information together under one area. BD

http://www.medstory.com/Home.html

Now featuring new search results through our Media Partner Program

Medstory is pleased to announce the launch of its new Media Partner Program, aimed at delivering the highest quality search results to our users seeking in-depth information on health and medicine.

Our inaugural Media Partners include breastcancer.org and The Wall Street Journal Online, two premier providers of health-related information on the web. We’re working closely with these partners (and others) to bring you their highest quality and most relevant search results, which generic search engines rarely uncover.

Federation of American Hospitals also have a plan for Insurance Coverage

Hospital firms outline plan for universal care - The Boston Globe: "Hospital firms outline plan for universal care

By Associated Press | February 22, 2007

WASHINGTON -- The largest hospital operators in the country say providing health insurance for all Americans can be achieved by expanding government coverage, and by giving lower-income Americans vouchers to pay for the private plan of their choice.

The strategy presented by the Federation for American Hospitals differs somewhat from other recent proposals -- including one from Wal-Mart and the largest US union -- by detailing how the public and private sectors should collaborate to provide coverage for the nation's 47 million uninsured. The plan was posted to the federation's website yesterday and will be discussed at a press conference scheduled for today."
American Federation of Hospital Members:
http://www.fah.org/membership/listing_of_facilities/state.cfm?state=ca

Good news for not-for-profits

Modern Healthcare Online

With the HIMMS conference this week in New Orleans, there will be many more additional news items coming forth this week as well. BD

The Internal Revenue Service may soon rule that not-for-profit hospitals can subsidize the cost of e-prescribing and electronic medical records systems for their affiliated physicians without jeopardizing the hospitals' tax-exempt status, an HHS official told several hundred physician informaticists Sunday during a pre-conference session at the Healthcare Information and Management Systems Society trade show in New Orleans.
This is a horrible way to start your process, that you’re going to reduce staff," he said. "You get a lot of passive-aggressive behavior."

Parker said changing workflow often creates short-term productivity losses, so IT conversions place financial stresses on a small group or solo practice beyond the cost of the IT systems alone. Physicians shouldn’t look to IT to rescue a financially troubled practice.

"We’ve actually seen failures that have caused the practice to break up or go bankrupt," Parker said. "You have to make sure the practice is financially healthy enough to be able to stand that, at least on a 90-day implementation schedule."

U.S. Regulators Approve Cymbalta® For Treatment Of Generalised Anxiety Disorder

U.S. Regulators Approve Cymbalta® For Treatment Of Generalised Anxiety Disorder

The U.S. Food and Drug Administration (FDA) has approved the antidepressant Cymbalta® (duloxetine HCl) for the treatment of generalised anxiety disorder (GAD), Eli Lilly and Company (NYSE: LLY) and Boehringer Ingelheim announced today.

Share Point Services? What is this?

norwichbulletin.com - www.norwichbulletin.com

This is a good article describing the basics of Share Point services. Share Point services tends to be used generically sometimes, when in fact there are many flavors of Share Point. This article describes a server/client installation, but there are also "web hosted" services available as well. Small Business Server 2003 and Windows 2003 Server include the "basic" portal features and it can grow from there with a full Share Point Server from Microsoft. Share Point is a valuable resource, but first do some homework and read up a bit to determine which flavor and whether local or web hosted will be the best solution for your practice. In short, an "intranet" is like a fenced-off part of the Internet that gives only a limited group access to its information.

Free Accounting Software - Microsoft Accounting Express

Do you need accounting software for the practice? Microsoft has free accounting software that will help you get started if you not set up with Quick Books or some other type of accounting software. The free version will only allow for use with one computer. If you are happy with the software, it can be upgraded later. You can also connect to ADP for payroll and Office Accounting Express is also integrated with Office 2007. You can also use the software even if you have an older version of Office from Microsoft. It's worth checking out and information can be exported to other formats, such as Excel Spreadsheets too.

http://ideawins.com/productinfo.html

Lilly Introduces World's First Digital Insulin Pen With Memory

Lilly Introduces World's First Digital Insulin Pen With Memory

Eli Lilly and Company today announced the launch of the first insulin pen with memory, HumaPen® MEMOIR™, to help simplify the daily management of diabetes.

MEMOIR is designed to meet the needs of people with diabetes who take several shots of mealtime insulin each day. It presents sophisticated technology and features in a consumer-friendly "push-to-know" digital display that allows patients to record and review their last 16 insulin doses, including the priming doses

New Storage Instructions Approved For BYETTA®

New Storage Instructions Approved For BYETTA®: "
Amylin Pharmaceuticals, Inc. (Nasdaq: AMLN) and Eli Lilly and Company (NYSE: LLY) announced today that the U.S. Food and Drug Administration (FDA) has approved more convenient patient storage instructions for BYETTA® (exenatide) injection. BYETTA Pens can now be kept at a room temperature not to exceed 77 degrees F (25 degrees C) after first use.

Help the cash patient...$4.00 prescription links

Both Target and WalMart/Sam's Club have $4.00 generic prescription plans. There are around 300 on each list. It just could be a good idea to keep a copy of the listings available, as the price could make the difference on whether or not some patients could afford the prescription. Sometimes the $4.00 could even be less than the insurance co-pay amount. This is not an endorsement for either retail chain, but an awareness item that might be of help to patients and physicians anywhere.
The links below go direct to the pdf form which you can save or print for future reference. I had this exact situation happen to me recently and paid over $70.00 for a generic prescription for antibiotics when it could have been located on this list and filled here. I thought I was doing good at that point as the name brand was almost $100.00. As a prudent patient I think I might also entertain keeping a list with me when visiting a physician. $70.00 versus $4.00..not hard to do the math here. When we are not feeling well, sometimes items like this slip by and end up costing additional money needlessly and I fell right into that category myself but hopefully not again. The lists contain many drugs commonly prescribed.
http://sites.target.com/images/pharmacy/pharmacy_4dollar_program_list.pdf
http://i.walmart.com/i/if/hmp/fusion/genericdruglist.pdf
Perhaps a good time to get started with free E-Prescribing too. Use the link on the right hand side for more information .

EO UMPC from Tablet Kiosk Mobilizes Southern California Physician

Dr. Jack Rubin, an internist and nephrologist is really putting his UMPC to work. Dr. Rubin is currently consulting and admitting at 15 local hospitals in the Orange County/Los Angeles area, as well as seeing a good number of patients at his local office.

Dr. Rubin makes the maximum use of his EO by being able to have the ability to have his patient records with him at all time. In addition, he also responds to emergency calls as needed. By maintaining a synchronized copy of his EMR (electronic medical records) with him, he is able to look up patient information in the matter of a couple minutes, the time it takes to boot the computer if it is not currently running. By having his records available and up to date, he can view all past notes, current medications, etc. relative to the patient chart and avoid creating needless errors.

I was able to catch up for a brief moment today with him as he stopped in the office in between hospital visits. He uses 3 methods of input with the EO, inking, a keyboard when needed, and also uses voice recognition. Voice recognition is very helpful for adding notes while at the hospitals as items are added immediately to the patient chart in the EMR. Having the ability to be mobile in today’s world not only allows for better patient care, but also helps in growing the practice, as time is not spent duplicating the same efforts with staff members having to do what he can do himself.

Dr. Rubin has been working at this for a while to get to where he is today with utilizing technology. By having his records with him he can also easily generate information from the patient chart to be used for admitting and consultations, thus providing a complete medical history of the patient chart. By having the ability to provide this information, sometimes this can and does lead to not having to order additional tests and wasting time, having to manually secure chart data from his office. It saves time for all and really benefits the patient with documented information relative to their current illness and treatment.

One of the real benefits of using the UMPC is the size. The UMPC has proven to be much more useful and portable than a full size unit, and yet offers all the same features as found on a larger tablet. Mobility has really paid off for Dr. Rubin. The EO UMPC travels with him at all times and is his constant electronic companion in the pursuit of better health care and I am glad we were able to provide the UMPC to help him with this mission.

Barbara Duck

Is it a bong or Exubera?

In case you haven't seen this product yet, it is has a very interesting design and a fairly large price tag that goes along with it. I don't see this being portable enough to carry in my purse, plus if I were in a public location, someone might think I have a bong and could possibly alert the authorities. Is it a bong or is it Exubera? BD

Get Ready For Those Exubera Ads

bong.jpg

Pfizer is making good on those recent threats and will soon run them on tv and in magazines. The desperate drugmaker wants to go directly to diabetics to salvage its failing insulin inhaler, which has bombed due to a high price tag and its cumbersome design (it looks like a bong, if you didn't already know).

http://pharmalot.com/2007/02/get_ready_for_those_exubera_ad.php

Using a UMPC as a Desktop Replacement

Did you you can use your UMPC as a desktop replacement? Hugo Ortega, a Microsoft MVP does an excellent job on showing how the UMPC can be both your desktop and and then be available to be mobile. He is demonstrating the EO from Tablet Kiosk in part 2 and does a very good job with a visual "how to", which is pretty much not more than connecting cables and setting up Windows display properties.

Part Two of the video focuses on something I like to term as the “Mobile Permanent Office.” Because the i7210 is the first UMPC (Microsoft Origami Project derivative) to run an Intel Processor with 2MB of L2 Cache [providing multitasking abilities] the possibilities of replacing a notebook or desktop are “somewhat” closer. Using i7210’s capacity to “Extend its Desktop” I demonstrate just how one might increase their own productivity in the office, or home.




http://ubertablet.blogspot.com/2006/09/umpc-as-desktop-replacement.html

Physician explains to other MDs the value of relational data bases

This is an excellent commentary with one physician discussing the benefits of relational data bases and their development and use, a nice way of explaining why document storage is not the ultimate answer for health records. BD

The reason is many physicians do not know what they need. They have little experience thinking about relational databases. They have difficulty understanding the potential to the increased efficiency of their daily workflow (effective relational databases) in the practice of clinical medicine. Most of the effective information technology in clinical practice has been in financial medical management. Financial outcomes have not been linked to medical practice outcomes in an understandable way.


Many businesses rely on relational databases. Two simple examples are Amazon.com
and Netflix. Amazon tells me what books I would enjoy and Netflix tells me which movies I should order from my order history.

The airlines let me schedule a flight online. Southwest has my online ticket buying reduced to three clicks.

http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/02/is_an_ideal_ele.html

Pharming Attack Targeted Bank Customers Worldwide

Good article about online awareness...BD

An attack this week that targeted online customers of at least 50 financial institutions in the U.S., Europe and Asia-Pacific has been shut down, a security expert said Thursday.
The controller also shows infection statistics. Websense said at least 1,000 machines were being infected per day, mostly in the U.S. and Australia.
http://news.yahoo.com/s/pcworld/20070222/tc_pcworld/129270

IBM, Duke develop Web site for patients

WASHINGTON - Patients in Duke University's health system can now go to one Web site to pay medical bills, schedule doctor appointments and eventually view their personal medical histories.

For now, patients, who must register with the site, can make non-urgent appointments and pay bills.

Clinical information, such as prescriptions, lab and X-ray results and immunization records, will be available online in about two months, Ahmad said.

http://news.yahoo.com/s/ap/20070222/ap_on_hi_te/ibm_health_it

FDA Warning - Xolair

FDA Warns About Asthma Drug, Xolair

Extreme Allergic Reactions Seen in Patients Using Injected Drug

Feb. 21, 2007 -- The FDA is calling for a "black box" label warning for the asthma drug Xolair, alerting users it can cause potentially life-threatening allergic reactions.

The FDA issued the alert after reviewing 48 cases of anaphylaxis -- life-threatening allergic reactions -- submitted to the agency from June 2003, when Xolair was approved, through December 2005.

These cases included symptoms of bronchospasm (narrowing of airways), difficulty breathing, drop in blood pressure, fainting, hives, and swelling of the throat or tongue.

http://www.medicinenet.com/script/main/art.asp?articlekey=79536

And one more story about lost/stolen data - when will they learn...

Social Security worker loses files

Some are never found; hearings on disability benefits delayed

Security is a huge focus for all. With flash drives being so convenient to use be very careful on what information you carry around on a device. As you can read from the article, this employee is no longer allowed to work from home. If you are carrying anything even close to relating to any medical information, for goodness sakes encrypt the information before leaving your office. If you don't know how to encrypt information to be portable, I would recommend not putting yourself in this type of position and either ask someone to help you or simply don't transfer the information and find an alternative method to get your work done. BD

The confidential files of six Wisconsin residents who had sought Social Security disability benefits were lost for months, as were documents from seven other files, after a Social Security employee took them home to work on them.

In a bizarre twist, the mother of one applicant received an anonymous call in November from a man who had "very specific" information on her son's medical condition, records show.

The caller told her that his Social Security file, along with others, had been found in a downtown Milwaukee Dumpster, according to federal investigative reports.

In addition to private medical information, the files include Social Security numbers, addresses and phone numbers of family members, dates of birth and work history - all of which could be used by identity thieves.

All of the applicants had been waiting at least two years for a final decision on whether they qualify for disability benefits when their files were lost, delaying decisions even further.

The Social Security Administration allows employees nationwide to work on confidential files at home under a program called Flexiplace, which has come under fire in the past because of privacy concerns.

The employee who took the files home told authorities she believes some were left behind when she fled her home last summer because of domestic violence. She told authorities she had kept them in a locked two-drawer file cabinet.

Full story at the source:

http://www.jsonline.com/story/index.aspx?id=567240&format=print

Fighting surgeons leave patient in lurch

When I read a story like this, there's only one real question that comes to mind....Why?

"At one moment Vukanic pulled the ear of the operating doctor, slapped him in the face and walked out," she said.

Radulovic followed and an all-out fight ensued, resulting in bruises, a split lip, loose teeth and a fractured finger.

Fighting surgeons leave patient in lurch

What happens when a Hospital CEO Blogs?

Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston has started his own blog. It is fairly new as is this blog, but full of action. I have linked to the doctor and nurses post whereby he is now adding physicians and nurses who are reading the blog. Good things happen when people get involved. If you haven't had a chance to take a look at his blog yet, I have included the link below. I have added the blog to my RSS Feeds to keep abreast on what he has to say at the top level of hospital management. Again, it's good to see hospital CEOs involved in the process of creating better medical care. The name of his blog: Running a Hospital.
http://runningahospital.blogspot.com/2007/02/new-feature-nurse-and-doctors-links.html

Sahara Tablet PC - Acooustic digital Microphone

AKU2001 CMOS MEMS Microphone Arrays in TabletKiosk Sahara Slate

Akustica, Inc., pioneer in acoustic system-on-chip solutions, today announced that TabletKiosk's family of Sahara Slate PCs are shipping with an embedded "dual array" of its AKU2001 digital microphones. The Sahara Slate i412T, i440T, and i440D are the first tablet PCs using Akustica digital microphones.

The AKU2001 is a single-chip digital-output microphone manufactured using Akustica's patented Complementary Metal Oxide Semiconductor (CMOS) microelectromechanical systems (MEMS) technologyThe small form factor and digital output of the AKU2001 deliver the ideal microphone solution for enhancing the voice-input quality in a tablet PC.

"Akustica's digital microphones bring a new level of voice input quality to the Sahara Slate PC and ensure that users will never experience the irritating buzzing noises that traditional microphones often pick up from a nearby cellphone or even from the WiFi antennas and that are also located in the slate itself," said Davin Yuknis, Akustica's vice president of marketing and product management. "Our digital microphones

Full story at Chris De Herrera's site:

http://www.tabletpctalk.com/

Online CME Credit

I had a client ask me last week about how to get started with Online CME credit. Google is always a good place to start, but then it requires searching each link to find what one may be looking for. To make it easy for my client to get started I compiled a simple listing of some links and will post here for any others just getting started using online CME.
This is the kitchen sink with something for almost anything you could think of being here, with links directly to the sites with CME credit courses, some are free, some cost a few dollars, some are sponsored, while some are not.
http://www.cmelist.com/list.htm
American Academy of Family Physicians - RSS Feed - get new articles and podcasts via RSS, podcasts can be set to automatically download to listen at any time with an RSS Feed Program - scroll down mid page to select to add. RSS Feed is the way to go to autopilot receiving updates and podcasts.
http://www.aafp.org/online/en/home/aboutus/theaafp/about/helpcenter/rss.html
These are all free CME courses, some are sponsored and some are not.
http://www.primeinc.org/
Medscape Website - also tracks all your online credits for you as well - search for listings from this page and most are free.
http://www.medscape.com/activitytracker
CME Corner - some free and some you pay
http://www.cmecorner.com/program_list.asp?audience=Physicians
Discovery Health Channel CME - free
http://discoveryhealthcme.discovery.com/programs/programs.html
http://health.discovery.com/tvlistings/series.jsp?series=119321&gid=0&channel=DHC
The last link above goes to the tv listings for Discovery Health CME. In case you want to watch from your computer, there are several free internet TV websites. The link below is to one site that carries the Discovery Channel, but there are plenty of others if you Google internet TV.
http://wwitv.com/portal.htm

Chicago Hospitals Offer Wi-Fi, Patient Portals - iHealthBeat - Daily News Digest on Health Care Information Technology

Chicago-area hospitals increasingly are offering Wi-Fi Internet access, patient-information portals and patient blogs, the Chicago Tribune reports.

The University of Chicago's Comer Children's Hospital since it opened in February 2005 has provided patients with an entertainment and education system that lets patients access the Internet, check e-mail, view education information, download movies and play games. Patients and visitors with their own laptops also are given secure wireless Internet access at no cost.
In addition, cell phones now can be used in most hospital areas, the Tribune reports.
Nice to see this one finally go away...BD

Chicago Hospitals Offer Wi-Fi, Patient Portals - iHealthBeat - Daily News Digest on Health Care Information Technology

D-Link DIR-450 3G Mobile Router for EV-DO Networks




I have ran across several physicians who use one of the "Internet Anywhere" services available from the wireless cell phone carriers. This is something well worth looking in to, especially if you are mobile and let's say traveling between many hospitals, visiting nursing homes where an internet connection may not be available. When deal with patient information, having everything you need relative to a patient file can even add to the possibility of being a lifesaving benefit!
In addition, with the use of a EDVO mobile router, this experience can also be multiplied and you can use your imagination from here. If you were attending a meeting where you needed to collaborate or even allow a couple of your peers to access information relative to items being discussed, this device would enable you to immediately set up a temporary wireless network so all involved would have an internet connection. Having internet anywhere access can be a true friend to the mobile physician today and having this added capability to share and collaborate is phenomenal.
If one were residing in an area where dsl or cable connectivity is not available, perhaps in a rural area, but cell phone coverage is available, the barrier has now been broken as a wireless network when used with a pcmcia card or usb wireless device from a mobile carrier can now be the answer, and when mobile, you can take it with you.
This is a unit from D-Link, and there are several available from other manufacturers. What a great feature to be able to give a presentation and have the ability to enable a wireless network to let all attendees connect to added resources and information available via the web and really get your message across.
D-Link DIR-450 3G Mobile Router for EV-DO Networks

New Sahara Tablet


If you have missed any of the recent press releases on the new Sahara Tablet from Tablet Kiosk, here is a link to the page from the website. I have seen and held the unit and it is something to marvel at. Of course, those that know me already know I like those tablets. In the past I have demonstrated various models of tablets and the products from Tablet Kiosk are my top choice. The new Sahara now offers the ability to change from digitizer to touch screen, and it works with one touch from a hardware button! If you haven't seen the press releases and would like more additional information, follow the link below. By the way, I also use an EO UMPC from Tablet Kiosk and hope to be sharing some real success stories soon with some of my clients who are using the unit for their electronic medical records and are finding the unit not only convenient and portable, but a real asset to enable them to have all their patients notes with at all times.
http://www.tabletkiosk.com/products/sahara/i400s_pp.asp

Tablet EO UMPC at the Hollywood Bowl from TabletPC2.com

Linda Epstein at TabletPC2.com has posted an update on the use of the new Tablet Kiosk EO at the Hollywood Bowl. Linda and I chatted quite a bit at the last Tablet Kiosk show. Her site is always updated with the latest information about using tablet pc. The Hollywood Bowl has been using tablets for over a couple years now and recently have made the move to the smaller EO unit as it is much smaller and easier to carry around. I have included a picture here with the engineer and the EO.
The reason I have included this article is really demonstrate the innovations being use with the UMPC units. If it can do this type of functionality with a very complex sound system, imagine what it can do for the medical business. A unit could easily be used to stream media from a Media Center PC, which with Vista, can now be added to a domain for complete IT management and control. Educational videos, lectures can all be streamed internally for a unique learning experience anywhere and this can really be helpful in getting valued information to attendees who cannot attend a session in person!

Wireless Router Security - Please don't Share

This was an item on my mind this week, and for that matter it seems to come to mind every week when I am in the field working with clients. Wireless is on the move today and we all like the convenience. Here is an article about Health Care catching on to Wireless fever.
http://enterpriseinnovator.com/index.php?articleID=9644&sectionID=13

The point of this post is to once again try to bring an awareness to light in reference to security with wireless routers. I still see routers every week in use at physician's offices without have any security, thus creating a free "hot spot" for me or anyone else who comes along. My efforts are to take a few moments and stop in to hopefully make the medical practice aware of the fact that they do not have security enabled. Well when you stop and think about someone being able to access medical records or any other information stored on your network, this can be pretty scary, and you do need to protect patient information, HIPAA says so, and good common sense does as well.
A few months ago one of the television stations did a "drive by" of various medical facilities showing how easy this was done and being able to see patient information and basically doing the same as I do in making the office aware that they are broadcasting. EMR software does of course have passwords in place, but what if the software was open and data was being entered - the password does no good at this point as they can see what you are seeing.
Here are some helpful links and some information about war driving. If you don't know what that is, be sure to check it out and find out how your pcs could become zombies under the control of someone outside your network.
http://www.microsoft.com/athome/security/online/homewireless.mspx
This on demand webcast is also worth the watch for more information.
http://support.microsoft.com/kb/895616
One more item here that can also apply to small business networks. Use WPA and not WEP! WEP is not security enough and packet sniffers can pretty easily break the code.
http://www.microsoft.com/windowsxp/using/networking/expert/bowman_03july28.mspx
If you have questions or still have problems, call your IT help contact or the individual or company you contract with for service.
One other short item worth the mention, be sure to keep your PCs updated with Windows Updates to ensure you have the latest security patches. Every update now also contains the free malicious code removal tool update. I think of this from a patient side as well in the fact that I would not be too happy with my physician easily broadcasting any information on myself out there for anyone who passes by and logs on to the network.

Microsoft Home Server

I am going to be testing the new Microsoft Home Server! Yes!!

It will be a few days before I have everything up and going but I am looking forward to this opportunity to beta test!

Vista is hot, but this really gets me going when you can add a home server to the overall picture. Keep posted for my upcoming comments on how it works. I hope to provide some useful information and give all the latest features and report on how it works!

I have worked with Microsoft Servers in business, but having one in my home, designed for the home user is going to really be exciting.

HealthBlog : National e-Prescribing Patient Safety Initiatve, HIMSS and more


Dr. Crounse, Director of Health Services for Microsoft speaks about the free e-prescribing initiative in a very positive way. The interview is very good and he explains how IT Technology is going to grow and change. Scroll down to the bottom to the page links and video interview.
I sent an email out a couple weeks ago on how to enroll and get started with E-prescribing, and have also linked to the site on my new blog. I have had a couple emails from physicians thanking me for the information as I refer them to the site. As we all know today hospitals need doctors more than doctors need hospitals. The E-prescribing initiative is a free service that participants had to pay for in the past. Spread the word to colleagues and others than can immediately benefit.

So I ask, what is your hospital doing for you the physician? Is your hospital giving you helpful IT information that you can use? Do meetings cover various areas of health care IT? I have seen some hospitals taking this task on with a vengeance and really working to solidify their relationships with physicians, to the extent of offering in person support at the offices to enable the physicians to partake and benefit from the technology as the hospital makes each portion available. They recognize the need to make each portion available as soon as it can serve the purpose without delays to roll out one huge project at once. This actually works better as it becomes a progressive learning curve and not one big meal to digest at once.

Something that is definitely worth thinking about. Does your hospital work with the physician as a partner to enable progress and better health care for all? Even if the total support picture is not here altogether, there are baby steps that can be taken to bring partial and smaller solutions until the final creation of the ultimate goal is attained. This is something I hear and see every day and sometimes ask myself, is this technology fear or is there still some "old school" thinking blurring the vision and goal.
The world of IT is changing and now is the time to embrace change and new technology as those who do not are going to find themselves on the short end of the stick and working their staff members much hard than it needs to be, not to mention a continuous day full of frustrations. Along with technology also comes training, and this has been a real shortcoming in convincing the industry as a whole on this importance. One of the items he mentioned is "crane" mind set of hospital CEOs, based on his recent talk to a group of hospital CEOs. The health care industry competes today like it has never had to do in the past.
"It's time to make the move."
Some of the most profound comments are about corporate blogging and what role it plays today and the folks it reaches this way and how it opens a forum for discussions and collaboration that was not possible years ago, as it enables everyone from all walks of life to participate, whether your are in the health care business or not. The internet is the way of getting the news today of the younger generation (and some of us older ones too), and reading a newspaper in print is becoming a way of the past. This also saves trees!
All in all a very informtative interview and with prime focus on embracing and learning more about IT Technology and dealing with the road blocks encountered with others who are less motivated to accept new methodologies and tools and what we can do to narrow the gap.

We have some of the finest physicians and surgeons in the world who work with the most sophisticated medical diagnostic systems and equipment in the world and technology will only serve to make the practice of medicine better for all, which is the final goal we are all working toward. As a consultant I encourage physicians to talk and discuss items among themselves as more minds together are better than one, and try to steer away from the "me" posture and turn it around into a "we" - where we all win, patients too!

HealthBlog : National e-Prescribing Patient Safety Initiatve, HIMSS and more

Click below to go directly to the video interview.

http://health.scribemedia.org/2007/02/16/paper-kills/

RSS Feeds - Valueable , Timely Information

Many of you may already be using RSS Feeds for your news items. In today's world many of us simply do not have the time to sit down and read a newspaper for all the news items we want and need to be informed of. To do a daily search even with a pc on the internet is also very time consuming and can take us away from completing other pressing projects we need to complete.
RSS Feeds are the answer to this issue and can filter and deliver the information you need, daily, hourly or what ever time filter suits your needs. There are many RSS feeds available, along with various version of software to make this work for you. Vista and Outlook 2007 have RSS feed capability built in. RSS Feeds can be used for both business and personal use.
Do you need to keep on top of the latest and breaking medical news? If you are a physician or administrator involved with a heavy work schedule, who has the time to even go to internet favorites and search from there? Do you need the latest information about Medicare? Medicare provides RSS feeds to providers and the general public on the website. This way you can easily keep on top of any new changes in procedures, rules, etc. that pertain to Medicare and some of these go right to the bottom line and influence how one gets paid!! I have included a link to the Medicare site at the bottom of this post where you can subscribe and find out more information. They have also written a complete help section on using RSS feeds, so there's no use to re-invent the wheel here. Podcasts are also made available.
If you haven't explored the world of utilizing RSS feeds in today's busy world, you may be working way to hard to locate and view all the daily health issues that you want to be abreast of! It's simple to get started and once established, new feeds are easily added. Here's the Medicare site for more information:
http://www.medicare.gov/rss/default.asp
Sample Feed Title:
Only 141 more days until the National Provider Identifier (NPI) compliance date! Do you have your NPI?

Anna Nicole Prescription Update - Another good reason for e-prescribing

If you are keeping up on the Anna Nicole Smith story, this is an interesting web page complete with copies of the hand written prescription for the methadone. Even celebrities work several physicians to get their desired drugs. She was using an alias of Michelle Chase and this was prescribed from a physician in California. I don't think we have heard the last of this one. The prescription was filled in the San Fernando Valley and shipped to the Bahamas and the page even has an imaged copy of the airbill. Dr. Kapoor refused comment on the issue.
At any rate, it makes a good case for the new and free e-prescribing service available to all physicians as this will help put a limit to some of this type of activity. I now have the link posted on my blog as another way to make it easier for physicians to locate the web site and sign up. BD
www.nationaleRx.com This is the link to the site where physicians can enroll.

Full story at the link below:

The Doctor Who Scored Methadone for Anna Nicole

http://ww.tmz.com/2007/02/14/the-doctor-who-scored-methadone-for-anna-nicole/

Barbara Duck

L.A. mayor wants muni WiFI by 2009 - Engadget

This has to be the last place I thought I would have seen a picture and article with the Mayor of Los Angeles.

Good story on his efforts to provide WI-FI for the City of Los Angeles.

One Note for Office - Test Drive

I have spent the last couple weeks working with the latest version of Microsoft One Note. I have been using One Note ever since the beginning for taking notes in meetings, which is the very basic use, but with the new 2007 edition they have really opened the doors with many new features, including more integration with Outlook and use with a Windows Mobile Device.

For those still using a lot of Word Documents, you can attach a Word document to the file. It even has text recognition in a picture!

I have used the live sharing features to share a page or notebook with another individual in the past and this is awesome, like whiteboarding live, but it is all captured in your notebook!

If you want to see what all the talk is about, try the free online 90 minute live demos, or you can download a 60 day trial. The online demos for all the MS Office products are great.

One Note is for anyone who takes notes. I can't remember the last time I had to drag out an old yellow pad, besides when I need to find a note from 6 months ago, One Note does it. One Note can be used on multiple pcs now as well. What I have done is to use Folder Share on my network. When I return and place the tablet on the network it is synchronized on 2 desktops, thus I never have to worry about ever losing my notes.

Folder Share is also a nice "free" Microsoft program. You can download and set permissions across anywhere on the web or within a small network. On a larger network, you may need to dedicate a port for use.

I have been using Folder Share since Microsoft brought the company into their umbrella, and then made the service free. It uses encryption when synchronizing so all medical folks take note.

https://www.foldershare.com/


Attorneys and the legal profession are also discovering One Note; how convenient can it be to have all your information relative to a case in one place and be able to add more information at any time! One Note is also for a desktop user as well. If you want inking from your desktop, simply purchase a Wacom tablet to use instead of your mouse. It works great and I have one on every desktop.
Take a look at One Note 2007 and if you have not seen an inking program, I think the 90 minute experience will be a real eye opener. To get the most out of One Note, a UMPC or full sized tablet pc really does the whole job.

You never see me at a meeting without the tablet and One Note! It also helps save time for my clients as I don't waste their time with call backs with information I could have provided right from the tablet!

Test drive the 2007 Microsoft Office release - Products - Microsoft Office Online

Windows Desktop Search

Windows Desktop Home Page

This is another free software download from Microsoft. I have been using it now for about 3 weeks and it is certainly making the search process much easier. It takes a while for the software to index the pc, but once it is done, what a time saver and much better than the standard Windows Search!

What is impressive is the speed of the results. I have used other desktop searches, but this one certainly puts everything together, especially when I can locate files on the drive without having to leave Outlook.

It comes with Windows Vista, but if you are still using XP or Windows 2000, check out the download and there's a good flash video on the page. It also can be incorporated into group policy for a network roll out.

Theft from Tablet Kiosk Warehouse


I have copied this information to my blog here from GottaBeMobile, who was kind enough to aid in helping Tablet Kiosk in their efforts to locate the stolen tablets.

If you see any of the tablets offered very cheap, they could be stolen. Use the links below to visit the site for additional information. Thieves make life difficult for all.

Yesterday, we posted the bad news about the TabletKiosk warehouse being robbed. The community is stepping up and posting the story, getting the word out. It was on TechMeme last night and today.

Josh Bancroft has a good list of suggestions on what you can do to help. In addition to his list, if you have a blog or forum site, post the story as well:

First, Digg this story, so we can get the story in front of as many people as possible. (As of the time of this writing, it wasn’t on Digg yet, so I added it.) Post it to reddit, Netscape, forums, or wherever you think people might see it and be able to help.

Second, create some search feeds to keep an eye out for any TabletKiosk units on eBay or Craigslist. Here is an eBay RSS feed for all “TabletKiosk” items (only 5 as of now).

Subscribe to that feed, and you’ll see any new items listed on eBay that match. You could also subscribe to the feed for a more specific search, like v7210, but as of now, there are no results, so I think the “TabletKiosk” search is about the right level.

You can do the same thing on Craigslist, but since Craigslist is separated by city, do it in your own town. I’ve got a search feed for Portland, but you’ll need to create one for your town. Just search the “For Sale” area, and click the little orange link to get a feed to subscribe to.

If you find anyone selling these devices for “too good to be true” prices, or you have any other leads, please email Gail directly with your tips. If you want to be anonymous, use your favorite anonymizing proxy service.

So tell me, what is all this talk about mobility, how do I handle it?

So tell me, what is all this talk about mobility, how do I handle it?

This is a question no doubt that we have all pondered at some point in the last year or so.

What is mobility and does this have an effect on my life today?

If you think mobility is just for others, you may want to consider giving this some second thoughts. We are all mobile today with needing our information “on the go” and I can’t think of anyone or any scenario I have found yet that is immune.

Once you step outside your office where your desktop pc is located – you are mobile!

Once you leave your home where the desktop or notebook PC is located – you are mobile!

There is one very simple solution of never leaving your office or your home, but we all can agree this is not a realistic solution. Do you arrive at your office when traveling from home without needing some type of information? You may, but chances are there is some type of information floating around relative to your life that could be in the process of being transmitted or waiting for your approval or confirmation.

All information today is not critical to respond immediately, but having the opportunity to make that choice is what mobility brings to the table and allows us to make better informed and educated decisions and choices.

The most common device which most of us utilize today is the cell phone, but demands are growing beyond the simple voice to voice exchange we have all known and used for years; data exchange is becoming more and more prevalent to fill in the gaps where voice communication leaves off.

For a simple example, take a look at the cell phones we use today, they do not even resemble the units used 5 years ago and now have data capabilities, but the question to ask yourself is to figure out how to take advantage of this new world of text and internet information. Do you really need this technology? At first you may not think so, but give this some additional thought here, how about others who are using mobile technology, attempting to supply information to you?

Sometimes the lack of being open to mobility works a hardship on others or can make their efforts much more time consuming with relying on old methodologies when a simple data technique might save time for everyone all the way around, not to mention the fact that you will benefit with immediate information, so this can be a win-win for everyone involved. Think perhaps about the last time you asked someone to send you a fax. A simple email easily replaces this function and requires no paper.

In addition to the cell phone there are other hardware devices that can also enhance mobility and depending on your lifestyle and what one does for a living, this is also personal choice, as what works for one, may not the ultimate solution for all. Some of us may choose to have more than one avenue and device to supply all the information we require. As an example you may want mobile email capabilities. There are several solutions and today’s cell phones can provide this information easy enough, but let’s say your needs go beyond simple email with needing to supply more than just a quick response.

Perhaps your response relies on accessing additional information you need to reference before creating an answer. That information could be stored in an office somewhere or could be accessed by contacting other individuals by phone, but let’s face it, this is now becoming a time consuming chore and can involve a bit of time in order to put everything together before responding.

First of all, if the information is located in a paper file residing in a file folder in an office, this could mean having to get in your car and drive to the office, or calling an associate to physically locate the file and read the information to you. Now the situation is involving not only your time, but taking time from your associate to assist so we have 2 people involved in the search for information as an example.

Are we mobile at this point? I think “immobile” might be a better term based on the above possible solutions.

Some of the Smart Phones available today are capable of handing some of the information needs, but there is also the opportunity to go beyond the phone and explore the next level up with using a portable PC. We see this every day with coffee shops full of people using their notebooks in sending and receiving information. One thing for sure, these folks have figured out they are “mobile”.

I can agree that being mobile can be a bit frustrating, but we really don’t have a choice per se, as again, as soon as we leave our desktop devices, we are mobile.

Lucky for all of us, the hardware world with PCs is making it easier and more convenient every day for us to be mobile. No longer do we need to be stuck with an “open pizza box” looking notebooks, searching for a table or ledge to be able to use the device to input and receive our information. We no longer are totally dependent on keyboards to interact with our devices!

I can think of over 100 different scenarios where using a keyboard with the typical notebook is just an absolute inconvenience when one is away from their home or office and it can be a big distraction when trying to conduct business, whether you are an account representative trying to capture your client information or an MD who is entering patient information while interacting with another human being. Myself, I don’t relish in the thought of sitting there watching someone else type if I am a client or patient.

So what’s the solution to bring this situation back to a more normal human to human interaction?

Get a tablet! After all, every tablet is a notebook, but all notebooks are not tablets!

Utilizing a tablet is not asking you to give up your “beloved” keyboard, but it is offering alternative methods of getting and receiving data and offers a much better human-to-human interaction scenario. Myself, I just hate having a client sit there and watch me “letter by letter” typing data into a notebook, not to mention they can see exactly what typing skills I do or do not have! I also end up losing that important eye-to-eye contact with a client and I can’t talk about how important this is when making sure I get my information and perceptions done correctly, and sitting there working with a keyboard at the same time is a huge distraction if not a down right annoyance!

Mobility = Tablet PCs

Ok now I have figured out I am mobile, like it or not, so what is this tablet going to do for me. Why does a tablet need to be part of a mobile arsenal?

Tablets offer mobility where no other hardware has gone. The biggest and best feature with tablets is using “inking” capabilities. I write – it types. “Look Mom, no keyboard”.

It also can keep your handwriting in its own format, in other words, it becomes your portable “yellow pad” for taking notes, and I save a few trees at the same time! When I need to find notes I have written down from a meeting I attended 6 months ago, they are all located in one place, on the device and I no longer need to search through stacks of “yellow legal pads” to locate my information, plus I don’t have to find a place to store all the paper pads, and most importantly I am not losing that eye-to-eye contact with a client or patient!! Yes!! (I don’t need a table or ledge and it doesn’t look like an “open pizza box”.

I can download and read books too! This is great as I no longer have to carry around books for my reading material. I can use it to write a book too, insert a microphone and start dictating with speech recognition.

I can do email too and again, I don’t need a keyboard either! I write – it types. I can show a media presentation live to a client and when using a Power Point presentation, I can write on the slides too to make a point or just save it as a note to reference later.

There are many different types, shapes and sizes of tablet PCs on the market today. Whether you are looking for a full size tablet or a UMPC smaller mobile unit, tablets are the way to go for having ultimate mobility! UMPC tablets also come with touch screens used with inking and now some of the full size tablets also feature touch screen availability.

So why in the world do I really need a lot of keyboard functionality when I am mobile? I can move data around with touch screens, use the stylus to add handwritten comments or translate to text and carry it around in a fashion similar to walking around with a clipboard, and enter information while I walk if needed. I have yet to see someone walk and type yet, although I guess it could be done, but what a hassle especially when trying to hold that “open pizza box” notebook in your hands and type at the same time!

Inking works with Cad, Outlook, Word, PowerPoint, you name it, any Windows application and so does dictation for that matter.

When thinking about mobility use with information today, be sure to entertain what a Tablet PC can do for you. I think you will be amazed and be able to create your own functionality on how it works best for you. As far as cost, you will pay just about the same for an “open pizza box” notebook by comparison, so why limit yourself.

Microsoft Vista has tablet functionality. This does not mean you have to give up your keyboard, but merely entertain better mobile methodology uses when the demand is there.

There is life beyond the keyboard in the world of mobility today! Be your best at being mobile – get a tablet!

Barbara Ducknet

Ducknet Services

Free E-Prescribing for All MDs

This is an update on the free E-Prescribing site. They are making free web sessions available for training, or you can choose to pay for a one on one session.

This is a free service for all physicians in the US and well worth taking a look.

www.nationaleRx.com

Windows Daylight Savings Time Update

Windows Daylight savings time adjustment:

This is the link for those using XP and there are additional links for those using Vista and other operating systems. You can find this update under Windows Update as well as "optional'. At this time is has not been included as a security update that is automatically pumped out to the PCs via Windows Update, so you may want to visit the site and look for additional information. This is especially important to those using Outlook to have your emails time stamped correctly in the future. We have more time with Daylight Savings Time, thus the pc will need to be updated to reflect the new times to automatically make the change for you. If you are on a business network connected to a server, your IT administration will more than likely make the adjustments for you when rolling out system updates.