For the Love of Caffeine but maybe not for your heart..

I thought I was seeing things at first! No smoke, no nicotine, just break and inhale for those who can't seem to get enough from coffee.
You don't actually light SurgeStix, that's too 1990, instead you bend them (like a glow stick) until you hear a snap. This will send the caffeine solution flowing into the filter-looking end. Wait five seconds for the "filter" to absorb the solution. You will notice a slight temperature increase as the solution reacts with the harmless chemicals in the "filter" which causes the caffeine to vaporize. Then, take a drag. Each "puff" will suck roughly 18mg of caffeine into your lungs (and right into your bloodstream!) With about 10 "tokes" per SurgeStix, you'll get 180mg of caffeine in just a few breaths. That's more caffeine than a really strong cup of coffee just by breathing. Ouch.
SurgeStix are only slightly habit forming and do not contain Nicotine.



And if that isn't enough, you can try some caffeine soap, and no, you do not eat it or wash your mouth with soap, it is delivered through the skin.


Or there's some lip balm...the description from the page is very funny!
Developed by an Alaskan Police Officer, who needed both quality lip balm for the cold and the ability to stay awake during long shifts, Spazzstick is the world's only caffeinated lip balm. Spazzstick is made in a vast underground volcano lair by the busy hands of industrious worker trolls in a beautiful little Eskimo Village called Kaktovik, AK, by the inventor of Spazzstick and his hordes of worker trolls in a vast underground volcano lair.

Once I looked at the original page, Think Geek had even more caffeine products listed, for those who can't get enough caffeine with their morning coffee. For the prices here, coffee is a lot cheaper. BD

http://www.thinkgeek.com/caffeine/

The Surgical Da Vinci Code

This site also allows a patient to search, locate and email a physician who performs surgery with the Da Vinci robot. They cost over a million to purchase, but over time this can be a huge savings as most patient recovery times are at least cut in half from the normal recovery time. I found both USC and UCLA equipped here as well as a couple other hospitals from the MD listing. The link below has patients speaking about their procedures as well as videos showing selected portions of the surgery. In the left hand column of this site, there are permanent links to procedures done at various hospitals via OR live, and many of these procedures are done via the DaVinci system. I sure wish the DaVinci could have been around a few years ago when I had my surgeries! This has to be where the play station practice comes in handy for quick and fast manipulation of the hands. BD



http://www.davincisurgery.com/surgery/index.aspx



Imagine major surgery performed through the smallest of incisions. Imagine having the benefits of a definitive treatment but with the potential for significantly less pain, a shorter hospital stay, faster return to normal daily activities – as well as the potential for better clinical outcomes.



With the da Vinci Surgical System, surgeons and hospitals are re-writing accepted standards for surgical care. da Vinci is changing the experience of surgery.



Learn more about the urologic, gynecologic, cardiothoracic and general surgery procedures performed today with the da Vinci Surgical System. With da Vinci, both patient and physician are realizing these unprecedented benefits.



It is important to know that surgery with da Vinci does not place a robot at the controls; your surgeon is controlling every aspect of the surgery with the assistance of the da Vinci robotic platform.





If you care to watch a procedure, here's a link to You Tube, narrated by the surgical team.  It does a good job on describing the entire set up and procedure.  It is over an hour long.



http://video.google.com/videoplay?docid=6390446192795481593&q=da+vinci+pediatric



The Digital Life: How To Go Paperless

This is a great article that talks about "being mobile" and the devices that can help you do this today.  In the medical arena, it's almost impossible for a physican not to be mobile from time to time...BD

In this issue of "The Digital Life," let's talk about some of the technologies and solutions that will allow you to rid your life of paper-based data. From smartphones to UMPC's, you have a lot of choices. Which ones will fit you best?

After backing up your data, the next move in your quest for a paper-free life is deciding which devices will best serve you. Thankfully, "convergence" has come a long way since the days of monochrome PDA's. Convergence is the idea that multiple technologies will eventually "converge" in one or a few devices - MP3 player, video player, photo camera, video camera, email client, document editing, TV, banking, and games, just to name a few.

A new-comer to the convergence game, the Ultra Mobile PC is a sort of hybrid, with a questionable market. The UMPC was introduced with tremendous fanfare and hype (rivalling the hype surrounding the Apple iPhone) as the "Origami" platform from Microsoft. Placed somewhere between a Tablet PC and a PDA, the UMPC is too big to fit into your pocket, but too small to be a practical everyday computing platform.







Source: The Digital Life: How To Go Paperless | IntoMobile

Uninsured patient billed more than $12,000 for broken rib

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/03/30/BUG1LOTC6T75.DTL

He learned how costly this can be after fracturing a rib in a relatively minor motorcycle accident and subsequently being hit with a bill for more than $12,000 from San Francisco General Hospital.
"There's no way I could pay something like that," Palmer, 32, told me. "I'm not a bum, but I'm not making a lot of money right now. How is anyone supposed to pay a bill like that?"
Shortly afterward, he said, a clerical staffer approached with discharge papers for Palmer to sign.
"She asked how I intended to pay for everything," Palmer said. "I told her I didn't have any insurance. She looked at me and then asked if there was anyone I could sue."

Happy Doctors Day - May 30th is National Doctors' Day

Happy Doctors Day from Ducknet Services....also recognized today by the American Medical Association....BD 

CHICAGO — The American Medical Association (AMA) joins with patients, family, friends and colleagues on National Doctors' Day in expressing gratitude for the hard work and dedication of the nation's 900,000 physicians.

In the United States, March 30 has come to be known as a day when Americans can gratefully remember physicians and express appreciation for their continuing commitment to exceptional medical care.



Source: AMA (Comm) AMA celebrates National Doctors' Day

Basics of Pharma Sales Rep Watching

This is a rather humorous take on the number of big pharma reps in the field, sometimes even giving us, the patient, a little competition for a few minutes of time with the MD. BD



To amuse myself, I carefully observed these reps in their natural habitat. It was an exhilarating experience that I urge everyone to try. The beauty of it is, you don't need any expensive equipment like binoculars. You are immersed in the same habitat as your prey -- you can even engage them in conversation.

http://pharmamkting.blogspot.com/2007/03/basics-of-sales-rep-watching.html







Cutera Aesthetic Systems receives FDA approval - skincare

BRISBANE, Calif., March 28, 2007 — Cutera, Inc.® (Nasdaq: CUTR), a leading provider of laser and other light-based aesthetic systems for practitioners worldwide, today announced FDA clearance for its new laser, Pearl, with proprietary YSGG technology. Pearl is cleared for the treatment of wrinkles and represents the first application of the 2790 nm wavelength for cosmetic dermatology.

During treatment, Pearl removes a portion of the epidermis with a controlled thermal effect. The thermal effect creates a natural protective dressing on the skin to minimize downtime during the restorative process.

Source: Cutera - News

Health insurance options dwindle for self-employed - Los Angeles Times

 

A major source of health insurance for people who work for themselves is disappearing, casting thousands of contractors, freelancers and solo practitioners into the ranks of the uninsured with little hope of obtaining new coverage.
Health plans offered by professional associations were once havens for millions of people who couldn't get coverage anywhere else. But as medical costs have soared, groups representing professions as varied as law and golf have been forced to stop offering the benefit or been dropped by insurers.
More than 8,000 people with coverage through the California Assn. of Realtors could be next if Blue Shield of California succeeds with its plan to cancel the group's health coverage.
"It's a real stab in the heart," said Marcy Garber, 62, an Encino real estate agent whose history of breast cancer makes her an almost-certain reject if she seeks similar coverage on her own.

Source: Health insurance options dwindle for self-employed - Los Angeles Times

Your face is your password

This could have some real use in a medical scenario to automatically sign individuals in and out of their computer and software programs...would be a time saver and especially beneficial for those who do not have real good typing skills. BD
Your face is your password with Bioscrypt's VisionAccess 3D DeskCam - Engadget: "Being touted in what sounds like patent-speak as the 'world's first 3D face recognition camera for use in authenticating individuals accessing a computer,' security firm Bioscrypt Inc's upcoming VisionAccess 3D DeskCam promises to enable sub-second logins to applications, networks, and websites with just a quick glance at your ugly mug. The webcam-looking device (which we assume can also be used as an, um, webcam) looks for 40,000 identification points to verify authenticity, and is said to be capable of not just accounting for facial hair (or the lack thereof), but actually distinguishing between identical twins. "

OneNote Calendar

This is one fabulous add on for anyone using One Note. Thanks to the folks at Gotta Be Mobile for the post! This is one great tool and I am using it myself to track my notebooks! This is a great addition


http://www.gottabemobile.com/CommentView.aspx?guid=64267EEA-DF5A-463F-9FB9-D44594BCE7B4

For physicians, what a great addition to the One Note Soap Kit.

http://ducknetweb.blogspot.com/2007/03/ablet-factory-one-note-toolkit.html




Download here:
http://www.josheinstein.com/download/onenotecal/publish.htm

Today's Robotics Update

The video narrated in Japanese is truly worth a watch with images showing as the hand is being moved with responses from the brain. There are a few additional videos on the site showing similar technologies being used, including controlling the keyboard of a computer by thoughts...BD



http://www.techeblog.com/index.php/tech-gadget/gadgets-you-can-control-with-your-brain

Microsoft Live Labs: Deepfish

I have watched this in action and the browsing is so far ahead of what we have today..will be anxious for Deepfish to be released...BD
Microsoft Live Labs: Deepfish

he Deepfish Technology Preview enhances existing mobile browsing technologies by displaying content in a view that is closer to the desktop experience. Our zoom-able interface and cue map allow you to quickly access the information you care about over the web without ever losing track of where you are.

Note : Deepfish is currently only available by invite only to a small number of beta users. Please visit http://labs.live.com/deepfish page to keep informed of future updates and availability.

Bill Clinton Backs Electronic Health Records -

Bill Clinton speaks out about the importance of blogs and electronic medical records...BD 

Blogs can play an important role in the media as the traditional media tries to cover an increasingly complex world with growing competitive pressures and fewer resources, Clinton said.

"Because they don't have to put out a newspaper or even put together a whole evening news show, these blog sites typically deal with one, or at most two, subjects a day, so they can do research and get the facts," Clinton said. "Technology needs to keep pushing this process of the public debate so that there will always be alternative channels."

Source: Bill Clinton Backs Electronic Health Records - Yahoo! News

Corporate Sloppiness Is the Real Culprit for Data Loss, Not Vilified Hackers

Good article about security...also this brings to mind Windows Server 2003 and Windows Mobile...many mobile devices can now be wiped remotely by the IT department...visit the Microsoft site to find out more...BD 

Expect to see the 2 billionth personal record compromised by year's end, according to recent research from the University of Washington. But don't blame it on rogue hackers; sorry to say, it's your own fault, Corporate America.

Researchers at the university in Seattle estimate that electronic records—those containing Social Security or credit card numbers, academic grades or medical history—are bleeding out of North American organizations at the rate of 6 million a month so far in 2007—up some 200,000 a month from last year.

Excluding the exceptional 2003 incident that involved 1.6 billion records stolen from information aggregator Acxiom, hackers have been responsible for only about 550—31 percent—of confirmed breaches between 1980 and 2006.

The majority, 60 percent, of incidents of compromised records were attributed to organizational mismanagement. That includes missing or stolen hardware, administrative errors, insider abuse or theft or accidental posting of sensitive information online.

Source: Corporate Sloppiness Is the Real Culprit for Data Loss, Not Vilified Hackers

Got Voice - Retrieve cell phone messages from the web

This is truly a lifesaver.  Sometimes I don't remember where I left my cell phone and other times when I am at the computer, this makes it very convenient to check my voice mail messages.  This is web based and free.  Once you set up an account, you can also download desktop software to work with the program if your security settings allow.  BD

GotVoice is the only service which effortlessly integrates with all major mobile and landline networks for sending and receiving voice messages, or instantly updating personalized voicemail greetings. Without requiring either you or the phone networks to change anything, GotVoice is the quickest, easiest and most powerful voice message service and it's 100% FREE! There are no hidden call forwarding fees, you don't need a new number and there is no software to install.

 

http://www.gotvoice.com/

del.icio.us tags:




New Genetic Pap Smear Can Easily Diagnose Hidden Sexually Transmitted Diseases

 

The APTIMA COMBO 2 Assay is a second generation nucleic acid amplification test that uses target capture for in vitro qualitative detection and differentiation of rRNA from CT and GC. The assay uses a family of Gen-Probe’s proven technologies including target capture (TC), Transcription-Mediated Amplification (TMA) and Dual Kinetic Assay (DKA). This is the same family of technologies used to screen the nation’s blood supply.)

Now that the FDA has cleared this test to be combined with the pap smear it is possible that millions of women could be screening with one test for these hidden dangers.

For extensive information on STD’s from the CDC read here.

Source: New Genetic Pap Smear Can Easily Diagnose Hidden Sexually Transmitted Diseases » docinthemachine

MEG Scanners Are Mega Powerful -

While other types of brain scans detail the geography of the brain or detect blood flow, the MEG scanners track the magnetic signals that neurons throw off as they communicate. "You can look at how the networks of the brain are talking to each other in real time," said Greg Simpson, director of the Dynamic Neuroimaging Laboratory at the University of California at San Francisco.While the technology has existed for decades, improved computing power and hardware have recently increased interest in the scanners. There are an estimated 100 MEG scanners around the world -- at a potential cost of $2 million each -- and their numbers are growing.

http://www.wired.com/medtech/health/news/2007/01/72277

Docs Improve Stethoscope Skills Using IPods

 

After demonstrating last year that medical students greatly improved their stethoscope skills by listening repeatedly to heart sounds on their iPods, lead investigator Michael Barrett, M.D., clinical associate professor of medicine and cardiologist at Temple University School of Medicine and Hospital, set out to test the technique on practicing physicians.
During a single 90-minute session, 149 general internists listened 400 times to five common heart murmurs including aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation and innocent systolic murmur. Previous studies have found the average rate of correct heart sound identification in physicians is 40 percent. After the session, the average improved to 80 percent.

http://www.medicalnewstoday.com/medicalnews.php?newsid=66120&nfid=rssfeeds

UMPC As a Navigation Device...

Good article on how the device can be your travel companion as well. Be sure to get a car power charger so it is always ready. BD

http://franksworld.com/blog/archive/2007/03/28/4516.aspx
On the way up to Vancouver, I made sure we stopped and picked up a power inverter. With the power issue resolved, navigation was a breeze and the UMPC was a delight to use, with the exception of how hot the thing got.
I'll blog more about it and how I'm using it, but for now, I am content to play with my new toy. ;)

State Grant Awarded To Study Broadband Access Among Pennsylvania Physicians And Hospitals

 We could easily use a study like this in California as well...BD

State Grant Awarded To Study Broadband Access Among Pennsylvania Physicians And Hospitals

A proposal by the Pennsylvania Medical Society to use broadband network technologies to improve health care in the Keystone State has received a $300,000 grant from the Broadband Outreach & Aggregation Fund through the Pennsylvania Department of Community and Economic Development to fund a study that will measure broadband access in doctor offices and other health care settings. 

Dr. Piasio adds that a 2006 Society survey indicated that approximately 7,500 Pennsylvania physicians either have no Internet access or only dial-up access.

"Today, there is great momentum in Pennsylvania to improve health care through the use of electronic communications," said Rhett Hintze, Managing Director of The Affinity Group. "After this study is completed, we believe that we can put together an accurate plan to encourage more doctor offices to use broadband, much like we have seen through our efforts with the public schools in Pennsylvania."

Hospitals, clinics, Wake to track uninsured patients

Interesting move for the hospitals in Texas, might catch on in other areas as well...BD

Eight clinics, health systems and county agencies are teaming up to keep Wake County's uninsured patients out of emergency rooms and lighten the financial burden on the hospitals that are straining to care for them.

Through the CapitalCare Collaborative, they're working to connect patients with nonprofit and county organizations that can provide care more cost-effectively than emergency rooms can.

The program also will consolidate uninsured patients' financial -- and some medical -- data in one location online, which the groups expect will save time and money by helping them better coordinate care.

Hospitals, clinics, Wake to track uninsured patients
Another related story, website lets consumers shop hospitals as well. BD

A new Web site launched by the Texas Hospital Association in Austin will allow health care consumers to view and compare prices on inpatient hospital services at Texas hospitals.

The Web site, Texas PricePoint (www.txpricepoint.org), includes charge data on the most common inpatient services, links to data and general information on all Texas hospitals.

"The consumer's role in managing his or her own health care is changing," says THA President and CEO Dan Stultz. "People need reliable information so that they can make educated choices. For that reason, Texas hospitals are committed to making hospital charges and quality information more transparent and accessible."
http://austin.bizjournals.com/austin/stories/2007/03/26/daily9.html

JOHNS HOPKINS HOUSING AND TESTING ONLY 256-SLICE CT SCANNER IN NORTH AMERICA

 

Johns Hopkins Medicine has installed for three months of initial safety and clinical testing a 256-slice computed tomography (CT) scanner, believed to be the world’s most advanced CT imaging software and machinery. 

The new 2-metric-ton device - the first of its kind in North America and only the second outside of Japan, where its manufacturer is based - has four times the detector coverage of its immediate predecessor, the 64-CT.  It can measure subtle changes in blood flow or minute blockages forming in blood vessels no bigger than the average width of a toothpick (1.5 millimeters) in the heart and brain. 

http://www.hopkinsmedicine.org/Press_releases/2007/03_26b_07.html



Picture from Medgadget
http://www.medgadget.com/archives/2007/03/aquilion_beta_2.html

Blue Cross Of California Improperly Canceled Health Insurance Policies, State Investigation Finds

 

Blue Cross of California improperly canceled individual health insurance policies after some members became pregnant or sought medical treatment for chronic conditions, an investigation by the California Department of Managed Health Care has concluded, the Los Angeles Times reports. [click link for full article]

Source: Blue Cross Of California Improperly Canceled Health Insurance Policies, State Investigation Finds

Israeli device transmits heart data directly to doctors

Israeli scientists have developed a portable electrocardiograph machine that can transmit highly detailed data on heart activity to physicians by mobile phone.
The CardioSen'C is considered an advance in portable heart-monitoring devices because it uses many more electrodes to measure heart activity and is equipped to communicate the results instantaneously to a cardiologist.
SHL, the Israeli company behind the CardioSen'C, says its machine can dramatically reduce deaths from heart attacks through early diagnosis of patients who might otherwise hesitate before calling a doctor or rushing to a hospital to be monitored.

http://www.israel21c.org/bin/en.jsp?enDispWho=Articles%5El1597&enPage=BlankPage&enDisplay=view&enDispWhat=object&enVersion=0&enZone=Health

Epocrates

Updated information from Epocrates...good PDA quick reference as well as free pc version for subscribers...BD



ACC And Epocrates Deliver Customized Mobile Software To ACC Members


A record number of cardiologists will be reaching for their mobile devices to access the latest clinical information thanks to the American College of Cardiology (ACC). At the ACC Annual Scientific Session in New Orleans, all association members and users of Cardiosource, the College's clinical cardiovascular portal, received a complimentary subscription to Epocrates®-ACC Essentials for Cardiology, a mobile-based clinical application.

For the second consecutive year, the ACC and Epocrates Inc., a California-based medical software company, are partnering to deliver a comprehensive set of cardiology applications to ACC members. The specialized product combines Epocrates Essentials premium drug, disease and diagnostics guide, with relevant cardiology applications including cardiac calculations and an obesity tool.

www.epocrates.com









Using a single thumb - fly in and out of your Zoomspace

http://www.mobilitysite.com/2007/03/using_a_single_thumb_fly_in_and_out_of_y.php
Nice new capabilities for Windows Mobile phones...BD
Using a single thumb, you fly in and out of your Zoomspace -- two
simple taps gets you directly to any Tile. Through some clever
engineering, we constantly refresh your Tiles in the background, so
they're always fresh, available, and ready to be Zoomed.

New Treatment For Canker Sores

New Treatment For Canker Sores
http://www.sciencedaily.com/releases/2007/03/070323104734.htm
Licorice has been used for over 4000 years as a healing agent. The medicinal capabilities of licorice root (Glycyrrhiza) extract (GX) have been established by long-term clinical use and, most recently, by scientific research. GX has been identified to have anti-inflammatory, soothing, and coating abilities and provides proven, rapid relief for canker sores.

NiliMEDIX Insulin Pumps

http://www.nilimedix.com/
Insulin pumps deliver insulin the way a healthy pancreas does allowing freedom in daily activities and improving the quality of life of their users.  FDA approval pending.
  
Additional Information here:
http://www.medgadget.com/archives/2007/03/nilimedix_insul.html


Trials for Bionic Eye Implants

http://news.bbc.co.uk/2/hi/science/nature/6368089.stm


US researchers have been given the go-ahead to implant the prototype device in 50 to 75 patients.

The Argus II system uses a spectacle-mounted camera to feed visual information to electrodes in the eye.











New Interactive Television To Assist Patients And Elderly

http://www.sciencedaily.com/releases/2007/03/070323104734.htm

Science Daily — Telecommunications engineer at the Public University of Navarre, Alejandro Fanjul Fernández, has designed a pioneering system of telemedicine for interactive digital television. This system enables the monitoring and treatment of and support for both patients and elderly people, from the comfort and convenience of their homes, by means of the television. This is the first tele-assistance system in Spain for interactive digital television and a number of companies and government bodies have expressed interest in marketing the application.

Employers Increase Use of High-Deductible Health Plans

http://www.medscape.com/viewarticle/553685?src=mp
Nine percent of U.S. employers in a poll by a health consulting firm said they plan to offer only one health insurance option next year -- a high-deductible policy that may encourage workers to skimp on care.
"Employers can offer these plans, but it takes more than that to get employees to enroll," said Ted Nussbaum, director of health consulting at Watson Wyatt, which advises employers. "In the old model, I (the employee) paid a $10 copay, and that was the end of my responsibility,Tags:


Radio-sized device provides home care for heart patients

http://www.poughkeepsiejournal.com/apps/pbcs.dll/article?AID=/20070323/NEWS06/703230345
Karl is one of about 30 patients using home medical monitoring systems provided by the Home Care Services at Saint Francis Hospital.

She is sold on the device, which was installed in her home after she was discharged from a hospital stay. "I think it's terrific," the Poughquag resident said. "This way they can find out more about me than at the office." Karl has congestive heart failure, a condition in which the heart cannot pump enough blood to the body's other organs. The clock-radio-sized device is hooked into the home's phone line and transmits the data collected to a computer in the home care offices.


Aged, Frail and Denied Care by Their Insurers

Story from the New York Times on how insurance companies view paying claims...BD

http://www.nytimes.com/2007/03/26/business/26care.html?ex=1332561600&en=2df67ad437336bc0&ei=5090&partner=rssuserland&emc=rss




"The bottom line is that insurance companies make money when they don’t pay
claims,” said Mary Beth Senkewicz, who resigned last year as a senior
executive at the National Association of Insurance Commissioners.
“They’ll do anything to avoid paying, because if they wait long enough,
they know the policyholders will die.”

Breakthrough VeinViewer Imaging System

http://www.gizmag.com/go/6860/
Last time I had some blood drawn, this sure could have come in handy!
Memphis-based Methodist Le Bonheur Healthcare has become the first healthcare system in the world to implement the VeinViewer at multiple sites. The health system plans to have nine devices in its seven Memphis area hospital locations. Some are already in place.

"The VeinViewer is a revolutionary technology that will greatly enhance patient care, safety and comfort," said Gary S. Shorb, president and CEO, Methodist Le Bonheur Healthcare. "Making patients more comfortable during the blood drawing process is a major benefit, and it also helps our healthcare professionals work more efficiently."




Technorati :

The First Conception Kit for At-Home-Use

http://www.gizmag.com/go/7028/
We have had home pregnancy testing for a while, so this is the next item on the market, or should I say it should be the first product. BD


Millions of people the world over struggle with fertility issues each yea and until recently have had few options beyond expensive drugs or very expensive, invasive medical procedures. The Conceivex Conception Kit is the first comprehensive reproductive healthcare system designed for couples and was this week granted 510K clearance by the U.S. FDA. The Conception Kit contains fertility prediction tools, semen collectors and the only FDA-cleared home-use cervical cap for conception, which are designed to be used together for up to three months in order to enhance the couple’s chance of becoming pregnant.
Additional Information here:
http://www.medgadget.com/archives/2007/03/the_first_conce.html

Intel, Wal-Mart to Announce Electronic Medical Record Plan

http://www.redorbit.com/news/health/880634/intel_walmart_to_announce_electronic_medical_record_plan/index.html?source=r_health



"The theory is that employers have the economic clout to move the health care providers off the dime to provide data," said Rishel. "That is part of the bold idea. It is also not proven yet. ...You have to get the data from the providers. That is fundamental in getting any personal health records system off the ground."

The proposed project will not replace the need for hospitals and doctors to create their own systems for electronic medical records. But the system under development will seek to link to other proprietary systems, through joint development efforts of health care providers.

Coding - Hospital Admissions and Asthma Codes from Medical Economics

http://www.memag.com/memag/article/articleDetail.jsp?id=312268&ref=25
Q. I discharged a patient from the hospital and had to readmit him the next day. Should I code for the second admission service?
Q. When reporting an asthma diagnosis, do I need a fifth digit?
Topic are covered at the link above.

3D effect with XP and with Vista too

I found this nice application that allows me to flatten the windows instead of moving them to to the tray. Works well with any pc and even nicer with a tablet. Very interesting when used with an EMR. Some programs, such as ITunes windows may not function, but most of the standard Windows will flatten and you can move the windows around as well. Also, it could provide some interesting possibilities with radiology working with images and having several moving images on the screen at once for easy access and moving images around.


Here is a link to a site where you can download...
http://samanathon.com/2007/03/20/madotate-a-lite-weight-3d-windows-application/

First Oral Once-Daily Mesalamine For Ulcerative Colitis: LIALDA Available Now

http://www.medicalnewstoday.com/medicalnews.php?newsid=65634&nfid=rssfeeds
LIALDA is available to patients by prescription for oral administration in dosages of 2.4 g/day and 4.8 g/day, allowing patients to take as few as two tablets once daily. Other currently available mesalamines require three to four times daily dosing and six to 16 pills a day. A study found that patients who are not compliant with their mesalamine medications have a five-fold greater risk of disease flares, a serious worsening of symptoms, than compliant patients.

Potential Non-Surgical Repair Technology To Replace Spinal Fusion

http://www.medicalnewstoday.com/medicalnews.php?newsid=65617&nfid=rssfeeds

Scientists at The University of Manchester believe injections of tiny sponge-like particles could provide an alternative to major surgery in the treatment of chronic lower back pain.
Dr Brian Saunders from The School of Materials and Professor Tony Freemont from The Faculty of Medical and Human Sciences have developed tiny gel particles that swell and stiffen when injected into a damaged area.

Newark Airport - retail medical clinic at Terminal C

http://biz.yahoo.com/bw/070321/20070321005237.html?.v=1

Conveniently located in Terminal C at Newark Liberty International Airport, Harmony Pharmacy will redefine America's retail drugstore shopping experience. From dispensing prescriptions to offering access to an on-site nurse practitioner to providing an exceptional shopping experience, Harmony Pharmacy is bringing together the best aspects of a traditional European pharmacy coupled with a service focused staff to reach today's busy traveler. In addition, Harmony Pharmacy will offer a broad array of preventative assistance and screening services, such as flu shots, vaccinations and examinations.

Sahara Tablet from Tablet Kiosk - great video presentation

Sahara Tablet PC video from Hugo Ortega...he does a nice job in reviewing the tablet. This is the one I use every day for my own business. The Sahara and EO are my 2 everyday companions as I need to be mobile every day. BD

Bionic hand with can-crushing grip

http://www.pinktentacle.com/2007/03/bionic-hand-with-can-crushing-grip/
From Engadget that links to the story above...
A team of researchers from the Tokyo Institute of Technology (TIT) claim to have developed the world’s first electromechanical prosthetic hand with a grip strong enough to crush an empty beverage can.
This bionic hand weighs a little more than 300 grams and has a grip strength of around 15 kg (33 lbs), which is about half that of the average adult male. The hand also features four quick, nimble fingers that take as little as 1 second to flex and extend. When used in combination with the hand’s opposable thumb, each finger can deftly pinch and pick up small objects of various shapes.

Zoom it for Presentations - Tablets or Desktops

I saw this tool at a recent MSDN presentation. The inking works well with a tablet and allows you to draw on the screen on the current application and then once disabled, it goes back to normal program functions. The zoom is nice too when projecting to a larger screen.
ZoomIt is screen zoom and annotation tool for technical presentations that include application demonstrations. ZoomIt runs unobtrusively in the tray and activates with customizable hotkeys to zoom in on an area of the screen, move around while zoomed, and draw on the zoomed image. I wrote ZoomIt to fit my specific needs and use it in all my presentations.
http://www.microsoft.com/technet/sysinternals/utilities/zoomit.mspx

New look for Cell Phones with Windows Mobile 6

http://www.mobilitysite.com/2007/03/gigabyte_gsmart_wm6_eye_candy.php



Today's Eye Candy is brought to you by AkihabaraNews. These two Gigibyte devices are running Windows Mobile 6. These are expected to see the light in April.

From Medical Economics - good article on secuirty with patient data and suggestions on how to implement security

http://www.memag.com/memag/article/articleDetail.jsp?id=312270&ref=25
Security has to be a top priority today with medical records. This article offers some common sense suggestions on how to lock down your data. It is much more difficult to obtain records from a server for the most part. If you are a physician using a portable device, make sure you have a password in place if the device does not have fingerprint identity hardware. BD
Jumbo breaches in computer security also plague the rest of society, but when the wrong eyes are looking at your medical history as well as your Social Security number, there's even more cause for angst. And healthcare IT has had plenty of scary mishaps besides the one in Oregon over the last 12 months:

California Hospital Ratings - Consumer Page to Review Hospitals in California

http://www.calhospitalcompare.org/
A Service of the California HealthCare Foundation....if the hospital has chosen to participate, information can be found here...BD
Some hospitals provide better care than others. This site rates quality of care, patient satisfaction, and safety measures for hospitals in your area.
The 209 hospitals rated on this site account for 70% of all hospital admissions in California and the conditions and procedures rated (heart attack, heart failure, heart bypass surgery, pneumonia, and maternity) are the five most common reasons for being admitted to a hospital. Other conditions and measures will be included in future updates to this site.

Electronic Nerve Stimulator Enables Walking

http://www.curespinalcordinjury.com/electronic-nerve-stimulator-enables-walking

For those of us at the AAAS meeting, nothing was more impressive than the demonstration given by Jennifer French. She's not a scientist. She's a young woman sitting in a wheelchair, paralyzed from a snowboarding accident. She presses a button on a control box strapped to her waist ... and then she stands up.
Sooner or later, it seems, most everything imagined in science fiction comes true. From flying in space to talking on a telephone without wires, today's science increasingly resembles yesterday's fiction. And that's becoming more and more true in medicine.

Einstein Philadelphia Pioneers Use Of Technology To Ease Stress Of Medical Emergencies

Registration in the program is fast, secure and free. Area residents simply call 1-800-EINSTEIN or visit http://www.einstein.edu/prereg where they will voluntarily provide as much relevant information (name, primary care physician, insurance information, etc.) as they want about themselves and any family members they wish to enroll. Einstein logs this information and sends them special ID tags that can be carried in their wallet or on a key chain. If they ever have a need to visit the Elkins Park ER, the card is scanned and their information automatically entered, saving the patient valuable time and avoiding extra paperwork in an actual emergency.

Patient information is 100 percent secure, because the ID cards contain no personal information and can only be scanned at the Einstein at Elkins Park Emergency Department. If the ID tag is ever lost, the participant need only call Einstein for a replacement.

Picture from Medical Gadgets...
http://www.medgadget.com/archives/2007/03/einstein_helps.html

The Devil Wears Prada - Microsoft Spoof

They are always connected here.using Windows Mobile Technology and a few other goodies...BD

Can you read this prescription???

I ran across this article at the Kevin MD blog and a picture just paints 1000 words! This is a real good reason for E-Prescribing. This post was made by a pharmacist and he's actually taking guesses on his site for 2 more and will post the answers tomorrow. It takes valuable time from staff and MDs to have to sit on the phone to ensure the correct medication is dispensed. Good time to maybe look at signing up for the FREE E-PRESCRIBING INITIATIVE.

http://onthepharm.net/2007/03/can-you-read-these-prescriptions.html
http://www.nationalerx.com/

Skype Rolling Out PayPal Service

Skype announced Tuesday that the popular Voice over Internet Protocol (VoIP) service would soon allow PayPal payments, further opening the service for business transactions.
http://news.yahoo.com/s/nf/20070321/tc_nf/50904
If you are not familiar with Skype, you can read more here:
http://www.skype.com/download/skype/windows/business.html

Also, there are many additional add ons. I currently use the Skype Office Toolbar and it includes a PayPal link, whereby you can send payments. So why have I included this information on Skype? If you have patients/clients who are not set up with credit cards or debit cards, this is another way you can collect payments! You can also set up a video conference with a web cam with a patient.

Then there is the standard voice over IP features where you can use your PC for phone calls, free anywhere in the world to other Skype members and for a small fee, you can call telephones from the software.
http://www.skype.com/download/skypeofficetoolbar/
https://www.paypal.com/
http://www.skype.com/products/controlpanel/

UCI on probation again

http://www.ocregister.com/ocregister/homepage/abox/article_1624975.php

UCI Medical Center, which in recent years has run afoul of state and federal regulators for a number of missteps, confirmed Monday that the hospital's Radiation Oncology department is on probation.
The Accreditation Council for Graduate Medical Education sanctioned the department in January for failing to meet the council's requirements in an on-site review conducted in May 2006. While neither the hospital nor the accreditation group would discuss specific reasons for the probation, the council evaluates all residency programs for their quality of training and leadership.

From UMPC Portal - Tablet Kiosk Power Bank

http://www.umpcportal.com/modules/news/article.php?storyid=429
DO YOU NEED 10 HOURS OF PORTABLE BATTERY LIFE?
This is a new product from Tablet Kiosk that can be used with not only the products from Tablet Kiosk, but other units as well.

Is there another Ultra Mobile PC package in the world that can run for 10 hours, weighs under 1.5KG and costs under $1200? Just under 10 hours ago I plugged the TabletKiosk MP3400 Powerbank into the fully charged Kohjinsha SA1 and its just shut down. That's 9hrs and 45 minutes of disk thrashing, movie playing, 100% CPU, WiFi-connected mobile goodness. (No easy tests here!) Without the movie playing or WiFi, I would get about 11 hours life.

More information at the Tablet Kiosk Site:
http://www.tabletkiosk.com/tkstore/pc/viewPrd.asp?idcategory=19&idproduct=176

Ever wonder what students are doing with Tablet PCs?

This is a great site to see how students are making use of tablet pcs, doing everything from taking notes in class to downloading digital books. I visit the site from time to time myself and pick up hints and suggestions as well. The page is unique in the fact that it is all supported by students. They know exactly what they are doing with tablet pcs and with one look at the site, you'll understand. This group has definitely figured out what it is all about and how having everything together really makes a huge difference, they post many how to pages. The group also is very active in using MS Office One Note and they offer all types of hints and even some student oriented templates for use. The site is so good that it earned Tracie a Microsoft MVP title.
http://studenttabletpc.com/beginners_guide/

Welcome to The Student Tablet PC! If you are here, you are likely considering a Tablet PC or you already own one and want to maximize your experience. The following will serve as a rough guide to help you explore some of what a Tablet PC can offer.
(For any term you’re not familiar with, please take a look at our Glossary)
We do cater to students, as we are students ourselves, but the information here relates to anyone who is interested in Tablet PCs and wants to manage information more effectively.

Medical site is on a mission to set records

Practice Fusion, free web based EMR - well the jury is still out on this one. From my own perspective in creating an EMR, real estate is something all software developers deal with, in other words getting the maximum amount of information available on a page and it never seems to be enough, and the ads would appear to add to this issue. In dealing with many MDs, one of the most annoying issues is having to constantly click to view additional information and add chart data. You could opt for no ads, but then the price is no longer free. In addition, profiling will be enabled as well, minus patient name, etc. so where does all this information go as well? The free version will be full of pharma and insurance ads as well. Interesting concept and it will be interesting to see how the product advances through time. As the information is available now, there seems to be just too many unanswered issues to create a concise review. BD
http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2007/03/16/BUG9OOM1FJ1.DTL&type=printable

In addition to a medical records system, Practice Fusion offers practice-management tools, such as billing systems. It says that by partnering with Google's AdSense network, the company can cover the cost of its services.
Practice Fusion is not the only company offering Internet-based medical-record systems. "We just happened to find a way to subsidize the cost of it," said Ryan Howard, the company's chief executive officer.
Advertising will be discreet -- no pop-ups -- and keywords are limited to a patient's condition, diagnosis or treatment. Practice Fusion says it complies with all federal privacy laws and will protect patient data, Howard said.
Practice Fusion will provide advertisers with basic demographic information about the physicians who view the ads -- such as their city and specialty -- but will not reveal names.
Pharmaceutical companies interested in having their ads viewed by a captive physician audience are expected to be the primary advertising clients. But Howard says the model will also appeal to insurance companies and other health-related firms and services.

NewYork-Presbyterian Hospital Selects Microsoft’s Azyxxi Solution for Its Enterprise Operations

http://www.microsoft.com/presspass/press/2007/mar07/03-19MSNYPHPR.mspx
Microsoft will support the implementation of the software in an agreement with NewYork-Presbyterian, which will serve as a development partner. The hospital will use the implementation to focus on applications that enable its clinicians to practice better medicine, that achieve truly integrated reporting across the enterprise, and that advance its organizational goal of being one of the nation’s top hospitals based on quality measures. The facility has more than 2,335 beds and 5,000 physicians, and serves a population of more than 6 million people in the New York City tri-state area.

Tablet Kiosk - new EO Tuf Tab UMPC V7112 XT

This is a great looking UMPC. You should be able to order on the website shortly. I do like the new biometric finger print reader too!
Also look for the new Sahara Tuftab for those wanting a full size tablet. Both are water, shock and dust resistant. We don't have a picture yet for the Sahara, but will include one as soon as one is available.



Here are some of the features at a glance.
eo TufTab™ v7112XT Fast Facts:
Processor: VIA C7-M® ULV, 1.2 GHz, 5W, 400MHz FSB
Memory 1.0 GB DDR2 SDRAM
Hard Drive: 40 GB,1.8” IDE Ultra DMA PATA HDD
Operating System: Microsoft Windows Vista™ Business, Windows® XP Tablet Edition or SUSE Linux
Display: 7” LCD sunlight viewable touch screen (80 gram sensitivity)
Expansion: 1x PCMCIA 2.1 Type II 32-bit PC Card Slot
Wireless: 802.11 b/g networking / Bluetooth® 2.0
I/O: 1 x USB 2.0
1 x SD-IO/MMC
1 x Headphone jack, Built-in Stereo Microphone
1 x HD15 VGA (Dual Screen Support)
1 x 10/100 Mbps Full Duplex 32-bit Ethernet (RJ45)
Digital camera
Security: Biometric Fingerprint Reader
Weight: 1.97 lbs (895 grams) with standard 4-cell battery
Dimensions: 206 x 135 x 29 mm (8.1” x 5.31” x 1.14”)
Ratings: IP53 compliant for resistance to water and dust; Shock/ Drop/ Vibration: 75cm

Medication Costs: The Role Physicians Play with Their Senior Patients

Until there is a full integrated solution, there are a few links on this site to give some helpful information regarding discounted or $4.00 prescription prices at retailers. I use these too! I need help as well as the seniors with prescription costs. Sometimes this can mean the difference of whether or not the patient can afford the prescription. Not to fault the physicians either here as this is a new thought process to be considered and included with the office visit. They know what works and when patient flow is heavy, may not think about the lower cost alternatives if one is available for treatment. It's also a good idea for us, the patient, to be aware of these facts so as not to put the entire burden on the physician too, so we have teamwork. I have spoken with some senior groups and I always make sure I take time to cover this topic so they too are in the know.
http://www.medscape.com/viewarticle/553368_print(may require log in)
A cross-sectional, random sample of 1,200 internal medicine and family practice physicians in California, selected from the American Medical Association (AMA) Masterfile list, were mailed self-administered questionnaires.
Physicians need resource guides to assist with rapid and up-to-date access to health plan formularies, discount programs, and the least-expensive therapeutic alternatives to assist them with cost-reducing strategies and cost-effective prescribing. An integrated e-prescribing system is one example of how a healthcare system could assist physicians with this challenging and often confusing task.[27] A tool to assist physicians in prospectively identifying seniors at high risk for financial burden due to out-of-pocket medication costs may prompt clinicians to take the time to discuss medication costs and possibly prevent detrimental cost-reducing strategies such as skipping or spacing out medications when seniors cannot afford their medication.

Robotic brace aids stroke recovery

Robotics on the move for better health care, good article about how robotics in the health industry are working for us. BD
http://web.mit.edu/newsoffice/2007/brace.html
The device--which sensed Fermental's electrical muscle activity and provided power assistance to facilitate her movements--also altered her brain.

Following a stroke, the destruction of brain cells leads to loss of motor function. With painstakingly repetitive exercise therapy, other neurons can take over some of the lost function. Devices such as the MIT-developed robotic brace can help people exploit their neural plasticity--the increasingly recognized ability of the brain to rewire itself in response to experience and training.


WalMart Health Issues Phoenix, AZ

http://ktar.com/?nid=6&sid=422585


A health inspector said he found mouse droppings at a Valley Wal-Mart on Monday after shoppers reported seeing rodents in a bakery case.

Windows Smart Phones and Pocket PCs

Are you looking for a new Cell Phone? If you are mobile and rely on your contacts stored in your phone, why depend on the software from the phone. Upgrade to a Windows Mobile unit. With synchronizing contacts with Outlook, you will never have to worry about storing information with a sim card or on the phone itself, plus all contacts will have much more information available. Synch with 2 PCs and always have a back up of your valuable contacts.
Voice commands to dial numbers works like a charm.

http://www.microsoft.com/windowsmobile/gettingstarted/default.mspx


http://www.microsoft.com/windowsmobile/microsoftprograms/outlookmobile.mspx


Training - Use it or Lose It - Best ROI for the money

If you are not taking advantage of software training today, you are in fact helping to sink health care IT. This is a subject dear to my heart in the fact that I see this every day.

As the world is rapidly changing around us and IT continues to grow at a rapid rate, training seems to be the last issue at heart, when in fact it should be number one. In some areas, the software is very inexpensive, however, the training costs can be quadruple the cost of the software itself.

After spending a large amount of time on selecting the software to work in your organization, don’t skimp on training, or you will end up with users not utilizing new procedures and not have a successful implementation, and the bottom line will not allow for a good ROI for your time and efforts.

In my travels, I see this frequently, even with staff not even using Microsoft Office to it’s fullest, or not knowing which product to use to create the type of document they desire and time after time, it takes up much more time than necessary to either re-create the document in another format, or in many instances, the data may not be re-useable in other areas.

Most are familiar with MS Word and see it as the answer to all their needs, when in fact, there are better and more efficient solutions right at hand and basic training on MS Office would allow one to perhaps use another solution for the information they want to create. MS Word is not a data base, but is a word processing program, not made to store data in re-useable tables and requires human manipulation to transfer non ASCII text into other software. Word can be used in conjunction with other software to provide user templates though and the data is still stored elsewhere, thus the information created can be easily re-created at any time. Think about this the next time you go to open Word, is there a better way to work more efficiently?

When introducing an EMR to an office, the basic understanding of MS Office is a real plus as well, as most software will export to either Word or Excel formats or many beyond this. Are you doing a mailing list, then Excel would be a better choice if this information is to be re-created and use in other software. Are you doing a presentation, perhaps Power Point would be the better solution rather than trying to do this with Word.

In summary, DON’T CUT YOURSELF AND VALUED STAFF SHORT ON TRAINING WHEN IT IS AVAILABLE. You can have the best and most proficient software installed, but if management and staff are not equally proficient, you may have wasted a whole bunch of money on software that will do the job for you, but the staff has not a clue on how to maximize the software to it’s fullest potential, thus you end up with staff and management taking up to 4 times the amount of time to complete the same task, whereby a trained staff could accomplish the same thing in a minimal amount of time.

Also, use software that is secure when needed, and avoid storing information in unsecured Word and other document formats if privacy implications are there. Don’t be another statistic in the “lost information” headlines. Use software wisely and store this type of information where it belongs, in the software, not with unsecured documents that also require a lot of disk storage areas. Your software program will also back this up for you too, unlike having to store a file of documents and it can be reproduced again at any time. With security as it is today, it is just way to risky to rely on unsecured documents for storing information with privacy implications.

Put the shoe on the other foot for a moment and think of the information being stored without security being yours, now that's a scary thought. Nobody wants to purposely expose information that shouldn't be out there for those that are less than honest. Think of the implications this creates for others having to do all the legwork to clean up an identity after it has been compromised. I hope that I never have to face this or be the cause of someone else having to do the same if it was easily preventable by having enough training in how to handle documents, software and a basic knowledge of security.

Medical Education Technologies - Patient Simulators

Interesting training site with using both adult and baby mannequins...and full training courses available....BD
http://www.meti.com/Product_HPS.html
Meet Stan (Standard Man), the Man who saves more lives.
At every level of patient care, hands-on experience is the best teacher. The Human Patient Simulator (HPS) – a computer-model-driven, full-sized mannequin – delivers that experience in true-to-life scenarios that swiftly change to meet instructors’ goals. The ultra sophisticated and highly versatile HPS blinks, speaks and breathes, has a heartbeat and a pulse, and accurately mirrors human responses to such procedures as CPR, intravenous medication, intubation, ventilation, and catheterization.


Forensic Data Recovery - Be Aware it does exist in places you might not even think of

More and more we see this technology being used, not only in law enforcement areas, but this site has several medical stories included. We read so many stories about data recovery and loss in the news today. If you think you have destroyed your data for good, think twice as companies like this one sure make a good living at data recovery. BD


http://www.krollontrack.com/

Say Ah! to Windows Mobile

Check out information available for your PDA/Cell Phone here. BD
http://www.microsoft.com/windowsmobile/articles/medical.mspx

While they may not be as common as a stethoscope or a tongue depressor, Windows Mobile powered devices are becoming vital tools for doctors and nurses.
Many drug and disease databases are now available electronically, and Pocket PCs certainly are much easier to carry around than thick reference books.
There are also plenty of medical software packages to choose from, regardless of your medical specialty.

Alive Diabetes Management System

Interesting to see how the glucose meter works with a cell phone to transmit results. BD
The Alive Diabetes Management System utilises the latest advances in technology to provide an affordable solution which meets the need for improved disease management and care planning. The system uses Bluetooth, GPRS, and SMS wireless technologies.
http://www.alivetec.com/products.htm

Live Surgeries on line - Register to receive CME Credit for Physicians

http://video.google.com/videoplay?docid=6390446192795481593&q=da+vinci+pediatric
This is a long video that shows actual robotics surgery at Children's Hospital in Boston from You Tube. There are additional live surgeries at OR Live and links to upcoming events have been added to the blog on the left hand side for future reference.

http://www.or-live.com/

OR Live also offers RSS Feeds. Why use RSS Feeds? Upcoming events are automatically received in preview format for registration purposes without having to re-visit the site.
Here is another site, Hartford Hospital, as an example with an upcoming event, available for CME credit.
http://www.or-live.com/Hartfordhospital/1619/index.cfm?r=orlive
If you have ITunes, the videos can be downloaded to view at your convenience as well as sending to an IPOD.

A Better Artificial Skin

http://www.technologyreview.com/Biotech/18059/
Over the past decade, artificial-skin products--made from scaffolds of collagen, the molecule that gives skin its structure and elasticity--have drastically improved burn victims' chances of survival. Large sheets of the flexible mesh placed over open wounds encourage growth of new dermis, the bottom layer of skin, which does not regenerate under normal circumstances. Surgeons can then transplant small pieces of the patient's epidermis, the top layer of skin, which grows and spreads over the newly grown dermis.

Typical Annual Salary for Family Practice MD $75,000.00 in Connecticut

I think the title here says it all - why we are facing a shortage of Primary Practice physicians. Also, this reinstates the need for "affordable" EMRs and technology for many to convert to paperless and continue to practice. BD
http://www.courant.com/news/opinion/commentary/hc-commentarydoctors0318.artmar18,0,6179078.story?coll=hc-headlines-commentary

Each year, it's harder for Volpintesta to stay in business. His malpractice insurance costs $15,000. His annual salary is $75,000. That's not a typo - it's fairly typical for a primary care physician in Connecticut. For the record, Volpintesta plans to drive his 5-year-old Toyota until it stops running.
Government hasn't done them any favors lately. Medicare reimbursements have been frozen since 2004, and a 10 percent cut is expected in 2008 - a $96 million decrease for Connecticut, according to analysts at the American Medical Association.
Medicaid reimbursements are also so low that the Department of Social Services recently found that only one in four Medicaid patients can obtain an appointment with a physician.
Five years ago, a family physician would have received $56 for that visit. Today, he receives $46. If he performed 1,500 of these evaluations a year, a physician like Volpintesta would have lost $14,600 - and that figure covers just one of hundreds of thousands of medical billing codes.

Rugged UMPC from Tablet Kiosk to be released soon

As you all know from reading this blog, I am a big fan of the products from Tablet Kiosk. Coming soon is the latest released of a "ruggedized" UMPC. It still has some of the same familiarity of their current products. By adding a card reader for example, a restaurant worker could easily become mobile by entering orders and running a credit card for payment while still in the view of the customer. From the health care side of things, the unit could also be used to enter chart data and have the potential of adding patient data simply by swiping a patient's insurance card or personal health record card to add the information to a medical record, which would mean no longer having to fill out all those "paper" forms we all see in most practices and hate to write the same information over and over. Tablet PCs and UMPCs are really the ideal tool to bring paperless records to the forefront. Something along this line also saves valuable staff and physician time in not having to enter the hand written information from the paper to chart as well. It's a win-win for all.

Wal-Marts Linda Dillman Talks About Changing the Health Care System

Interesting article with WalMart executive vice president of risk management and former CIO. In this interview many topics are covered including their involvement in Dossia, the personal health record program initiated by several large employers. Walmart as well as Intel are the founding members of the initiative. She also discusses the involvement of the retail clinics in the full scenario. BD
http://www.workforceonline.com/section/09/feature/24/81/12/index.html
As CIO, Dillman led Wal-Mart’s embrace of radio-frequency identification (RFID) tags, which use wireless bar-code technology to track products from factories in China to store shelves around the globe. Now, the use of RFID is standard in the industry—and just about everywhere else.
WM: How soon after talking to Intel chairman Craig Barrett did you give the OK to join Dossia?
Dillman: We knew we were interested. You go through an initial interest level, which was actually pretty quick. And then work through all the logistics. So it was probably three or four months.
WM: What does Wal-Mart bring to Dossia?
Dillman: We’ve got a pretty good track record for being able to use technology. We’ve built large data warehouses. We’ve deployed to a large number of people, specifically. Our associate base uses a lot of technology every day, so we kind of know how to do that.
Dillman: Dossia is meant to be the framework that personal health records, that are customer-facing, and electronic health records, that are provider-facing—they all can connect to this framework. Dossia is not trying to create the software that others are going to go use. But whatever anybody creates will have the ability to connect to this to get all the information. Having said that, all of our [health] clinic providers have their own information systems that they use to manage their clinics. Most are already using electronic health records. Of course, we’d like for their system to connect to Dossia so when [customers] come in they can have an entire record.
More information on Dossia here:
http://www.dossia.org/index.html

Pirates of the Health Care-Ibbean

Cute video talking about health insurance carriers...BD

Does anybody take encryption seriously? They should......

http://www.nytimes.com/2007/03/14/business/14insure.html?_r=3&ref=health&oref=slogin&oref=slogin&oref=slogin
Medical Data on Empire Blue Cross Members May Be Lost
WellPoint, one of the nation’s largest health insurers, has begun notifying 75,000 members of its Empire Blue Cross and Blue Shield unit in New York that a compact disc holding their vital medical and other personal information had disappeared.
Empire began notifying the affected consumers by mail on Saturday that their records — including their names, Social Security numbers, health plan identification numbers and description of medical services back to 2003 — had been lost.
subscription may be required

Health Plans: The only game in town? - Medical Economics

http://www.memag.com/memag/article/articleDetail.jsp?id=410226&pageID=1&sk=&date=

In the greater Los Angeles area, Blue Cross of California, owned by WellPoint, is the 800-pound gorilla, as ophthalmologist David H. Aizuss calls it. Aizuss, who practices in a six-doctor group, says the company "doesn't negotiate—you accept its terms or you take a hike."
Some primary care doctors in the area have decided to do just that, but it's hard, he says, for surgical specialists to follow suit. "Most surgical specialists find that they have to contract with a lot of different plans."
It's also hard to jump plans, he says, unless your specialty is in short supply: "A good friend of mine is a pediatric neurologist, one of only a very few in the San Fernando Valley, which has a population of well over a million people. Because he's a scarce commodity, he's able to refuse any new contract that doesn't meet his terms, which amount to paying him his usual and customary fees. Otherwise, he doesn't bother." His own situation, Aizuss realizes, is quite different. "For ophthalmologists who may have 10 colleagues down the street, it's much more difficult to negotiate these things."

When the EMR goes down....

http://theblogthatatemanhattan.blogspot.com/2007/03/when-electronic-medical-record-goes.html
This MD has some great idea on the blog on how to respond when the EMR goes down. As he mentioned, a "read only" chart can be a simple solution, even if it is only available on one PC to get through the down time. One good thing about electronic records is that there is always back up and everything can be restored, versus the alternative of paper documents, as once they are gone, they are gone. BD

If Crack Dealers Took Lessons From Walgreens, They Really Would Be Rich

http://www.freakonomics.com/blog/2007/03/15/if-crack-dealers-took-lessons-from-walgreens-they-really-would-be-rich/

This is a must read for all, patients and MDs. On the left hand side of my blog you can easily link to Target and WalMart pdfs that show the cost of their generic drugs listed on their special program. Many thanks to the authors of this blog for bringing this to our attention. BD

So Wolf began snooping around and found that two chains, Costco and Sam’s Club, sold generics at prices far, far below the other chains. Even once you factor in the cost of buying a membership at Costco and Sam’s Club, the price differences were astounding. Here are the prices he found at Houston stores for 90 tablets of generic Prozac:

Walgreens: $117

Eckerd: $115

CVS: $115

Sam’s Club: $15

Costco: $12

Those aren’t typos. Walgreens charges $117 for a bottle of the same pills for which Costco charges $12.

VA nurse fails to visit patients, lists dead patient as 'stable'

http://www.heraldsun.com/state/6-829665.cfm
This has been around for years with folks documenting without making the actual calls and eventually it will catch up with one who does the administrative entry without all the facts that is only gained by doing the job. BD

SALISBURY, N.C. -- A nurse responsible for monitoring care of frail military veterans didn't visit patients as required for two years and filed one report that listed a dead patient in stable condition, according to a federal inspection obtained by The Charlotte Observer.

Bill Gates Still Loves the Tablet PC

This week the Microsoft MVP Summit is taking place in Redmond. One of the Tablet MVPs from Australia, Hugo Ortega was able to capture a few moments of the discussion area with Bill Gates. The video starts with everyone getting seated and continues on with Mr. Gates re-affirming his commitment and involvement with Tablet PCs. The medical arena is truly a real benefactor with Tablets. BD

One Big Tablet

This is a product on display at CeBit in Germany this week. The product shown is one big tablet! The video is extremely interesting to watch and of course the unit is not portable, but gives some real interesting thoughts on using the item for presentations, etc., you name it. From the medical side of the arena, I could see a radiology department truly having some real benefit in this area, think about it. BD

HMO Humor

Saint Peter at the Pearly Gates
Three guys died at the same time and ended up in front of Saint Peter at the Pearly Gates. Saint Peter said to the first guy, "Why should I let you in?" The guy answered, "I was a doctor and I helped many people get well." Saint Peter said, "Okay, you may come in." Saint Peter said to the second guy, "Why should I let you in?" The guy answered, "I was a lawyer and defended many innocent people." Saint Peter said, "Okay, you may come in." Saint Peter then said to the last guy, "And why should I let you in?" The guy answered, "Well, I was a managed health care professional and I helped to keep health care costs down." Saint Peter thought about this a moment and said, "Okay, you may come in, but you can only stay three days!"

Q: What does HMO stand for?

A: This is actually a variation of the phrase, "Hey, Moe!" Its roots go back to the concept pioneered by Dr. Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eyes. Modern practice replaces the finger poke with hi-tech equivalents such as voice mail and referral slips, but the result remains the same.

Q: Do all diagnostic procedures require pre-certification?

A: No. Only those you need.

Q: I just joined a new HMO. How difficult will it be to choose the doctor I want?

A: Just slightly more difficult than choosing your parents. Your insurer will provide you with a book listing all the doctors who were participating in the plan at the time the information was gathered. These doctors will fall into two basic categories: those who are no longer accepting new patients and those who will see you but are no longer part of the plan. But don't worry--the remaining doctor who is still in the plan and accepting new patients has an office just half a day's drive away.

Q: What are pre-existing conditions?

A: This is a phrase used by the grammatically challenged when they want to talk about existing conditions. Unfortunately, we seem to be pre- stuck with it.

Q: Well, can I get coverage for my pre-existing conditions?

A: Certainly. As long as they don't require any treatment.

Q: What happens if I want to try alternative forms of medicine?

A: You'll need to find alternative forms of payment.

Q: I have an 80/20 plan with a $200 deductible and a $2,000 yearly cap. My insurer reimbursed the doctor for my outpatient surgery, but I'd already paid the bill. What should I do?

A: You have two choices: your doctor can sign the reimbursement check over to you, or you can ask him to invest the money for you in one of those great offers that only doctors and dentists hear about, like windmill farms and frog hatcheries.

Q: What accounts for the largest portion of health care costs?

A: Doctors trying to recoup their investment losses.

Q: What should I do if I get sick while traveling?

A: Try sitting in a different part of the bus.

Q: No, I mean what if I'm away from home and I get sick?

A: You really shouldn't do that. You'll have a hard time seeing your primary care physician. It's best to wait until you return, then get sick.

Q: I think I need to see a specialist, but my doctor insists he can handle my problem. Can a general practitioner really perform a heart transplant right in his office?

A: Hard to say, but considering that all you're risking is the $10 co-payment, there's no harm in giving him a shot.

Q: My pharmacy only covers generic drugs, but I need the name brand. I tried the generic medication and it gave me a stomach ache. What should I do?

A: Poke yourself in the eye.

Q: Will health care be any different in the next century?

A: No, but if you call right now, you might get an appointment by then.

Coding Help - Diabetes from Medical Economics

http://www.memag.com/memag/content/printContentPopup.jsp?id=410217
Patients who have diabetes often have one or more complications that require your extra attention, and these added problems can have a significant effect on the E&M level you bill. Use these steps for diabetes diagnosis coding to ensure that your ICD-9-CM codes justify the services you bill.
Use the correct digits
Determine the fourth digit for 250.xx (diabetes mellitus) according to the type of diabetic complication the patient has (1 for ketoacidosis, 4 for renal conditions, 6 for neurological involvement, etc.). You should code only the complication relevant to the services you render during the visit.
Use V codes
Just as fourth and fifth digits paint a more complete picture of a patient's diabetes, V codes are also important for telling the carrier the whole story. Assign V58.67 as a secondary code for patients who take insulin.

Ablet Factory - One Note Toolkit

If you are perhaps not ready to invest in a full EMR system, the Ablet Factory has a nice One Note Soap Toolkit. You can find the link to the Ablet Factory on the left hand side of the page under the Tablet PC Links.
By using One Note, physicians can select to "share" patient profiles with other physicians using One Note. With a small investment in a tablet pc, One Note (part of Microsoft Office) this is a great way to get started with putting charts on a computer. One Note can also be used on a desktop pc as well. For a small example, physicians in an ER room could easily start creating records and sharing with other physicians, so if a patient is seen by more than one physician, the patient record is available. With the new Mobile version of One Note, these can also be shared and used with a PDA.


There are many ways to go by using the One Note Soap Kit as a starting point for charting.


The One Note Soap Kit is also a great solution for the small practice with one or more physicians.