2008-03-04 00:00:00

Many Patients Can Reach LDL Cholesterol Goal Through Dietary Changes Alone

Patients worried about their cholesterol may want to visit a registered dietitian (RD) to get some sound advice about how to shape up eating habits, according to a new national study led by University of Michigan Health System researchers. The new results, published in the February issue of the Journal of the American Dietetic Association, are based on data from 377 patients with high cholesterol who were counseled by 52 RDs at 24 sites in 11 states.

  • In the group of 175 patients who started the study with triglycerides less than 400 milligrams per deciliter of blood (mg/dL), and who had their cholesterol measured before they changed or added medication, 44.6 percent either reduced their levels of ???bad??? cholesterol by at least 15 percent, or reached their cholesterol goal.
  • A significant number of patients reduced the fat in their diets to less than 30 percent of calories, as recommended for heart health. Many participants also lost weight and/or increased the number of days each week on which they exercised for 30 minutes or more.

Filed under: — @ 2008-03-04 00:00:00
2008-03-02 00:00:00

Interesting video on paperless healthcare

Robert Pierce, a Healthcare IT Guy reader and fellow healthcare technologist, recently sent me the following note:

I attended a breakfast at HIMSS put on by Allscripts at which Newt Gingrich spoke.  Before Newt came to the mike they aired a video that’s pretty interesting I think; makes the point with precision and power even though it’s a vendor product (understated).

Though I was slightly offended as a health professional by the over-the-top focus on medical errors, it’s worth viewing as a reminder of why we need to get paper out of medicine.


I checked out the video and it was generally well done– it brought to light the issue of paper in healthcare. I agree with Bob that it went a bit over the top with the issue of medical errors (like "if you buy AllScripts you can somehow eliminate medical errors") but it did make the point how bad paper is to the healthcare industry.

Thanks for the link, Bob. I always appreciate my readers chiming in.

Filed under: — @ 2008-03-02 00:00:00
2008-03-02 00:00:00

Guest Article: Dr. Olson asks if we’re looking at healthcare IT to solve the right clinical problems

A physician friend of mine, Dr. Richard Olson ("Rich") of Gainesville, GA, and I often discuss healthcare IT issues over e-mail. He is a thoughtful, caring surgeon in private practice who has been involved in health IT issues for decades (as a consumer of them and on multiple selection committees for products at various hospitals). He definitely knows his stuff. Recently Rich sent me a note wondering about whether or not the years of healthcare IT that has been applied was in the best manner to help patient outcomes and improve clinical care. I thought it was a great question and since I’m not bright enough to answer it alone I thought I’d open it up to the rest of the readers of this blog to see what they thought. Please drop comments here to let Rich know what you think.

Here’s the complete text of the question Dr. Olson posed:

On Amazon.com recently I was pitched a book titled "CHI Remixed" about computer human interaction (CHI). I began to wonder whether the traditional informatics field has blinders on and is trying to automate too much of the textual work. Based on the effort I spend as a clinician each day, the patient/physician-provider communication process is what I need help with.

If the computer helped me translate the layman’s language into ‘medicalese’, not jargon, but description based on physiologic understanding, and vice versa to the patient, we would be ON to something. Traditional informatics looks to start AFTER all that face time with the patient, then ask me to click or type in data to populate the database, enter orders, and to what end? So that a machine structures all decisions, and my choices can supervised by an automated process?

If the academic discipline of CHI (see for example, http://www.hcii.cmu.edu/Research/projects.html) were to begin with the patient/physician relationship, and not the traditional textual medical record as its starting point, I wonder what direction the field would take. I think we would see more image-based communication (words just don’t convey understanding of many processes as well as pictures, diagrams, or video). Furthermore, the time pressure of the office appointment could be reduced, if a patient, if educated well enough, could take time for independent or family study of "what the doctor said" and logged on the Personal Health Record and went from there to online or other resources, before coming back for discussion, or other online interaction.

Data entry for analysis could be a role performed by a new class of technical worker, a glorified transcriptionist, who can work with the digital voice record, and fill in the blanks for the information system for all purposes: billing, performance improvement, public health, and subsequent clinical care. Doctors could spend their valuable time doing what we do best, in one on one time with patients and family, in an emotionally highly charged environment, inherently not very structured and unique to each individual patient (for most of us.) I pity the doc cranking the same old crank day after day - the cataract guy for example.

The standard practice of medicine also is rather isolated for the physician, with an appeal for help or consultation kind of a big deal. Without so much infatuation with artificial intelligence, we might focus instead on having records available for review by a trusted mentor. This would provide a much needed opportunity to enhance quality of care using the EHR and technology to facilitate good old regular human cognition. Pathologists routinely send out tough cases for consultation, but never do our radiologists, or internists, or surgeons for that matter. We now have information and communication systems to do so, but no reimbursement allowance to fund that at this time.

My basic question is, did we start at the right place? If our starting point was the medical record, and not the patient-physician relationship, have we picked the best path to apply technology to improve clinical care?

Filed under: — @ 2008-03-02 00:00:00
2008-02-29 00:00:00

Employee Health Promotion No Headache for this Manufacturer

In a recent discussion about the importance of creating a workplace culture of health, David Sensibaugh, Eastman Chemical Company’s director of Integrated Health, described how his organization addressed the indirect impact of workers’ headaches and migraines on the safety of a manufacturing environment:

It is important to note that whenever we have accidents, like most manufacturing companies will tend to do on occasion, we review the cause, the results and the factors around the accident. We have found that in addition to unsafe behavior, health is a contributing factor to accidents on the job. Of the different types of health factors, a migraine is one of those.

We also participated in a health and productivity questionnaire survey that did much to help us understand the indirect cost of poor health within our population. A subset of that is the migraine element, which showed that about 28 percent of our employees suffered from migraines or headaches, and that the cost of that to our population is over $4 million annually.

That led us to participate in a headache education project. It was a joint effort between Eastman Integrated Health, HealthFitness and Johnson & Johnson Health Care. We had a company-wide marketing effort and employee information sessions, some which were held byan outside migraine expert from Vanderbilt Medical Center. The expert also held a physician dinner to help people in our community understand why this was an important issue and what we were trying to do with it here. Then we allowed people to voluntarily participate in this migraine study.

The study began with a pre-survey to help get an assessment of people???s headaches, their headache status, the severity of their headaches, their knowledge of headaches and headache treatment and so forth. Then we followed that up for period of about three months with educational materials provided by Johnson and Johnson. There was a small incentive to complete this study, a $25 gift card. After those three months of education and study there was a follow-up survey that was sent out, and then we had a headache severity survey that is currently being completed. Over 500 employees voluntarily participated in this study. The results of that will be forthcoming.

Filed under: — @ 2008-02-29 00:00:00
2008-02-28 00:00:00

Childhood Obesity Increasing at Alarming Rates

According to the American Heart Association, 9 million children and adolescents between 6 and 19 years old are considered overweight, and the prevalence of overweight among this age range has increased more than 10 percent between 1971 to 1974 and 2001 to 2004. If that isn’t enough, nearly 14 percent of preschool children are overweight as well. These statistics paint a grim picture for many children, as overweight adolescents have a 70 percent to 80 percent chance of becoming overweight adults. As of 2006, 142 million American adults are overweight or obese.

This week’s Disease Management Update looks at studies involving obesity in children as well as in adult males and the not-so-obvious side effects this condition can have.

Filed under: — @ 2008-02-28 00:00:00
2008-02-27 00:00:00

What Doctors Think — useful Physician surveys

A friend of mine sent out this link to WhatDoctorsThink.com, which “provides survey results as a public service to the medical community to stimulate innovation and improve the quality and economics of healthcare.”

The one I found most useful, since I’m a tech guy, was the EMR and HealthVault (PHR) Survey Results. Interesting bedtime reading.

Filed under: — @ 2008-02-27 00:00:00
2008-02-27 00:00:00

100 Search Engines and Tools for Medical Self-Diagnosis

Amy Quinn just pointed me to e-Second Opinions: 100 Search Engines and Tools for Medical Self-Diagnosis. Very nice list of tools and worth checking out. Thanks, Amy.

Filed under: — @ 2008-02-27 00:00:00
2008-02-27 00:00:00

CCHIT info and Free Software Advice for Medical/Health industry

I just ran across the Medical Software Advice, which bills itself as a free resource that helps physicians find the right EMR, medical billing and practice management software for their practices.

They have a nice article, “Should CCHIT Influence Your EHR Selection,” that I think everyone looking at CCHIT certification should read about. Very timely and useful advice.

Filed under: — @ 2008-02-27 00:00:00
2008-02-27 00:00:00

Web 2.0 in a Nutshell: Learn, Find, Share.

Blogs. Podcasts. Wikis.

MySpace. Facebook. YouTube.

New media is everywhere, and the healthcare industry is no exception. A growing number of healthcare organizations are using such Web 2.0 technologies to advertise their services and provide healthcare consumers with access to more interactive health education.

During this webinar, John Sharp, project manager forIT Web services with the Cleveland Clinic, sheds some light on Web 2.0 and all it encompasses — and what it means to healthcare.

???It’s about participation, usability and design. The core principles that define Web 2.0 are Web-based and easily accessible. One of the most important principles is that you control your own data, whereas in what is called Web 1.0, information was controlled by the Web site owner. Web 2.0 Web sites are open to complete participation by users.

Health 2.0 is a newer concept that takes the Web 2.0 technologies and imports them into healthcare. For instance, social networking is now available for patients, healthcare consumers or providers. Podcasts are available for medical and patient education and other uses in healthcare, wellness for instance. Wikis are available for medical references. Blogs are written by physicians and other medical experts. Tagging of medical topics, photos and videos is happening all over the Web.???

But even as a comparatively new form of media, Web 2.0 is already evolving into something bigger and better, says Dave Bennett, director ofWeb resource services at the Medical University of South Carolina (MUSC).

???A lot of people are talking about Web 2.0, and I am often asked when we are going to reach Web 3.0. We’re moving in that direction with many of the new technologies that we see online. With Web 2.0, we move away from static content to dynamic content in the forms of video and audio.”

University of Alabama Health System???s Internet Marketing Manager Susan Reid notes that engaging your audience is essential to Web 2.0 success.

???The difference between Web 2.0 [and Web 1.0] is now you have to engage the audience where they are. There are many ways to do that: email, social networks, blogs bulletin boards, Wikis, video and audio, RSS feeds, mobile phones. The key is going out and engaging them where they are.???

Filed under: — @ 2008-02-27 00:00:00
2008-02-26 00:00:00

HITCHtv Beta - health IT TV land

HITCHtv is a new site with healthcare IT videos and multimedia. Worth checking out.

Filed under: — @ 2008-02-26 00:00:00
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