Dec 7, 2009

The top 10 hazards of Health care Technology



Superior technology need not always mean better healthcare. Very often, technology comes with its own attendant risks.From infections to cancer to surgical fires, this list covers the top 10 healthcare technology threats for 2010.


1. Cross-Contamination from Flexible Endoscopes
 This mainly results from failure to adhere to cleaning and sterilization procedures.
 To prevent risk, hospitals should:
  • Develop and adhere to comprehensive, model-specific reprocessing protocols;
  • Ensure that model-specific reprocessing protocols exist for each flexible endoscope model; and
  • Ensure that any automated endoscope reprocessors (AERs) are compatible with the disinfecting agent, the appropriate channel adapters are available, and staff adhere to maintenance schedules.
2. Alarm Hazards
  Alarm issues are among the most frequently reported problems, mostly due to the sheer variety of equipment – patient  monitoring, ventilators, dialysis units and many others.
To avoid potential risks:
  • Avoid alarm fatigue by configuring alarm limits to appropriate, physiologically meaningful values;
  • Look for designs that limit nuisance  (false or excessive) alarms, which can desensitize staff; and
  • Consider implementing an alarm-enhancement system to increase alarm volume or convey alarms remotely.
3. Surgical Fires
 Most surgical fires result from the presence of an oxygen-enriched atmosphere during surgeries to the head, face, back and upper chest.
 New recommendations include:
  • With certain exceptions, the traditional practice of open delivery of 100 percent oxygen should be discontinued during head, face, back, and upper-chest surgery.
  • Hospitals should implement a surgical fire prevention and management program.
  • Each member of the surgical team should clearly understand the role played by oxidizers, ignition sources, and fuels – the classic fire triangle in the operating room.
4. CT Radiation Dose
 In the United States alone, CT is thought to be responsible for about 6,000 additional cancers a year.
 To avoid potential risks:
  • Make sure the expected benefits of a CT study outweigh the radiation risks.

  • In most modern systems, the dose can be reduced by up to 80 percent. Adjust CT acquisition parameters to allow the required clinical information to be obtained with the lowest possible dose.
  • CT precations are especially important for pediatric patients – for whom the cancer risk is as much as triple that for a 30-year-old – and pregnant women.
  • Ensure that technologists performing CT exams are trained specifically for CT and that they maintain their training and certification.
5. Retained Devices and Unretrieved Fragments
 These take the form of retained devices, where an entire device is unknowingly left behind, and unretrieved device fragments in which a portion of a device breaks away and remains inside the patient
 To prevent risks:
  • Inspect devices before use. If a device appears damaged, don't use it.
  • Be alert for significant resistance during device removal, which could indicate that the device is trapped and at risk of breaking.
  • Inspect devices as soon as they are removed from the patient.
6. Needlesticks and Other Sharps Injuries 

7. Problems with Computerized Equipment and Systems

8. Surgical Stapler Hazards

9. Ferromagnetic Objects in the MR Environment


10. Fiberoptic Light-Source Burns
    To read the complete list, click on the link below.
    ECRI identifies top 10 health technology hazards for 2010 | Healthcare IT News


    Nov 26, 2009

    Quantros to provide health care SaaS in India

    Fatal medical errors in health care services are much commoner than generally believed. The number of years of potential life lost from potential medication errors is greater than the number of years of potential life lost from all accidents combined, including falls and drowning! A recent study in Archives of Internal Medicine showed that deaths due to medical errors are increasing exponentially, with increase of fatal medical errors by 360% over 2 decades. Use of health care IT will go a long way in preventing such consequences.



    >Dr. Sanjaya Kumar’ is a Medical informatics and healthcare technology expert bringing message of patient safety and quality to Bangalore hospitals. His mission is his passion- working to make healthcare safer worldwide, and promoting hospital safety.With a talented team of doctors and technologists, Quantros now provides SaaS in the health care field with special emphasis on decision support system and patient safety protocols, to bring down fatal medical errors. Quantros also provides software and services to healthcare organizations in the areas of quality, risk management, performance improvement, accreditation and compliance, real-time surveillance and centralized business and clinical decision support solutions. Claiming to service more than a thousand clients, Dr.Kumar is now trying to bring his technology to India, via Bangalore.


    Dr. Sanjaya Kumar, of Quantros, Inc., along with San Francisco Mayor Gavin Newsom shall visit Bangalore during Late November < 27th november onwards>as part of a San Francisco-Bangalore Sister City Initiative. The San Francisco-Bangalore Sister City Initiative is a volunteer-driven, not-for profit-organization that aims to engage individuals and institutions in Bangalore and San Francisco in creating sustainable 21st century cities through an exchange of environmental, economic, technological, and cultural ideas, expertise and resources.

    Hoping to see some interaction between Dr.Kumar (Quantros) and Dr.Devi Shetty <Narayan Hradayalay) at Bangalore. Dr.Devi Shetty is one of India"s foremost change-pushers and has already demonstrated some brilliant out-of-the-box ideas , typical to Indian conditions and attitudes, which have clicked superbly.

    Nov 11, 2009

    Top Ten US Healthcare companies to work @

    Top US Healthcare companies to work @


    Modern Healthcare announced its second annual list of the Best Places to Work in Healthcare.


    healthcare IT
    • 317 healthcare companies participated in this survey and were ranked on basis of employee feedback, company policies, benefits and demographics.

    • A complete list of over 100s of companies ranked in this survey can be found too. 


    A video announcement is now available at modernhealthcare.com/bestplaces.




    The top 10 health care workplaces for 2009 in US are-


    1) Intelligent InSites -- intelligentinsites.com

    2) Doctors Hospital of Sarasota --  doctorsofsarasota.com
    3) CHRISTUS St. Michael Health System -- christushealth.org
    4) Holy Name Hospital -- holyname.org
    5) Sage Products -- sageproducts.com
    6) Memorial Healthcare System -- mhs.net
    7) VHA  -- vha.com    the vista way..
    8) Awarepoint Corp. -- awarepoint.com
    9) Premier -- premierinc.com
    10) Valley Medical Center  -- valleymed.org


    Related articles 

    Oct 8, 2009

    Communication issues with Tele-consults , new study shows

    HELP Telemedicine clinic 1








    With newer technologies and net-centered consultations on the rise, this study below shows us the disadvantages of Telemedicine.



    Background: The quality of physician-patient communication is a critical factor influencing treatment outcomes and patient satisfaction with care. To date, there is little research to document the effect of telemedicine (TM) on physician-patient communication.

    Objective: The objectives of this study are to measure and describe verbal and nonverbal communication during clinical TM consultations and to compare TM with in-person (IP) consultations in terms of the quality of physician-patient communication.

    Methods: Veteran patients (n = 19) requiring pulmonary medicine consultations were enrolled into the study. The study group included 11 patients from the Iron Mountain Veterans Affairs Hospital (VAMC) remote site. Patients had individual TM consultations with a pulmonary physician at the Milwaukee VAMC hub site. A control group of 8 patients had IP consultations with a pulmonary physician at the Milwaukee VAMC. Video recordings of medical consultations were coded for patient-physician verbal and nonverbal communication patterns using the Roter Interaction Analysis System (RIAS).

    Results: There were no differences in the length of TM consultations (22.2 minutes) and IP consultations (21.9 minutes). Analysis of visit dialogue indicated that the ratio of physician to patient talk was 1.45 for TM and 1.13 for IP consultations, indicating physician verbal dominance. Physicians were more likely to use orientation statements during IP consultations (P = .047). There were greater requests for repetition from patients during TM consultations (P = .034), indicating perceptual difficulties.

    Conclusions: The study findings indicate differences between TM and IP consultations in terms of physician-patient communication style. Results suggest that, when comparing TM and IP consultations in terms of physician-patient communication, TM visits are more physician centered, with the physician controlling the dialogue and the patient taking a relatively passive role. Further research is needed to determine whether these differences are significant and whether they have relevance in terms of health outcomes and patient satisfaction with care.
    Patients seem to be put at a certain communication disadvantage as they are immersed into a totally new environment and need the Doctor to guide them through the interview.As technology gets better, these virtual meetings might get more realistic and take away the awe associated with high technology AND Medicine working together in tandem.

    Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.

    Sep 24, 2009

    A truly semantic medical search engine - HealthBase

    Image representing NetBase as depicted in Crun...

    HealthBase is a new and truly semantic search engine based on NetBase's Content Intelligence platform.When i first decided to try it out, i was not very hopeful, having spent many hours in the past analysing pathetic results from so called Smart search engines. But Boy, i was very pleasently surprised at the results !!

    NetBase's Content Intelligence technology reads every sentence inside documents, linguistically understands the content and powers breakthrough search experiences that deliver highly relevant answers and insights.



     I checked the search engine semantics by searching for a simple disease " Asthma".

    All the results shown for Treatment, Causes and complications were almost 100% accurate, though the results for Pros and Cons were very ambiguous. In fact i don't see too much justification for that section at present.

    A few reviews on NetBase have not been very complimentary. but then, i have perceived a bias in them. Of course there are many other really good medical search engines, a few of them even calling themselves semantic. But most of them are just glorified and customized search engines without any really intelligent tool involved in calculating results.

     

    •  




    •  





    But for my money, I would go with Healthbase anyday, until someone else can show me a better semantic medical search engine. 
     

    Sep 18, 2009

    Best layout and design for pharma- communication

    Best layout and design for pharma- communication: "

    Over the years companies have adopted various tactics to get doctors to engage with their online product presentations, or e-details. Initiatives include obtaining permission from doctors to email them an e-detail, placing the e-detail on a pharmaceutical website, placing a banner on a website linking to an e-detail, and placing the e-detail on a doctor community website. The results have been varied..
    There are a number of ways to e-present to doctors and choosing the best layout and design is not always easy. Making a simple bullet presentation with linear navigation (next/previous arrows) is one simple way to kill your content. But then, What actually works?
    • Pharma websites have been proved rarely to attract doctors (only 2 per cent of the 2,762 doctors questioned in a Doctors.net.uk survey stated pharmaceutical-owned websites as a source).
    • Banners on websites, although considered cheap, do not drive engagement and, dependent on banner location, may not allow you to know the profile of the individual clicking on your banner.
    • E-detail on a doctor community website, however, offers the advantage that doctors are already utilising the site on a daily basis, and campaigns can be promoted to specific specialties.


    Understanding the audience
    Doctors.net recently conducted a survey to investigate the best way to engage doctors with an e-detail. A total of 94 members of the community were surveyed, 32 of whom were GPs and 62 were in specialist care (across a number of different specialities). Of the 62 from specialist care, 43 were consultant/specialist registrar level. The study combined facilitated face-to-face research and non-facilitated online methodology to determine the optimal design structure for an e-detail based on doctor feedback and the speed with which doctors find information.


    In the online study, 84 doctors were shown wireframe templates of potential e-detail layouts (template 1 contained three key messages; template 2 offered menu navigation and prioritised key messages; template 3 provided menu navigation, and template 4 was a linear 'click through'). Participants were asked for their preferred layout based on certain criteria such as ease of use, design, and simplicity. The content was presented as data only and did not involve webcasts (or other rich media). The doctors were invited to indicate their favourite and their second-favourite template based on how they would most like to receive information online. Responses were submitted through an online form and results were collated.


    Of the 84 doctors, 62 chose template 3: menu option as their most, or second most, preferred layout, making this the clear winner. With two points awarded for a first choice and one point for a second choice, the final rating was template 3: menu navigation in first place with 90 points, followed by template 2: menu navigation and prioritised key messages with 69 points, template 1: three key messages with 47 points and finally template 4: linear 'click through' with 45 points.Doctors stated that they felt template 3 was clearly laid out and that the left hand navigation showed exactly where to go to get the required information. It was also seen to demonstrate good use of space and the top buttons were popular. In addition they felt that the headings were obvious and the fact that they could choose where to go, among other things, was appreciated.

    Below is a sample of template 3 - Menu navigation





    Template 3: menu navigation prove to be the most popular choice in the online study, it also proved to be the most efficient format for finding information quickly, with the tasks being performed more than twice as quickly as with templates 2 and 4. Based on their speed, they also got to the information they wanted the quickest using template 3.



    Template 4: the linear 'click through' model was the least popular with doctors in both studies.


    Recommendation to companies wishing to engage with their target doctors using email / epresentations in 2009 would be to use the Left menu navigation approach.


    Related articles



    Hospitals as Lean machines !



    Lean means creating more value for customers with less resources. Starting with Toyota in Japan, Lean methodologies are being increasingly stressed upon all industries, and health care is there too, with a few important caveats.In the current international scenario, All healthcare institutes are following some, if not most, strategies to improve quality and streamline its activities without wasting resources. The percieved value of care and cost is ingrained in a lot of minds, and its difficult to convince people that healthcare quality can be maintained without overspending and overstaffing.


    Healthcare services are complex processes which involve diverse professional skills, varying patient needs with cutting edge technologies. Variation and Non-value added activities are inherent on the process. Lean can assist healthcare providers in reducing costs, improving service levels and increasing value but must do so without compromising quality of care, compliance, brand, patient safety, or conformance
    Interviewed by Modern Healthcare reporter Jean DerGurahian, Delnor ommunity Hospital, Geneva, Ill., executives discuss Lean methodologies that they say have helped the facility find cost savings, improve processes and increase satisfaction. Tom Wright, president and CEO, and Jim Kearns, chief information officer, say that organizational changes like Lean will become crucial to hospitals as they face continuously shrinking reimbursements and an unclear path to healthcare reform.

     

    The Iowa Healthcare Collaborative brings health care services closer to the people, urging them to take charge of their treatment. The Iowa Healthcare Collaborative (IHC) is a provider-led and patient-focused nonprofit organization dedicated to promoting a culture of continuous improvement in health care.  

     

     

    Also check The Institute for health care improvement on  IHI website 

     


    Here are also a few articles by Lean management consultancy, VIP Group.
    So lets stand up and take charge.




    Sep 9, 2009

    Technology based learning in Medical sciences

    healthcare IT

    Internet based training has been adopted in a number of disciplines but for some vested interests, not much progress has been made in the Medical field. Reasons given for this hesitation range from constructive real doubts (Will it teach them all the nuances they need to know?) to manipulative self doubts (what if the students don't need me anymore?).Not too many of the Teachers realize that these tools are to assist them in grooming future doctors, and not to replace them in the system. The last time any major breakthrough was achieved in education was when oral teaching was supplemented by printing of books. I can only imagine the astonishment and resistance the teachers of that era would have expressed on realizing that students could get information in their absence, too!! "Stop printing Books!", they said, " It will poison the minds of our students. And anyways, what can some ink on paper teach a student without having heard the same thing from a Guru"s mouth?". But very soon we had the same gurus jostling to publish their own books and integrate those into their own evolving didactic styles. Use of internet in education is probably the single most beneficial addition to education after Printing press.


    A study led by a team of education researchers from Mayo Clinic and recently published in the Journal of the American Medical Association concludes that Internet-based education generally is effective.The study was conducted by David Cook, M.D, and Denise Dupras, M.D., Ph.D., Patricia Erwin, and Victor Montori, M.D., all of Mayo Clinic; and Anthony Levinson, M.D., and Sarah Garside, M.D., Ph.D., from McMaster University.


    "The research also showed that Internet-based instruction compared favorably to traditional instructional methods... confirm that, across a wide variety of learners, learning contexts, clinical topics, and learning outcomes, Internet-based instruction can be as effective as traditional methods." Dr. Cook notes that Internet-based instruction has unique advantages, including flexible scheduling, adaptability of instruction, and readily available content that is easily updated. "As health care workers balance challenging practice demands, the ever-expanding volume of medical knowledge requires us to find more effective, efficient ways to learn," says Dr. Cook. "Internet-based instruction will be an important part of the solution."


    News report on Eureka alert


    This is not the first report which says this, and this definitely wont be the last. Private players in India, like MEdRC Edutech have taken a bold lead in creating computer based medical e learning content and LMS, but with so much resistance in the higher places, it seems like a long war ahead for CBT pioneers in medicine.




    Related articles-
  • Twitter in Health care (medical-communication.blogspot.com)


  • Impact of EHRs on Medical Education (thehealthcareblog.com)


  • Technology based learning in Medicine? You wish! (meducationtechnology.blogspot.com


  • Sep 8, 2009

    13th Annual Healthcare Internet Conference


    The 13th Annual Healthcare Internet Conference takes place November 2-4, 2009 at Caesars Palace, Las Vegas, NV. The conference is presented by the Forum for Health care Strategists and sponsored by Greystone.net and Staywell Custom Communications. The program includes-

    • 30 Best-Practice Case Studies
    • Sessions on the Use of Personal Health Records, Patient Portals and Integration with EMRs including two special sessions on: NewYork-Presbyterian Hospital’s use of Microsoft’s Health Vault & Lucile Packard Children’s Hospital’s use of Google Health
    • Sessions Highlighting the Effective Use of Social Media
    • Sessions on How to Measure and Report ROI
    You can also join their community portal here.

    Conference details http://www.healthcarestrategy.com/conferences/2009/TECH2009.asp.

    From the look at the stated interests of all participants, it seems that social media is on the top of everyone's radar

    • Make your reservations by Friday, October 2, 2009.
    • You can register online Here.


    Aug 31, 2009

    Web 2.0 in health

    A tag cloud with terms related to Web 2.

    With increasing avenues for communication and knowledge dissemination, the practice of health care is changing faster than imagined. Free services like you tube, face book, Wikis, blogs, Twitter, social networks eg. Patientslikeme and a host of other services provide a health consumer with ample information and opinions. No longer is a patient forced to blindly trust his doctor"s judgment. The patient can easily search for more opinions, review personal experiences of friends and strangers plus the latest research studies in the field. This has changed the role of a Doctor to one of facilitator of health, rather than the unquestionable saviour .

    E-Health insider has come up with a 108 paged report titled ‘Web 2.0 in the Health Sector: Industry Review with a UK perspective’. {£575.00 (inc VAT)}





    The report argues that e-health 2.0 will first and foremost be consumer-led. Health is consistently one of the most searched for subjects online. The application of web 2.0 technologies into health is already challenging traditional doctor-patient relationships and beginning to place far greater power in the hands of consumers. These changes are likely to be rapid and may prove highly disruptive. Further, it concludes that new applications based on social health networks and content generated by health service users themselves - such as reviews of doctors and hospitals – will rapidly evolve to challenge existing healthcare systems and create new ways of delivering healthcare.
    The profiles provide a snapshot of innovation across healthcare: from organisations providing online communities for patients with specific conditions, tools for chronic disease management, sites that enable patients to rate the quality of care they receive, together with tools to enable clinicians to better search for and share research data.
    No doubt Web2.0 has changed the game, bringing about a total rethink in long established practices.But this is just the beginning.


    With Web3.0 and Personalized Medical services like Webicinia and 23andme , internet technologies are bound to change the rules of health care for ever.






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    Aug 24, 2009

    Using iPhone as CDSS




    Technology use has made the practice of medicine more accurate and more precise.One important feature has been knowledge management, in a way to achieve clinical advice for patient care based on number of items of patient data. Broadly called CDSS - Clinical Decision Support systems

    "Clinical Decision Support systems link health observations with health knowledge to influence health choices by clinicians for improved health care"
    The latest such application (pun intended) is eRoentgen™ for iPhone. It helps doctors order the most appropriate radiology test for their patients based on a diagnosis, sign or symptom.


    eRoentgen Radiology DX 1.0- Size:- 1.6 MB
    Physicians and other healthcare professionals use eRoentgen™ to choose the most appropriate imaging study for a selected diagnosis or symptom. The eRoentgen™ quickly and easily improves patient safety and the quality of the imaging workup.It is extremely useful in locations which do not have a radiologist to guide a general Physician regarding the most appropriate imaging test to be ordered for further work up of any patient. It reduces wasteful and needless tests, and also improves diagnostic accuracy.

    This app can be purchased online or via the iPhone apps store.Priced at $49.99.
    This app gets my Vote, for sure.

    In addition to eRoentgen™ for iPhone, iAtros is in the process of developing applications for a variety of mobile devices.




    Aug 10, 2009

    Special Interest Group -SIGGRAPH 2009

    SIGGRAPH 2009 is over.(Conference: 3-7 August (Monday through Friday) and Exhibition: 4-6 August (Tuesday through Thursday).
    It was sponsored by The Association for Computing Machinery (ACM), an educational and scientific society uniting the world's computing educators, researchers, and professionals to inspire dialogue, share resources and address the field's challenges.Its one of the best scientific animation/hypermedia/multimedia platform in the world.
    ... to stimulate communication and growth, and foster the fusion and mutual inspiration of science, art, and technology.




    It was full of galleries, competitions, events, presentations, Papers and exhibitions. A real feast!
    We @markivmedcom / @LastMohican hope to participate the next time round. (2010). Here are Two interesting Interfaces which surfaced in SIGGRAPH 2009.

    • 1) Immersive 3D plus Virtualization to let you move freely in Virtual world- A team from INRIA and Grenoble Universities in France (will) demo a new virtual reality system called Virtualization Gate.


    Virtualization Gate that tracks users' movements very accurately using multiple cameras, allowing them to interact with virtual objects with new realism.A user wears a head-mounted display (HMD) and moves through a virtual space while several cameras track his movement. The video here shows a guy kicking over virtual vases and pushing a virtual representation of himself around. A cluster of PCs is needed to perform the necessary image capture and 3D modeling.

    MxR works with USC’s Institute of Creative Technologies and the Interactive Media Division at the School of Cinematic Arts. ICT projects create and analyze immersive systems for education and training simulations that incorporate both real and virtual elements. IMD projects push the boundaries of immersive experience design and alternative controllers. The VRPsych Lab and Graphics Lab at ICT are frequent collaborative partners.

    HeadSPIN: A One-to-Many 3D Video Teleconferencing System from MxR on Vimeo.

    The MxR at the University of Southern California rapidly prototypes and explores techniques and technologies to improve the fluency of human-computer interactions and create visceral synthetic experiences.


    Aug 3, 2009

    Top 9 e-quipped Hospitals in India

    188px-India_(orthographic_projection).svg


    The Cybermetrics Lab recently published their world ranking of hospitals, taking into account the instituion"s activities in field of e-knowledge and their use of digital media for communications.
    Supporting Open Access initiatives, electronic access to scientific publications and to other academic material are our primary targets...The Web covers not only only formal (e-journals, repositories) but also informal scholarly communication.


    The Web indicators measure electronic contents, especially those used for scholarly communication, but also basic information about the hospital, its organization, services and personnel. The rank takes into account both the volume of information published and the impact or visibility of such contents measured by the number of external links the web pages receive from others. As expected, about 45 % of top 200 and 38% of top 1000 hospitals are situated in North America.




    The Laparoscopy hospital at N.Delhi is the only Indian hospital to figure in the top 100 hospitals from Asia ( 47/100, Asia), and also the only Indian hospital in top 500 worldwide. Amongst the others, Sir Gangaram hospital scores much better than Apollo and Tata Memorial.

    L.R.S Institute of Tuberculosis and respiratory diseases records a very enviable world rank of 19, in number of papers and citations visible on Google Scholar., a noteworthy list headed by The Institute of Cancer Research, London.
    Below is the list of 9 hospitals from India in the first 2000 worldwide , and their world rankings ( as per Cybermetrics Lab).








    POSITION


    WORLD RANK HOSPITAL
    SIZE VISIBILITY RICH FILES SCHOLAR


















    Jul 30, 2009

    HIPAA compliant mobile consultations for Doctors




    Finally, a commercially available intelligent system to allow all physicians to provide consultations from anywhere, simply through a Blackberry ( or any other smartphone, but not an iphone !?! See Comment 1).

    The mVisum Medical Communication System is a communication tool that allows medical professionals to securely receive, review and respond to patient data recorded at the point of care.

    Security-
    mVisum uses multiple levels of security and authentication to ensure HIPAA compliance. The handheld requires unique username and password for each physician, which is then authenticated by the server against the IMEI number and phone number. Data transmission between the server and the handheld is carried out through a patented double encryption system, where the data is first scrambled, which is further delivered through a 128 bit encrypted pipeline, each step individually meeting or surpassing HIPPA requirements. The sending console to server communication is also similarly architected, thus providing strong security end-to-end.

    Types of Data Transferred include-
    • DICOM Images - loss-less representation of the original file, with Zoom capabilities.
    • CT Scan
    • MRI
    • EKG
    • Cine Loops
    • X-Rays
    • Free text

    The system has advanced technology that allows the system to be availability aware,so that another physician can immediately be contacted if the original intended physician is unavailable.Once received, the physician can review data and securely respond with medical opinion, prescription or other critical orders. Real Neat, eh?

    View more news videos at: http://www.nbcwashington.com/video.




    mVisum System - http://www.mvisum.com/index.php





    Jul 22, 2009

    Your cell phone is your ( doctor's) best friend.

    Microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases.It is an essential tool in disease diagnosis and widely used all over the world. Unfortunately, the EXPERTISE required to use the tool, and to evaluate the findings is not very common. One requires a pathologist with many years of experience to make sense of those seemingly random and confused pixels. (I know, i am a pathologist :-)

    It takes a lot of effort, and money to train a pathologist, equip him/her with all the instruments required, and then use the skills in a backward area without proper facilities. But the advent of digital imaging has solved many of our troubles. Telepathology made sure that we do not need a pathologist physically present at the site, to render a diagnosis.

    But microscopy and digital imaging of the biopsy/tissue fragment was still a hassle. Now we have done better. You don't even need a microscope to send a microscopic image over the network!! Researchers from the Univ. of California worked with high-powered LED – which retails for just a few dollars – coupled with a typical camera phone to produce a clinical quality image sufficient for detecting in a field setting some of the most common diseases in the developing world.




    The newly developed technology, CellScope, allows for average cell cameras to be retrofitted with powerful microscopes, able to detect malaria parasites, and even fluorescent marker-stained tuberculosis bacteria.
    Thus you have your humble cell-phone transformed into the sherlockian "cell-scope".

    “The images can either be analyzed on site or wirelessly transmitted to clinical centers for remote diagnosis. The system could be used to help provide early warning of outbreaks by shortening the time needed to screen, diagnose and treat infectious diseases,” University of California in San Francisco (UCSF)/UCB Bioengineering Graduate Group graduate student David Breslauer adds. CellScope could also provide remote access to digitized health records, and would be amenable to epidemiological studies, using triangulation or global positioning system location data, such that outbreaks could be monitored as they happen.



    So maybe i could click a photomicrograph of that mole on my friend"s forearm, twitter it to my onco-pathologist friends, who view it on their smartphones and twitter / message their diagnosis back to me. Simple and fast, especially with my own group of pathologists on the network.


    Jul 1, 2009

    Physiology of Propofol drug abuse

    Is Propofol, or Diprivan what Michael Jackson Used for ( Drug) Abuse ?

    According to Cherilyn Lee, a registered nurse who operates a Los Angeles-based nutritional counseling business, in California, “Jackson was complaining of insomnia and pleaded for her to get him some (Diprivan)". Other reports claim Propofol was recovered from his residence. This conversation reportedly occurred in April of this year. Preliminary reports say that M.J died of cardiac arrest, which is within the possible effects of unmonitored Diprivan use. (A rapid bolus injection can result in undesirable cardiorespiratory depression including hypotension, apnea, airway obstruction, and oxygen desaturation.)

    Diprivan is a general anesthetic, used to start or maintain anesthesia during certain surgeries, tests, or procedures. It is available in a white vial of 20, 50 and 100 ml (containing 10mg/ml.).Most adults require 2 to 2.5 mg/kg of the drug ( approx. 10 ml). DIPRIVAN Injectable Emulsion is an IV sedative-hypnotic agent and can cause potentiation of other narcotic drugs and benzodiazepines when used together. The most common side-effects include Change in mood or emotions; dizziness; drowsiness; lack of coordination. It is given intravenously, usually within the operation theater or in a clinic. It has a rapid onset of action ( less than 1 min) and short duration of action (approximately 10 min but is dose dependent).It has direct cardiodepressant effects, leading to decreased blood pressure and heart rate in higher doses. Its actions causing decreased heart rate and respiratory rate mean that use of propofol is done only under continuous monitoring of vital signs.Diprivan is not meant for use in pediatrics and elderly population since its safety has not been established in these populations. Prolonged use of propofol results in accumulation of the drug in body tissue and increases the duration of action as well as chances of overdose.

    Rarely, Cases of death due to propofol have been discussed in medical literature. All these cases have occured in hospital settings only.It is definitely not meant for home use and this is the first time I have heard of Diprivan being used as a drug of abuse outside hospital settings.

    Euphoria, sexual hallucinations and disinhibition have been described on recovery of propofol anaesthesia. These effects could explain the recreational use of the drug. Moreover, several experimental studies strongly suggest the potential for abuse and dependence on propofol,and few cases of abuse and dependency have been described, mostly in medical professionals. As propofol is generally not recognized as a substance of abuse, and because of its safe profile, it is important to remember that rare adverse reactions of propofol could produce death in a context of abuse, even at therapeutic dose range, in the absence of ventilatory and medical assistance.

    British Journal of Anaesthesia 2006 97(2):268; doi:10.1093/bja/ael168

    Jun 15, 2009

    Catching Health consumer"s attention online

    A large number of people are increasing turning to the internet for their information needs. But when it comes to online activity, everyone has a short attention span. Garnering potential audiences for medical content websites, and then retaining them is a big challenge. How do websites and other applications draw and hold consumers for long-form media like podcasts and video-downloads?


     As per Alexa ranking for two years, WebMD beats all other competition hands down, followed by everydayhealth.com. All others fare way behind these leaders in daily reach.



    The important issues identified for such patient or consumer centric multimedia medical websites are,

    ---high.quality.content
    --- Accuracy
    ---Individualization tools
    --- Good medical imagery
    ---
    short 2 minute animation /user experience videos.

    Below are quotes by a few top online medical/patient education resources.


    Nan Forte EVP, consumer services, WebMD - (The WebMD )content staff blends award-winning expertise in medicine, journalism, health communication and content creation to bring you the best health information possible. Our esteemed colleagues at MedicineNet.com are frequent contributors to WebMD and comprise our Medical Editorial Board. Our Independent Medical Review Board continuously reviews the site for accuracy and timeliness. # Health news for the public,Creating and maintaining up-to-date medical reference content databases,Medical imagery, graphics, and animation, Communities, Live web events, User experience, Interactive tools

    More consumers visit WebMD than any other health site in search of health information. Our editorial and programming teams work closely with our product and technology groups to create the appropriate balance of compelling content together with an engaging user experience. The high level of user engagement on WebMD can be attributed to the high degree of personalization combined with the mix of sight, sound and motion across our network. For example, video is presented as part of the integrated user experience. In the past year alone, we've seen an increase in the way consumers are interacting with long-form media. We credit our programming expertise and the fact that many of our visitors are engaged information-seekers who will take time to engage in relevant programming.

    Michelle Johnson Manager, pharmaceutical public affairs, Abbott -(The podcast series shares insights and tips from health professionals regarding diet and nutrition, the emotional impact of the disease and its effect on relationships. Each Crohn’s Cast also includes a first-hand account from a person living with Crohn’s disease.)

    Abbott's decision to create its “Crohn's Casts: Speaking from the Gut” series was about addressing the needs of patients by combining the right online tools with relevant topics. Each of the podcasts is under five minutes and shares insights from health professionals regarding diet and nutrition, the emotional impact of the disease and its effect on relationships, and accounts from people living with or impacted by Crohn's disease. CrohnsOnline.com is a site dedicated to people with Crohn's disease, a gastrointestinal disease that often strikes between ages 15-35. Since 50% of people with chronic diseases go online to find healthcare information, a podcast was a simple, creative vehicle for this young and web-savvy group.

    David Best, President, The Doctor's Channel- (site includes short one- to two-minute streaming video clips designed to get to the point, with insights and opinions from experts in 35 different specialties, as well as community and lifestyle features that help doctors stay on top of the latest news, ideas and information.)

    Ihave found that the best way to draw and hold consumers is to sell them on the idea of shorter content that is packed with more information. The world is media snacking, getting their information in bite-sized bursts. Here at The Doctor's Channel, we have decided that our best chance to grab the attention of the medical community is not to fight the urge for media snacking, but rather to embrace it. We offer the same content you would find in an 8-minute video, but we provide it in four segments, each 2 minutes long. More often than not, people end up watching all four segments anyway. So consumers end up viewing 8 minutes of content, but because it is presented to them in smaller doses, they are more engaged. But remember, no matter what the “dose,” interesting content is paramount!

    Marjorie Martin SVP & general manager, Everyday Health Network - (..help you manage your own and your family's conditions and overall well-being through personalized advice, tools, and communities)


    Online health users have a reputation for being impatient; however, it may be because they're not finding what they need. Internet users are generally in search of answers to specific questions as opposed to casual browsing. When they find relevant content they stick with it. Audio and video perform best online when they're specific to a condition and use the visuals and audio to provide important information. For instance, someone in search of content on weight loss surgery is more likely to view animation of the procedure and an interview with a former patient (including visuals of the scar) than watch video of two doctors sitting in a studio talking about it.

    Based on a December ,2008 article in MMM-Online.com

    Related article
    Medical Animation- How is it Used ? (medical-communication.blogspot.com)

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