Jan 29, 2010

Preventing hospital acquired infections

Hospital acquired Infections, opaquely called 'Iatrogenic" infections, are a major cause of morbidity and mortality. It has been estimated that such infections in hospitalized patients increase hospital stay by 4 to 5 days, resulting in extra expenditure of billions of dollars. A Center for Disease Control (CDC) report published in March-April 2007 estimated the number of U.S. deaths from healthcare associated infections in 2002 at 98,987.According to the World Health Organization, “At any given time, 1.4 million people worldwide are estimated to be suffering from an infection acquired in a health facility. The risk of acquiring healthcare-associated infections in developing countries is 2-20 times higher than in developed countries".Proper aseptic techniques and strict following of all protocols can drastically cut down this "needless" infection rate.

It is important that the latest guidelines on proper infection management are known to all medical personnel. The "Not on my watch" campaign by Kimberly-Clark Corporation in association with other organizations has developed haiwatch.com, primary source for healthcare professionals for information on the fight against preventable healthcare-associated infections (HAIs). On the site, you can find guidelines and protocols for aseptic precautions in hospitals.

The "Not on My Watch" campaign also provides accredited continuing education (CE) programs based on best practices and guidelines as well as research available on reducing the incidence of healthcare-associated infections.

So, if you need to refer to recent reports, news items, guidelines, articles, etc. on Hospital acquired Infections, head to haiwatch.com

Jan 28, 2010

eBook formats for medical literature



EBooks are here to stay, and are changing the way Medicine is studied. The sheer volume and weight of Medical literature makes it the ideal candidate for 'Whole batch" conversions to an eBook readable format.

The Mobipocket file format is a binary format for the distribution of eBooks. It is one implementation of the Open eBook Publication format with a number of proprietary extensions. The Open eBook Publication format is developed and specified by the IDPF (International Digital Publishing Forum) an independent organization formerly known as the Open eBook Consortium. As a consequence, the Mobipocket format is based on HTML and is reflowable. Mobipocket supports most features of standard HTML to format and layout text and images.


A few other noteworthy formats include EPUB and Fictionbook. Kindly note that i have not considered any of the non-Open standards.

The .epub or OEBPS format is an open standard for e-books created by the International Digital Publishing Forum (IDPF). Currently, the format can be read by the Apple iPad, Barnes and Noble Nook, Sony Reader, BeBook, Adobe Digital Editions, Lexcycle Stanza, BookGlutton, AZARDI, Aldiko and WordPlayer on Android. Several other reader software programs are currently implementing support for the format, such as dotReader, FBReader, Mobipocket, uBook and Okular. Another software .epub reader, Lucidor, is in beta. Notably, Kindle still does not support this format.

The Kindle supports Mobipocket file format, PDF file format, Amazon's proprietary DRM-restricted format (AZW), as well as the PRC and the TXT formats. 

Eveda format is used for Multimedia EBooks.The 'multimedia eBook' term is used in contrast to media which only utilize traditional forms of printed or text book. Multimedia EBook includes a combination of text, audio, still images, animation, video, and interactivity content forms.

My Choices for Medical Literature ?- At present, it is PDFs and Mobi, besides EPUB.

Waiting for a suitable multimedia enabled file format, with annotation and bookmarking support.

Images- Wikimedia Commons.

Related articles

Jan 27, 2010

Just what the Doctor requires- an "iTablet" !


Apple Inc - Photo from my iBook




Apple has created many Gadgets/ applications which have changed the face of health care. The apple "iTablet", when it does come out, could be another such device.
(They called it "iPad" !)

For years, efforts have been made to integrate the use of Tablet PCs in Hospitals. Conventional laptops are just too bulky/big to carry during clinical rounds, and most hand held devices almost "actively" resist being "button-punched". :-)

The much awaited "iTablet" may just be what the Doctor requires!

Take a look at a few of Apple"s e-Health friendly offerings, (via ReadWriteWeb.com)


Mobile Health Momentum
The iPhone has already changed the face of healthcare. Apple shared this fact at last year's iPhone OS 3.0 release and within the keynote at WWDC. The momentum that started with consumer applications has moved to forward-looking doctors and health providers. We know that it is becoming common practice for some doctors and nurses to carry both their company-issued Blackberry and their personally purchased iPhone.

There are already amazing applications in the market. AirStrip allows doctors to monitor patient vital signs and receive alerts from afar. There are now personal health records that can be carried and updated from anywhere.

Additionally, there are information-rich applications that allow nurses, doctors and patients to look up health information in real time. Last week during the Haiti tragedy, an injured individual was able to use an iPhone to treat himself using an first aid application on the iPhone.

Clinician Ready-
Apple and EPIC systems have been collaborating to release the first version of MyChartManager on the iPhone. EPIC is a leading provider of EHR in the United States, and powers systems such as Kaiser Permanente and Palo Alto Medical Foundation in the Bay Area, to name a few. The application, named Haiku was released on Jan. 13, 2010, and several health systems are in the process of testing it. It's a clear contender for the "killer app" in the hospital setting. Looking at the screenshots, it's clear that more screen real estate would be ideal - which means it may be just the right time for an iTablet-like device to emerge on the market.

It's the Apps
It is nearly certain that iPhone OS 4.0 will create a path for existing applications to "upsize" to a tablet device, and this includes size. The medical category today is already the highest-aggregate-priced category on the App Store today, and with the promise of applications inside the clinical walls, the opportunity gets much larger.

The iPhone-to-tablet combination may be the biggest reason that a tablet is successful in the market, since the entire iPhone developer community will be able to deliver on this new platform. With Apple's success in having an integrated OS that shares core libraries across both the Mac and iPhone, it is likely that a table device will also connect with apps from both the iPhone and the Mac.

Jan 13, 2010

W.H.O and Big Pharma cooked up the "Swine-Flu Scare"?




Eminent doctors are now coming out openly with comments on the alleged "Swine-Flu-pandemic conspiracy". Dr Wolfgang Wodarg, an epidemiologist, claims the WHO was persuaded to change the definition of 'pandemic' by scientists linked to pharmaceutical companies in order to trigger lucrative 'sleeping' vaccination contracts. The accusations are to be investigated by the Council of Europe after Dr Wodarg, the chairman of the body's health committee, tabled a damning resolution. Dr Wodarg claims the WHO "in cooperation with some big pharmaceutical companies and their scientists re-defined pandemics and lowered the alarm threshold" so that governments would begin to order vaccines. In fact, at one time , the WHO warned against preventive anti-virals thus leaving a free field for Vaccines.



GlaxoSmithKlein is estimated to have made $1.7 billion from sales of H1N1 vaccine sales in the fourth quarter of 2009 alone. Lower than expected uptake of the vaccine has led to a huge oversupply, to the extent that France, Britain, Germany and the Netherlands are all attempting to sell or give away surplus shots - or cancel orders, where possible.


Quite apart from the cost implications to already stretched national health budgets, if Dr Wodarg is right, then millions of healthy people have been, as he puts it, "unnecessarily" exposed to "the risk of poorly tested vaccines" for a flu strain that is "vastly less harmful" than all previous flu epidemics.


Jan 12, 2010

Increase in EHR / EMR use, CDC study says

Sample patient record view from VistA Imaging







EHR use is slowly but surely inching ahead. 

Healthcareitnews.com reports that four of every 10 office-based physicians use electronic health records, according to 2009 preliminary estimates by the Centers for Disease Control and Prevention..The estimates are based on the CDC's National Ambulatory Medical Survey (NAMCS), an annual nationally representative survey of patient visits to office-based physicians that collects information on the use of electronic medical records or electronic health records.

According to the estimates for 2009, 
  • 43.9 percent of physicians reported using full or partial EMR/EHR systems (not including systems used solely for billing) in office-based practices. 
  • About 20.5 percent reported having systems that meet the criteria of a basic system, (A basic system is defined as having patient demographic information, patient problem lists, clinical notes, orders for prescriptions and viewing laboratory and imaging results)
  • 6.3 percent reported using a fully functional system.(these include include medical history and follow-up, orders for tests, prescription and test orders sent electronically, warnings of drug interactions or contraindications, highlighting of out-of-range test levels and reminders for guideline-based interventions.)

The survey indicates that from 2007-2008, physicians' use of any EMR system increased by 18.7 percent and the percentage of physicians reporting having systems that meet the criteria of a basic system increased by 41.5 percent.

 Related articles



Jan 4, 2010

Healthcare in early 21st century





Healthcare in the 21st century faces many challenges. Optimum integration of communications technologies can dramatically improve access to quality health care.Services can be made available to almost anyone, at any time, at any location. Besides traditional health service outlets, locations as varied as retail stores, community centers, office buildings, hotels, shopping malls, rural outposts, and homes can become effective care-delivery points.


Cisco HealthPresence is a new concept developed by the Cisco Internet Business Solutions Group (IBSG) and prototyped at the Cisco Technology Centre. Using the "Advanced technologies" network as a platform, Cisco HealthPresence combines state-of-the-art video, audio, and medical information to create an environment similar to what most people experience when they visit their doctor or health specialist.

Jan 2, 2010

Demystifying HL7






HL7 was founded in 1987 to produce a standard for hospital information systems.It was accredited in 1994 by the American National Standards Institute (ANSI). HL7 standards specify a number of flexible standards, guidelines, and methodologies by which various healthcare systems can communicate with each other. Such guidelines or data standards are a set of rules that allow information to be shared and processed in a uniform and consistent manner. These data standards are meant to allow healthcare organizations to easily share clinical information.

This is a simple explanation using fun animation explaining how HL7 works.