We need more doctors online

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having been online, blogging and doing other social media, it has become increasingly clear to me that I need to be there—and that more doctors need to be there with me.


The main reason? Because that’s where the patients are.


We need more doctors and other health professionals writing good content, but getting online doesn’t necessarily mean writing. It could mean finding good websites and sharing them. It could mean commenting when we see something that we agree with—or don’t. It could mean engaging in one of the many conversations going on in social media about health.


It seems like most of the conversation about doctors being online involves concern about ethics and professionalism. I admit that I’ve seen some stuff on Facebook and Twitter that has made me cringe, and clearly it’s not a good idea to give specific medical advice online (nothing can replace a good history and physical examination). But this is all manageable.


Dr. Katherine Chretien did a study of Tweets sent by doctors and found that only 3% might be considered unprofessional, and less than one percent had any private patient information. Overall, these are small numbers. As my doctor-blogger colleague Wendy Sue Swanson says, we are way worse on elevators than we are online. It’s easy enough to come up with guidelines and education to help doctors navigate the online space ethically, professionally and safely. Another doctor-blogger friend of mine, Bryan Vartabedian, who writes a great blog called 33 Charts, has some really good ideas about this, including a recent post about how he handles online questions from patients.



See on childrenshospitalblog.org


Could Hackers Create Spyware To Steal Passwords From Your Brain?

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Just in case you felt there weren’t enough ways for people to try and steal your passwords and online identity, researchers have imagined security breaches through theoretical brain-hacking. It’s not that far-fetched, either.


An increasing number of so-called EEG devices that record electrical activity along the scalp are becoming available for computing, allowing users to interact with computers with the help of their own brainwaves. And scientists at the Universities of Oxford and Geneva are looking into whether a “brain spyware” app could be developed for EEG devices that might steal your passwords and pins.


The researchers focused on the P300 signal, which is usually emitted when you recognize something with meaning. By monitoring the signal while EEG-wearing test subjects looked at ATM numbers and bank cards, researchers trying to extract the numbers with software could reduce the program’s random guessing by 15 to 40 percent. That’s a long way from hackers knowing your grocery list—but it’s a step closer to them cracking into your head. Perish the thought!

See on www.slate.com

Reaping the Rewards of a Mobile Health Environment

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As the mobile world continues to open new opportunities in all aspects of life, physicians, like all of us, know that they will come to rely more on these devices to practice, communicate and collaborate.


Clinicians and practice leaders continue to embrace the devices in the care setting, and they expect practices to allow them in their work. When technology delivers upon its promise and actually makes life easier, it is obviously going to be supported and used.


Patients are not the only ones who will become more engaged as mobile devices continue to infiltrate healthcare; physicians, too, are reaping the so-called rewards.


As the debate continues to rage about the efficiencies created when EHRs are used in a practice setting, there seems to be little argument as to whether tablet PCs, smart phones and even applications like Skype actually improve the business of communication and interaction with patients and their physician partners and physicians with their colleagues.


A physician whom I very much respect, Dr. David DeShan, is one such physician who communicates with patients and colleagues via Skype from his mission outpost in Moscow, Russia.


Spending weeks at a time in Russia each year, he also maintains his status as a partner and practicing physician at a growing OBGYN clinic in Midland, Texas. As an early adopter of the virtual visit, DeShan is able to maintain contact with his patients if they need a consult, and he’s also able to maintain his connection to his practice so he can check labs, review diagnosis and provide counsel to his practice mates should they request it.

See on electronichealthreporter.com

How video observation can improve health IT efforts

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Danish research reviewing nine case studies using video observation argue that the method can be an effective tool for understanding clinical practice. And understanding clinical workflow, the study’s authors say, can be integral to improving health information technology development.


While traditional study methods ask what clinicians say they do during their daily work, they don’t always include all of their actual activity because some aspects of a job become second nature. Video, in this regard, can capture their actual practice–even those tacit aspects of the job–according to the research article published at BMC Medical Informatics & Decision Making.


The nine case studies, videotaped in various hospital wards, took place between 2004 and 2011. They were varied–one detailed the medication process in a cardiology department, while another sought to understand, from clinicians’ views, the implementation of an electronic health record system by chronicling their work before and after.


Video observation, can be useful in four ways, according to the researchers:


Informing and improving system design;
Studying changes in work practice;
Identifying new potentials;
Documenting current work practices.


See on www.fiercehealthit.com

EHR Systems Should Be Taking Larger Strides, But Aren’t

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When your child takes that first step, wild excitement ensues. The phone lines light up. You spread the news to the grandparents, aunts, and uncles. It makes no difference that they fall after the second step, the milestone is noteworthy.


A similar phenomenon occurs the first time many people succeed in doing something with a computer.

Whatever was accomplished takes on magical properties and many feel an irresistible urge to spread the good word; they proselytize others to join their cult of their newly embraced computer/software belief system. Neither the computer nor the hardware can do any wrong. It can crash, freeze, loose work, consume hours of you time as you apply updates, and reboot and reboot yet again. All is forgiven. Your willingness to glory in a stumbling child or and unreliable computer system does not alter the fact that the child is not ready to walk on their own or that the computer is not ready for mission-critical applications.


Why worry about this? Two reasons come to mind. First, the country has a lot riding on the expectation that today’s computer systems are more reliable and capable than they really are. Second, I believe that it is possible to do better. If it were not, then our only option would be to continue business as usual — live with the interruptions, lost work, errors and outages, and institute manual fail-safe procedures that attempt to detect critical errors, omissions, and failures and correct them.

See on member.ubmmedica.com

Censoring or Regulation by the FDA & how much is hype?

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Medical apps are not necessarily medical devices. The FDA only want to regulate those that are, but guidelines are various shades of gray.


There has certainly been a lot of hype lately (as in “Extravagant or intensive publicity or promotion”) about the role the FDA will have in regulation of medical apps for mobile devices. The draft guidance put out by the FDA on mobile medical apps (document 1741) at first seems very straight forward, but gets a bit more ambiguous the more you look into it.

Now I realize this is just “guidance”, but there are some potential implications to consider. Last year, a study came through our IRB that looked to implement the use of an iPhone app. While I won’t disclose the details of the study, I will say there was a bit of an urgency to read and better understand the guidance from the FDA for medical apps. As many researchers know, if they are using a tool or piece of equipment in their research that meets the definition of a “medical device” then it must be regulated by the FDA (Title 21 CFR). Their definition of a device is below and can include anything from a simple tongue depressor to a sophisticated robot that conducts surgery:

“an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is:

– Recognized in the official National Formulary, or the United States Pharmacopoeia, or any supplement to them

– Intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or,

– Intended to affect the structure or any function of the body of man or other animals, and which does not achieve any of it’s primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes.”

See on medicalappjournal.com