Monday, July 30, 2012

Implementing New Technology at Your Site

My primary care physician, the last time I was in for a checkup, had not adopted ePrescribing or started using an electronic health record (EHR). My understanding is that the medical group to which he belongs had not rolled out these capabilities to him yet but was planning to do so. Hopefully, this summer when I see him again he will be plugged into the electronic health record that the group is adopting. Although he may not be happy about having to adapt to this new way of working, I will be happy because it provides another layer of safety for me as a patient. For instance, the risks of miscommunication between my doctor and my pharmacy will be greatly reduced. From my experience as a quality and productivity expert, I know that there will be many benefits for his practice group. As the American Medical Association has shown in a white paper my physician may not be spending much less time handling prescriptions, but his office staff surely will. Overall, there will be a significant gain in productivity and safety for the office.
After examining this example of the adoption of technology at my physician's office group I recognize several challenges that the group faces, many of which are common to any enterprise adopting new technology faces, including not just healthcare providers but also small businesses and nonprofit organizations:
· Will the new technology increase productivity?
· Will there be a positive return on investment?
· Will the new technology improve patient safety?
· If the technology is adopted, how should it be rolled out or implemented?
These challenges and questions should not be faced by just one person. Rather, a team with effective leadership should undertake the responsibility. The team should use a formal problem solving approach such as Plan-Do-Check-Act to insure success. One of the first things that the team should do is determine why the technology should be adopted. That is, it should clearly state the goals for the adoption. Perhaps the technology is mandated by an accrediting body or government body. This is the case for ePrescribing as CMS has mandated its adoption by the beginning of this year or physicians will be penalized. Another example is the case of my auto mechanic, Arie Nol Auto Center; his business is adopting new technological tools so that he can repair newer autoes that have many complex computer-based electronic components, thus remaining competitive.
The technology should not be adopted if a good case cannot be made for doing so. This is the approach of Toyota Motor Systems, which first maximizes the effectiveness of any of its manufacturing processes that use human labor before adopting any robotic machinery on the floor. Using this approach it has stayed atop of quality when compared to other auto manufacturers. This year Consumers Reports placed Toyota first in 6 or 10 of categories of autoes.
If a team decides to adopt a piece of technology or software it should next set up a detailed plan for adoption. One of the elements of the plan is the identification of measures of success. In the opening illustration I identified two measures: will the technology increase productivity and will it increase patient safety? The AMA stated that it would but each site should go beyond the research reports and measure its own success in implementation. Another measure that a team may want to examine is patient or customer satisfaction. Physicians implementing an EHR should see how it affects patient satisfaction.
Next the team should create a detailed plan for implementing the technology. The plan should include collecting baseline data for the measures of success that it has identified, a detailed listing of steps in the implementation and the identification of a leader of the implementation. For larger businesses or medical groups the steps of implementation should focus on first having a limited rollout of the technology to a group that is eager to try it; this way, if the rollout cannot reach the goals that it has set the failure will be much less costly. Imagine the cost to a business if it does not experiment first and the supplier of the technology mislead the group on the capacity of the technology!
During the implementation of the technology the leader should continuously collect data on the measures that the team has identified. This way adjustments can be made to the implementation if necessary or the project can be terminated if it can be seen that it will end poorly.
If the implementation goes well, the team should celebrate its success and then plan how it can make better use of the technology that it has adopted while it rolls it out to the rest of the business or site. Most new technology is complex and fully implementing its features takes time. In fact, a business or healthcare provider may never use all of the capabilities of a product. For example, I purchased an iPad2 several months ago and I am still learning about some of it capabilities for my business. I anticipate learning much more so as to increase my own productivity.
Before I close, I would like to mention a couple of sites that review medical apps for physicians, not for patients. One that I recently found and recommend is It reviews apps not just for Apple products but also for Android systems and Blackberry. One feature that I found at this site was that the newest iPad will record dictation and add it to documents. This may be very handy for physicians who do not want to enter data into an EHR during a patient encounter. Apple in its App Store for iPad and iPhone has identified what it considers the top 50 apps for medical professionals. You can find out more about it at
In conclusion, the adoption of new technology can be daunting. However with effective teams and leadership along with good problem solving techniques the adoption and implementation is quite manageable. Identifying goals and measures and creating a detailed plan of adoption will make the process much smoother, especially to those who are being asked to use the new technology.

Monday, July 23, 2012

Pediatric X-Rays Might Expose NICU Staff To Radiation

One of the big concerns patients tend to have when they go in for radiation treatment is the negative side effects they may end up enduring as a result of the radiation; after all, radiation has been linked to everything from minor afflictions to cancer, and it is certainly understandable that patients would have at least some level of concern. While the majority of patients can be assuaged, however, by assurances from nurses and doctors that the small, intermittent doses of radiation they receive will not put them in any imminent danger, what may be of bigger concern is the inadvertent radiation exposure nurses are sometimes subjected to; in fact, a recent study that examined x-ray images from a particular Canadian hospital discovered that nearly half of the images acquired showed adult fingers in the image - and many nurses may be unaware of this inadvertent exposure they are receiving.
This same study revealed that more than 10% of images at the hospital in question had been cropped in order to remove fingers in them - and this led to even greater concern, as the hospital can basically be seen as "covering up" the radiation exposure these nurses are subjected to.
In all, the results of an audit of 230 radiographs revealed the following, shocking statistics: 13% of PACs have fingers visible in the direct beam; an additional 10% of fingers were cropped before they were sent to PACS for review; 19% had fingers in the coned area - and in all, this amounts to 42%, a number that is certainly far too high!
Of course, radiation exposure may simply be part of the bargain when one is assigned to work in an area where radiation is used, but it is also true that individuals should be apprised of the risk before being subjected to it; what's more, there are steps that can be taken in order to lessen the amount of radiation exposure emitted.
Educational interventions, it seems, will be the best way to prevent this problem from continuing to worsen, and there is ongoing research exploring the different things that can be done in order to fix this problem; after all, such simple things as increasing communications between the medical radiation technologists and the nurses in the NICU at the time of the acquisition of the image - as well as more precise cropping when the image is actually being acquired - can make a big difference, and can drastically cut down on the shocking numbers that currently reveal a level of radiation exposure that is far too high.

Sunday, July 15, 2012

How to Handle a Senior Living in a Senior Home

Senior homes are a reality that people have to face in their lives - whether it is shifting your loved ones to one or living in one yourself in the end. Staying in a senior home can be many things. It can be a welcome change to the senior as well as the family, because the main reason that such homes exist is that some people simply do not have the wherewithal to handle a senior.
Yet others might genuinely not have time to take care of their elderlx, while yet others would need to decide between having a job to taking care of their senior loved ones. However, just because you have shifted an elder member of your family to such a house does not mean that you have completed all your responsibilities towards them. Here are some steps that you should ensure to take, even after shifting the elderly in your family to a senior home.
A good senior home will take in someone only after the completion of all the medical tests and documentation that they would need. These medical tests may spring up some surprises to the doctors as well as the relatives of the elderly. You should pay attention to these tests, and in case any serious medical issue arises, you need to ensure that the person gets the correct medical treatment for it. Most senior homes have their own doctors and medical facility, but you should ensure that they get the medical attention that they require.
The most serious mistake that families commit after shifting an elderly to the senior home is not visiting them on a consistent basis. Remember that once a person crosses the age of sixty, it is their second childhood, and they may become uneasy and even disillusioned if their families do not visit them. You should also visit them to ensure that the old age home provides them all the facilities and the amenities that they promised at the time of the shifting. There have been many cases where the senior homes promise the moon just to get the person into the house, and do not live up to their promises at the end of it all.
Thirdly, you should be very careful about taking children to visit the seniors, even if they are relatives. A child's visit may become quite a bad memory for the child, and may lead to some embarrassing and awkward moments. This does not mean that you should not let them meet their elderly relatives, but you should do it in a considerate manner. Even so, children are generally not comfortable in places like senior homes, where the presence of doctors and other medical personnel is the most entrenched.
These are some aspects to remember if an elderly member is in a senior home. There are several senior homes in all areas, and you should research them well before signing up with one. Ensure that the place is comfortable enough, has all the amenities and features, and has a good medical service.

Sunday, July 8, 2012

Is Your Doctor Finished in 3 Minutes?

Health care, my behind! It's more like sickness care at most! That is a more appropriate word for it. In the good old USA the debate is heating up daily. I drove by the city county building today and there were a hand full of people out there with raised signs complaining of Obama's health care bill.
There is a ton of political, corporate, special interest groups involved, and chances are they are not the least bit interested in your health. If they were, we wouldn't allow harmful foods such as, high fructose corn syrup, diet sweeteners antibiotics and hormones in our meats. Colas, bacon & hot dogs filled with nitrates... water that you can't drink; air pollution, polluted rivers, lakes and oceans, mercury in our fish are being pushed into the air. I could go on and on, but that's enough!
When you just treat the symptom you don't cure the problem, it's a bandage at most. Let's say your house is filled with garbage - you will attract flies, rats and other insects. You can poison and trap the pests to get them out of your space for a moment, but they will come back if you don't eliminate the garbage.
That's the root cause of the pests. The same with our health if you have cancer, tumors, heart problems, high blood pressure, diabetes, bad breath, or a host of other illnesses, and you treat the symptom alone and not the cause you will never, ever cure it. You may be able to hide it for a while, but it will raise its ugly head again and may even cause permanent damage; if we really want to get people well we should eliminate the problem. That's the real health care cure.
If you eat fast food and don't exercise, you will eventually have to pay with poor health sickness. You can keep yourself in tip-top shape with just a few changes.
Drink clean water every day 3 quarts up to a gallon 
Stay out of fast food restaurants 
Exercise your organs and tendons daily 
Stay under 15% body fat 
Wash your hands several times a day 
Eliminate complex carbohydrates 
Do Qi Gong breathing exercises daily

It would be wise to learn internal exercises like Qi Gong, Tai Chi and Yoga. Qi Gong is a Chinese exercise that can lower your stress level, give you more energy and heal your internal organs. People want to stay young, stay or get healthy and increase their Energy. Practices like these can be life changing and adds years to your life.
"Why isn't he a doctor that finishes in 3 minutes?"
If you're wondering why, most doctors only see you for a few minutes it's because of the insurance policies. The insurance companies only allow them a limited amount of time to see each patient that's why it's necessary to train everyday, watch your diet and take some time for relaxation and meditation. In this day and age you have to take the bull by the horns and take responsibility for your own health mentally, physically, emotionally and spiritually. If you get in trouble see a health professional and get all the proper tests so you know exactly what's going on, and then change your lifestyle for the better.

Monday, July 2, 2012

So You Want to Major in Sports Medicine

If you dream of being able to work in a field where you can make a difference and improve the health of athletes, then you may want to consider a career in the field of sports medicine. Professionals who work in this field are committed to diagnosing and treating the physical and emotional injuries that athletes and many other people experience when they injure their limbs or suffer from a deficiency in their muscular skeletal motor functions. Since athletes make their living training and playing sports, they often find themselves under a lot of pressure and stress when they become injured, which can further impact the success of their treatment and even delay their progress. The best way that sports medicine professionals can help their patients is to provide them with proper treatment and teach them how to reduce their risk for subsequent injuries in the future.
Surgeons that work in this field are actually orthopedic surgeons who have undergone additional training learning all about sports and the many injuries that can be sustained. The surgeons learn about all of the surgical and nonsurgical ways they can successfully treat their patients to help them regain full use of their limbs and joints after an injury. In the United States, it is not unusual for an orthopedic surgeon to complete at least fourteen years of education and training just to enter the field.
Sports medicine is a highly competitive field. If you want to become a professional in this field, you need to take a very serious approach to showing you are the best early on in the educational aspect of your career. In order to get a good start, you will need to get a bachelors' degree from an accredited college or university. You need to make sure that you get the best grades possible while earning your degree. Since you will need to apply to medical school, you need to meet medical schools' standards. Once you are accepted to medical school, you still have a way to go before you can start practicing as an orthopedic specialist.
Don't just bury your head in the books while you are in medical school. Make sure you make time to get out and network. The relationships you make now will help you in the long run when you gradtate from medical school. Once you have successfully finished medical school and earned your medical license, you can then proceed to finding a sports medicine residency program that will help you gain the experience you need to be able to practice on our own someday. Get recommendations from every professional you come in contact with. Remember that it will take you five years to complete your residency program before you can be viewed as a sports medicine and orthopedic specialist in your own right. Once you have finished your training you have the option of working in a hospital or starting your own practice. Even though you can make more money with a private practice, it is a good idea to work in a hospital until you have spent several years building up your patient base.

Monday, June 25, 2012

Being A Member Of A Medical Aid Is Always Beneficial

The existence of medical aid has made it possible for people to receive life saving treatments. All kinds of people are able to afford medical care. That is because the industry is growing with a number of medical aid companies having increased over the years.
Nations are becoming healthier and the lifespan of people is also increasing. This is helping with improving the standard of living for people because they are able to lead disease free lives. The level of stress also goes down because people do not have to worry about their future wellbeing.
Paying The Same Premiums
Everybody pays more or less the same premiums every month. However this will change from case to case depending on what sorts of needs the different members have. Your age when joining a scheme will also play a role in determining your premiums.
Generally if you join after you have reached the age of 35 you will be subjected to a small penalty in a form of increased premiums. This is done to enable the medical aid to provide you with appropriate benefits. The money you pay will always go toward ensuring that you have adequate cover.
People with pre existing conditions are also able to join medical aids and also pay the same amount as the rest of the members. The only thing they would have to do is serve a waiting period that is imposed by schemes to make sure that they are protected against risk.
People are never prevented from joining based on the illnesses that they are suffering from. Everybody has an opportunity to join as long as they can afford to keep the monthly premiums up to date. All kinds of people are able to join irrespective of what is happening in their personal circumstances.
Chronic Illnesses Covered
People with chronic illnesses can be accommodated so that they can receive the medication they need to treat their illness. A special programme is drafted for them to accommodate the special circumstances. The chronic medication will be available to the member for as long as they need it.
Their condition will be monitored regularly to see if the treatment regime needs to be modified. Should there be a need for any modifications the medical aid will make the proper arrangements. They do this with relevant medical institutions to ensure that your programme is changed accordingly.
The contributions that are made by members on a monthly base are pooled together to make sure that cover will be provided for the members. The monies are never used for anything else because the sole reason for the existence of medical aid companies is to provide cover for members.
Medical aids are regulated by authorities so they have to always conduct themselves in a manner that is beneficial to the members. This ensures that the monies that people pay are not wasted on anything else. Hence as a member the money you pay will never go to waste.

Tuesday, June 19, 2012

The Rise and Rise in Healthcare

Health care cost have been rising way over the cost of living for all us for many decades now. This is the case whether you are serviced by a public sector or private sector health service or a mixture of both (as is most common).
What is going on? Why are we paying ever more high costs for healthcare?
There appear to be a multitude of reasons to choose from: 
1. Drug and healthcare equipment inflation 
2. More treatments and more drugs being available 
3. Increased longevity 
4. Subsidised and insured health increasing demand 
5. More access to self-diagnosis/amateur diagnosis (internet) 
6. Healthcare more widely available in the third world making healthcare resources more stretched 
7. Increase in preventative care resulting in inevitable waste (providing healthcare for those who are not ill)

A long book could be written about drug inflation and that is just the first topic. However, this is surely more of a symptom rather than a cause of higher health costs. My hunch is that no.2 is the greatest reason for higher healthcare costs: increased availability for treatments.
The problem with healthcare is that it doesn't follow normal supply/demand patterns, especially in western countries. If we have eaten well then we can say we are full. Demand has been fully satisfied. However, healthcare is different; the goalposts are constantly on the move. There was a time when most people would only see a doctor if they we were too ill to function. Then we started to lower the bar to the point when even a mild headache could trigger a doctor's appointment (for some people at least). Then as our health improved more emphasis was put on measures we could take to prevent illness and live long and agile life. The goalposts are moving yet again with recent forays into cosmetic treatments.
I offer no judgements but merely observe. Surely it is a good thing that we are healthier? However if we are under increasing financial pressure and stress as we try to find money to pay for all of this, where should the line be drawn?
Does the stress caused by the higher cost of living makes us less happy? Is mental health being sacrificed in favour of physical health? We have a greater quantity of life but are we getting the quality of life to go with it?