Docnotes

links for 2006-07-25

• Aberdeen Server
  1u Server

The EHR consolidation begins ..

CCHIT released the results of the first round of EHR certifications. Products that don't have certification will fall out of the marketplace. Yeh ... you can disagree .. and whine about CCHIT being a tax .. and how small vendors can't afford to do the certification .. but the certification is necessary and important. It does level the playing field a bit ...

Allscripts (HealthMatics Electronic Health Record 2006) Allscripts (TouchWorks Electronic Health Record 10.1.1) Cerner Corporation (PowerChart 2005.02) Companion Technologies (Companion EMR v8.5) eClinicalWorks (eClinicalWorks Version 7.0 Release 2) Emdeon Practice Services (Intergy® EHR v3.00) e-MDs (e-MDs Solution Series 6.1) Epic Systems (EpicCare Ambulatory EMR Spring 2006) GE Healthcare (Centricity® EMR 2005 Version 6.0)

JMJ Technologies (EncounterPRO® EHR 5.0) McKesson (Horizon Ambulatory Care Version 9.4) MCS-Medical Communication Systems (mMD.Net EHR 9.0.9) MedcomSoft (Record 2006 (V 3.0)) Medical Informatics Engineering(WebChart 4.23) Misys Healthcare Systems (Misys EMR 8.0) NextGen Healthcare Information Systems (NextGen EMR 5.3) Nightingale Informatix Corporation (myNightingale Physician Workstation 5.1) Practice Partner (Patient Records 9)

"I don't Judge people"

"I don't judge people in my business" he said. An attribute that we share, I suppose - but for different reasons. My job is to help my patients achieve their health goals. His job is to sell them beer.

But he made me a little six-pack sampler that has been truly enjoyable. I used to enjoy Yeungling Porter but apparently it's no longer available. I asked him to bring me some .. and he said "no dice." I liked it because it was cheap and pretty good.

Here's what I've tried from the sampler:

Day 1:

SmuttyNose Porter hmm .. just OK. Better than an amber beer, but not full enough.

Day 2:

Sinebrychoff Porter   Wow  Very (very good)  Finnish Porter.  Rich. Complex taste - not too thick .. but not too thin .. juuuust right.

Day 3:

D. Cargagie & Co Stark Porter  Swedish.  Not as good as the Finnish, but better than the SmuttyNose.  Big bottle.  Couldn't finish it. (yeh - I'm a lightweight) ..

EHR != redunction in health care costs

It Ain't Necessarily So: The Electronic Health Record And The Unlikely Prospect Of Reducing Health Care Costs -- Sidorov 25 (4): 1079 -- Health Affairs

This article has been widely cited in the last week or so. It's a good read. Not sure I agree entirely .. but there are some valid points.

... and Matt points us to this excellent summary (pdf) on IT tools for chronic disease management.

Wiki for the Intranet in healthcare

See this post on using wikis for an Intranet in healthcare.  Wiki software is getting good enough these days that the look-and-feel is now tolerable for an Intranet.

Many years ago (1999) .. in a galaxy far, far away .. I built an Intranet home page that was butt-ugly, but it got the job done, and I was trying to spread the concept of an Intranet as a useful tool for clinical and administrative tasks.

Alas, that page still adorns the Intranet there (though it doesn't run from a server under my desk anymore, thankfully!) and while progress is being made (the www site was recently revised - though usability experts would likely give it a C+ at best) .. while I have moved on to other places.

 .. and one of the most successful projects at CapitalCare was the re-building of the Intranet as a Wiki.  It was fun and challenging and I can take credit for only planting the seed and evangelizing a bit.  Watering, fertilizing and nurturing were well managed by a great team of colleagues. 

Physician's First Watch

Physicians' First Watch launched today

What's good about PFW:

• Daily updates on important medical publications and news
• Professionally written, concise summaries
• Hyperlinks to relevant information and source article (see dave's post on how "sending them away" is a fundamental law of making money on the Internet)
• Stories are thoughtfully reviewed by a team of physician editors yeh .. I'm of of 'em
  
• Editorial selection of articles or news items for inclusion is unbiased - without any influence from advertisers, mafia bosses, or old college roomates
  
• Available for free, in the flavor you prefer: RSS or e-mail

I'm hoping Enoch will chime in about what's not-so-good about PFW.  I know he has some concerns -- and perhaps some suggestions for improvement ;-)

New residents, 2006

Fat Doctor describes an adorable new resident. My recent July interaction was not so adorable. Last friday, the new intern barged in to a hospital room and ordered me (no white coat, but the stethy around my neck should have tipped her off that I was not Cousin Vinny) and the patient's husband out of the room while she examined "my patient." The brash over-confidence and paternalism that comes with adornment of the new white coat is an unfortunate disease we continue to fight.

Yeh - I gave her a talking to ... ever so gently reminding her that humility will earn her far more stars ...

On the Medlogs Controversy ...

Looks like there is a bit of a spat between an anonymous reader and Eliot Gelwan.

Weblogs on Medlogs.com are selected.  Sure .. some are NOT selected for inclusion .. and there are many reasons for that .. one of which is that I don't have the time to review all of the new submissions (I'm about 200 behind at the moment!). I take the editing functions seriously .. though I yearn for a better method of categorizing the blog than the one we devised years ago. I have resisted commercializing the site - at the expense of revenue - so we will all have to wait for medlogs 3.0. But I digress .. The others reasons I don't include a blog in medlogs:

• I don't think that the blog is about issues relevant to healthcare
• The blog promotes a business rather than discussion

Not much else. I would argue that politics is often (always?) relevant to healthcare, and that separating science from politics is more of a challenge than most of us will ever admit. The whole point of weblogs is to learn from each other. If you disagree with someone - well then that is great. Disagree and make your point well so that we can all learn from the discussion.

Do you need styled text in the EHR?

Charmglow Grill recall

The grill we bought last year was recalled not long after we bought it.  I didn't know about the recall untile recently when I went looking for a solution to a different problem that we're having with the grill.

I didn't find anything on the Internet about our problem - so here's my contibution.  No - not a medical post, but perhaps this will help save someone's eyebrows.

Our problem was that the grill was leaking at the junction of the gas line to the valves.  There's a little o-ring. that went bad on two of the three valves in only 1 year.

I looked at the company's (lame) website (the grills are made by Nexgrill, not Charmglow) and found no way to order a replacement part.  The poor soul at Home Depot suggested I call the 800 number.  The people at the 800 number offered to sell me a new valve assembly and didn't know about any o-ring.

Here's the problem:

You can see where the gas leaked and fire came out.  Scary.  The valves sit on the gas-line which has a hole in it.  Each valve sits in/on the hole .. and the o-ring keeps the gas going to the right place.

I couldn't find anything @ Home Depot that would fit.  Real o-rings are too skinny.  Finally I found the solution.  I bought 1 foot of 1/4" ID, 5/8" OD hose and cutr off tiny pieces of it to make my own o-rings.

Here's one in place of the o-ring: