Docnotes

Rabbit Medicine

Rabbit medicine notes comes up next to "Family Medicine Notes" in a google search.

Dr Bob goes to Africa

E-mail today from Theresa, the office manager in the Department of Family and Community Medicine at Albany Medical College:

Hello,
I received a phone call from Dr. Bob P yesterday with a request for help and I'm asking each of you in the small chance that one of you can help or may have some ideas for Bob. Dr. Bob will be leaving next week on another trip to Africa with a group of AMC medical students. To date he has taken countless AMC medical students with him on 21 medical missions. When our students travel with Bob, they are 100% responsible for the cost of their trip. One third year student, Oteng W, is from a village very near where Dr. Bob is going with his group this year. Many of Oteng's family is still living in this village and he was very excited about the opportunity to be part of this medical team and have the opportunity to help his village and family. Dr. Bob was also very excited to have a student who was from that area and felt it would be a great learning experience for the rest of the medical students to have Oteng be a part of their team. Unfortunately, Oteng's financial support fell through just this week and he no longer has any funding for his travel. Bob did not want to take the chance of Oteng not being able to go and put the airline ticket on his own credit card. For those of us familiar with Bob, we all know he does not have $1,500 to cover a student's travel. His response was typical Bob, "This is a gift I can give to Africa and to our medical school - it's worth it no matter how much it costs." So.............I asking anyone and everyone who knows of Bob and his work with our medical students to try and come up with any way we can help reimburse him for the cost of this airline ticket. I don't know if there are any funds that can help support a medical student - but if we find a little bit of money from a few different sources, it could lessen the financial burden on Bob. If you know of any funding or agency that might be able to help Dr. Bob, please let me know as soon as possible. His team flies to Africa on the 17th of January.

Bob and I were calssmates in medical school.   He is a guy who has given his life to serving the community - and he continue to make enormous personal sacrifices so that he can meet the needs of others.  Click the button below to send Bob money via paypal so that he's not spending $1500 of his own money to send this student to Africa.  I'll forward the cash to Bob.

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RSS - Shellen - Winer - Atom

Boring technology topic:

Dave Winer points to Jason Shellen's proposal for using a CSS to make XML look nicer in Atom.

No reason not to do this in RSS too ... here it is.

How I did it:

I had to modify my MovableType 2.0 template (view source if your browser tries to open it) to make it look better.  Now my feed may even look "un funky" to Dave.

I copied Jason's CSS example and modified it some to work on the RSS format.  

Then I found  Eric Kidd's dormant weblog.  He did this about a year ago.  His CSS is better than Jason's.

I can't get rid of the spaces .. (NBSP) ugh ..

HealthyEmail - Zixcorp links - One company or two?

In response to this post in my weblog on 2/28 .. I received the following e-mail:

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Dr. Reider - I'm passing on the following from Stacy Smith, Executive Coordinator of HealthyEmail, regarding your 2/28 posting on www.docnotes.com

 

Please feel free to use the following in it's entirety there, and to contact us if you have any questions concerning the HealthyEmail initiative. Thanks.

 

March 7, 2003

Dear Dr. Reider, I was recently apprised of a posting on your website, Family Medicine Notes, dated Friday, February 28, 2003 and felt compelled to contact you to clarify several misconceptions about HealthyEmail.

HealthyEmail is a nonprofit organization, recently created to maximize the potential of email use in the healthcare industry.

The organization is addressing the increasing problems involving physicians' email communication with patients, hospitals, insurers and other doctors, particularly where sensitive patient information is involved. HealthyEmail is not one in the same with Zix Corporation.

To be sure, ZixCorp has been integral to the formation of our initiative, providing us with seed funding, facilities and some manpower to jump start HealthyEmail operations, as well as a grant of two million licenses of ZixMailTM. These resources came at a very critical time for our organization as we had a short amount of time to accomplish a great deal.

However, despite ZixCorp's initial support, their "control" over HealthyEmail is limited to one vote on our nine-person Advisory Board. As the Healthy Email operations move into higher gear, I anticipate that one or more of the companies represented by advisory board members will also make financial contributions. We're also hoping that other companies in the industry will step forward to support this initiative as it becomes better known. I also want to note that the initial HealthyEmail tool set includes more than just the ZixMail application. It includes educational materials, policies and patient pamphlets.

The HealthyEmail program came about out of interest from the industry to address the problems around adoption of secure email by physicians and their staffs. After discussions with various industry organizations, it became apparent that adoption of secure email by physicians was a concern and of interest to a significant number of industry organizations, and that the answer was a combination of education, process and technology, which was greater than anyone healthcare organization. As for the matter of the licenses of ZixMail being free for two years, they are exactly that. That verbiage that was discovered in the licenses, regarding the 30-day trial period, was inadvertently carried over from standard ZixMail licenses.

This oversight is being corrected as I type. Finally, regarding the concern you raised about luring physicians in with a free offer and then charging them a premium after the free period has expired: The intention was to provide the tool for a reasonable amount of time for organizations to understand the benefits of secure email. As this has been a frequent question, discussions have been taking place to provide the licenses at a very reasonable price after the two years has expired. I hope to have this issue resolved in the next few weeks.

Any organization that would like to learn more, or who would like to participate in the HealthyEmail initiative, should not hesitate to contact me at 866-###-###. Very truly yours, Stacy S. Smith Executive Coordinator.

Treatment of the Ingrown Toenail

Physician Scheduling

Physician Scheduling www.oncalls.com Who’s On-Call? By Jacob M. Reider, MD “Who’s on-call?” Anyone who works in a hospital understands that the answer to this question is of paramount importance to patient care. Despite advances in technology over the last few years, many call schedules are still created on paper. The time may have come, however, for the pencils to finally rest. Software that supports the creation and management of a call schedule is now available from any computer for quick and easy access to the physician’s whereabouts What is the call schedule? The call schedule for a group of physicians or healthcare workers is a sensitive and important document that is created and updated on a regular basis. Holidays, vacations, illness, and equity are key factors that must always be considered in the creation of a call schedule. Otherwise, conflicts over accountability and responsibility are inevitable. In residency programs, the chief resident is often charged with the task of building the call schedule. For physician groups, often the junior member earns this “privilege” … putting him/her in the middle of a whirlwind of expectations that may have been brewing for years. Often, debate over who has done more (or less) call will become an issue; and the one who worked Thanksgiving last year will most certainly object to working it again this year! The process the “old fashioned way” Creation of a manual call schedule often begins with the solicitation of requests. Since people need to plan vacations ahead of time, often there will be negotiations among members of a group to determine who will take call for the major holidays of the year. Larger groups and many residency programs have request forms that need to be filled out in order to request time off. Smaller groups may just ask the person in charge of the call schedule to “make sure I’m off on the 14th it’s my wife’s birthday.” What happens when four people ask for the same week off? Tracking the requests and determining the status of a request is a key element in the initial steps of building a call schedule. When too many people vie for the same time off , there has to be a fair, systematic way of determining who does and gets what. Tracking the requests and the date and time that they came in is therefore an imperative component of the creation of a fair call schedule. In addition to requests for time off, many providers will express preferences for when they want to work. For example, Dr. Jones may like Tuesdays, while Dr. Smith prefers to work Wednesdays. The creation of the manual call schedule is usually performed at this point: requests and preferences have been determined, and now the administrative member of the group puts together a schedule for a given time period usually a month which will determine who works when and where. This is a painstaking process when done at the kitchen table with pencil and eraser. Part of the scheduler’s duties include calculating days on & off for each provider, while ensuring that requests and preferences are honored whenever possible. Publication When complete, the call schedule is faxed, e-mailed, mailbox-stuffed, and hand delivered to everyone involved including hospital and office operators, answering services, and hospital emergency rooms. While the sharing of this schedule in so many forms is a great feat, a challenge remains for the manager of a call schedule at this point: how to update the already published schedules when the inevitable changes occur? While faxes, a-mails and mailbox-stuffing can deliver a newer version of the schedule, there is no way for the end-users of this schedule to know with certainty that the schedule in their hand is the most recent revision. The Technological Solution With the advent of the Internet, publication of call schedules via the world-wide-web is an obvious alternative to the analog delivery methods. Users would know that the version that they are accessing is the most authoritative one, and the schedule could be updated from anywhere, and accessed from anywhere. Users could log in to the website, enter requests and preferences, and run reports so an accurate count of who’s done the most Saturday nights would be only a mouse-click away. Administrators could use such a system to automatically count the calls, and even insure that Dr. Jones isn't scheduled to work at the Hospital when she’s on vacation in Hawaii. The paper schedule simply can't do that by itself. Over the last 24 months, a small team of physicians and software developers in Albany, New York, has developed an end-to-end tool for the creation and management of call schedules. Oncalls (www.oncalls.com) is a simple, robust application that performs all of these functions well. There will always be arguments over who worked Thanksgiving in 1988, but with web-based call schedule software, management of this complex and thankless job can be much less challenging. Jacob M. Reider, M.D., is a practicing family physician in Albany, New York. He is the Associate Dean of Biomedical Informatics at Albany Medical College, Medical Director of Hospital Informatics at Albany Medical Center, and is the founder of Oncalls. - # # # -