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This page shows you the most recent publications within this specialty of the MedWorm directory.

Justifying EpiPen pricing, once again
Back with more I enjoyed Medical hackers create $30 DIY EpiPen in defiance of corporate greed over at inhabitat. The Four Thieves Vinegar collective cobbled together an “EpiPencil” from an auto injector for insulin, a hypodermic needle, and epinepherine. It’s a pretty cool trick but it proves nothing about EpiPen pricing nor does it help real patients. Actually, it unwittingly reinforces the points I made in my very unpopular EpiPen may still be too cheap post, which is that the pricing of EpiPen has almost nothing to do with the cost of its parts. Consider these caveats about the DIY EpiPencil fr...
Source: Health Business Blog - September 30, 2016 Category: Health Management Authors: dewe67 Tags: Devices Economics Pharma Policy and politics EpiPen Source Type: blogs

End-of-Life Issue Conversations with Your Elders Needn't Be Horrible
I've found in my experience that it isn't always the elders who shy away from end-of-life talks. Some do, of course, but many would like to discuss the arrangements they've made for finances, as well as their opinions about what measures they would want taken if they needed someone to make their decisions if they can't, however the adult children often find excuses to put off that particular "talk." Read more on Agingcare about having that end-of-life talk: Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or ebook “I hold onto your book as a life preserver and am reading it slowly on pur...
Source: Minding Our Elders - September 30, 2016 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Research and Reviews in the Fastlane 153
Welcome to the 153rd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - September 29, 2016 Category: Emergency Medicine Authors: Soren Rudolph Tags: Airway Clinical Research Education Emergency Medicine R&R in the FASTLANE Renal Resuscitation critical care Intensive Care research and reviews Trauma Source Type: blogs

When EMTALA forms meet EMRs, chaos can ensue
Ah, EMTALA! The revered Emergency Medical Treatment and Active Labor Act! It’s one of those things which is like a nursery rhyme to emergency medicine folks like me. We’ve heard about it from the infancy of our training.  “And then the bad doctor sent the poor lady to another hospital because she couldn’t pay!  And the King came and crucified him for doing it!”  The end. EMTALA, for the uninitiated, is a federal law which ensures that we don’t turn people away from the ER because of finances, and also keeps us from transferring people to other hospitals without that hospital’s agreement.  It also...
Source: Kevin, M.D. - Medical Weblog - September 28, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Health IT Source Type: blogs

How Will You Handle Loss? Here ’s How Substance Abuse Makes Grieving Harder
How Will You Handle Loss? Here’s How Substance Abuse Makes Grieving Harder Tragedies are frequently unexpected. When we think about worst case scenarios, we assume our planning is all hypothetical, but tragedy in one form or another hits all of us sooner or later. How can you make sure you’re ready for the emergency or crisis headed your way? Your most important tool may seem obvious: preparing to grieve. Luckily for us all there are several practical ways you can strengthen your ability handle stressful experiences and their aftermath before finding yourself in the lions’ den. Of course, making plans for supporting ...
Source: Cliffside Malibu - September 27, 2016 Category: Addiction Authors: Richard Taite Tags: Richard Taite Source Type: blogs

Helping a patient is more important than following a policy
Pretend you’re a 30-year-old woman who’s 34 weeks pregnant. You develop a cough while cleaning a dusty room. You put up with it for several days. After a week you realize the cough has kept you from sleeping and is creating pain in your rib cage. Time, you think, for medical attention. That should be an easy thing to do. After all, you have health insurance, and you’re articulate and assertive. Your obstetrician is on vacation, so you see a physician assistant in a drop-in clinic. He suggests you take an over-the-counter cough medicine and Tylenol. You do that, but after two more days of zero relief, you ...
Source: Kevin, M.D. - Medical Weblog - September 27, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/jeff-kane" rel="tag" > Jeff Kane, MD < /a > Tags: Physician Primary care Source Type: blogs

BrainScope Ahead 300 Traumatic Brain Injury Assessment Device FDA Cleared
BrainScope, a Bethesda, Maryland firm that’s been working with the U.S. Department of Defense to develop technology for assessing traumatic brain injuries (TBI), just won FDA clearance for its latest device, the Ahead 300. This the first of the company’s products that will actually be distributed commercially and it’s touted as their most advanced version. It can provide a rapid electroencephalographic (EEG) assessment of a person who suffered a head injury, utilizing disposable electrodes and a connected smartphone to process the information. It relies on the firm’s proprietary algorithms and mac...
Source: Medgadget - September 27, 2016 Category: Medical Equipment Authors: Editors Tags: Emergency Medicine Military Medicine Neurology Sports Medicine Source Type: blogs

Chronic Constipation: A Potential Health Emergency for Elders
... metabolisms slow naturally as we age, which can affect digestion, but when things come to a screeching halt, it can cause discomfort and anxiety. Although most people prefer not to talk about their bowels, if this issue does not resolve on its own or worsens, it can lead to serious health problems like impaction, anal fissures and bowel incontinence. Read full article on Agingcare about preventing constipation from turning into a health emergency: Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or ebook “I hold onto your book as a life preserver and am reading it slowly on purpose.....
Source: Minding Our Elders - September 27, 2016 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Building A 21st Century Health Department To Lead Baltimore ’s Culture Of Health
Editor’s note: This is the first of a periodic series of Health Affairs Blog posts discussing the Culture of Health. In 2014 the Robert Wood Johnson Foundation announced its Culture of Health initiative, which promotes health, well-being, and equity. The initiative identifies roles for individuals, communities, commercial entities, and public policy that extend beyond the reach of medical care into sectors not traditionally associated with health. Health Affairs is planning a theme issue in November 2016 that will explore various aspects of the Culture of Health. In the aftermath of the unrest sparked by Freddie Gray’...
Source: Health Affairs Blog - September 26, 2016 Category: Health Management Authors: Sonia Sarkar and Leana S. Wen Tags: Equity and Disparities Featured Population Health Public Health Quality Baltimore culture of health gun violence Opioid Addiction Source Type: blogs

Stay Safe During Hunting Season
For many parts of the United States, fall is hunting season. Recreation.gov has tips for hunters and non-hunters to stay safe in the woods this time of year. Spotlight: Safety During Hunting Season: https://nnlm.gov/bhic/rd10 (Source: BHIC)
Source: BHIC - September 26, 2016 Category: Databases & Libraries Authors: Kate Flewelling Tags: Emergency Preparedness Rural Source Type: blogs

Oxy-Iso Color Correction Glasses for Healthcare Workers: A Medgadget Review
Color blindness can be frustrating for those with the condition, and it can also create challenges for some medical professionals while they’re doing their daily tasks. Veins, in particular, can be hard to spot by normal seeing people, and it’s even more difficult if your color perception is off. There are also issues like noticing how flush or pale someone is and assessing dermatological problems. We were sent a pair of Oxy-Iso Color Correction Glasses from a company called O2AMP that were developed to help color blind clinicians be better at doing things like starting IV lines. Luckily for us, we have a coll...
Source: Medgadget - September 26, 2016 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Emergency Medicine Exclusive Military Medicine Surgery Source Type: blogs

Mylan CEO Under Fire at House Hearing
Two weeks ago, in the midst of the hubbub surrounding Mylan and its  EpiPen, Jason Chaffetz and Elijah Cummings, Chairman and Ranking Member of the House Committee on Oversight and Government Reform, sent a letter to Mylan’s CEO, Heather Bresch. The bipartisan letter requested documents and communications regarding the increasing price of EpiPens, including documents relating to the company’s revenue from sales of EpiPens since 2007, manufacturing costs, and the amount of money the company receives from federal government health care programs. Chaffetz and Cummings requested the documents by September 12, 2016, a...
Source: Policy and Medicine - September 26, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

LITFL Review 250
Welcome to the 250th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Prone ventilation has a myriad of potential beneficial effects in respiratory failure. So why not try it in patients who are not intubated but hypoxic? Great and thoughtful stuff from Josh Farkas. [SO] The Best of #FOAMed Emergency Medicine Core...
Source: Life in the Fast Lane - September 25, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review LITFL R/V Source Type: blogs

“ I know my pain doesn ’ t mean I ’ m damaging myself – but I still have pain ”
In the excitement of helping people understand more about pain neuroscience, which I truly do support, I think it’s useful to reflect a little on the history of this approach, and how it can influence the experience people have of their pain. If we go right back to the origins of pain self management, in the groovy 1960’s and 1970’s – the first truly significant work in chronic pain self management came from Wilbert Fordyce (Fordyce, Fowler & Delateur, 1968). Bill Fordyce was a clinical psychologist working in the Department of Physical Medicine and Rehabilitation, University of Washington, Seat...
Source: HealthSkills Weblog - September 25, 2016 Category: Anesthesiology Authors: adiemusfree Tags: Chronic pain Clinical reasoning Education/CME Pain conditions Science in practice acceptance biopsychosocial healthcare pain management Research Therapeutic approaches Source Type: blogs

The Connection Between UTI, Dementia and Memory Loss
Researchers have found a link between common infections, such as a cold, stomach bug or urine infection and an increase in inflammation like reactions in the brain which can exacerbate dementia symptoms. Study results show that people who got an infection had twice the rate of memory loss as people without infections.By Bob DeMarcoAlzheimer's Reading RoomUrinary tract infections are particularly worrisome, and they should be to most Alzheimer's caregivers. There is a growing body of scientific evidence indicating that infections can hasten memory loss in persons suffering from Alzheimer's.Years ago, before we discovered th...
Source: Alzheimer's Reading Room, The - September 25, 2016 Category: Neurology Tags: alzheimer's care Alzheimer's Dementia dementia care help alzheimer's help with dementia care memory care memory loss tips on dealing with alzheimers patients urinary tract infection Source Type: blogs

Doctors must preserve their empathy at all costs
It was several years ago. I was a first-year internal medicine resident. Keen, tired, overworked, and still idealistic. Mr. Smith was a 45-year-old lawyer who rolled into St. Paul’s Hospital Emergency room, while our medicine team was on intake. He was a healthy appearing lawyer who noted that for the past month he had become more short of breath performing his regular exercise. Things were especially bad for him during his morning treadmill workout, so he came in for evaluation. The ED started the standard work-up including blood work and a chest x-ray. The x-ray came back showing a large right-sided pleural effusion. A...
Source: Kevin, M.D. - Medical Weblog - September 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-levy" rel="tag" > Michael Levy, MD < /a > Tags: Physician Cancer Source Type: blogs

GE Healthcare Launches Vivid iq Portable Cardiovascular Ultrasound
GE Healthcare has recently announced the global launch of its new generation of high-end portable compact cardiovascular ultrasounds, the Vivid iq. The Vivid iq improves upon the company’s already available Vivid q portable scanner by being 10 percent lighter and thinner, weighing just under 10 lbs (4.5 kg). It features up to one hour of battery life, a touchscreen, and a transportable cart. It is rugged and has a cleanable design, and to transport it you simply close the screen and lift it by the built-in handle. The ultrasound machine can do 4D TEE and is purposed for every situation from the cath lab to the OR or ...
Source: Medgadget - September 23, 2016 Category: Medical Equipment Authors: Wouter Stomp Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Emergency Medicine Ob/Gyn Pediatrics Radiology Source Type: blogs

How to create a modern superhero
You start out by working in a busy emergency department. You see patients with all sorts of complaints: abdominal pain, headaches, and chest pain. Vomiting, diarrhea, and dysuria. Ankle sprains, bug bites, and allergic reactions. Domestic violence, rape, and child abuse. You don’t ever let the stress of the job take away your humanity. You treat your patients with empathy and respect. You listen to their stories, treat their symptoms, contact the police, fill out paperwork, transfer them to a facility that performs rape kits, and get the social worker involved. Then you go home, drink a glass of wine, watch television, a...
Source: Kevin, M.D. - Medical Weblog - September 23, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/alberto-hazan" rel="tag" > Alberto Hazan, MD < /a > Tags: Physician Emergency Source Type: blogs

Let Public See Charlotte Shooting Body Cam Footage
A recent police-involved shooting in Charlotte, North Carolina helps illustrate the importance of body cameras and why North Carolina ’sbody camera law is misguided and unhelpful. Last night, Governor Pat McCrory declared a state of emergency following protests over the shooting of Keith Scott, who was shot and killed by an officer on Tuesday. The protests have left one citizenon life support and numerous police officers injured. The National Guard has been deployed. Making footage of the shooting publicly available would show that the Charlotte-Mecklenburg Police Department is dedicated to accountability and transparenc...
Source: Cato-at-liberty - September 22, 2016 Category: American Health Authors: Matthew Feeney Source Type: blogs

Too many emergencies
Yes, the Trump Foundation and the border wall and birtherism and all of the dreck that spews from Ronald T. Dump should get news coverage.However, there is shit happening in the world that is like, really, really important and probably ought to be discussed by the candidates. You know, that little climate change problem, nucular weapons, mass extinction . . .There is also this. When antibiotics stop working, it ' s not just those poor dusky-hued people in distant lands currently dying of tuberculosis who will be shit out of luck. It ' s you. Not only might you die from an infected scratch on your hand, common surgical proc...
Source: Stayin' Alive - September 22, 2016 Category: American Health Source Type: blogs

Not Everyone Wants to Ban Kratom: Here Are Some Issues to Consider
Never heard of kratom? The media has been so focused on the ongoing opioid epidemic that it’s easy to miss a less frequently used or abused substance, like kratom. But a movement to ban or restrict the sale of kratom in cafes, at head shops and on the internet is gaining momentum across the country and states are taking legal action to curtail the public’s use of this drug. So what exactly is kratom, and why are people divided about its use? Common in the United States for almost ten years before catching the attention of the federal government, kratom is a plant grown in Southeast Asia and cultivated as a kin...
Source: Cliffside Malibu - September 22, 2016 Category: Addiction Authors: Constance Scharff, PhD Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health drug addiction drug treatment center Source Type: blogs

Research and Reviews in the Fastlane 152
Welcome to the 152nd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - September 21, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Airway Anaesthetics Education Emergency Medicine Intensive Care Pediatrics R&R in the FASTLANE Resuscitation Trauma critical care literature recommendations research and reviews Source Type: blogs

Statin Wars: Less-is-More versus Unlimited Medicine  
By SARAH JHA, MD It is the beauty of evidence-based medicine (EBM) that a scientist can at once be a Pope and a Galileo. His transmutation is as effortless as it is discretionary. If you think you’ve met Galileo – a rebel, a free thinker, a rocker of the establishment – the following week he is a Pope, castigating detractors, censoring critics, and celebrating uniformity. He changes by a roll of the dice. His change is decided by a quirk in hypothesis-testing known as statistical significance. If the p value is 0.051 he is Galileo, if the p value is 0.049 he becomes the cardinal. He is one day a raging skepti...
Source: The Health Care Blog - September 20, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Why I oppose home strep testing
Yesterday I read this tweet: home strep test likely to reduce inconvenience, cost, strep complications, unneeded antibiotic and antibiotic resistance #medx I disagree, but the reasons are fairly complex. In order to understand this problem, we have to define the possible test, its use, the likely misuse and both the intended and unintended consequences of such a test. What makes a good home test?  Users should have no difficulty collecting the test sample.  The test performance must be straightforward and simple.  The test should answer a question that has a dichotomous implication. Clearly, even health care profession...
Source: DB's Medical Rants - September 20, 2016 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

In Shock
We moved to our new neighborhood last January. January in New England is not a time when people are outside much (unless they are playing in the snow somewhere). People are not outside in their yards and being social. All socializing is inside.We met one family of neighbors a few weeks afterwards because we were outside dealing with snow and ice. We then met more neighbors as the weather got warmer. Because of the street ' s turns, we have one neighbor directly across the street and one next door. Everyone else is around a corner someplace. I met the neighbor across the street, B, in April or so. We talked gardening. She w...
Source: Caroline's Breast Cancer Blog - September 20, 2016 Category: Cancer & Oncology Tags: cancer death Source Type: blogs

Who knows best? Older people ’s contribution to understanding and preventing avoidable hospital admissions
University of Birmingham -The authors of this report interviewed 104 older people, exploring their experiences of emergency admissions. The research focused on whether the older people felt it was appropriate to be admitted to hospital and whether they thought anything could have prevented their admission. The findings of this study confirm the belief that older people have an important role to play in helping understand the nature of emergency admissions and to devise appropriate responses to their rising numbers. The report concludes that ignoring this expertise could be detrimental to ensuring older people get the appro...
Source: Health Management Specialist Library - September 20, 2016 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Patient involvement, experience and feedback Source Type: blogs

The Rest of the Story About the Economic Good News
By PAUL KECKLEY Legendary radio commentator Paul Harvey ended his daily report with a final story introduced by the tease “Now for the rest of the story.” Last Tuesday, the U.S. Census Bureau announced that median household income increased 5.2% in 2015 to $56,516—the first increase in inflation adjusted income since the start of the downturn in 2007. The Bureau also noted that the U.S. poverty rate decreased to 13.5% in 2015, down from 14.8% in 2014 and those lacking health insurance coverage shrank to 9.1% from a high of almost 16% in 2007. According to the Center for Budget and Policy Priorities, that’s the firs...
Source: The Health Care Blog - September 19, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Paul Keckley Source Type: blogs

Non-Vagal Syncope and Saddleback Morphology in V2
This is another case provided by Mustafa Alwan, an internist from Jordan and very talented ECG enthusiast. He posted it on Facebook EKG Club, and I am reposting with his permission.CaseThis is a 26 year old male who presented after having had 2 episodes of syncope in 1 day. Both episodes started with palpitations, then dizziness. He had no family history of sudden death.  Vital signs: normal Initial ECG :This is suggestive of Type 2 Brugada morphology because of the Saddleback in lead V2At first glance, the beta angle looks wide. See this post for a review of Type 2 Brugada.The metho...
Source: Dr. Smith's ECG Blog - September 19, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

LITFL Review 249
Welcome to the 249th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Swami discusses the process of thin-slicing in the ED: “the pathophysiology and relative illness of patients on the spectrum are different; [not] apply[ing] the concepts of management of one of the spectrum to the other end…allows u...
Source: Life in the Fast Lane - September 18, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Injeq IQ-Needle for Easier, Safer Spinal Taps
Thecal punctures can be tricky procedures with quite a bit of potential for serious complications. It’s important to know when the needle has reached the cerebrospinal fluid and if it strayed from the target, but this is typically a matter of good training, attention to detail, and having a good hand that can feel as different tissues are penetrated.  Injeq, a Finnish company, developed a new device called IQ-Needle that may take a lot of the guesswork and inconsistency out of performing lumber punctures. The IQ-Needle has electrodes via which an external control device is able to sense the environment of the needl...
Source: Medgadget - September 15, 2016 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Critical Care Emergency Medicine Neurology Neurosurgery Oncology Source Type: blogs

The social history: Our patients are more than their diseases
“Any alcohol use? Any tobacco use? Any other drugs?” These are the three main questions that most health care providers ask their patients when documenting a social history on a note. “What stressors do you have in your life? What social support do you have? What is your home life like? What do you do for fun? Do you wear a helmet when you ride a bike? Do you wear a seatbelt?” I remember learning these questions and having to ask them to a standardized patient as a medical student. My classmates and I laughed about how silly some of these questions seemed. How does wearing a helmet have anything to do with ...
Source: Kevin, M.D. - Medical Weblog - September 15, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/david-goldberg" rel="tag" > David Goldberg, MD < /a > Tags: Physician Primary care Source Type: blogs

Updated Disaster Information Specialization Courses
The National Library of Medicine Disaster Information Management Research Center (DIMRC) is updating disaster health information courses and formatting them for self-paced study online. Two updated courses are now available (see below). By the end of the year, there will be four more courses: US Response to Disasters and Public Health Emergencies; Information Roles in Disaster Management; A Seat at the Table: Working with Local Responders; and Health and Disasters: Understanding the International Context. Disaster Health Information Sources: The Basics This class provides a comprehensive overview of the essential resour...
Source: BHIC - September 15, 2016 Category: Databases & Libraries Authors: Annette Parde-Maass Tags: Emergency Preparedness Environmental Health National Library of Medicine News Public Health Source Type: blogs

Heart Pain: When To Sound The Alarm
Is the pain heartburn or a heart attack? How can you tell the difference between a sharp, burning sensation in your chest caused by the pizza you just ate or a sign of something more serious? Women’s heart attack symptoms can be difficult to diagnose. My heart attack absolutely started out feeling like heart burn. I’ve experienced both severe heartburn and a heart attack and the pain is very similar at the beginning. Here are 7 ways to tell the difference between heartburn and a heart attack: Did you just eat something which upset your stomach? If your tummy is usually upset 30 to 40 minutes after eating spicy or grea...
Source: Embrace Your Heart Wellness Initiative - September 15, 2016 Category: Cardiology Authors: Eliz Greene Tags: Award Winning Blog Heart Health Source Type: blogs

Engaging Patients With Health Data Cuts Louisiana ED Overuse
Maybe I’m misreading things, but it seems to me that few health IT pros really believe we can get patients to leverage their own health data successfully. And I understand why. After all, we don’t even have clear evidence that patient portals improve outcomes, and portals are probably the most successful engagement tool the industry has come up with to date. And not to be a jerk about it, but I bet you’d be hard-pressed to find HIT gurus who believed the state of Louisiana would lead the way, as the achingly poor southern state isn’t exactly known for being a healthcare thought leader.  As it so happens, though, t...
Source: EMR and HIPAA - September 15, 2016 Category: Information Technology Authors: Anne Zieger Tags: Digital Health EHR Electronic Health Record Electronic Medical Record EMR Healthcare Healthcare Business HealthCare IT HIE Patient Portal Patients Population Health Management EHR Awareness Emergency Department EMR Awareness Source Type: blogs

The Politics of Hillary ’s Pneumonia
By SAURABH JHA, MD It is selfish of a leader of a nation to drop dead during office. Jawaharlal Nehru, India’s first prime minister, died suddenly at 74, apparently from a ruptured aneurysm. His aneurysm, allegedly, had something to do with Edwina Mountbatten – the wife of Lord Mountbatten, the last Viceroy of India. Shortly after Nehru’s death, Pakistan attacked India. Nehru’s replacement, Lal Bahadur Shastri, died mysteriously in Tashkent two years after Nehru’s death, and was succeeded by Indira, Nehru’s daughter. India’s future was forever changed by a burst aneurysm or, if rumors are to be believed, by ...
Source: The Health Care Blog - September 15, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

FDA and Access to Medications
By: Janet Woodcock, M.D. A severe allergic reaction called anaphylaxis is a medical emergency that affects the whole body and, in some cases, leads to death. If you have had an anaphylaxis episode, you always face the risk of another … Continue reading → (Source: FDA Voice)
Source: FDA Voice - September 14, 2016 Category: American Health Source Type: blogs

Research and Reviews in the Fastlane 151
This study takes data from a trauma registry and shows a survival rate for resuscitative thoracotomy (RT) of 9.7% vs. 37.5% for REBOA. There are a number of issues with this study due to the retrospective design. Additionally, the RT group was more likely to be dead on presentation in comparison to the REBOA group (71% vs. 38% without vital signs). While this data supports REBOA use, a prospective study should be undertaken to gauge the benefit of this modality. Recommended by: Anand Swaminathan Retrieval, Pre-hospital and Disaster Sadek S, et al. Resuscitative endovascular balloon occlusion of the aorta (REBOA) in the ...
Source: Life in the Fast Lane - September 14, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Cardiology Disaster Education Emergency Medicine Intensive Care Pre-hospital / Retrieval Trauma critical care examination literature R&R in the FASTLANE recommendations research and reviews Resuscitation Source Type: blogs

Pharmaceutical Company Leaders Pretend to Advocate for the Public Interest - But Maybe it ' s All " For the Love of Money "
In this political season, the US public is confronted with a blizzard of protestations from candidates who claim to want to serve their interests.  We ought to be used to this, because leaders of big health care organizations have been protesting for years about how they are always in it for the public and the patients ' health.  Yet as we have repeatedly discuss, such leaders oftenmanage in ways that subvert their own mission.Recently, there were two striking examples of pharmaceutical leadership saying they were all about the public interest, despite evidence to the contrary.It ' s All About the Children Says I...
Source: Health Care Renewal - September 14, 2016 Category: Health Management Tags: deception Insys Therapeutics mission-hostile management Pfizer public relations Source Type: blogs

The Women ’s Health Amendment Is Getting An Update. What Should It Include?
The Affordable Care Act (ACA) requires most private health plans in the United States to cover four sets of recommended preventive services without copayments, deductibles, or other out-of-pocket costs. One of those four sets of services focused on women’s preventive care needs. It was called for under the law’s Women’s Health Amendment, developed by an Institute of Medicine panel, and officially incorporated by the federal government into health plans’ requirements in 2012. Taken as a whole, the ACA’s preventive services provision requires coverage of a wide array of sexual and reproductive health services, from...
Source: Health Affairs Blog - September 14, 2016 Category: Health Management Authors: Adam Sonfield Tags: Costs and Spending Equity and Disparities Public Health Quality ACA contraceptive coverage HIV/AIDS sexually transmitted infections Women's Health Source Type: blogs

The hospital is a microcosm of America ’s melting pot
“Doctor, why can’t my mother breathe?” he asked, eyes full of concern as he watched his mother’s chest heave like someone who has spent too long underwater. I turned up her oxygen as we discussed the possibilities we were testing for: infection, a reaction to chemotherapy, blood clots. Her breathing eased as we spoke, and in turn, I saw some of her son’s anxiety dissipate. As our conversation came to a close, he paused before asking, “Where are you from?” I smiled and responded, “I was born and raised in Texas, but my parents came from Iran.” I turned to my patient, “Where are you from?” For the first...
Source: Kevin, M.D. - Medical Weblog - September 14, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/roxana-daneshjou" rel="tag" > Roxana Daneshjou, MD, PhD < /a > Tags: Physician Hospital Source Type: blogs

JellyBean 048 with Resa Lewiss
Resa Lewiss; Ultrasound Enthusiast Extraordinaire Dr Resa Lewiss is another stand out woman in Medicine and she has become very well known particularly in Point Of Care Ultrasound. Resa was inspired by people that worked outside the USA health care system where she had started out. Since then she has been the first President of the Academy of Emergency Ultrasound and a founding member of WinFocus & Sono-Games. She has been at the forefront of ultrasound throughout her career. The ultrasound modality has moved from a poor cousin in the imaging world to a position of pre-eminence. It is now THE point of care imaging to...
Source: Life in the Fast Lane - September 14, 2016 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean POCUS Resa Lewiss ultrasoundrel Source Type: blogs

An Update on Price / Cost Transparency + A Promising New Service
By STEVEN FINDLAY Transparency for consumers on prices and costs is a bipartisan goal in healthcare.  The good news is progress is afoot.  The bad news: that progress is still painfully slow.  This blog presents a quick status update with discussion of and links to some recent reports and events. The Healthcare Incentives Improvement Institute (HCI3) and Catalyst for Payment Reform (CPR) have tracked state healthcare price transparency laws and their implementation for the past four years.  In a July 2016 report they found the following:  on an A to F scale, three states got As (Colorado, Maine, New Hampshire); one go...
Source: The Health Care Blog - September 13, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Aware in Care toolkit
The National Parkinson Foundation has developed the free Aware in Care kit with tools and information to share with hospital staff during a planned or emergency hospital visit. A recent study reported that many of those with Parkinson’s often do not receive their medications when needed while at the hospital putting them at a greater risk while there. This Aware in Care kit will assist hospital staff  informed during these visits.  These kits can be requested from your local chapter or center at https://nnlm.gov/bhic/ynxk. If in Canada, call Parkinson Alberta at 1-877-243-9992 to order your kit. Find out more at h...
Source: BHIC - September 13, 2016 Category: Databases & Libraries Authors: Carolyn Martin Tags: General Public Health Senior Source Type: blogs

Would Our Procedural Competence in Medicine Stand Up to the Same Level of Scrutiny as … a Hockey Goalie?
Editor’s Note: This post is one of two pieces on the topic of procedural competence. Read the other piece here. By: Martin Pusic, MD, PhD, assistant professor, Emergency Medicine, and director, Division of Learning Analytics, New York University School of Medicine Institute for Innovations in Medical Education, New York, New York. When I read Vaisman and Cram’s thoughtful Perspective on academic faculty procedural competence, I agreed with most of what they had to say. Academic faculty are certainly having to adapt to a myriad of dislocations as our health systems adapt to new realities. What doesn’t change is the b...
Source: Academic Medicine Blog - September 13, 2016 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective big data deliberate practice faculty procedural competency Source Type: blogs

Do Integrated Delivery Systems Provide Higher Quality and Less Expensive Care?
I have always been somewhat dubious about the claim that hospital mergers and the development of integrated delivery systems (IDSs) will provide less expensive and higher quality care. A recent article discussed this idea in depth (see: The Downside of Merging Doctors and Hospitals). Below is an excerpt from it:One approach...[to the fragmentation of healthcare] is to consolidate more of the health care you need in one organization called an integrated delivery system. An I.D.S. owns one or several hospitals and also employs physicians across multiple specialties. It may also provide nur...
Source: Lab Soft News - September 13, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) General Healthcare Healthcare Business Healthcare Delivery Quality of Care Source Type: blogs

An inhumane way to help those in greatest need of immediate intervention
Imagine losing your grip on reality; your only place to turn is the local hospital. Once there, you give up your personal effects, your clothes, and often, your right to leave. You wear paper scrubs in a sparse room, lay on an uncomfortable bed, and have a guard nearby preventing your escape. In seeking help, you have become a prisoner. This is done for your and for the hospital personnel’s protection, but nevertheless, it is a distinct loss of freedom. But it is all for a greater good, to get you, the patient, transferred to a psychiatric facility where you can get the help you need. Except the wait can be excruciatingl...
Source: Kevin, M.D. - Medical Weblog - September 12, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/ilene-benator" rel="tag" > Ilene Benator, MD < /a > Tags: Conditions Psychiatry Source Type: blogs

You can ’t prepare for a rotation in the pediatric ER
Walking into Riley Pediatrics Hospital in Indianapolis, Indiana, and having just completed from two prior rotations in emergency medicine at two other level 1 trauma centers, I thought I would be able to easily fit in with pediatric population here. I thought I would be able to slide fluidly from patient to patient, oral reports to consults, and stay connected with the rest of the team. I thought I would be able to resume as I had previously functioned in the adult world, and I thought I would enjoy seeing kids again, as it has been almost a full year since my outpatient pediatric rotation. I was entirely surprised by how ...
Source: Kevin, M.D. - Medical Weblog - September 12, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/austin-beck" rel="tag" > Austin Beck < /a > Tags: Education Emergency Pediatrics Source Type: blogs

The Canadian Centre for Aging and Brain Health Innovation (CC-ABHI) launches funding program to spark R & D and commercialization initiatives
———- Up to $500,000 Available Through Canadian Centre for Aging and Brain Health Innovation’s Spark Program to Fund New Innovations (Baycrest press release): The Canadian Centre for Aging and Brain Health Innovation (CC-ABHI) announced today the launch of its Spark Program, an initiative designed to provide point-of-care workers in the healthcare delivery or service industry in North America with as much as $50,000 each in funding to further develop their grassroots ideas into real-world applications. CC-ABHI will select up to 10 projects to receive funding. In total, up to $500,000 in funding will be availabl...
Source: SharpBrains - September 12, 2016 Category: Neuroscience Authors: SharpBrains Tags: Cognitive Neuroscience Health & Wellness Technology aging Baycrest brain-aging Brain-health CC-ABHI cognitive-fitness dementia healthcare innovation Spark Source Type: blogs

LITFL Review 248
Welcome to the 248th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Susan Wilcox drops some serious knowledge on pulmonary hypertension and clapped-out right ventricles on EMCrit Podcast. Brilliant guest with excellent clinical applications. [JS] Anatomy is back, Andy Neill returns with more of the superb Emergen...
Source: Life in the Fast Lane - September 11, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

A Hole in the Heart, Part II
This study looked at patients between 18 and 60 years of age who had a prior stroke or a transient ischemic attack within the prior 6 months. This was a resoundingly negative study.  At two years, the 12/447 patients in the closure group suffered a recurrent stroke, while 13/462 patients in the medical therapy suffered a recurrent stroke.  The trial, however, reveals one of the important chinks in the armor of the randomized control trial (RCT).  Randomized control trials are only as good as the patients they enroll.  Enroll the wrong patients, and the results don’t tell you much.  CLOSURE-1 didn’t provide closure...
Source: The Health Care Blog - September 11, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs