Would You Use a Free EMR/EHR?

There are currently many free EMR solutions. Some of the more popular ones are: Practice Fusion, VersaForm, OpenEMR, Mirror Med, and Medscribbler. Get ready to see some advertisements if you select a free EMR and don't fall for any "free trials." There is currently a large amount of skepticism regarding the long-term viability of free EMR solutions. So if you are currently using paper records and you're thinking about transitioning to an EHR/EHR/Practice Management Solutions, are you looking into any free EMRs?

Recharging Batteries in Seconds

What if you could recharge your dead cell phone battery in just a few seconds? It may be possible, thanks to some Course 3 (Materials Science and Engineering) researchers at MIT. We haven't seen any major breakthroughs in battery technology over the last decade. It's time we see a major improvement in rechargeable batteries.

Rechargeable batteries are also critical in the world of healthcare. Think about all those implanted cardiac defibrillators that rely on a tiny battery. Plus, other cardiac monitoring devices may use rechargeable batteries. As mobile computers like UMPCs become more commonplace in the medical arena, these devices rely on improved battery life.

MIT Researchers Develop a Novel Drug-Delivery Gel

Shuguang Zhang, associate director of MIT's Center for Biomedical Engineering and his team have shown that a special gel may be used to deliver medications such as insulin, hormones, growth factors, or monoclonal antibodies like trastuzumab (Herceptin). The gel is being called a "nanofiber hydrogel scaffold." Wow, try explaining that to patients. This research was funded in part by the National Institutes of Health (NIH) and the High Q Foundation. The High Q Foundation, Inc. is a private philanthropic foundation that was established in 2002 with the mission of bringing together academia, industry, governmental agencies, and other funding organizations in the search for Huntington disease (HD) treatments.

Master of Science in Medical Informatics at Northwestern University

The Master of Science in Medical Informatics at Northwestern University is offered in partnership with the Feinberg School of Medicine, Northwestern University. This program is offered online and seems like it's a terrific program. When I was applying to colleges, I applied to Northwestern as my 2nd choice college. Since I got accepted to MIT, I went to Boston. But sometimes I wonder how my life would have turned out if I had gone to Chicago instead of Boston. I suppose I'll never know. Speaking of MIT, they actually offer a program in biomedical informatics through the Harvard-MIT Division of Health Sciences and Technology (HST). If I could go back to MIT to study, I think I'd be torn between the biomedical informatics program and an MBA program at the Sloan School of Management. Maybe someday they will develop a joint curriculum that will be a joint MBA/MS for people who have a strong interest in business and biomedical informatics.

Careers in medical informatics are very broad and include areas like: health care administration; management; consulting; health IT; public health; research; academia; and much more.

Digital Journals and Magazines

Because of the economic challenges of today, more and more publishers are choosing to offer their journals/magazines in digital format. One popular format is Nxtbook Media. You may have seen popular journals like Medical Economics and Locum Life in digital format.  You can also get most of the regular newstand magazines in digital format through Zinio. I personally prefer the digital format because it reduces the clutter in my office. Plus, you can save them on your computer and carry them around with you.

Prevent Opera Mini from Freezing in Windows Mobile

I've been testing Opera Mini on my Windows Mobile device and I was pleased by the speed and performance, but I noticed that it would freeze up occasionally. My entire device would crash and I'd have to reset the phone. I decided to change the Network Protocol from Socket to HTTP. Now, I have yet to experience a freeze or a crash. Opera Mini 4.2 has become my favorite mobile browser on my XV6800 (HTC Titan, Sprint Mogul) Pocket PC because it's so much faster than Skyfire, Opera Mobile, Iris, or Pocket Internet Explorer. So, if you use your mobile device to browse medical websites and participate in CME activities, I would urge you to try Opera Mini. You won't get any "out of memory" messages and if you switch your Network Protocol, you shouldn't get any frustrating freeze-ups. Caveat: you won't get Flash content on Opera Mini.

Rivaroxaban to be Reviewed by the FDA Panel on March 19

March 19 is match day for 4th year medical students. It's also the day when the FDA Panel is supposed to review the anticoagulant rivaroxaban (also known as BAY 59-7939 or Xarelto). It is an oral, direct Factor Xa inhibitor (I don't think I'll ever forget that coagulation cascade diagram that I learned in medical school). If approved, this drug could shut down all those coumadin (warfarin) clinics out there that monitor blood INR in people taking this vitamin K antagonist. Rivaroxaban would not require any blood monitoring. Plus, all those home INR tests manufacturers would need to look for something new to do.

I think everyone is wondering how the FDA will react to this new medication. If approved by the FDA, rivaroxaban will be sold in the US for short-term use as a prophylactic anticoagulant for patients undergoing knee- and hip-replacement surgeries. I'm sure the drug manufacturers will go for additional indications later on. Rivaroxaban is manufactured by Bayer and will be marketed by Ortho-McNeil Pharmaceutical which is a Johnson & Johnson group.

Lenovo Thinkpad X61 Tablet for $649

If you're looking for an incredible deal on a Lenovo Thinkpad X61 Tablet, now's the time to buy. You can get one for less than $649! I would suggest that you avoid the Lenovo Outlet, since your order may get delayed for weeks. The Thinkpad tablet is a solid machine and it has one of the best keyboards out there. It has consistenly been rated as one of the best convertible tablets out there. If you use an EHR/EMR, then you should try entering information on a tablet. You may fall in love with the pen interface and the easy ability to tap and click.

Applying to Medical School

I've recently had the opportunity to review a few personal statements from people who plan to apply to medical school. As I think back to my college days, I seem to vaguely remember what my personal statement was about. The healthcare system in this country is in flux and so much may change under this new administration. However, with the unstable economy and the uncertainty of job security, many people are still applying to medical school. Although this country has a shortage of physicians, I don't think any medical school will ever see a shortage of applications.

Advantages of an ASP model EHR/EMR

If you're shopping around for an EHR (or EMR), you may be hearing vendors talk about an ASP model versus a client/server model. Many of the EHR vendors (such as NextGen, eClinicalWorks, GE Centricity, and others) offer both options. So what are the advantages of an ASP model? What is an ASP model?

Think about e-mail. If you use Outlook on your computer, then that would be analogous of a client/server model. All your messages are kept on your local hard drive and you have quick and easy access to all your old e-mails. An ASP or Application Service Provider model is almost analogous to using Gmail, Hotmail, or Yahoo for your e-mail services. This may not be the best analogy, but it's close. All the data is stored somewhere else (off-site) and not on your local hard drive.

Here are the major advantages of an ASP model from my perspective:

1. Less cost. Your overall costs will be lower. You don't need to purchase a dedicated server, so you'll need less hardware. Plus, the vendors typically charge less for ASP models compared to server/client models.

2. Less cost. You won't need to invest in backup hard drives and other backup mechanisms to backup all the patient data that is on your server hard drive.

3. Less worry since you don't have to worry about backing up all that important data. No need to worry about off-site backups in case your office burns down. All your data is already off-site and it should be backed up with several layers of redundancy.

4. Access your data anywhere. As long as you have an Internet connection, you should be able to access your data remotely. Think of cloud computing. No need to set up a VPN (virtual private network) or use Remote PC to access those electronic files at the office. Plus, you can easily access your data from mobile devices such as laptops, UMPCs, netbooks, and even iPhones and PDA Smartphones (for certain EHR solutions).

There are clearly many more advantages to an ASP model, but I'm just highlighting some that really stick out to me.

So what are the major disadvantages? Well, you need to ensure that you always have a high-speed Internet connection. If your office is in a rural area and your Internet comes and goes, then you can't rely on an ASP model. You'll need to house all your data on-site. Don't rely on dial-up modems either. You'll be at the mercy of your EHR vendor who is supplying with access to your data. If any of their servers were to suddenly go down, then you'd be without access and you may have to temporarily revert to (gasp) paper.

Massachusetts Officially Bans Industry Gifts to Physicians

Have you noticed that there will be fewer and fewer major medical meetings in Boston? Boston used to be one of the major hubs for national association and society meetings and symposium events. This includes CME (continuing medical education) events. Now, major medical groups are shifting gears and looking for other cities. Why? Well, part of it may be related to this new ban in the state of Massachusetts. According to the Boston Globe, drug companies will have to disclose payments to doctors and hospitals for research designed to promote a particular product, sometimes called "seeding trials"; funding for research aimed at answering a scientific question will still not have to be disclosed. In the MS Word document titled, "Pharmaceutical and Medical Device Manufacturer Conduct Regulations," you can see the changes in Track Changes (if you have MS Word).

Something is Different at Medscape

Have you noticed the change at Medscape? They now have all their CME in an entirely separate section from the main Medscape pages. The URL is MedscapeCME.com, but you land on the subdomain cme.medscape.com. When you're there, everything you see is certified CME and you're not exposed to any marketing or promotional content. In the world of CME, any educational content that is not certified CME is considered promotional content. We live in a strange world, but that's just the reality of the CME environment.

Walmart to Sell Digital Health Records

You've probably heard that Walmart is getting into the e-health record space by selling eClinicalWorks. This Electronic Health Record (EHR or EMR) is a CCHIT Certified system (for 2008) and includes a suite of several different options. According to the NY Times, this move by Walmart is to target small physician offices. Speaking of Walmart, have you noticed that they've gotten rid of the hyphen between Wal and Mart? Now they're just Walmart. Anyways, the bigger question remains: will more and more physicians embrace EMRs just because it's available from Walmart of Sam's Club? Plus, what about all those people who hate Dell computers? (I'm not one of them, but I seem to meet them all the time. Some people really have strong opinions about specific PC manufacturers. Maybe that will change with the new Dell Adamo.) With only 17% of the physicians using EHRs, there is a huge marketplace to sell and offer EHRs to those who may lack those strong computer skills. Once BestBuy gets involved in this competition, you'll start seeing a lot more of those "Geek Squad" vehicles around. If you're looking to break into the Health IT industry, maybe you should get a job at Walmart selling EHR solutions and acting as an EHR consultant. I'm sure that eClinicalWorks is bolstering their support staff and preparing for all those phone calls.

Opportunities in Medical Writing

A student recently asked me if you had to be a physician to be a medical writer. The answer is no. Opportunities in medical writing are vast. If you want to write and be a lifelong writer, then you can excel in this field as a nurse, a PhD, a PharmD, an MD/DO, or even an MS in biomedical writing. Some medical writers also do really well with a BS or BA in scientific journalism or biology. You'll have more opportunities if you have an advanced degree, but it's not a requirement to be an excellent writer.

Keep in mind that many clinicians may start out writing, but then they advance into other senior positions that may involve project planning, team management, company strategy, new business development, etc. Others love to write and that's their passion, so they have no ambition to do anything else.

Panasonic CF-H1 Medical UMPC

Have you ever wondered why medical UMPCs (ultra-mobile PCs) have a built-in handle? When's the last time you saw a laptop that had a built-in handle? Maybe the One Laptop Per Child (OLPC) project?

Panasonic has the Toughbook CF-H1 Medical UMPC that looks like a very solid device. One of the nicest feature is the screen - it offers either a passive touch screen, or an active digitizer screen if you're using a special tablet pen. It looks like similar to the Motion C5 Mobile Clinical Assistant, but it looks like Panasonic took some of the feedback on the C5 and improved on the design. It's great to see UMPCs used in the healthcare industry. There is such a need for better medication management and monitoring that can all be done electronically now.

2009 Match Day is Approaching

March 19 is the magical day for graduating medical students.They get to open a sealed envelope in front of their classmates and announce where they will be going for their post-graduate residency. It's quite an exciting day, generally filled with tears (of joys for some and sadness for others). It's ultimately the day when career paths are determined (unless you decide to switch specialties or transition into a non-clinical career path). For most of the students, the match is determined by an automated computer system that takes your rankings and then compares that to the way various residency programs ranked you. Couples have the option of doing a couples match, and this alters the algorithm a bit to try and match both of you in a similar geographic location. Some specialties work outside of the match. And, for those students who don't end up matching, the week before match day ends up being quite the scramble as they try to get into unfilled positions. Want to learn more? Check out the National Resident Matching Program (NRMP).

How the Apple iPod is Changing Healthcare

You've probably heard of the new Apple iPod shuffle. This thing is tiny! I think they should have named it the pico. Anyway, when I saw the announcement for this new iPod, I started thinking about the different ways that the iPod has changed healthcare.

First, doctors and other healthcare professionals are using iPods and other MP3 players to participate in audio continuing medical education (CME) activities. Most of these come in the form of podcasts, but some are straight MP3 audio or MP4 video files that you can load on your iPod. Clinicians are now listening to medical education while they exercise, while they drive, and when they travel on planes. iPods have made it so easy to carry volumes of audio medical education on a tiny little device.

There's another way that the iPod has changed healthcare. Patients now have access to audio (and video) health information. Doctors, nurses, and hospitals are releasing audio podcasts programs that are very popular among patients. They are learning more about their own conditions and this patient education is leading to better self-management. Self-management is critically important in for conditions like diabetes and heart failure.

American Board of Quality Assurance and Utilization Review Physicians

How do you pronounce ABQAURP? It stands for the American Board of Quality Assurance and Utilization Review Physicians. They offer Health Care Quality and Management (HCQM) Certification through an online study course and then a certification exam. Once certified, you can hang a certificate that says, "Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, Inc." The ABQAURP is the only Health Care Quality and Management organization with an exam developed, administered, and evaluated through the National Board of Medical Examiners (NBME). So, you may want to learn more if you have an interest in working in quality improvement, utilization management, managed care, risk management, case management and workers' compensation. 

Medical Informatics Programs in the United States

Clinicians who have a strong interest in learning more about medical informatics (or health informatics) should probably invest the time and money to get formal education in this topic. There are many different ways of getting this education. You can do a fellowship in medical informatics. You can also pursue a master's program. If you're looking for a list of educational programs, take a look at the AMIA list. You can also take a look at this University of North Carolina site, although it may be a bit outdated. There are also a number of online programs where you can receive an MS in medical, biomedical, or health informatics. If you can be disciplined to study independently, then you may find that an online program is the most flexible way to receive more education.

RelayHealth

If you've been keeping up with the Personal Health Record (PHR) industry, then you'll be very familiar with RelayHealth. RelayHealth provides a secure way for patients and doctors to communicate online. It's been linked with Microsoft HealthVault and offers a way for patients to get access to their personal health records as well. Google Health is another PHR provider that has been gaining a lot of traction recently.

the FDA is using Twitter

The FDA is using Twitter to notify people about FDA recalls. Twitter was founded by Jack Dorsey, an NYU drop-out who eventually started this very successful start-up company. I think it's a great idea that the FDA has decided to leverage this powerful Web 2.0 resource.
For more information on FDA recalls, visit: http://twitter.com/fdarecalls.

Managed Care Terminology

If you're looking for a glossary of managed care terminology, take a look at this simple site:
http://aspe.hhs.gov/Progsys/forum/mcobib.htm

Here, you can decipher acronyms such as: DRG, EQRO, EPO, FFS, IPA, PRO, PCCM, PHP, POS, QMB, TEFRA, and more. The US Department of Health and Human Services (HHS) also has some additional resources about managed care that may be very helpful if you're interested in a career as a medical or pharmacy director in a health plan.

Apple Netbook or Tablet?

According to CNN/Money.com, it looks like Apple is preparing a netbook. Or, is it a tablet? A netbook with a touch screen? Wait, I'm confused.

I suppose no one really knows what Apple will be coming out with later this year. If it's a netbook, then I hope it's reasonably priced. Sony's Vaio P series are nice and small, but they're just way too expensive when you compare them to other netbooks on the market. I suppose the same could be said about MacBooks if you were to compare them with PC laptops.

FDA: Contaminated Cheese

The FDA has released a press release about the possibility of contaminated cheese. Here are the specifics: avoid Queso Fresco Fresh Cheese Mexican style soft cheese (two specific lots) or any Queso Cotija Molido Mexican style grated cheese manufactured and distributed by Peregrina Cheese Corp. of New York City. According to the FDA, there is a risk of infection with Listeria monocytogenes, so people are being urged to throw away this type of cheese.

Merck, Schering-Plough, and now J&J/Centocor

The Merck/Schering-Plough merger/reverse acquisition may hit some problems according to some because of J&J/Centocor and the co-marketing of Remicade (infliximab). Golimumab is a similar biologic agent that is currently in development. It is supposed to be co-marketed with Schering-Plough, but I guess we're not sure what's going to happen if Merck and Schering-Plough join forces. All these pharma merges/acquisitions are starting to get pretty crazy. Some are forecasting that thousands of jobs may get cut, but no one seems to be sure where those cuts may occur. I guess we'll just have to wait and see what happens here. These are some incredibly dramatic times in the pharma industry.

Merck to Acquire Schering-Plough

It looks like Merck will be acquiring Schering-Plough in a $41.1 billion deal. But wait, it's a bit confusing. People are referring to this as a "reverse merger" and Merck's top executive, Chairman and CEO Richard Clarke, will lead the combined company, but Schering-Plough will be the surviving public corporation. The new company will be called Merck.

Congrats to MIT student Geoffrey von Maltzahn!

Congrats to MIT student Geoffrey von Maltzahn! He's a 28-year-old Ph.D. candidate in the Harvard-MIT Division of Health Sciences and Technology (HST) and he did his undergrad at MIT (Course 10). He received the prestigious $30,000 Lemelson-MIT Student Prize for his research in the area of cancer therapy and nanomedicine: a new class of cancer therapeutics and a new paradigm for enhancing drug delivery to tumors. Nanotechnology is such an exciting area right now, especially in the area of oncology and drug delivery. I envy those who are devoting their lives to biologic research and applying innovations in technology to improve healthcare.

Handbook of Medical Informatics

A frequent question that comes up is: "What is medical informatics?" There are all types of explanations to that question, so let me refer you to a book that can be found here: Handbook of Medical Informatics


There are many different types of opportunities in health or medical informatics. If you're serious about learning more, I encourage you to join the American Medical Informatics Association (AMIA) found here: http://www.amia.org/

The American Health Information Management Association (AHIMA) is also an excellent resource found here: http://www.ahima.org/