EHRs and the iPhone

Read about how more EHR/EMR (electronic health/medical record) providers are developing a platform that is compatible with the Apple iPhone at MedicalSmartphones.com. Will the iPhone dominate the mobile EHR space?

Windows XP Continues to Live Within Windows 7

If you upgrade to Windows 7 Professional or Ultimate, then you'll be pleased to know that it will come with a virtual engine running Windows XP. Despite their efforts, Microsoft won't be letting Windows XP die. Since I still have a few old computers laying around, I run XP on them. I've tried Vista and even Windows 7, but at the end of the day, XP wins. I'll be glad to replace Vista with XP. I've just had so many problems with Vista that it's been refreshing to use XP. Windows 7 is a light at the end of the tunnel for those of us still running Vista and hitting various roadblocks in our productivity.

Swine Flu Getting Serious?

CNN is reporting that the WHO is worried about the growing number of swine flu cases. There have been eight cases of human infection in the U.S. Six of the U.S. cases were in California and two in Texas. More than 1000 people are infected in Mexico and 68 people have died. How worried should we be? I think we need to stay tuned for updates from the CDC. Thanks to CNN for the image.

Interested in Testing Windows 7 RC?

Want to read a bit about the latest build of Windows 7? It's the Release Candidate (build 7100) and you can see how it runs on the Samsung Q1 Ultra by reading this: Testing Windows 7 RC (build 7100)

What Happens if We Eradicate Malaria?

So what happens if we eradicate malaria? What will medical students learn about the banana-shaped falciparum? CNN has an interesting perspective about this issue. As World Malaria Day approaches, I often wonder what could happen if we develop a successful vaccine against malaria by bioengineering mosquitoes. Would the world population get out of control at that point? Public health professionals will have a major ethical dilemma on their hands. Thanks to Michigan.gov for the photo.

Medical Blogging Can Lead to $upplemental Income

You wouldn't believe the type of supplemental income you can generate by blogging. I'm not talking about blogging about Apple computers like Dr. Arnold Kim. He left his nephrology practice to devote his time and energy into full-time blogging. Instead, I'm referring specifically to writing about health and medical issues. The key is to capture the right audience. I'm speaking about medical students, physicians, nurse practitioners, physician assistants, pharmacists, nurses, nursing students, and other healthcare professionals. It's essential to get the right type of people viewing your blog. If you primarily capture patients, then your blog still has value, but it's not like blogs that draw the attention of healthcare professionals. Why? Blogging income comes from advertisers. That's the primary source of income. So, if you're not willing to put some ads on your blog, then you'll have a hard time generating any income unless you write for someone else (or a company) who pays you for your writing.

You won't reach the status of KevinMD overnight. He started blogging in 2004 and now he captures a huge audience! If you want to start blogging, you have to be patient and persistent. There are some tips and tricks that can help you speed things up, but you need to make sure that you don't abuse any services and get identified as a "spammer."

So how do you start? Are you an "expert" in a particular area? For me, I've always had a passion for technology (yes, I blame that on my MIT education). Do you colleagues and peers ask you questions about a particular topic all the time? I always got questions about PDAs, handhelds, smartphones, mobile devices, laptops, and other gadgets. What about you?

Schizophrenia on CNN: Young Teenager

If you look on CNN.com, there's an interesting story about a teenager who suffers from schizophrenia. It's quite a compelling story about how he hears voices in his head. His mom quits her job to take care of him. I personally know several young men who developed schizophrenia and it's been a struggle for their families. Even with advances in medical technology, schizophrenia remains a very difficult disorder to treat. Make sure you go out and watch the movie titled, "the Soloist."

Visit to the Doctor: Today vs. the Future

I had a visit to the doctor yesterday. I admit that I still chuckle inside when I see people filling out paper forms. Someday in the future, when people visit their doctor, they won't be filling out forms. Instead, they will be pressing on-screen buttons on kiosks and tablets. Everything will be digital and paperless. You'll see electronic health records (EHRs) everywhere. We'll be represented by barcodes or some type of sophisticated RFID chip (no, I don't think this chip will get implanted under our skin). However, I am convinced that in the future, doctors will be operating with a paperless system. All our health data will be digital. If you use an Internet-based personal health record (PHR) service, then you'll have access to your information whenever you need it.

Adoption of Health IT

Read my post titled, "The Adoption of Health IT" on Brain Blogger.

Bioengineering Mosquitoes to Cure Malaria

I hate mosquitoes. I love to hike and camp, but I hate using bug spray to keep these nasty pests away. Well, scientists are growing, or actually I should say they are bioengineering mosquitoes to create a vaccine against malaria. If the vaccine is successful, then I think we'll have a really serious global population problem on our hands. It may be strange to think that malaria actually controls the world's population in certain areas of the globe. If a vaccine eradicated malaria the same way a vaccine eradicated smallpox, then the who knows what would happen to the world's population. Maybe countries may need to enforce one-child policies that are found in China. Who knows? But this would lead to a very interesting public health ethical dilemma.

Are People Getting Addicted to Facebook?

Are people getting addicted to Facebook? We recently heard that the older generation (specifically, women over the age of 55) are the fastest growing segment on Facebook. So how can you tell if you're addicted to Facebook? Check for these "five clues" that appeared on CNN. Will Facebook addiction get added to the DSM-V?

Here are the 5 clues:
1. You lose sleep over Facebook
2. You spend more than an hour a day on Facebook
3. You become obsessed with old loves
4. You ignore work in favor of Facebook
5. The thought of getting off Facebook leaves you in a cold sweat

What do you think? Are you getting addicted?

Telemedicine Leads to Criminal Conviction

This morning, I was reading an article about how telemedicine was improving stroke outcomes in Arkansas. Doctors in remote towns were getting consultation over the phone and Internet. You can send radiology images through e-mail, have a radiologist review it, and then provide advice for the patient. Telemedicine makes it possible for physicians to practice medicine in remote locations. Telemedicine technology was developed primarily to help healthcare providers in remote locations who don't have access to large medical centers. Well, a doctor in Colorado abused this technology and is now paying for it by spending 9 months in jail. His name is Christian Hageseth and he was convicted of practicing medicine in California without a medical license. He did not have an active California medical license and prescribed generic Prozac to a Stanford student John McKay who later committed suicide. So do you need to have an active medical license in every state if you're to practice telemedicine? To be on the safe side, perhaps you should only practice telemedicine within your own state (assuming that you're licensed to practice medicine in your state, of course).

Choosing a Medical Smartphone

It used to be simpler when you only had the Palm Treo and a few different phones running Windows Mobile. There are now so many different smartphone operating systems. If you're a medical student or a resident, how do you choose your phone's operating system (OS)? You have Palm Pre, Microsoft Windows Mobile, Apple iPhone, RIM BlackBerry, Google Android, and several others. How do you choose? Take a look at the post on MedicalSmartphones.com titled, "What's the best smartphone for physicians?"

Goodbye OQO

The writing is on the wall. OQO has canceled pre-orders for the new model 02+. This probably means that the model 02 will be the last OQO. I now own a collector's item. Of course, I could also say that about the Apple Newton Messagepad 2100 (which is now a relic, but was very advanced for its time). I used to carry my Newton in the hospital. It was a bit heavy for the white coat, but it was very useful because I kept all my patient notes on it. I was paperless even before most hospitals had computerized physician order entry (CPOE)! Will we ever see another gadget that compares with the OQO? I'm sure we will as more manufacturers build small PCs that have full capabilities. As hardware technology improves, we'll see more tiny devices permeate the healthcare industry and soon hospitals will be full of gadgets and gizmos.

Problems Viewing Web Pages with Firefox

I'm a big fan of Firefox, but I've recently been having some problems viewing certain pages with Firefox. They appear fine on Google Chrome, Apple Safari, and Microsoft IE (Internet Explorer). I really like Firefox because of all the plug-ins (add-ons), but it's starting to get a bit annoying. I've been relying on IE Tab, but now I'm wondering if I should abandon Firefox. They just released a new update to Version 3.0.9 but that still didn't fix the problem for me. Since I use several different computers (including a tablet PC and an Ultra-Mobile PC), I like to have all my files and bookmarks synchronized on all my machines. That's easy with Windows Live Sync (which used to be called FolderShare) and Xmarks (which used to be called Foxmarks).

Avastin in Early-Stage Colon Cancer Misses Primary Endpoint of DFS

Does Avastin plus chemotherapy improve outcomes in patients with early-stage colon cancer? These types of questions are difficult to answer because the answer depends on what you're measuring as your main outcome. Survival? Disease-free progression? Quality of life? The world of oncology is a complex one with many different measurable outcomes.

The National Surgical Adjuvant Breast and Bowel Project (NSABP) C-08 study did not meet its primary endpoint (which was improved disease-free survival or DFS) with adjuvant use of bevacizumab (Avastin) plus chemotherapy in patients with early-stage colon cancer. Avastin (or bevacizumab) is made by Genentech, Inc. (which is to be acquired by Roche). Who can keep up with all these mergers and acquisitions in the pharma/biotech world?

ACP is in Philly

The ACP (American College of Physicians) meeting runs from April 23-25, 2009 in Philadelphia, PA. Make sure to grab some Philly Cheesesteak (and don't forget to take a statin).

Craigslist killing suspect was a model student

According to this report on CNN.com, Philip Markoff was a "model student" and his fiancee maintained his innocence in an e-mail to ABC News and wrote that Philip Markoff "is the wrong man" and "was set up." It's so hard to know what goes through the minds of people who commit murder. Markoff was a second year student at Boston University where his peers and colleagues thought that he was a fairly normal guy. Is it possible that the stress of medical school caused him to snap? Is it possible that he succumbed to some strange mental illness during medical school? After all, he's in that age group where psychosis and schizophrenia begin to manifest symptoms.

What's Going on at Siemens Medical Solutions?

According to the Associated Press, some government officials raided the U.S. headquarters of Siemens Medical Solutions in Malvern, Pennsylvania. Details remain unclear at this point, but we do know that the officials had a search warrant. The DCIS is the criminal investigative arm of the Office of the Inspector General for the Defense Department. Recently, Siemens Medical Solutions had received a Defense Department contract worth up to $267 million to sell medical-imaging equipment to the military. Could it be related to that?

Earth Day 2009

It's Earth Day! Let's remember our planet today for the sake of improving environmental health. Toxins and other pollutants are destroying our planet and causing significant health problems. The "Green Generation" campaign begins today.

Portable Ultrasound Fits in Your Pocket

That would be the tagline for this new product if one ever gets developed. If you could convert your smartphone into an ultrasound device, would you do it? Then you'd have a real medical smartphone! Go to Washington University and you'll see what I mean. These guys (William D. Richard, Ph.D., Washington University Associate Professor of Computer Science and Engineering, and David Zar, Washington University Research Associate in Computer Science and Engineering) have developed a USB-based ultrasound probe that plugs into smartphones. Now that most smartphones are going to have a universal micro-USB port, such a probe may actually be useful in the future because all the phones will have compatible connectors. Microsoft has funded research in this area. I wonder when Apple will start providing research grants in this area. Let's hope they don't change iPod/iPhone connectors if they build a probe that plugs into the bottom of the device.

More People Getting Interested in Non-Clinical Opportunities

I seem to be meeting more and more people who have questions about non-clinical opportunities in medicine. I'm not talking about specialties that involve the least amount of patient interactions like pathology. I mean that people want to leave the clinical setting and enter the world of business. Or, they want to work for themselves and do some medical writing. For those of you who have an interest in non-clinical jobs and opportunities in medicine, I encourage you to subscribe to my updates on my blog that is dedicated to this topic: http://www.nonclinicaljobs.com

Blogging for Supplemental Income

You've probably heard that you can make money by blogging. It's a great non-clinical opportunity if you enjoy writing. But how do you get started? What type of blog should you create? Can you make more if you write a medical blog? These are some of the questions that I often get asked.

Blogging can be a hobby (that may result in some supplemental income) or it can be a full-time career. There are people who have left six-figure salaries to go into full-time blogging. Remember the story about the nephrologist Arnold Kim who left his clinical practice to be a full-time blogger? I'm sure that KevinMD also makes a significant amount of money through his blog. I often wonder if he will leave clinical medicine to devote his time fully to his writing.

Blogging is a great option for retired physicians and other healthcare professionals who enjoy writing about different things. Keep in mind that the largest revenue generator are advertisements. However, there are other unique opportunities if you capture the right audience with your blogs.

To get started, I suggest that you use Blogger on Google. It's free and easy to create a Google account. Plus, after you create your blog, you can use Google Analytics to see what type of traffic you're getting on your blog. Many people also use WordPress for their blogs.

Tragic Story: Philip Markoff, the Craigslist Killer?

As someone who spent 4 years in Boston at MIT, this sad story hits home for me. A Boston University medical student named Philip Markoff has been charged with the murder of Julissa Brisman, a 26-year-old masseuse who advertised on craigslist. I've used craigslist for many things: to buy and sell merchandise, to find job candidates, and much more. It's a great service and there are some people who offer (or sell) their services online.

I'm sure this isn't the last time we're going to hear about Philip Markoff. He was charged today and he plead "not guilty" so we'll have to see where this goes. He's currently being held without bail for the fatal shooting of Brisman. This story makes me think about television shows like CSI. I don't usually watch TV unless I'm at the gym. I admit that I'll watch CSI if I'm running on the treadmill or using the eliptical. Without a doubt, medical technology has improved our ability to solve crimes by analyzing biological evidence. Let's hope that the evidence leads to the correct diagnosis of this criminal case.

50% of Physicians are using Wikipedia

According to a study performed by Manhattan Research, almost 50% of physicians are going to Wikipedia to view health condition information. Why? Because they use search engines like Google to look up information about diseases and various conditions. Isn't it amazing how we rely on Internet search engines for information? The Manhattan Research study, titled Taking the Pulse, surveyed physicians during the first quarter of 2009.

Medical Transcriptionists

Do you know how to find a medical transcriptionist? Is it like finding a medical writer? With all the new drugs that are out there, it can get difficult to keep up with all these names. If you want to follow the life of one medical transcriptionist in India named Raj, then I urge to visit his blog. He provides some great commentary and tips about medical transcribing from an overseas perspective.

Grand Rounds is at Diabetes Mine

Grand Rounds is hosted at DiabetesMine today. It's the "Birthday Edition" for the author. Congrats on a wonderfully creative post!

What's Happening at the FDA with Rivaroxaban?

Last month, the FDA panel (which included clinical experts) voted 15 to 2 in favor of rivaroxaban (which may get marketed as Xarelto by Bayer and J&J if it receives FDA approval). What's going on at the FDA this month?

Speaking of new anticoagulants, Pradaxa or dabigatran etexilate is another agent that may be nearing approval. This drug is made by Boehringer Ingelheim and has received maketing approval by the European Commission. Unlike rivaroxaban (which is an oral factor Xa inhbitor), dabigatran is an oral direct thrombin inhibitor (DTI). Both are oral pills and both may someday replace warfarin (Coumadin) if they receive FDA approval for anticoagulation.

There's always a bleeding risk associated with an any anticoagulant drug, so the big question is whether the risks outweigh the benefits. Let's hope that these drugs don't follow the same fate as ximelegatran (Exanta).

Top 10 Keywords in the Last 30 Days

Here are the top 10 keywords that are bringing people to my website through search engines:

1. medicine and technology
2. joe kim
3. joseph kim
4. jobs for mds without residency
5. blackberry storm medical applications
6. free emr
7. cchit 2009
8. medicine and technology joe kim
9. opera mini vs opera mobile
10. rivaroxaban fda

I guess people are still looking for a free EMR solution.

Scientific Dangers of Twitter?

I don't usually watch television because I spend my time blogging. However, I do follow the news on CNN.com. There was an interesting story about the scientific dangers of Twitter. Titled, "Scientists Warn of Twitter Dangers," this story suggests that "the streams of information provided by social networking sites are too fast for the brain's "moral compass" to process and could harm young people's emotional development." Wow! How was this study conducted?

According to researcher Mary Helen Immordino-Yang, "If things are happening too fast, you may not ever fully experience emotions about other people's psychological states and that would have implications for your morality."

I'm sure parents have a difficult time controlling how much time their children spend on the computer or on mobile devices like cell phones, PDAs, and smartphones. After watching this story, they're going to make sure their kids don't send any more tweets. Maybe CNN released this story because Twitter was getting overloaded with volume and they needed to give their servers a break.

SkyFire 0.9 Now Available for Windows Mobile

I've been using SkyFire for several months now and it's a solid Windows Mobile browser. It works quite well on my Verizon Wireless XV6800 smartphone. Version 0.9 is now available as a free download. It's still not mobile Safari on an iPhone, but it's one of the better mobile browsers for Windows Mobile. It's not as fast as Opera Mini running on a Java Virtual Machine, but it's capable of displaying Flash content.

To get it, type: http://get.skyfire.com into your mobile browser and download the CAB file. It has links built-in for Twitter and Facebook.

Twitter While You're On-the-Go

I'm still relatively new to Twitter but I'm trying to use it more and more. I carry my Verizon Wireless XV6800 smartphone everywhere I go, so I'm always connected. More and more medical students are using smartphones even before they start their clinical rotations. I even see high school students carrying iPhones and BlackBerrys. These devices are no longer just for the "business user." As these mobile devices become ubiquitous, healthcare professionals will be using them for everything ranging from clinical needs to social networking. We live in a world of Web 2.0 where people want to stay connected all the time.

The Viliv S5 and the Buzz about UMPCs

Do you use an ultra-mobile PC (UMPC)? I'm not talking about those tiny netbooks that you see at Best Buy. I mean a touch-screen tablet that you can carry in your pocket. Tiny tablets are becoming more popular in the healthcare industry.

I love my OQO, but I fear that the company may not be here much longer. What will I do if I can't carry a full PC in my pocket? The Viliv S5 Premium may become the OQO replacement for those of us who have an OQO model 02. From a distance, it looks like the model 02. However, it's not a slider and it doesn't have a built-in keyboard. The Viliv S5 looks like a solid little device, but who's heard of Viliv? Viliv is a Korean company that creates ultra-mobile PCs like the S5 which fits in the palm of your hand. Would you pay $599 for this computer? You won't find it at Best Buy, but you can get one at Dynamism. This little computer has generated a lot of buzz recently and it may be a great little mini table for those of you who need a full PC but don't need a small built-in keyboard like those found on netbooks.

You'll See Something New and Exciting Later this Week!

I'm anticipating some new and exciting changes to this site later this week (as long as everything goes as scheduled). I can't go into many details, but please stay tuned! If you follow me on Twitter, you'll be one of the first people to find out when it happens.

Advances in the Pathology Lab

Some of the most significant updates in the world of medicine occur in the lab. The pathology lab to be precise. Pathology isn't the most popular specialty among medical students, but it's gaining momentum because more and more students are recognizing that you can have a fairly normal lifestyle as a pathologist. Think about how technology has allowed us to understand the science of diseases. The electron microscope is a brilliant invention! Modern technology will only improve our ability to understand diseases at a molecular level.

The American Society for Clinical Pathology (ASCP) is having "Lab Week" this week. The theme is: "Laboratory Professionals Get Results."

Join a FREE Social Network of Non-Clinical Healthcare Professionals

We currently have 487 members on the free social network titled, "Non-Clinical Healthcare Professionals." My hope is that we'll reach over 500 members by the end of this month. There are many new and exciting things that I'm working on to help those of you who may be looking for non-clinical job opportunities, supplemental income, and complete career changes into the non-clinical world. Right now, there are many jobs in Health IT (information technology), but you may not feel like you have the right skills and training for that industry. I may be able to help you with that. Join the FREE network and tell others about it so that we may collaborate and help each other find the right types of opportunities.

Multi-Touch Screens on a Tablet PC

The phrase "multi-touch" has gotten confusing in the tablet PC industry. My Lenovo Thinkpad X200 tablet is considered to have a multi-touch screen because I can use my active digitizer pen or my finger as an input device. However, I can't use two fingers on the screen because it is a passive screen (not a capacitive touch screen like the iPhone or BlackBerry Storm).

I was walking through Best Buy today and I played with the convertible tablet PC made by HP. It was the HP tablet TX2Z that features a capacitive multi-touch display (which means that you can use two fingers on the screen and perform gestures).

Windows 7 will include the capability to use some of those cool multi-touch gestures. Apple already leverages this technology on the iPhone and on their MacBooks.

Windows 7 Much Better than Vista and XP

I didn't have high hopes for Windows 7. I didn't think that Microsoft could build an operating system that was more efficient than XP for slower machines like ultra-mobile PCs (UMPCs). For these reasons, I've been running Windows XP on my Samsung Q1 Ultra which has a very slow processor (single core, 800 MHz). It's not like my Lenovo Thinkpad X200 Tablet that has a blazing Intel Core 2 Duo processor.

My hat's off to you Microsoft. You've learned from your mistakes (and failures) on Vista and you've created a great operating system with Windows 7. I'm very impressed by the way that Windows 7 is running on my Ultra-Mobile PC (UMPC). I had tried a few of the earlier builds of Windows 7 on my Samsung Q1 Ultra and they were not better than Vista. However, the latest build of Windows 7 (build 7077) has been fast, efficient, and very responsive. If you're still running Windows XP, I urge you skip Vista and go to Windows 7.

Interview With a Pharma/Biotech Recruiter

If you've been interested in getting a non-clinical job in pharma (pharmaceuticals) or biotech (biotechnology), you may not know where to begin, especially if you've only been in clinical practice and/or academia. You may have questions that you want to ask, like "How do I break into pharma?"

Well, I have the unique opportunity of interviewing a seasoned pharma/biotech recruiter who has extensive experience working in HR (human resources) at several major pharma/biotech companies. This individual has also interacted heavily with various executive search firms (or head hunters if you prefer) and can provide some practical tips and advice.

I'd like to give you the opportunity to ask your questions to this individual. Please either e-mail me your questions or post them as comments. Once I collect a handful of questions, I will post the responses in a Q&A format.