How many nursing homes use Electronic Health Records (EHRs)?

What percentage of nursing homes (NH) use electronic health records (EHRs)? Perhaps I should call them skilled nursing facilities (SNFs) instead of nursing homes. There's a paper that was recently published in the Journal of the American Medical Informatics Association (JAMIA) that answers this question. The authors on this paper were: Helaine E. Resnick PhD, MPH; Barbara B. Manard PhD; Robyn I. Stone DrPH; and Majd Alwan PhD.

Here are the key points:

• Nearly 43% of U.S. NH had EIS (electronic information system) for medical records, including nurse's notes, physician notes, and MDS forms. EIS use ranged from a high of 79.6% for admission, transfer, and discharge to a low of 17.6% for daily care by certified nursing assistants (CNAs).

Although this paper was published in 2009, it reflects data from 2004. One of the key points in the discussion is: "One way that electronic information systems could lead to improvements in quality of care would be for these systems to provide better support for transitions across care settings."

Care to view the abstract? Click here.

Resnick HE, Manard BB, Stone RI, Alwan M. Use of electronic information systems in nursing homes: United States, 2004. J Am Med Inform Assoc. 2009 Mar-Apr;16(2):179-86.

FDA Alert: Don't eat Nestle Toll House Prepackaged, Refrigerated Cookie Dough

I love cookies! However, the FDA has released a consumer alert: Don't eat Nestle Toll House Prepackaged, Refrigerated Cookie Dough. There's a risk of contamination with E. coli O157:H7.

Faith, Religion, Praying, and Medicine

Do you pray? How would you feel if your physician wanted to pray with you? What role does faith play in the world of medicine?

We live in a world where people don't wish to offend anyone with religious comments. There are many people who would welcome prayers (even if they're not religious). Do prayers actually impact clinical outcomes? Various studies have been performed to evaluate this question. One of the most famous studies was a Harvard study published in the American Heart Journal. The 2006 study was titled, "Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer." Researchers concluded that "Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of receiving intercessory prayer was associated with a higher incidence of complications."

In a press briefing, Rev. Dean Marek, a co-author who is director of chaplain service at the Mayo Clinic, called the results "unexpected and counter-intuitive." How are we to interpret these results?

Here's my opinion: It's not just about prayer. We have to ask a critical question: Who are you praying to? This is critical. After all, if you're praying to a false god that doesn't exist, then your prayers won't do anything. If God doesn't exist, then prayer is meaningless. However, if you're praying to a real God who does exist, then your prayers can do mighty things. Those who pray and believe in God will attest to that.

Do you pray? Do you believe in God? Do you consider yourself to be a spiritual person? I do and I pray. Painting titled, "Chief of the Medical Staff," by Nathan Greene.

U.S. swine flu cases top 21,000 as deaths rise

MSNBC has a story titled, "U.S. swine flu cases top 21,000 as deaths rise." Are they trying to cause panic? We know that swine flu is a pandemic and that it's going to spread. It's already in 93 countries. As the WHO put it: it's not stoppable. However, since it doesn't seem to cause severe illness in most healthy individuals, how much should we be concerned?

Here's a snippet from the MSNBC article: "The continued spread signals the new strain of H1N1 flu is causing “something different” to happen in the United States this year — perhaps an extended year-round flu season that disproportionately hits young people, the Center for Disease Control and Prevention said."

Image source: MSNBC

Moore's 7 Levels of CME Outcomes Measurements

In the world of certified CME (continuing medical education), outcomes measurements have become a critical component. It is an ACCME (Accreditation Council for Continuing Medical Education) requirement to measure outcomes in all certified CME activities.

Donald E. Moore Jr., PhD from Vanderbilt University School of Medicine has outlined a framework for the assessment of continuous learning and traditionally this has been presented as a pyramid consisting of 6 different levels:

1. Participation
2. Satisfaction
3. Learning
4. Performance
5. Patient health
6. Population health

Moore DE. A framework for outcomes evaluation in the continuing professional development of physicians. In: Davis D, Barnes BE, Fox R, eds. The Continuing Professional Development of Physicians: From Research to Practice. Chicago, Ill: American Medical Association; 2003.

Earlier this year, Moore published a paper titled, "Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities." Here, he makes some modifications to this six-level framework and we now have 7 levels for CME outcomes measurements. The main changes are:

• Level 3 is now broken up to 3A and 3B

• 3A = Declarative knowledge

• 3B = Procedural knowledge

• Competence was a new addition and became Level 4 (shifting everything else up)
• Performance is now Level 5 (used to be Level 4)
• And Level 6 “population health” was renamed “community health”

So, here’s the new 7-level pyramid for CME outcomes measurements:

1. Participation
2. Satisfaction
3. Learning
3A = Declarative knowledge
3B = Procedural knowledge
4. Competence
5. Performance
6. Patient health
7. Community Health

Moore DE Jr, Green JS, Gallis HA. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities.J Contin Educ Health Prof. 2009 Winter;29(1):1-15.

Kids at summer camp getting swine flu

Three kids at a summer camp in Georgia got the swine flu. Thankfully, it sounds like the infection is mild and the kids are recovering quickly (according to a report on CNN). It seems like the virulence of swine flu might be diminishing, but we probably don't know how it will impact individuals who have chronic lung conditions or immunodeficiencies such as HIV/AIDS. Most kids have robust immune systems and they're able to bounce back from infections pretty quickly. Let's hope that we don't hear any stories about immunodeficient kids at summer camps getting H1N1.

Q&A on Healthcare Reform

CNN has a nice Q&A about Obama's healthcare reform plan. I don't think anyone would argue that we desperately need to overhaul our existing healthcare system. Here are some snippets that I'd like to highlight (and offer my comments):

• Nearly 46 million Americans have no insurance, and 25 million more are underinsured.(this number seems to climb each year and will certainly rise as unemployment goes up)
  
• ... many employers have stopped offering insurance to employees because of the high cost. (rising insurance costs are killing small businesses)
  
• A central point of the president's plan is to create a government-sponsored health insurance program that would be an option for all Americans, similar to how Medicare is now an option for Americans over age 65. (some level of care is better than no care. what will this do to managed care?)
  
• If you receive high-quality health insurance from your employer, Obama said, his plan won't change that, and you can still keep your insurance and your doctors. (don't expect many changes if you already have good coverage)
  
• Obama said at the Green Bay town hall meeting that under his reforms, no insurance plan "would be able to deny coverage on the basis of pre-existing conditions," but he didn't explain how he would force insurance companies to insure people with pre-existing health problems. (if you have a pre-existing condition, you may get coverage, but it may cost you too)
• In the United States, every person spends on average $6,714 for health care. (do you know how much of this is due to unnecessary tests?)

Want to read the entire CNN article? Click here.

Advances in Technology and Medicine

I've been thinking about some of the major advances in medical technology over the past decade. We've seen some significant new drugs, new drug delivery systems, and tremendous innovations in medical devices. These advances have improved the care of acute and chronic medical conditions and have taken the field of medicine to a whole new level. Despite our growing understanding of the medical science, healthcare professionals still admit that there are many medical phenomenons that we simply can't explain. For instance, the spontaneous regression of cancer is something that we as medical professionals can't really explain. Will advances in medical technology someday provide us with a clear explanation?

Searching for a Free EMR or EHR?

The keywords "free EMR" are still going into Google every day. EMR = electronic medical record. I prefer to use EHR = electronic health record. I get a fair amount of traffic to this site from people who type "free EMR" into Google and they land here because my site is on the first page of search results.

As this country moves forward with healthcare reform and hospitals, clinics, and offices implement electronic health records (EHRs), some are still looking for a free option. There are some free EHRs that are certified by CCHIT (Certification Commission for Healthcare Information Technology), so does it make sense to choose a free option? I've been thinking about this issue and here are some of my thoughts:

• If you're a solo physician and you're struggling to survive because of reduced and delayed reimbursement from managed care, then perhaps you should go with a free EHR. There's no point in investing over $40k in an EHR just to declare bankruptcy. (by the way, they're not all that expensive)
  
• If you're completing residency soon and you're about to embark on your own and start a brand new solo practice from scratch, then maybe you should go with a free EHR and then switch to a different system in several years once you've generated some revenue.
• If you're getting really close to retirement and you want to play around with EHRs just for fun, then maybe you should try a free EHR.
  
• If you're a solo physician using paper records and you're planning on retiring within the next 5 or so years, then it might make sense to invest in a free EHR. I say "might" because there are obviously multiple factors at stake and I am not making any recommendations here.

The honest truth is that I really don't know how free EHRs will evolve over the coming years. I don't think anyone really knows. Some free EHRs are really simply "lite" versions of the software and you won't qualify for "meaningful use" if you're using these versions. Other free EHRs are fully functional and robust, but it's hard to predict the long-term viability of some of these companies.

Asbestos in Montana

My cousin used to live in Montana. Now, she lives in Alaska and loves it up there. Unless you enjoy the outdoors, you may not enjoy a life in Montana. According to the EPA (Environmental Protection Agency), the town of Libby, Montana has a serious asbestos problem. The problem is so bad that the EPA has declared a "cleanup emergency" in this town and it will get more than $130 million in cleanup and medical assistance from the Obama administration. Asbestosis isn't your typical "acute" emergency, but I suppose that enough health officials decided that enough was enough.

Here's a snippet from CNN: "The town was heavily contaminated with asbestos-laced dust that federal prosecutors said resulted in more than 200 deaths and 1,000 illnesses. "For decades, the disease and death rate from asbestosis in the Libby area was staggeringly high -- much higher than the national average... EPA spokeswoman Adora Andy said $6 million from the Department of Health and Human Services will go to local health care providers to screen, diagnose and treat asbestos-related illnesses, while $125 million will go toward cleaning up contaminated areas."

Wow, how do you clean up a mess that started in 1920? The asbestos contamination in that town is being blamed for 200 deaths and 1,000 illnesses. This is going to be a long and arduous clean-up effort. Better late than never.

Read about Epocrates on the BlackBerry

Read my post on MedicalSmartphones.com about Epocrates on the BlackBerry: Epocrates on the BlackBerry

MIT on Brain Disorders

Watch this video as Professors Susan Hockfield (MIT President and Professor of Neuroscience) and Mriganka Sur (Newton Professor in Neuroscience
Head, Department of Brain and Cognitive Sciences) discuss brain disorders.

Novartis Produces First Batch of Swine Flu Vaccine

Novartis has produced a batch of experimental swine flu vaccine. Don't get your hopes up quite yet. The vaccine hasn't in been tested in humans yet. Instead of using eggs, this vaccine was deveoped using cell-based technology. In other words, the vaccine was made using cells, not eggs. I also heard that Baxter has completed testing and evaluation and is now in full-scale production of a commercial H1N1 vaccine using its Vero cell culture technology.

The WHO (Word Health Organization) is anticipating that swine flu (H1N1) vaccines should be ready and available by this fall. Let's hope that they are effective in controlling and reducing outbreaks this upcoming flu season as we face this pandemic.

Fraudulent 2009 H1N1 Influenza Products

The FDA is warning consumers about fraudulent swine flu (H1N1) products that are mainly being sold on the Internet. You probably won't find these products at Walmart, Rite Aid, or CVS, but if you open your computer, then you may see advertisements and other links that promote such products.

Not sure if a product is fraudulent? Make sure to consult the FDA H1N1 product list here.

Challenges and Opportunities in E-Prescribing

What do you think about e-prescribing? Do you think that physicians want to use e-prescribing resources? At the HIMSS Virtual Conference, there was a session titled, "E-Prescribing: Physician Acceptance is the Easy Part." Do you really think that's true? Is physician acceptance really the easy part? Maybe it really depends on the physician. Those who embrace EHR (electronic health record) technology find it really easy to use e-prescribing since it only takes a click of a button to get a script sent to the pharmacy. Now that ARRA will be pushing physicians, we should see a dramatic rise in the use of EHRs and e-prescribing. At that point, physician acceptance will be the easiest part. What will be the hard part?

Here's the abstract of the session: "Two years ago, Cotton O’Neil Clinics in Topeka, Kansas implemented e-Prescribing for over 125 physicians and 135 pharmacies. In January, 2009, Cotton O’Neil processed more than 23,000 e-Prescriptions including those in rural communities with populations of 1,000 or fewer. This presentation will detail the processes used to move Topeka and the surrounding community to successful use of e-Prescribing technology."

The speakers were Judy Corzine, MBA, CPHIMS and Gray Woods, MD. In case you may be interested, here are their bios:

• Judy Corzine, Administrative Director and CIO, Stormont-Vail Healthcare, Topeka, Kansas. Judy Corzine has worked in the information system department at Stormont-Vail Healthcare for the past 8 years. Prior to moving to Topeka, she worked at several healthcare organizations in Waterloo, Iowa. She holds an MBA from the University of Iowa and became a CPHIMS in April, 2005. She is a member of CHIME and serves as Chair of the HIMSS Enterprise Integration Steering Committee.

• Dr. Gray Woods, Clinical Information Systems Associate, Stormont-Vail HealthCare, Topeka, Kansas. Dr. Woods has been a member of the IS team at Stormont-Vail since August, 2005 supporting the NextGen EMR application and providing training to physicians, nurses and other clinical staff. He is a board-certified ophthalmologist and was formerly the Medical Director of the Ophthalmology Residency Program at the University of Missouri-Kansas City (UMKC) School of Medicine. Dr. Woods obtained his MD degree from UMKC in 1983 and completed his ophthalmology residency there in 1987.

FDA Alert: Do NOT Use Zicam Cold Nasal Sprays

FDA Advises Consumers Not To Use Certain Zicam Cold Remedies: Intranasal Zinc Product Linked to Loss of Sense of Smell (anosmia)

The U.S. Food and Drug Administration (FDA) today advised consumers to stop using three products marketed over-the-counter (OTC) as cold remedies because they are associated with the loss of sense of smell (anosmia). Anosmia may be long-lasting or permanent.

The products are:

• Zicam Cold Remedy Nasal Gel
• Zicam Cold Remedy Nasal Swabs
• Zicam Cold Remedy Swabs, Kids Size (this is a discontinued product, but maybe you have some in your medicine cabinet)

Defining "Meaningful Use" Begins Today

We've all been waiting for today. Today (June 16), those in the health information technology (Health IT, HIT, or HITECH) industry began getting glimpses of the definition of "meaningful use" from government leaders. If physicians use an electronic health record (EHR), they must use it in a meaningful way if they are to reap the benefits and avoid the punishments stated in the ARRA. Who gets to decide if you're using an EHR in a meaningful way? The government.

Today is just the beginning of a long conversation, according to Dr. David Blumenthal, National Coordinator for Health Information Technology. Today, the HIT Policy Committee met and highlighted some of the essential components that outlines this mysterious phrase, "meaningful use." We won't see physicians meaningfully using an EHR overnight. This will happen in three stages (although many things will also be happening simultaneously):

1. Data capture and sharing by 2011
   
2. Advanced clinical processes by 2013
   
3. Improved outcomes by 2015

Here are some key points of data capture and sharing:

• Physicians must actually document outpatient progress notes using an EHR (so can you still dictate your note and have it manually transcribed into the EHR?)
  
• They must use computerized physician order entry (CPOE) for all order types, including e-prescribing
• They must improve care coordination (that's a bit nebulous if you ask me, but I'm sure they will eventually iron out the critiera for this)
• Submit electronic data to registries and other databases to improve public health and assist with disease surveillance
  
• Comply with HIPAA Rules and state laws (isn't this obvious?)

So, this is just the beginning of a long conversation. Any surprises here, or have we simply stated the obvious?

Support CaringBridge

CaringBridge has been such a powerful social networking tool for some of my close friends and colleagues who have gone through serious medical conditions. Please support this site that has been a "lifeline during health crisis" to many individuals according to CNN. A good friend of mine has been posting regular updates on CaringBridge so that friends can stay updated. Many tears and prayers have been poured out for this individual.

If you know someone who is going through a medical crisis (such as cancer) or some other type of life-changing medical event, encourage that person to find social support. There are many resources out there and CaringBridge is only one example. According to CNN, "Other popular sites include CarePages, Planet Cancer for young adults, and Group Loop, where teens with cancer can chat with other teens. The American Cancer Society's Cancer Survivors Network also offers plenty of support." Remember that support networks can also be very good for family members who are at risk for depression and anxiety during these types of stressful situations.

Donate Your PC and Help African Hospitals

Donate your computer through ComputerAid.org and help people in Africa. Computer Aid's mission is to reduce poverty through practical ICT solutions. They are running their first charity twitterthon for computers to equip schools and hospitals in Africa. To support this twitterthon, tweet messages with the words "Computer Aid twitterthon." If you Twitter, then follow @Computer_Aid.

Are ADHD Meds Causing Unexplained Deaths?

If you follow CNN, you may have seen the story titled, "Study links some ADHD meds to rare deaths." That's not the type of headline you can ignore, even if you have ADHD (attention deficit hyperactivity disorder). So what's going on here?

Let me remind you that we should never judge an article by its headline. This story is based on a recent publication in the American Journal of Psychiatry. Researchers noted that stimulant medications may pose a risk in children who have no underlying heart problems. A matched case-control design was performed. United States mortality data from 1985–1996 were used to identify 564 cases of sudden death occurring at ages 7 through 19 years. The primary exposure measure was the presence of amphetamine, dextroamphetamine, methamphetamine, or methylphenidate. The authors concluded that, "This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents."

Here's a brief snippet from CNN from the lead author of the study Madelyn S. Gould, PhD, MPH, a professor of psychiatry and public health at Columbia University, in New York: "There probably does need to be more careful monitoring, but the bottom line is that parents should not take their children off stimulant medication they're currently on and should not be scared to have their child go on a stimulant if that's what they and their doctors decide is the best thing for their child."

Access the American Journal of Psychiatry abstract by clicking here. Image source: CNN

Obama on Healthcare Reform

President Obama spoke about healthcare reform today. He is pushing for universal healthcare coverage and I agree that everyone in our country should have some type of coverage. According to CNN, "In a speech to the 158th annual meeting of the doctors' advocacy organization, Obama called an overhaul of the ailing health care system the most important issue for the nation's long-term economic stability... The AMA (American Medical Association) acknowledges the need for reforms but opposes any public option plan that forces physicians to participate, expands the fiscally challenged Medicare program for senior citizens or pays Medicare rates."

So what type of reform will we see? I hope we see some significant reform in medical malpractice so that physicians no longer need to practice "defensive medicine" and order a battery of unnecessary tests. What will a public health insurance plan look like? I doubt we'll resemble Canada, but maybe it will mirror some of the things we currently see in the VA (Veterans Affairs) health system. Some type of health coverage is better than no coverage. Image source: CNN

FDA: Labeling Change for Leukotriene Modifiers

Leukotriene modifiers (also known as Leukotriene Receptor Antagonists) are common asthma drugs that have been rarely linked to something called Churg-Strauss syndrome (good trivia fact). The FDA has requested that certain drug manufacturers include a precaution in the drug prescribing information (drug labeling) regarding neuropsychiatric events (behavior, mood changes) that have been reported in some persons taking montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo and Zyflo CR).

• Singulair is manufactured by Merck.
• Accolate is manufactured by AstraZeneca
• Zyflo is manufactured by Cornerstone Therapeutics, Inc.
  

What is it about certain medications? Can we be certain that these are all drug-induced effects? If clinical studies are not designed to look for such findings, can we be confident that post-marketing data can be interpreted properly? Do these drugs really cause mood changes? Or, are these simply associations that have no causality? Pretty soon, every single prescription drug out there will have some type of black box warning about mood changes and possible suicidal behavior. Once that happens, everyone will be ignoring these warnings.

Should Babies Sleep Alone or with Parents?

This continues to be a topic of debate. I don't think the debate will never end. Some mom's advocate that babies should sleep alone. Others say that babies should sleep with mommy in bed. Who's right? Are they both right?

Time.com has an article titled, "Advice for Coddling Parents: Put Baby to Bed Alone." Seems like the answer is clear then. Can we be so sure?

Sleep researcher Dr. Jodi Mindell, a psychology professor at Saint Joseph's University and associate director of the Sleep Center at the Children's Hospital of Philadelphia (CHOP), collected infant sleep data and reported some of her findings in this Time.org article. "Only 12% of parents reported bed-sharing, and 22% reported room-sharing. But in Asian countries the numbers were much higher: fully 65% of parents shared beds with their infants, and 87% slept in the same room."

What's interesting is that Mindell found that co-sleeping led to more disturbed sleep in infants. Accordingly, babies living in Asia got much less sleep overall and significantly less quality sleep than infants in the U.S. However, note that the quality and duration of Asian babies who slept alone were just as low as babies who co-slept with parents. So what exactly does this imply? Do Asian babies need less sleep? How does sleep duration and quality impact infant development? There are still very many unanswered questions when it comes to infant sleeping. What do you think about infant co-sleeping?

Congressman Michael C. Burgess at HIMSS

At the HIMSS Virtual Conference, Dr. Michael C. Burgess gave the Opening Keynote Address titled, "Congress’ Role in Advancing 21st Century Medicine."

Everyone want to know how the government will reform healthcare. Have you visited HealthCaucus.org yet? If you want to keep up with all the hot topics that surround healthcare reform, then make sure you frequently visit the Congressional Health Care Caucus website and stay tuned with all these important topics. If you use Twitter, then you can follow @HealthCaucus.

Congressman Michael C. Burgess, M.D., was first elected to Congress in 2002, and subsequently re-elected in 2004, 2006, and most recently in 2008. Dr. Burgess serves on the prestigious House Energy and Commerce Committee and its subcommittee on healthcare, and recently founded and is Chairman of the Congressional Health Care Caucus. During his six years in Congress, Dr. Burgess has been a forceful and vocal advocate for healthcare legislation aimed at reducing healthcare costs, improving choices, reforming liability laws to put the needs of patients first, and ensuring there are enough doctors to care for America’s patients. Dr. Michael C. Burgess spent twenty-five years practicing medicine as an Ob/Gyn in North Texas.

Sunday Evenings

How do you spend your Sunday evenings? I just got back from a nice picnic and we had a great time because the weather was beautiful. Now, I'm on my computer and I'm catching up on e-mail and doing a bit of "work."

If you Twitter, you may be interested to know that on Sunday evenings, healthcare professionals come together to discuss topics related to Healthcare Communication and Social Media.

Topics covered tonight include:

• legal ramifications of social media for healthcare professionals
• doctor and hospital rating websites
• communicating with patients via social media networks
• targeted social media outreach
• and more...

HFMA in Seattle

The Healthcare Financial Management Association (HFMA) is having its annual meeting in Seattle right now. The conference starts today (June 14) and runs until June 17. The focus is on the current economic and healthcare climate. We're in serious need of healthcare reform. This year, there will be many sessions targeted at cost savings, efficiency, revenue and capital strategies. They Keynote Addresses will be given by Al Gore, Patrick Lencioni, and Karen Davis, PhD. To learn more about the HFMA, go to: http://www.hfma.org/

Voice Assisted Care Technology and Healthcare

At the HIMSS Virtual Conference and Expo, there was an educational session on the topic of Voice Assisted Care Technology. How do you think voice assisted care technology can improve the nursing workflow? Nurses are often so busy because they are caring for so many patients.

In a nursing pilot program (3 weeks, six IV nurses), voice technology in IV application was shown to reduce documentation time by 75%, improve communication, and improve point of care documenting. The researchers also felt that infection may be reduced because nurses who used this voice technology were not touching as many items that may contaiminate the IV. They were using a hands-free headset and they could speak more and write less. Will future nurses all walk around the hospital with a headset (or earpiece)? I'm sure Vocollect would like to think so.

Here's the brief abstract that sums up how voice assisted care technology can impact healthcare: "In today’s complex healthcare setting, IT is seen as the number one method for improving efficiency and quality. Voice assisted care technology provides hands and eyes free accurate documentation for nursing staff while enabling easy verbal access to patient information, effective communication and task management. This innovative technology is believed to increase the accuracy of documentation, while interfacing directly into the EHR. This presentation will introduce you to innovative voice assisted technology designed to support nurse clinicians at the bedside, allowing real time documentation and communication with patients and co-workers."

The speaker was Debra Wolf, PhD, MSN, BSN, RN. She is an Associate Professor of Nursing at Slippery Rock University. Her program of research focuses on nurses impacting patient outcomes using a patient-centered model of care. Dr. Wolf oversees the Healthcare Informatics Certification Program at Slippery Rock University.

What's the Most Popular Free Medical App for iPhone?

What do you think? Top Free Medical iPhone Application

Medicine and Technology: Top 5 Posts for Last Week

Here are the top 5 posts for last week:

1. Teenager Diagnoses her Crohn's Disease in AP Science Class

2. Jobs for Physicians with No Residency Experience

3. Sermo vs. Ozmosis: Physician Social Networking

4. A free EMR Solution?

5. Twitter Growth: the Last 2 Months