Tuesday, July 14, 2009

Grand Rounds July 14, 2009: Technology and Healthcare

Welcome to Grand Rounds Vol. 5 No. 43 @ Medicine & Technology. The theme is this week is to look at different ways technology is changing the world of healthcare. I am your host this week and I hope you'll enjoy some of these interesting stories.

To start things off, we see Marya (Healthcare, etc.) talking about patient rights and the potential effects of false positive results. This may lead to unnecessary tests and/or medications and possibly even some invasive procedures. Do we really need to biopsy every small incidentaloma that appears on imaging studies? Perhaps as diagnostic testing improves over time, we will have fewer false positives.

Ramona (Suture for a Living) reminds us that we must not Forget HIPAA Privacy Rules as we continue to expand the use of electronic health records (EHRs). We know that EHR adoption will increase rapidly over the next several years as billions of dollars get channeled from the government.

Jolie (I am Dr. Jolie Bookspan, The Fitness Fixer) describes some of the high-tech things she got to do as a military research scientist. I wonder what those pilots experience as they go through acceleration testing and undergo serious g-force effects.

Bongi (other things amanzi) writes about a funny story that happened during his Saturday rounds when his boss focused on clothes and not on anyone's morning breath (improved breathalyzers in the future should pick up faint signals of ETOH during morning rounds).

Alison (Shoot Up or Put Up) talks how the internet has provided her with some useful tips to help her live with diabetes. The web is full of both reliable and unreliable health information for patients. Even healthcare professional sometimes get misguided by the information that can be found online.

Ryan (ACP Internist) shares an awesome acronym of the week: SHUTi, a new Internet program that shows promise for helping people get to sleep. Can stories, quizzes and games really teach people to have better sleep habits? Let's see.

Hank (InsureBlog) talks about how some patients are cleaning up their own hospital rooms. Perhaps once we have some fully-automated cleaning robots, we should be free of that problem. We just need iRobot to make make some hospital-grade Roomba and Scooba cleaning robots.

Nancy (Teen Health 411) writes about an exciting electronic Wellness Assessment for Youth - called WAY2GO! that's coming to We're Talking Teen Health at the Palo Alto Medical Foundation (PAMF). Thanks to a partnership between the Health Trust, Vive, and PAMF, teens will be able to get a personalized health report back with links to a new service providing free personal health coaching via the web and their cell phones.

Sam (Canadian Medicine) writes about Dr. Bob Thirsk, a Canadian physician who is living on the International Space Station. What's he doing up there? Providing medical care for his fellow astronauts and operating the Canadarm2. I'd love to head out to space some day.

Jay (Colorado Health Insurance Insider) suggests that change in protocol for breech births may actually benefit mothers, babies, and health insurance companies. Is it possible that surgical technology has made it too convenient to opt for a C-section? What if we performed fewer C-sections?

Dr. Charles (The Examining Room of Dr. Charles) writes about the low-tech importance of empathy in taking a family history, and the precarious control of emotions that is needed in being a good listener. What does that look like? A level-headed, composed and somewhat thoughtful response.

OTW (On The Wards) writes how the increasing prevalence of drug-resistant bacteria is generating a need for newer weapons against infectious diseases. Why do we have all these superbugs? Are healthcare professionals too eager to prescribe antibiotics? Let's hope some advances in drug development will lead to more effective therapies against these multi-drug-resistant organisms.

Clinical Cases (Clinical Cases and Images - Blog) writes about ways to improve medical RSS aggregators. Do you even know what RSS stands for? What about Web 2.0? Speaking of RSS and Web 2.0, do you Twitter? Make sure to follow interesting medical bloggers on Twitter. You can start by following me @DrJosephKim

Allergy Notes (Allergy Notes) talks about one of my favorite topics: chocolate. Or, actually, chocolate allergies. I think if I ever developed that, I'd be taking Benadryl all the time. It's hard for me to imagine a life without chocolate. I could live without many things, but I'd really miss chocolate. If I developed a chocolate allergy that resulted in anaphylaxis, I'd probably go through several epi-pens each day.

Murali (SharpBrains) discusses the Pros and Cons of the most common assessments to identify cognitive problems, introducing the opportunity presented by innovative computerized neuropsychological tests. I think I'd prefer going through a battery of assessment tests over a brain biopsy. How about you?

Barb (Florencedotcom) writes about the well-known IT caveat "garbage in-garbage out," and what it means since the medication use system we rely on is rife with failure points. I haven't thought about GIGO in a very long time. We definitely need more drug safety specialists to help prevent medication errors. Computerized Prescriber Order Entry (CPOE) may reduce some errors, but it won't eliminate all of them.

In a guest post, Michael (Health Business Blog) talks about how Dr. Francis Collins (nominated as the head of the NIH) is getting a bum rap. What do you think about the Human Genome Project? I think it's rather amazing to see how far we've come in human genomic science.

The Samurai Radiologist (The Samurai Radiologist) asks: Which background music/sound is optimal for cognitive activities such as film interpretation? A quick and dirty study while on call suggests classical music. Bach, to be precise. In my former life, I used to play the oboe (but I wasn't one of those crazy, fanatical oboe players).

Randel (Disruptive Women in Health Care) blogs about the medical device industry, particularly the “use (or underuse)” of technology as it relates to what she describes as an “arcane” payment system. Although comparative effectiveness research must be used to test new medical technology, reform in the payment system is equally necessary.

Jan (Doc Gurley, Posts From An Insane Healthcare System) covers new information about the placebo effect, including a hierarchy of results (did you know big pills work better than small ones?). In her article, she also points out that positively reinforcing a result makes it more likely to happen. So does this mean all those TV and internet drug adds are boosting a drug's efficacy?

David (HealthBlawg :: David Harlow’s Health Care Law Blog) spoke with Prof. Rodwin about his proposal that all de-identified health data be subject to public ownership, so that private companies cannot restrict access to it and/or monetize it. Public ownership would ensure availability of data for comprehensive public health and evidence-based medicine uses.

Chris (Life in the Fast Lane) offers some pointers to help ‘Web 2.0 laggards’ pull their heads out of the ground and off-load the stress of information overload. Fear of information overload is a barrier preventing doctors from using web resources. But, given that humanity has been experiencing information overload since the invention of the Gutenberg press, ignoring web resources to avoid confronting this daunting problem is a maladaptive, self-defeating strategy.

Well, that wraps it up for this week. Thanks for attending Grand Rounds here at Medicine and Technology. And next week, head over to our surprise, last-minute guest host's site: www.docgurley.com (Doc Gurley, Posts From An Insane Healthcare System), for details on how you can submit. In addition to hosting Grand Rounds, Doc Gurley also will be, that same weekend, speaking at the Mystery Writer's conference in Marin about death, mayhem and the urban underside of life. If you're looking for inspiration, or a theme for Grand Rounds' July 21 submissions, the code word for next week's Grand Rounds is...mystery! Get your submission in early and win big Big BIG karma points! [AND, if you're a San Francisco Bay Area health blogger, send an email to Doc Gurley at docgurley (at) gmail (dot) com for details about the first ever health bloggers' meet-and-greet - ALSO on July 21!]


  1. Nicely done! Thanks for including mine.

  2. Great job, Joseph, thanks! Should we start thinking about a Northeastern health bloggers' meet-and-greet soon?

  3. Super job, Dr Kim!

    Thanks for hosting, and for including our post.

  4. wow, fantastic theme and execution of grand rounds today! my readers at chronicbabe.com are going to LOVE it. just posted a link...thanks for your hard work on this!

  5. Thanks for such a great topic and interesting selection! I appreciate being included. The topic got me talking about cochlear implants, Bill Gates, and Forrect Gump. (Definitely time for Flo&Bo to take a vacation!)

    Here's the GR link: http://florencedotcom.blogspot.com/2009/07/grand-rounds-health-it-man-behind.html

  6. O thanks its avery intresting topic,