Wednesday, April 7, 2010

EHRs improve patient contact, distract docs: study from Health IT Strategist

Electronic health-record systems can be a boon and a bane to physician-patient communications, according to a new report by the Center for Studying Health System Change, Washington, with support from the Commonwealth Fund, New York.

On the positive side, the study found that an EHR helps improve physician-patient interaction because it provides quicker access to patient information, affording physicians time to spend with patients that they might otherwise lose hunting for information through paper records that are less organized.

On the other hand, for some physicians, simply using an EHR can pose a distraction. It may also lead physicians to rely on EHRs for information gathering "at the expense of real-time communication with patients and other clinicians," according to a news release.

"Electronic medical records are a double-edged sword when it comes to communication with patients and other clinicians," said study co-author Ann O'Malley, a physician and researcher with the center, in the release.

According to O'Malley, vendors also need to keep refining their systems to make them less distracting to physicians.

In a shout out to the folks running the multibillion-dollar federal EHR subsidy program, O'Malley suggests policymakers "should consider incorporating communication-skills training for medical trainees
and clinicians" using EHRs.

The study, "Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less?" is based on 60 interviews with physicians and staffers at 26 small and medium-sized physician practices with commercial ambulatory EHRs in place for at least two years.

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A DC airport ticket agent offers some examples of 'why' our country is in trouble!

1. I had a New Hampshire Congresswoman (Carol Shea-Porter) ask for an aisle seat so that her hair wouldn't get messed up by being near the window. (On an airplane!)

2. I got a call from a Kansas Congressman's (Moore) staffer (Howard Bauleke), who wanted to go to Capetown.

I started to explain the length of the flight and the passport information, and then he interrupted me with, ''I'm not trying to make you look stupid, but Capetown is in Massachusetts .''

Without trying to make him look stupid, I calmly explained, ''Cape Cod is in Massachusetts , Capetown is in Africa ''

His response -- click.

3. A senior Vermont Congressman (Bernie Sanders) called, furious about a Florida package we did.

I asked what was wrong with the vacation in Orlando .

He said he was expecting an ocean-view room.

I tried to explain that's not possible, since Orlando is in the middle of the state.

He replied, 'don't lie to me, I looked on the map and Florida is a very thin state!'' (OMG)

4. I got a call from a lawmaker's wife (Landra Reid) who asked, ''Is it possible to see England from Canada ?''

I said, ''No.''

She said, ''But they look so close on the map.'' (OMG, again!)

5. An aide for a cabinet member(Janet Napolitano) once called and asked if he could rent a car in Dallas .

I pulled up the reservation and noticed he had only a 1-hour layover in Dallas .

When I asked him why he wanted to rent a car, he said, ''I heard Dallas was a big airport, and we will need a car to drive between gates to save time.'' (Aghhhh)

6. An Illinois Congresswoman (Jan Schakowsky) called last week. She needed to know how it was possible that her flight from Detroit left at 8:30 a.m., and got to Chicago at 8:33 a.m.

I explained that Michigan was an hour ahead of Illinois, but she couldn't understand the concept of time zones.

Finally, I told her the plane went fast, and she bought that.

7. A New York lawmaker, (Jerrold Nadler) called and asked, ''Do airlines put your physical description on your bag so they know whose luggage belongs to whom?

'' I said, 'No, why do you ask?'

He replied, ''Well, when I checked in with the airline, they put a tag on my luggage that said (FAT), and I'm overweight. I think that's very rude!''

After putting him on hold for a minute, while I looked into it. (I was dying laughing). I came back and explained the city code for Fresno, Ca. Is (FAT - Fresno Air Terminal), and the airline was just putting a destination tag on his luggage..

8. A Senator John Kerry aide (Lindsay Ross) called to inquire about a trip package to Hawaii .

After going over all the cost info, she asked, ''Would it be cheaper to fly to California and then take the train to Hawaii ?''

9. I just got off the phone with a freshman Congressman, Bobby Bright (D) from Ala who asked, ''How do I know which plane to get on?''

I asked him what exactly he meant, to which he replied, ''I was told my flight number is 823, but none of these planes have numbers on them.''

10. Senator Dianne Feinstein (D) Called and said, ''I need to fly to Pepsi-Cola, Florida. Do I have to get on one of those little computer planes?''

I asked if she meant fly to Pensacola, FL on a commuter plane.

She said, ''Yeah, whatever, smarty!''

11. Mary Landrieu (D) La. Senator called and had a question about the documents she needed in order to fly to China .

After a lengthy discussion about passports, I reminded her that she needed a visa.

'Oh, no I don't. I've been to China many times and never had to have one of those.''

I double checked and sure enough, her stay required a visa.

When I told her this she said, ''Look, I've been to China four times and every time they have accepted my American Express!''

12. A New Jersey Congressman (John Adler) called to make reservations, ''I want to go from Chicago to Rhino, New York .''

I was at a loss for words. Finally, I said, ''Are you sure that's the name of the town?''

'Yes, what flights do you have?'' replied the man.

After some searching, I came back with, ''I'm sorry, sir, I've looked up every airport code in the country and can't find a rhino anywhere."

''The man retorted, ''Oh, don't be silly! Everyone knows where it is. Check your map!''

So I scoured a map of the state of New York and finally offered, ''You don't mean Buffalo, do you?''

The reply? ''Whatever! I knew it was a big animal.''

Now you know why the Government is in the shape that it's in! Could people be this DUMB?


I don't write it, I just offer it for your consideration.

Like manure, you just gotta spread it around.

Posted via web from Dr. Mom's Posterous

Monday, April 5, 2010

Does Apple Need to Pull the iTunes 9.1 Upgrade for Windows?

Amid all the fanfare of the successful release of the Apple iPad a new problem for Windows users of iTunes software has arisen.

In preparation for the launch Apple released version 9.1 of their software for both Mac & Windows (32 & 64 bit), besides the usual security tweeks the software package included some major changes including:

  1. The drivers for the iPad
  2. Changes to iTunes to allow for syncing iBooks and other iPad specific content
  3. An updated version of Bonjour

While the update seems to have gone smoothly for Snow Leopard/Leopard users it has been anything but for Windows users.  A quick look at the Apple support forums, the " Installing & Upgrading iTunes for Windows" will show the myriad of problems which have occurred to Windows users. While I'm always amazed that, considering the wide variations in the configurations of Windows computers, software updates on PC go as smoothly as they do it's apparent that this one is much worse than usual.  Within hours of it's release the issues started to arise, they included:

  • Bonjour 2.0 not being installed correctly in Vista & Win7 machines
  • Apple Mobile Device Manage not being installed properly
  • Problems with the update to the library format including
    • Videos being reformatted (probably being optimized for the iPad) and no longer displaying correctly on smaller iPods
    • Podcast being relabeled as music
    • Library format being updated (that's the usual event but in this case it means that if you roll back 9.0.x won't be able to read your library

Uninstalling and rolling back to 9.0.x may or may not solve the problem depending on whether or not you're able to delete the new version of Bonjour from your system.

Not for one moment to I believe that Apple failed to do some quality testing on their software but it is rapidly becoming apparent that there are too many problems with this version of iTunes for it to be out in general distribution (I haven't seen such error reports since the 7.7 "Spinning beach ball of death" issues).
Although Apple obviously wants to push out this version of iTunes so that PC users can enjoy their iPads I believe that it is time for Apple to admit that there are problems with the update and pull it from distribution.  Possibly they could offer iPad customers a chance to activate their devices at the Apple store so that they can be used.  While this will not allow users to add their personal content to the device at least they can start download apps from the iPad store and use it to browse on-line content.

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