Carl Gandola's bedside.org is active again .. so I guess he's been on service this month. Too bad we can't get his colleagues (or his residents) to keep the fire burning when he's not on service!
"By osmosis and by repetition over this month we have all learned to communicate better about patients, to listen to their concerns (and think about sitting down in a chair at their bedside). We have developed management plans to improve individuals' health and relieve their pain. We have all worked hard, grown tired at times, learned, and been part of a team giving good care."
It's the beginning of the year for our 4th year medical students, and I am reminded again about the defferences between how we train physicians in residency They struggle with career choices, and I struggle with how best to guide them. Innately, Carl guides his learners to listen to their patients — and to literally get down on their level by taking a seat at the bedside rather than maintain the physical dominance of standing above them. If you were a patient in a hospital bed, would you prefer …
Which patient feels more empowered and involved in their care?
… and it's interesting to me that an educator in family medicine involves this in both his education, and in his discussions of education as an important part of healthcare … while educators in other specialties just don't address these issues so routienly. While our residents often refer to Behavioral Science sessions as "BS" … this remains a required component in the training of family physicians (and no other specialty aside from psychiatry, of course), and an important differentiator in how physicians are trained. There is also evidence to support the hypothesis that this difference in training also may have impact on the healthcare that these physicians provide.
Gross Anatomy is another weblog added to medlogs.com today .. and Mr Hassle's RSS feed is working, so she's there too now.
I enjoy the new medbloggers … especially the medical students and residents. It's great to see/hear their development as physicians.
We've got an internal weblogging experiment going on here at Albany Medical College. We've got beginning 2nd year medical students placed around the country in culturally diverse clinical settings, and they are all using a weblog to communicate their experiences with each other. For the privacy of the patients, the physicians (even if no PHI is revealed) and the authors, it's all in a password – protected directory. So you can't see it. But it's top-notch stuff — and I think that it's been a great demonstration that this sort of technology can be quite useful. Are other educational institutions using weblogs in this way?
The AMA has released The Physician's Guide to Assessing and Counseling Older Drivers. I'll admit that I have not read the whole 200 page document. But it looks like a useful resource, with some screening tools and educational worksheets for both physicians and patients.
The AMA's web designers have a thing or two to learn about web user -interface though … when you click on the link above .. you get to the page that promotes the resource. It's a press release. The user is then told to "Click here to view" .. which leads to another page describing the resource … along with links to 18 separate PDF files .. which one must click (18 times) to view the document. What were they thinking? If we wanted to read it on the web — we sure didn't want to see it in PDF .. (recall that PDF is for printing – not for online reading) .. but if we want to print it … uh .. we sure don't want to download 18 separate PDFs to print! … well .. as a service to docnotes readers .. here's a link to the whole thing — in printable form — a bit smaller than PDF — using Macromedia FlashPaper as a delivery mechanism. Still not fit for web viewing, but at least you don't have to download 18 documents if you want it printed.
E-mail from our medical director today:
There is a new VIS (as of 7/28/2003) for the Meningococcal (Menomune) vaccine. The new form should be downloaded as a PDF and printed from immunize.org until you get printed copies.
Federal Law requires that we use the LATEST version of the VIS. (The outdated VIS is dated 3/21/2000.)
On a related note, there is a good article in Pediatrics on Immunization of Preterm and Low Birth Weight Infants (pdf) (HTML).
American Family Physician has a very good article this month on vaccinations in pregnancy.
This week in Neurology, there are two interesting papers. The first (link above) details how analgesic overuse is correlated with chronic pain. In an accompanying editorial, the question is raised about whether correlation = causality.
Not to be confused with RSS 2.0 (!) … Maybe tomorrow we'll build an Echo/Not Echo/Kuvop feed.
I've updated the URL to the link below so that it gets schedule data from the demo group. If you want to see the native Oncalls view (or even modify the schedule) You can log in to the demo account at www.oncalls.com with username "demo" and password "demo."
To modify the schedule that you will see in the RSS feed, you have to put someone on call today – as the feed reports today's schedule. (I suppose we could add a URL parameter with the date requested .. but that's tomorrow's project.)
You'll have to know some of the names of the providers in the Demo group, since the program won't let you put someone on call who doesn't exist in the system. That would be bad. So you can click on the EDIT menu and then MEMBERS to see (or add) members. Then go to EDIT ==> Schedule to change the schedule. Two notes: a) NO .. there's no "save" button. It saves every entry when you move from field to field. Cool, eh? b) IE 5+ required for editing the schedule. Sorry. Log in with Username "Dork" and password "Demo" for a typical user's view that doesn't require IE
To see the data in a newsreader, use this url. Here's what it looks like:
What is all of that?
http://www.oncalls.com/RSS/oncalls.cfm is the URL for the page that creates the RSS.
dID=805 is the ID of the user for whom this feed is created. Every user gets their own feed.
lg=%243X%2A9IP%20%20%0A&pg=%243XB%26HP%20%20%0A is the encrypted password for this user. Don't bother trying to crack the code. Every user has a unique encryption key in the database. Dave came up with this (cool) method of making a reasonably safe method of providing RSS access to password protected data.
And here's another idea: Use AmphetaMailer to mail the results to whoever "needs" them.
While we've built many methods for users to get at their data within our software, RSS enables the user to control this data by themselves. Nice. I'd love to hear from any current (or future) OnCalls users to hear how they are using this feature. We can do weekly or monthly feeds as well … if anyone asks for them.
I've added several new Medical Weblogs to the medlogs.com aggregator:
- Diabetes:A primer of basic diabetes facts and information for those new to the disease and diagnosis.
- Hermes: Documenting the life of an internal medicine resident at the University of Washington.
- Women's Health:Another about.com site about … women's health
- Mr Hassle's Long Underpants: Mr. Hassle's Long Underpants and Other Stories, by Doc Shazam. A young resident's perspectives about learning medicine, taking care of patients and being overworked. (actually – no RSS for this one yet — so it's NOT on medlogs yet) ..
It's been a (very) long time since I mentioned OnCalls. The physician scheduling software that is the best-thing-since-sliced bread. ;-) ….
Last week, Dave mentioned this post about RSS and calendars. Hmm … it got me thinkin … In addition to the web interface, we've had a .Net client for Oncalls for about 6 months – but it's a heavyweight – since it requires .Net framework to install.
Tonight while I watched the Red Sox win (will they make it this year?), I set up an RSS feed for OnCalls. It was pretty easy. Now any group that uses OnCalls can also use one of the many RSS readers or aggregators to see their call schedule.
I've got to work out a few little issues .. but it seems to work quite well with rather little effort. Here's a link to some demo data in RSS .. and here's a view of how it looks in FeedDemon:
EW INTERNET & AMERICAN LIFE PROJECT reports that 80% of Americans search for health information online.