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Comment: Re:Vaginosis/Vaginitis Plus (Score 2, Insightful) 532 532

IAAP (I am a physician, and a pathologist at that!). In TFA, she notes that the pathology was only marginally more informative by including electron microscopy and immunofluorescent study. I'm not sure what more she's expecting. There's a reason why medical school is 4 years, residency is 3-4 years, and fellowship is another 1-2 years (after 4 years of college for most US citizens). This stuff IS hard, and yes it actually does require a graduate degree. In this specific instance, should the bill explain that it's the standard of care to get EM and IF tests on medical kidney biopsies? Should the bill explain what those tests are? Maybe, but I've never seen a mechanic's bill that explained why part A was used and what that part is normally used for, or how often it's used/replaced. I've never seen any bill that really explained what stuff was for. It's going to be hard for most people to fully understand a medical bill, no matter how clear and un-obfuscated it is.

For medical billing, people are obviously more interested and vested in what's happening, but a lot of the times, the situation is going to be complicated. I don't know what the solution to that is, other than paying physicians for their time (instead of unnecessary procedures and tests) to explain things more clearly.

Comment: Re:Damn... (Score 1) 494 494

Well, Indira Gandhi, India's woman PM, was also assassinated. Although she apparently was pretty ruthless (and lacking insight) when she supremely pissed off her own bodyguards (who did the assassinating). Apples and oranges, I know, but Pakistan certainly doesn't have a monopoly on killing women in power.

Comment: Re:Why store the patient's Age instead of Birth Da (Score 1) 184 184

What doctors have you been talking to? Doctors definitely DO NOT like entering text. If they are typing out pages and pages of stuff, hopefully it's because that is relevant information.

That said, I think the summary is talking about when physicians copy and paste histories from one note into the next. The history and presentation probably hasn't changed, so why type it all out again? Just copy and paste! However, then you run into the problem when the history starts off with "Mr Slashdot is a 36 year old man with herpes, etc etc". Then the patient seemingly doesn't age according to the text, but they obviously are in the structured data portion of the EMR... This copy and paste also leads to propagation of errors. I once saw a chart where a patient had received 2 bone marrow transplants in the past (not unheard of). I went back through the chart to find out when those were and what the complications were, and it turns out someone had a made a typo years before and it had continued, not just in one department, but other departments were copying and pasting the same error in their notes too! Madness...

Comment: Re:Usability metrics, anyone? (Score 2) 184 184

I also spend a good deal of time combing through charts and it IS infuriating! I got some reports from another hospital one time, and except for the envelope in which it came, there was no way to tell where care was being given, just from the notes/reports alone. No letterhead, logo, institution name or anything. There doesn't seem to be a regulation, rule, or best practices scheme for what information should be included in every note, report, chart, result. IMHO, every page printed out should have the patient's name, DOB, MRN, page numbers (the lack of which has caused me a headache or two), and a clear designation of where this note came from: institution, department, service, attending physician, and type of document (H&P, progress note, lab result, etc).

Comment: Re:EMRs are doing their job (Score 1) 184 184

This. While EPIC is easy to use and does a good job of tracking mistakes, it's real power is giving the hospital a streamlined, easy to use interface for physicians to bill for services. Medical coders might go the way of travel agents.

Comment: Re:Don't fix what ain't broke (Score 3, Interesting) 184 184

I actually am a medical doctor and I can say that the VA EMR is very very good. It's not as shiny or pretty as some others out there, but it's solid, easy to use/learn, interconnected with every VA hospital and it's the same at every VA hospital. The scheduling problems largely revolve around lazy government employees (I'm a govt employee, so I can say that!) and trying to get doctors to work in the VA system. They only recently brought the salaries for physicians, but only for new hires, IIRC. I'm sure THAT's good for morale....

I'm also an armchair bioinformaticist (or whatever) and have seen the coding and modules behind EPIC, one of the most popular and widely-used EMRs around. It IS kludgey! I forget if the inpatient or outpatient systems came first, but the second had to be kludged in. THEN, when you factor in the very widely used radiology information system (PACS) you have to kludge that in. Then you have pathology and lab medicine using an entirely different system (CoPath, Soft, PowerPath, etc) you have to tie that into the EMR and PACS. Sometimes pathology and lab medicine use two entirely different systems, even though they're in the same department!

Yes, it's a mess!

Comment: Apologies from more than just Assange? (Score 4, Insightful) 161 161

I think Assange SHOULD apologise. After all, he was risking the life of a head of state (admittedly, the risk was probably fairly minimal). That said, it seems like Morales deserves an apology from a lot of countries, including the U.S. Right or wrong, it would be the diplomatic thing to do. Not apologizing just reinforces the perception of the U.S. as imperialist/bullying. It seems like France is the only one to have issued an apology so far...

http://en.wikipedia.org/wiki/E...

Comment: Re:Hmmmm (Score 2) 187 187

No, they are not, as all good scientists are. From the actual journal article:

"Some limitations of our work should be noted. Specifically, we cannot ascertain from the current studies whether acetaminophen might blunt individuals’ attention or motivation to process emotionally evocative stimuli instead of (or in addition to) their evaluative processing of these stimuli."

Honestly, it's a pretty weak self-critique. I wish they had talked more about how meaningful the differences they found were. Yes, the p values were low, so they were statistically significant, but their graphs aren't so impressive to me. Then again, I'm not a psychologist (although I am a MD) and I'm not familiar with their assessment tools (the IAPS picture database?). So what do I know? :)

Comment: Opinion from a scientist (Score 4, Informative) 370 370

I am a scientist in real life (yes, biomed PhD and everything) and I would like to offer a different opinion. We spent all this money on something that didn't work. Ok, that's less than desirable. However, I think it's inaccurate to call it a complete waste. For one, it employed people and secondly and maybe most importantly, it funded research, which is almost always a good thing. The only way this would be a complete waste, is if they did not use what they learned from these projects to take with them to the next. That's my real fear: we'll keep spending money in a very inefficient way. My only beef with the whole thing, is that they should have given that $10B to the NIH, NSF, NASA, universities, etc...

Comment: Maybe useful, maybe not effective? (Score 1) 175 175

It seems like this could be a useful training tool, especially for more complex/dangerous threats like multiple agent terrorist attacks. However, I fail to see how this will improve an agent's ability to stop a guy from jumping a fence and making a break for it. This might be simplistic, but isn't the solution to that problem to keep your eyes open and then radio it in? You know, like every other security job in the country?

Every cloud has a silver lining; you should have sold it, and bought titanium.

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