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Comment no wonder (Score 1) 432

If you think this is bad, consider that most electronic medical records pop up pointless warnings even more frequently. Sometimes they catch a legitimate error, but it's hard to not get conditioned to ignore those without really reading them.

I think I read some story many years ago about a boy who cried wolf... Same principle. Warnings cease to be effective if they pop up all the freakin' time for no good reason.


Submission + - SPAM: Apple to sell 500,000 iPhone 3G S in first week

Gwmaw writes: Apple is gearing for its widely-anticipated launch of its latest iPhone 3G S on Friday leaving analysts speculating on how the handset will perform in terms of sales. Piper Jaffray's senior analyst Gene Munster thinks it's going to be a good weekend for Apple and AT&T as it estimates they will sell 500,000 iPhones this weekend, according to a research note sent to clients, reports Fortune

Comment Re:IT Literacy Among Health Professionals (Score 1) 367

Don't get me wrong. There are tons of doctors that are computer and gadget freaks, but there are tons more that rarely touch a computer except for basic Internet and MS Office services and have to be guided through the intricacies of an electronic records system and how to use it.

Another explanation is that it's a failure in UI design on the part of the EMR. One should not have to be a computer geek/gadget freak in order to use an EMR. The same skills that lets someone type a word document or use a web browser should suffice. Most of the EMRs have horrible UIs and are not intuitive at all. I myself AM one of those gadget freak physicians, even wrote some of the templates in use at one of our hospitals, yet I still have difficulty figuring out how to do certain things.

But then, I'm a mac user. Perhaps my expectations are too high ;-)

Comment Billing drives EMRs, not medicine (Score 4, Informative) 367

I'm a resident physician, and so I've used various EMRs in different hospital and clinic settings, and they pretty much all suck in different ways. EPIC, which is based in Internet Explorer of all things, is the worst, but seems to the the one that's being adopted at the most hospitals.

The UI design is just horrible, but beyond that I had a hard time putting my concerns into words until I read an article somewhere that talked about something called "cognitive support to the physician." That is what most EMRs lack.

As a physician, I want an EMR that lets me rapidly get at important clinical information and give me targeted alerts that I need to make a decision. Instead, the systems are centered around billing and cover-your-ass medicolegal documentation. In the paper chart word, these issues had already diluted the meaningfulness of the chart. (Ever see a hospital chart - maybe 10-20% of it has meaningful clinical data in it, the rest is full of useless legal/billing/redundant crap.) Many EMRs just translate the same troubled paper chart system into electronic format, but then the ease of electronic data entry means that even more useless information is included/required, making it that much harder to find the info you really need to make a clinical decision.

I have to say that the best EMR I have used is still good ol' CRPS at the VA. It's not as slick looking as the newer ones, but the data is easily accessible and I have never had to waste my time looking up a billing code. It's been chugging along for over a decade, sharing data between hundreds of sites across the country. (And the issue in the first article about the EMR causing more deaths because you can't put in orders while the patient is en route - not an issue in CPRS, we do this all the time at our VA.)

My understanding is that the code for CPRS is open and free to anyone who wants it. I would gladly choose CRPS over the ability to type my notes with colored fonts in EPIC. They were considering adapting it for the large county hospital system where I work now, but in the end went with EPIC because... wait for it... it was easier for billing.

Comment Re:Is this flu really "special"? (Score 2, Interesting) 695

It's worse among doctors. It doesn't surprise me that the BBC article contains reports about residents and interns dying. I wonder how many patients get infected via sick doctors?

Large teaching hospitals are dependent on residents who work 80 hours a week to barely cover the workload. If someone calls in sick, then it means your already overworked and fatigued colleagues will have to cover for your "weakness." Oftentimes the onus is on you to find your replacement. And so the culture discourages it - either through active hostility or feelings of guilt and/or machismo on the part of the sick person. This culture is learned in med school and residency then gets carried forward.

I'm a resident physician and every year I have to do some online training for all hospital employees that says to stay home if you're sick, and we residents just laugh. The idea of calling in sick for a low grade temp and a cough is so out of the realm of possibility, it's absurd. I'm not saying this is a good or noble thing - there's a lot of things about the culture of medicine and residency (such as work hours) that are fucked up and end up adversely affecting patient care.

Comment Re:In a word... (Score 1) 1385

Totally agree, but they should be wary of the airlines that make their bread and butter from regional travel.

A while back a bunch of businesses in Texas formed a consortium to build a high speed rail network linking the major Texas cities. Southwest Airlines effectively lobbied against and killed it.

Which really sucks, because I'd much rather take a train from Dallas to Austin than deal the hassle of air travel. If you factor all of the airport BS, it takes nearly the same time as driving.

Comment Re:BeOS (Score 1) 626

I loved BeOS and was so sad when it went away.

The Haiku page says that it's "inspired by" BeOS. So what's that mean exactly - that they're trying to reverse engineer it? What happened to the old Be source code? Seems silly to have to reinvent the wheel if the code is already written and not being used for anything.

Comment Re:Postgraduate medical education. (Score 1) 605

3rd year psychiatry resident, so currently my schedule is nothing to complain about :-)

But it just boggles my mind how "evidence based medicine" is the new mantra... except when it comes to the body of evidence re the reduction of medical errors/poor outcomes with reduced hours. Not to mention the entire field of sleep medicine. Selectively evidenced based would be more accurate I guess :-/

Comment Re:Postgraduate medical education. (Score 1) 605

Yeah it is. The current rules say no more than 30 hours in a row, 80 hours in a week, with 10 hours between shifts. Even if those rules are followed, that's still fucked up.

The above rules don't apply to home call. When I was an intern we'd have home call for days in a row with little or no sleep. Last year they changed it to straight q4 overnight call, which was an improvement, which is fucked up.

But that's what you get when your educational model is based on the 100 yr old sleep habits of a cocaine addict (Sir William Halstead). It's shameful that this profession - which knows damn well that the brain was not meant to function this way - allow this to continue out of some romanticized idea of tradition.

Comment Ugh, can the media stop with the scifi headlines? (Score 3, Informative) 247

I'm sick of these stupid "propranolol deletes memory" headlines. There was even an episode of boston legal or law & order perpetuating this nonsense a year or so ago. The drug does not "delete" a specific memory. The only people who can that are on star trek. The drug simply reduces the emotional significance of the memory, uncoupling it from the autonomic/fear response associated with it. A HUGE difference.

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