How Technology Will Create a Safer Healthcare System

healthIt’s one of those great conundrums. Despite medicine being a highly intellectual field often at the cutting edge of science, we all too often remain near the bottom in terms of our information technology use. Maybe it’s the culture of medicine, a view that one should master everything and do everything despite knowing that this is an impossible goal? Maybe it’s lagging on the part of administration who may not understand the potential role of technology in the daily workflow of their physicians? Or maybe it’s just that we as a profession have never sat down and tried to understand what we’re missing, what we can do, and where we should go with the incorporation of informatics technology?

I choose to believe it is largely the last of these: that we as a profession have not yet began to put proper thought and action to purpose in terms of intelligently using technology to augment our abilities as clinicians.

Think about this scenario: You are on the wards covering 16 patients. Most of your patients are receiving multiple medications – anti-hypertensives, antibiotics, etc. – and let’s say one of them was getting a transfusion overnight as often happens. The team notices that patient begins having trouble breathing and chooses to administer a dose of Lasix which causes resolution of the problem. However, this same patient has a reaction to Lasix and develops allergic interstitial nephritis, which manifests with increased creatinine and reduced GFR on the next set of labs. Continue reading

Is YOUR Graduate Medical Education (GME) Failing? Point & Counter Point

Graduate medical education  has changed a lot in the last 20 years.

Whether its Internal Medicine, Surgery, Psychiatry or any of the other fields, the world of residency isn’t what it used to be. As we continue to look to reform and innovate to improve your education, there’s tons of debate out there if we’re heading in the right direction.

In fact, this debate to me has become the classic “Old School” vs “New School” type of debate.

If you’re currently in any form of residency or fellowship training, I’m curious about your opinion.

As a trainee, you have the most stake in this debate.

Recently, I’ve read 2 blog posts that make compelling arguments. Take a look and tell the world what you think.

 

Why Graduate Medical Education is Failing

http://www.kevinmd.com/blog/2013/12/graduate-medical-education-failing.html

Counterpoint: Why Graduate Medical Education will be fine

http://boringem.org/2013/12/22/counterpoint-graduate-medical-education-will-fine/

 

 

Dietary Supplements Blamed for Sharp Rise in Drug-Related Liver Injuries

“Dietary supplements account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from 7 percent a decade ago, according to an analysis by a national network of liver specialists. The research included only the most severe cases of liver damage referred to a representative group of hospitals around the country, and the investigators said they were undercounting the actual number of cases.

While many patients recover once they stop taking the supplements and receive treatment, a few require liver transplants or die because of liver failure. Naïve teenagers are not the only consumers at risk, the researchers said. Many are middle-aged women who turn to dietary supplements that promise to burn fat or speed up weight loss.”

Read the NY Times article here

2014 is coming – are you ready for the ACA?

For now, enjoy an easy-to-follow take on the ACA, as presented by YouToons from the Kaiser Family Foundation.

JNC-8 HTN guidelines finally released!

For more information, please see the following link.

Patchogue Inn Soup Kitchen Volunteering

Volunteer Opportunity!

All are welcome to volunteer any or every Saturday from 8 – 10:30 AM at Patchogue INN Soup Kitchen!

Help cook and/or serve breakfast!

Also, collecting gently-used adult and children’s clothing and shoes, canned foods and non-perishable breakfast food items, including pancake mix, granola bars, cereals, etc.

A collection box is in the Stony Brook Residents’ Lounge on the 15th floor.

Patchoque INN Soup Kitchen

St. Francis De Sales R.C. Church

140 Ocean Ave.

Patchoque, NY

 

Should We Lower Blood Pressure in Acute Ischemic Stroke?

In a randomized trial, outcomes were neither better nor worse with early antihypertensive therapy.

A 2013 guideline from the American Stroke Association recommends that we avoid antihypertensive drug therapy during the first 24 hours after onset of acute ischemic stroke unless systolic or diastolic blood pressure (BP) exceeds 220 mm Hg or 120 mm Hg, respectively. (The threshold is 185/110 mm Hg for patients receiving thrombolytic therapy; Stroke 2013; 44:870) The concern is that early BP lowering might worsen stroke outcomes. However, no large randomized trials have tested this theory, until now.

Read the full article

[PMID]24240777[/PMID]

Top 10 reasons I use Twitter in Healthcare

I’ve been on Twitter for almost a couple of years now and when I talk to people about it, I still get a healthy dose of skepticism.

So I’ve put together a top ten list of why as a physician and medical educator, I use Twitter.

10: Connecting with Leaders

To be lead, you must know what your leaders are thinking. Twitter has made leaders accessible. Now, instead of spending time looking for their opinions or hoping to catch a handshake or meeting at a conference, they send their thoughts directly to me, in small increments of 140 characters, everyday!

9: Connecting with Followers

As physicians, you are a leader. Whether it ‘s in your office, your patient panel, your learners, your colleagues, your academic society, you have the opportunity (and responsibility? ) to lead and lead effectively. Twitter allows you to share your thoughts in small increments, reach a vast audience with minimal effort. Quoting #10, “To be lead, you must know what your leaders are thinking.”

8: Networking

The importance of professional networking cannot be understated. Twitter easily connects people with similar interests. In less than 2 years, I have been able to access a vast network of people interested in things that are important to me such as Primary Care, Medical Education, Social Media, Evidence Based Medicine and Healthcare Technology. In the past, networking for me occurred in spurts, at pre-determined locations over a finite period of time. With Twitter, networking happens 24/7, with little effort no matter where you are (and in your pajamas, while watching tv!).

7: It makes me an active learner.

All through my education I took notes. Writing things down helped solidify that piece of knowledge. A notebook was also useful for exams, reviewing and reinforcing information. Now instead of a notebook, I have a tablet and instead of a piece of paper, I use twitter. The 140 character limitations forces me to be succinct which makes my virtual notebook very easy to review.

6: I can educate the world

This is a grandiose statement, but Twitter makes it real. As a Medical Educator, I take pride in being able to influence the learners in my immediate proximity. With Twitter I can take all those notes  (See reason #7) and broadcast it to learners in other cities, states, countries and continents! Currently I’m using the the hashtag #sbmgr to broadcast what we’re learning in our Internal Medicine Grand Rounds every Wednesday 8:30 to 9:30 AM.

5: I can attend multiple conferences simultaneously, year round.

Until human cloning technology advances, Twitter is the best way to be at multiple places at once.  I wish I could attend every medical conference out there. But thanks to people who prescribe to reason #7, I can virtually attend other conferences through my smart phone, all throughout the year. There are thousands of people out there like myself, live tweeting from conferences. This year, I personally attended ACP and APDIM live tweeting from both. But in addition, while being back home, I followed the tweets from Kidney Week and Chest in the past couple of months.

4: It’s a forum for debate

Healthy debate is part of our lives as physicians. New guidelines and treatments are always coming up, and Twitter I get immediate access to viewpoints from a wide variety of people. I often get immediate feedback on my own opinions.

3: My mom taught me to share

We are all online, all the time. As a physician, I’m always finding a great journal article, an interesting blog,  or an important news article. Before twitter, I had no mechanism to share that, besides e-mailing to a small set of people or writing it down somewhere and hope that I have an opportunity to suggest it to people. Now, every website has a Twitter link. You see something cool, you can share it with a large audience with just a few clicks.

2: The world at any given moment

Whenever I have a free moment, Twitter  is my go to activity. In 2 minutes, I can scroll through a myriad of messages and get a burst of information from a network of my choosing.  So it’s whether pumping gas, waiting for an elevator, a 15 minute lunch, a commercial break during the football game, Twitter helps me use these small snippets of time, constructively.

1: It broadens my mind

In patient care we are emphasizing a team-based approach that values the roles of every individual in a healthcare team. The same can be said for my continuing medical education. I think I have something to learn, from everyone. As a result I follow folks in Internal Medicine, sub-specialties, family medicine, psychiatry, surgery and so on. I follow nurses, physical therapists, social workers and patient advocates. I follow patients (not my own) sharing the story of their medical conditions. I am learning something from everyone from the palm of my hand.

If this doesn’t get you interested in Twitter, here’s a a blog post from someone who’s listed 140 Health Care uses for Twitter

http://philbaumann.com/140-health-care-uses-for-twitter/

In addition, here’s another post to help you make the leap.

Top Twitter Myths and Tips

This is written by Dr. Vineet Arora who is Director of GME Clinical Learning Environment Innovation and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago.

 

Shabbir Hossain MD
Assistant Professor of Clinical Medicine
Co-Director Combined Medicine Pediatrics Residency Program
Division of Primary Care & Geriatrics
Department of Internal Medicine
Stony Brook School of Medicine
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