Archive for July, 2011

Trying to spot some whales

July 21, 2011

Guest post written by Charlie Bennett

There are some really great things that I’ve done in my life. But most of those things have to do with just the accomplishments of my kids. But now that I’m a bit older and I’m not so worried about paying for their educations any more, my wife and I travel a lot more. It’s not like we’re going on these really long trips to Europe and foreign countries or anything. We’re taking short trips to see parts of our country that we’ve never seen before. There’s so much more to see here than I ever thought about!

Well, we recently went to Boston and I was working on finding some of the best things for us to do while we’re there. As i was doing that I saw the site http://hearingaids.miracle-ear.com/hearing-locations/florida/t/tarpon-springs/. I showed it to my wife and I went in to get some hearing aids. That made me more excited to go on the trip to try them out.

Whale watching really was one of the most fun things that we did while we’re there and we’re already talking about the next time that we’re going to go whale watching.

Reduce our national debt by reducing the federal electronic medical records mandate, comment

July 21, 2011

Your post Reduce our national debt by reducing the federal electronic medical records mandate is right on target. The federal government and President Obama should not be mandating electronic medical records in the way they propose. The medical/nursing community and hospitals know what is best for themselves and their budgets.

I will add that hospitals should pull the reigns on electronic medical records. What I see is fierce competition between hospitals to draw patients. This competition occurred with CAT scans, MRIs, helicopter ports, etc. Just because one hospital in town has the latest item, does not mean the other hospitals in town should follow suit. Sure, time and saving lives are critical things to consider. The money spent could be used in providing some basic and needed items for rural hospitals. This includes providing the personnel needed for some of the rural hospitals. Our rural hospitals have a greater need than our city hospitals.

Original Post
July 11, 2011

Reduce our national debt by reducing the federal electronic medical records mandate

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Foundations of an EHR

July 21, 2011

Identifying current processes, paper and electronic forms, (clinical decision support tools), and workflow processes is the foundation to building an effective EHR. When an organization manages its forms, paper or electronic, it manages its processes. Many forms are necessary for collecting and documenting patient information. Unfortunately, most organizations do not see the value of managing these documents. Whether for electronic or paper, forms management includes the design, creation, revision, and obsolescence of these decision support tools. Maintaining proper version control is essential to meet the current standards of documentation dictated by regulatory agencies and the organization itself. Standardizing forms used throughout the healthcare facility plays a large role in helping the clinical staff to know what data to collect and document which forms are available, and where to access them. This facilitates the delivery of proper patient care. Additionally, standardization saves costs not only in the production of the form, but also in the use of the form. Forms management does have an effect on patient safety and the quality of care. Proper forms management can greatly assist the development of an EHR. Understanding existing forms and processes is necessary for developing accurate electronic processes in the EHR. Before an EHR is implemented a disaster recovery plan must be defined. This plan must identify the paper forms required for use. These paper forms must continue to meet the requirements of creation, revision, version control, and obsolescence to meet the ongoing needs of the current documentation processes. It is necessary to have correct, backup paper data collection tools for clinical and business operations to continue. Often a forms analysis, which documents the current state, is a first step in migrating to an EHR. This is extremely valuable for an organization to know its current used forms, volume, costs, workflow, and production information. This enables the organization to make future decisions based on this information. If a bad process is not identified before automating it, one now has a very expensive bad process. Assessing the current forms management environment can significantly decrease this risk and increase the effectiveness of the EHR and guarantee its successful implementation.

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Reduce our national debt by reducing the federal electronic medical records mandate

July 11, 2011

I agree that electronic medical records (EMR) that help to save lives, reduce paperwork, reduce expenses, and secure healthcare information. Larger vehicles like SUVs can also save lives and secure passengers. But, this does not mean that every family or business needs to trade in their fuel efficient smaller cars for larger SUVs. This is more true when these families and businesses are struggling during this economic recession (or depression).

Our government can save money by not currently dealing with the EMR mandate, by not tying up our court system with this mandate and letting our hospitals spend this money within their communities (meaning the government does not have to put extra money into these communities).

President Obama, this is one way of reducing your stress, the legislators’ stress, the courts’ stress, and the stress of the American people. Relieve our nation of the current EMR mandate. Consider a revised and later mandate.

Thank you.

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Risk of Injury

July 7, 2011

One of the assessment questions I ask when interviewing one of our patients is “Have you fallen in the past 3 months”? It is a part of a standard assessment questionnaire. Our electronic medical record can be set so that it always has to be answered. To my surprise, often patients answer “yes”. The populations mostly saying yes are 65-75 year olds.

As we get older our vision starts to change. The ability to see in low light decreases and it makes walking in dim hallways or night driving a challenge. The light we see lessens due to the pupil shrinking. The lens of our eye thickens and can turn a yellow color. A patient described it to me as “having a dark pair of yellow sunglasses on all the time”.

Recommendations that I give my patients are to aide them in the fall prevention.  These include de-cluttering hallways in their homes and making sure all the small rugs in the house are removed. I have found that the use of a red light for a night light instead of a white light cuts down the glare and patients can then see better in the hallways. For outside, I also recommended the use glow strips on their stairs and entrances to their homes, garages and yards. If the patient is still driving, limiting nighttime driving would be a best choice for all involved. We discuss when they last had their eyes examined. One of my patients said “we do not think of those things all the time we just figure it is old age”.  Getting an exam is a good way to be proactive to prevent an eye complication. Once examined, the patient can be aided by a simple pair of glasses or a surgical procedure to improve one’s vision and prevent falls.  To expedite this process, I have the ability to do a direct transfer of the patient to the Eye Care Center at our clinic, so they can easily make their appointment.

Kenneth James, Jacqueline Gouldbourne, Chloe Morris, and Denise Eldemire-Shearer wrote an very good paper on “Falls and Fall Prevention in the Elderly: Insights from Jamaica.” They were effective in writing about the use of electronic data bases and electronic health records in the research of their paper. These same healthcare informatics resources can be used to identify and address falls in the seniors that may occur in almost any given community.

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