Personal Health Record

In addition to EMR (electronic medical record) and EHR (electronic health record), the latest three letter acronym in this area is PHR - or, personal health record. These are described in a February 4th article from the Associated Press. What's intriguing about PHRs is that they are patient-driven.

Everyone has heard of computer tax preparation software. Well, why not a health record created and maintained, not my doctors or hospitals, but by patients. Hmmmmm...... The article does take a shot at doctors for being slow to accept electronic records (although I do agree that docs have been slow to adapt certain technologies).

Doctors have been slow to switch from error-prone paper records to digital ones, so the trend promises to empower patients to take matters into their own computers.

From the front lines of American health care, I do admit that - every day - I have people bring in their blood sugar log or blood pressure log. They keep track of it on excel or other spread sheet program. Not only do patients print this out and bring it to their visit with them, they also bring color graphs which they print out on their ink jet printers. Quite impressive.

Plus, some of these devices, like home blood pressure monitors and blood sugar machines - they have a memory. So, that my patients can show me their trends for the past few hours, past few weeks, and even past few months. What would stop them from inputting this into their computer to further their personal health record.

While large hospital and insurance networks are making the switch, few private doctors have. And even then, software differences mean one doctor's system can't always share information with another's.

Hence the patient-driven trend. More than 100 vendors, from insurers to free Web sites, offer individuals or families the option of creating PHRs — records that they control.

The programs range from very simple electronic diaries to more comprehensive programs that link directly with doctors or hospitals for direct downloading of formal e-charts.

Computer vendors are taking the lead from pharmaceutical companies - direct to consumer advertising. With hospitals and now patients utilizing computer technology for health records, the community based primary care doc (ie - me) will be forced to make the huge financial investment to implement some kind of electronic record (this computer program will probably not be compatible with either the hospital system or multiple patient systems - then what?).

By the way, there is no doubt that electronic records make things more convenient for the hospital, the patient, the pharmacy, the insurance company, the regulatory agency, and others. But how about the physician? I believe the jury is still out on that one. Plus, if you treat electronic records like pharmaceuticals (Ek!), what is the number needed to treat for one person to benefit? There's an interesting question....

Dr. A on the road: Day 4

I just arrived home a couple of hours ago. It's taken a while unpacking and getting ready for work on Friday. And, how it's time to tell you what happened on Thursday - and what a day! We had our final site visit, which I found very valuable. I'm still processing the information that I have learned.

The exciting part of the day happened after that. When we got to the Cincinnati airport, we saw that our flight was on time. Our final destination is our home airport of Pittsburgh, but to get there we had to fly west to Chicago and then east to Pittsburgh. In the early afternoon, we started hearing reports that Chicago was getting hit with a snowstorm.

Right when our team got to the gate, we learned that our flight into Chicago was going to be delayed. I started getting stressed out at that point. I was starting to think that even if we got to Chicago, would we be able to get out of there and back home? Or, would our flight out of Chicago be delayed, or even cancelled.

After discussion, the team decided to ditch the flights, rent a car, and drive the 300 miles home. The entire time, we were trying to get weather reports wondering if the snowstorm was going to hit Ohio while we were on the road. We did manage to get home safely, but, I have to tell you. The past 10-12 hours has been very stressful, and I have to go to bed, because I have to go back to work tomorrow. Yeesh!

While we were on the road, we received word that the flight we were supposed to take from Cincinnati to Chicago was indeed delayed. When the flight left the gate, it went all the way out to the runway, but then was held there for about an hour. After that, the plane came back to the gate and the flight was subsequently cancelled. If we decided to stay at the airport, our flight would have been cancelled, and we would still be in Cincinnati right now.

Also, as I was scanning the news just when I got home, I see that there is a foot of snow forecast to fall in Chicago through the night. And, more than 600 flights were cancelled out of O'hare today. Of course, in hindsight, I'm glad the team decided to ditch the flights and drive home. But, at the time we were discussing, I wasn't sure what the right decision would be.

I'm featured on Viddler!

I just got home from my week long trip (I'll be talking more about that soon). I just checked my inbox and found a message that my Super Bowl video is right now being featured on Viddler's front page. YAY! If it is no longer there, you can always click here or here to also check it out.

Thanks so much to Viddler for featuring my video. I definitely recommend this site to anyone out there who is doing or is considering doing video blog posts. This is a great site, pretty easy to use and navigate, and the community over there is fabulous. "Me Todays" are fun and I'm looking forward to doing more of them in the future!

Dr. A on the road: Day 3

I finally go home later today - YAY! Since, there is no radio show this week, I (kind of) substituted this with the video post above (even with my phrase, "Beyond the Blog" included. This is also a video I'm including in the Viddler "Me Today" group.

The travel day was surprisingly calm and efficient on yesterday. As I remarked in yesterday's post, I thought that we would definitely have problems going into and/or getting out of Chicago. Fortunately, the weather cooperated, and I think we arrived in Cincinnati on time.

After a quick break at the hotel, our group went to dinner at a place called Newport on the Levee which is actually on the "Kentucky" side of Cincinnati. The restaurant was called Mitchell's Fish Market - excellent food. Great food and great company. That complex looks relatively newly built. I wish I had more time tonight to explore more of that place. Oh well, maybe another time.

One more site visit this morning. It'll only be a quick visit, and then the journey home. The last hurdle will be traveling through Chicago O'Hare one more time this week. On day one, the delays were frustrating. On day three, there were no delays. What will happen today?

Dr. A on the road: Day 2

I recorded this quick video this morning before leaving the hotel. (See video above) I apologize up front, because since I have little time this morning, the video quality may not be that great. I had to sacrifice quality for time, so the images may not be as clear as previous videos. When I get to my final destination today, I'll may re-encode the video and may re-post it later.

Anyway, I know people are curious about my comments about the electronic medical record. In talking with these people from our site visit yesterday. I have a little better understanding of kind of what happened. Initially, the marketing on EMR was similar to other computer products - computers will make the life of a doctor easier and will save time.

Well, that may not necessarily be the case, at least initially. There is definitely a learning curve, and it may take more time to see a patient than just using paper. And, until you really learn the system, it may make things much more complicated than what you were used to previously. So, now, I definitely have a better understanding of the physician backlash to this thing.

They gave me more to think about as I journey onward to the next hospital. If we ever get to our next destination today, the next visit will be a quick visit tomorrow. Then, finally, back home tomorrow night. Of course, you can keep track of my travel pains through My Twitter Feed. And, maybe I'll have another video post tomorrow morning. Thanks again for all of your comments and e-mails the last couple of days. Talk to you later!

Show cancelled

I really feel bad about this, but I'm going to have to cancel the show for this week. My plan was to pre-record some material and play it for you on Thursday night, since I'm not going to be available live to do the show. I'll be on a plane on my way home at the usual time for the show.

Unfortunately, instead of recording stuff for the show this week, I've been in my hotel room trying to recover from my illness that hit me right when this trip started - really a bummer. I've been able to do the required work stuff on this trip, but all my other free time here has been in bed sleeping.

If I get some strength, I may record a quick video post about my time here away from home. I know that some of you out there are curious about my opinion/experience about electronic medical records. So, hopefully, I'll be able to do that tonight or tomorrow.

From a travel standpoint, tomorrow is going to be a bugger. Here is the weather forecast for Chicago O'Hare International Airport for tonight and tomorrow - Ek!

A WINTER STORM WARNING REMAINS IN EFFECT UNTIL 9 AM CST /10 AM EST/ WEDNESDAY.

NEAR BLIZZARD CONDITIONS... PARTICULARLY IN RURAL AREAS...WILL GRADUALLY IMPROVE LATE THIS EVENING. A BAND OF HEAVY WIND DRIVEN SNOW PRODUCING VISIBILITIES NEAR ZERO IN SPOTS...WILL MOVE OUT OF THE AREA BY MIDNIGHT. AS THE SNOW ENDS VISIBILITIES WILL IMPROVE...THOUGH SOME MINOR BLOWING OF THE FRESH FALLEN SNOW COULD CONTINUE OVERNIGHT.

IN ADDITION TO THE SNOW...WINDS WILL CONTINUE TO GUST OVER 50 MPH AT TIMES. THESE VERY STRONG WINDS WILL COMBINE WITH THE BITTERLY COLD TEMPERATURES TO SEND WIND CHILLS PLUMMETING TO 20 TO 30 DEGREES BELOW ZERO BY MORNING.

A WINTER STORM WARNING MEANS HAZARDOUS WINTER WEATHER WILL MAKE TRAVEL VERY HAZARDOUS.

So, again, to keep track of my travel pain tomorrow, tune into My Twitter feed. The plan is for our team to leave the hotel right after daybreak for the trek to airport number one. Hopefully, we won't be delayed too much trying to get to O'Hare. What happens after that, who knows?

I'm sick

I can't believe that I'm out of town and this is happening to me. This stomach flu thing is still going. I mean, it's a little better this afternoon verses last night. I'm now back at my hotel room, and I'm back in bed trying to get comfortable.

The meeting today went pretty well, and I'll talk about that soon. Actually, the information in my head is still spinning. I do find it a little bit distracting with my illness. 

I'm even considering canceling the show on Thursday night, because I'm not really feeling very entertaining right now. Sorry for all the whining, hopefully, I'll be feeling better soon....

Dr. A on the road: Day 1

Just a quick update as I don't have a lot of time before my morning meeting. Yesterday started early when the alarm went off at around 5am. I definitely did not want to get up. I finished my packing, got on the road, and went to the airport. The check-in process was relatively painless, including going through the security area.

The plane was on time leaving the gate, but when we got to the end of the runway, the pilot said that Chicago was having a lot of rain and wind, so we had to sit there, on the plane, for about another 30 minutes. Good thing I had my iPhone with me so that I could listen to some tunes and some audiobooks while sitting there.

Stepping off the plane in Chicago (we were about an hour late arriving), we saw that our connecting flight to our final destination was already delayed - because of weather. So, that gave the group the chance to have some lunch. I have never traveled with this group before, so it was a chance to get to know them a little bit.

Following lunch, we looked at the departure board again and saw that our flight was delayed another two hours. And, there were some flights that were starting to be cancelled. Looking outside at the time, you could see the winds and the rain affecting takeoff and landings of planes.

The gates at the airport were really starting to become crowded with the delayed flights. People (including our group) were becoming restless. Next, another change - they added another 30 minutes to the previous delay. And, then, minutes later, they added another 10 minutes. I was really starting to get frustrated at that point - you could see it in my Twitter feed.

When we got to the airport of our final destination, a couple of people in our group did not get their luggage - Sheesh! So, we were delayed leaving the airport until that was sorted out. Luckily, they were able to find their bags. The hotel was another 45 minute drive from the airport. We finally got to the hotel at about 9pm - What a long travel day!

I'm not feeling very good today. I think I ate something that does not agree with my stomach. So, I'm tired, fatigued, weak, and whiney. That's a great combination for going and talking about electronic medical records today - YAY! So, we'll see what happens this morning.

I did want to give a plug and a shout out to Scan Man who just posted his first podcast. He did a great job and I recommend that you check it out. Also, crzegrl posted her second video blog. This is a great video about the aircraft that she uses at work. See, I'm inspired that more people are using things like podcasts and video. Are you next? Let's hope so!

Super Bowl XLII Sucks

As I leave early in the morning for points unknown (actually, I'll let you know later, but you gotta love the suspense, don't ya?). I just want to share these thoughts (video post above) about this year's Super Bowl game. Are you going to watch the Super Bowl this year? Why or why not?

Hopefully, the airports that I'll be at today will have free wi-fi, so I can blog on the way to my destination. I'll even try to Twitter via my iPhone or computer today. Isn't this exciting? Talk to you soon....

Dr. A on the road: Day 0

So, it's the day before I leave on my four day trip out of town. It's a business meeting on behalf of the hospital, and it's not to exotic locations - like the beach or tourist destinations. Where am I going? We'll I'll hold off on that for now> (This "teaser" may actually keep you reading this week).

The use of electronic medical records both in the office and hospital setting remains an area of continued discussion in medical circles. There is no doubt that this is something that the press, the public, and the government is demanding.

The way this thing was marketed was that there are a lot of deaths due to medical errors. Electronic records will help alleviate that problem. Well, the discussion continues and there are some docs out there who are not buying into this concept.

So, there is going to be a team of about a dozen of us from the hospital from the various departments (med staff - meaning docs, nursing staff, pharmacy, information systems, etc) going to visit a couple of hospitals this week to see how they have implemented some of this stuff.

Now, don't get me wrong, I'm on board with electronic records. I'm not going on this trip to convince myself that EMR is good. However, I also have my pessimist cap on. Let's face it, no one likes change - particularly doctors - HA! And, in general, docs are not early adopters when it comes to technology (except me).

So, as I learn more about this stuff, my job when I get back will be a little bit of marketer as well. How to convince a bunch of docs of something that they don't want to do? Sheesh! For the trip, I have my audiobooks planned out to listen on my iPhone: Meatball Sundae, The Dip, and The 4-hour Workweek.

Want to know what I'm doing this week? Well then, bookmark or subscribe to My Twitter feed. Depending on my schedule this week, I may even turn on my iSight camera on my MacBook and be live on My Ustream channel.

Also, my plan is to video record while on the road and post on My Viddler site. Finally, I plan to record some audio, edit it, and play it in my usual time slot for The Doctor Anonymous Show this week. So, this is definitely Doctor Web 2.0 on the road. How exciting!