*Politicans
*Egos of management
*Distribution
*Concentrating on PATIENT MANAGEMENT, not financial management.
*Training
*Training
*Training
For instance, if the open source community can help with the situation I'm about to describe, and just this, you have no idea how much of a difference it will make to primary healthcare in this country. Build the "system" so it can be grown, sure. But little steps is the only way you'll get anywhere in a third world country.
Here's the situation. Primary healthcare patients (GP-based needs, meant to go to clinics, both rural and metro BEFORE they get referred up to secondary and tertiary centres - where they would get seen by specialists and clog up already clogged hospitals) HAVE to carry around a green piece of cardboard - their clinic card.
This card links to a manually filed medical history inside the clinic archives. To get to a hospital, you're meant to get referred - thus creating the link. If you don't, hospital doctors are practicing blind, because there is absolutely no way to retrieve paper-based files from clinics around the country.
And most patients believe they can just pitch up at hospitals with primary care problems (translation: trivial from a hospital's point of view). Small wonder we're understaffed? Especially Baragwanath.
Hospital doctor's don't need every little bit of previous scrawl - but there are some critical pieces of information that should be kept centrally on a patient database - and easily accessed at critical times. Such as: Patient diagnoses (incl the controversial HIV + - status, in code), current medication / dosages, allergies and relevant major tests (eg. CT SCAN, ECG, major blood work).
Solve that problem and you've taken a huge leap forward.
We've also started doing a bit of digging... nothing like a good idea to inspire some late night surfing-with-purpose...
Mercy Hospital Opens Arms to Open Source... (Tina Gasperson)
"For almost 100 years a group of women called the Sisters of Mercy have been instilling a spirit of excellence into Baltimore's biggest hospital, appropriately named Mercy. Right from the start, the Sisters have made it their goal to push the medical institution beyond the ordinary by creating teaching affiliations, feeding the hungry, building state-of-the-art emergency services, and launching a neighborhood health center for the inner-city poor. In today's world, all that excellence requires a solid technology infrastructure--and one open source management package to manage a variety of systems.
"Mercy's data center houses more than 200 machines running Windows, Linux, Solaris, AIX, and other, more obscure operating systems. Mercy CIO Jim Stalder says about 160 of the servers are Windows-based, but because the health care services industry is 'fragmented,' with many essential applications available only on other OSes, he also has to maintain dozens of non-Windows machines..."
OpenVista(R)
OpenVista is the open-source version of VistA, which is an enterprise grade healthcare information system developed by the U.S. Department of Veterans Affairs (VA) and deployed at nearly 1,500 facilities worldwide.
MedPix Medical Image Database Uses Healthy Dose of FOSS (Michael Stutz)
"MedPix is a sprawling online medical images database and diagnostic tool that's used around the world by radiologists, nurses, physicians, and medical students--and the whole system is powered by Linux and open source software.
"MedPix is hosted by the US federal government's health sciences university, the Uniformed Services University in Bethesda, Maryland. It's the brainchild of James G. Smirniotopoulos, M.D., a USU professor of Radiology, Neurology, and Biomedical Informatics and Clinical Sciences Chair of its Department of Radiology and Radiological Sciences..."
Interview with Fred Trotter: The Medsphere (Tony Mobily)
"Recently Medsphere, supposedly an 'Open Source' Medical Software Company, has sued its founders Scott and Steve Shreeve. Why? Medsphere claims that the Shreeves illegally released Medsphere software to Sourceforge. An 'Open Source' Software company is suing its founders for releasing code under a free license... that's a bit like Ford suing its employees for making cars.
Recently Fred Trotter has come forward with evidence that he claims makes the Medsphere lawsuit baseless. Read on for an email interview with Fred Trotter regarding who did what in the Medsphere lawsuit, and why every free software developer should care about what is happening to the Shreeves..."
Raw Matter: Free Software and Quality
"Ben Chaff argues that Free Software is better than average in terms of security when compared to the proprietary software market, but falls short of the standards that apply for software used in crash-and-people-will-die type of mission critical applications.
"I fear I have to cry foul here: developing software for the kind of systems he describes (nuclear power plant controlling, medical equipment, ...) means developing software with a large budget and a limited, relatively well specified functionality..."
As Farrel says in his comment on the initial post - this could be done by pretty much any Linux distribution - but why not use the perfectly good South African one then eh? (Note to self: Proudly South African involvement?).
Would be nice to get a response out of Ubuntu themselves. These ideas sometimes have a tendency to run away with themselves - the developers and distributors themselves may be able to push this thing along the right path...
We've already started digging for interesting stuff. That post coming up next...
Oh, and a shout out to the Ubuntu Blog (unofficial) - who was looking for interesting stuff being blogged - about Ubuntu!
Baragwanath is 2km wide. How would you like to run a kilometre (the phones just don't get answered) and wait in a queue (only 5 terminals work currently) for those lab results as your patient lies gasping on the slab?If I'm not mistaken - movements like this ARE the spirit of Ubuntu. Leave a comment, we're really interested in your views...
Click4Care is a relatively new software company (although a lot older than most of those Health 2.0 companies I've been featuring) that’s spent a lot of time building a very, very complex system for what can broadly be described as care management, sold primarily to plans and payers—with United HealthGroup being the marquee customer so far.
Vindicated! Yes!- Advanced age
- Long-term constipation
- Long-term diarrhea
- Long-term straining during defecation
- Pregnancy and the stresses of childbirth
- Previous surgery
- Cystic fibrosis
- Chronic obstructive pulmonary disease
- Whooping cough
- Multiple sclerosis
- Paralysis (Paraplegia)
This isn’t differentiating between age, gender or pre-existing illnesses – three of the most fundamental differentiators. That’s WHY doctors have consultations. To narrow down, or eliminate lists of causes before a proper diagnosis.
Little Susie is now a potential victim of Whooping Cough and Multiple Sclerosis – and if Mommy is paranoid enough… Chronic Obstructuve Pulmonary Disease (Translation: Emphysema. Do you really think the 6 year old has been smoking 20 cigarettes a day for 20 years?)
Empower the patient - definitely! But who's going to help us undo the influence of bad research?
In the end, one key part of the solution to these problems is a better educated patient. If patients understand their diseases better -- the symptoms, the treatments, the drugs, and the side effects, they are likely to get better and quicker care -- before, during, and after treatment. We have already launched some improvements to web search that help patients more easily find the health information they are looking for. Using the Google Co-op platform, Google and the health community have labeled sites and pages across the web making it easier for users to refine their health queries and locate the medical information they need. Do a search on Google about a medical issue or treatment like diabetes or Lipitor and you'll see some choices for refining your query, such as "symptoms," "treatments," and so on. If you click on "treatment," your search results are refined and reordered so that sites that have been labeled as being about treatment by trusted health community contributors are boosted in the rankings. Note that how trusted a contributor is -– and thus how much they affect your search results -– is dependent both on Google's algorithms and on who the user decides they trust. For example, if my doctor is a Google Co-op contributor and I indicate to Google that I trust her, then when I search, the sites she has labeled as relevant will show up higher in my search results.
Patients also need to be able to better coordinate and manage their own health information. We believe that patients should control and own their own health information, and should be able to do so easily. Today it is much too difficult to get access to one's health records, for example, because of the substantial administrative obstacles people have to go through and the many places they have to go to collect it all. Compare this to financial information, which is much more available from the various institutions that help manage your financial "health." We believe our industry should help solve this problem.
We've all heard the harried medical team on ER call for something "stat." From the context, we knew it meant "quickly," but had no idea what the normal definition of the term was. We turned to the Net to cure our ignorance.
After various searches on phrases like "stat terminology" and "stat meaning" failed to provide an answer, we sat down and rethought our strategy. Several of our searches had turned up acronyms for the term, and while they weren't what we were looking for, they did point us in a new direction.Remembering a helpful site we'd used in the past, we pointed our browser to Acronym Finder, a web site devoted to decoding mysterious combinations of letters. Typing in "stat," we hit the "Find" button and awaited a diagnosis.
As it turns out "stat" stands for a number of things, ranging from the obvious (statistics) to the not so obvious (Society of Teachers of the Alexander Technique). However, the very first entry provided the answer to your question. "Stat" in medical parlance is actually not an acronym; it's short for statim, the Latin word for immediately.
That made sense, considering many medical terms have Latin origins. Next time we get a similar question, we'll know to head to our Latin dictionary. Stat.
"Appletini. Stat."
I actually thought there were a couple more when starting this post. Hmm. Any others out there? I'm sure I'm missing a bunch...
Who? Dr Perry Cox.
His Playground? Sacred
With quotable quotes like: “God? My brilliance is becoming quite a burden…” Ol’ Perry is fighting for first tee-off in the I-Am-God-Fourball (with Gregory House MD… of course).
Hot or Not: [4 out of 10] – He takes his shirt off all the time. Which is OK. But doesn’t lift him out of the realms of George Clooney’s ugly cousin. In fact, he’s not the eye candy I watch the show for (Dr. John Dorian has those crazy eyes!)
Apparent Medical Skill: [8 out of 10] – It’s a swoop in, swoop out, recite the diagnosis and the differentials type affair. He’s the typical Physician who knows his stuff. Has uncanny ability to impart wise teachings while belittling the life out of you. Make him your doctor. Don’t beat him at basketball.
Bedside Manner: [3 out of 10] – Has strange ability to extend one word into unusual amount of syllables. Re-he-he-he-he-he-he-heally… Also tends to confus the gender of male colleagues. Frequently. Pretty intimidating, really.
Ability to survive in Baragwanath: [9 out of 10] – A Baragwanath hero in the making. Completely tough nut to crack. No bending under 180-patients-in-one-night pressure. Deals with drunks, malingerers, psychotics and self-diagnosing Indian ladies with clinical efficiency.
What would I say if I woke up in his ward? Nothing. Anything I say would be used against me. Just let him do what he does.
Doctor Showdown SCORE
[6 out of 10]
Consummate medical skill unfortunately pulled down by odd gender bias and fascination with own pecks. Helluva teacher though. Wish I’d had someone like him in Anat Path.
Something about Meredith is just so flaky. I don’t know whether it’s the raspy possum-like voice used to narrate her way around the pitfalls of sleeping with her colleagues… Or, the mousy I-wish-I-was-the-girl-next-door looks.
Let’s be fair. It’s just the first season.
Hot or Not: [6 out of 10] – You kinda think she would look hot. And then she kinda does, but kinda doesn’t. I just don’t know with this one. It’s hot, but condescending I-went-to-a-better-private-school-than you hot.
Apparent Medical Skill: [5 out of 10] - Maybe as a psychiatrist she’d get a higher score. Although definite minus points for having a cry while shagging the shy doctor (George). Was expecting a better performance out of dear Meredith. With that name, and those “mature” looks – she must have bummed around as a Chicken Licken sales lady before becoming an Intern. Just not fresh-faced and innocent enough.
Bedside Manner: [5 out of 10] - That flaky voice just doesn’t inspire much confidence.
Ability to survive in Baragwanath: [1 out of 10] – She’d cry on the first day, sleep with all her mates and then get vomited on by that drunk guy. This would obviously ruin those designer pyjamas. Tickets.
What would I say if I woke up in her ward? Does this come in a nurse outfit?
Doctor Showdown SCORE
[4.25 out of 10]
But then you didn’t really have to be a good doctor to make it onto TV, did you?
A DSTV StreetPole ad recently caught my attention. In true DSTV style, it offered out some big words, some sexy pictures and a great special on decoders. It was the words that got me thinking. Score Big. Go Wild. Be Unfaithful. DSTV R599. The Be Unfaithful portion of that ad came complete with smacker lips Rihanna looking seductive (pretty sure it was her).
This wasn’t any ordinary flashing of the traffic. With stethoscopes flying, lab coats swirling and SA’s finest wiggling their jiggly bit – the event made KFM news 3 years in a row, and was responsible for more than a few dented bumpers.
I’d like to say I met my anonymous SA Doc like that… Idling down the highway, afternoon traffic, sweet sounds of some boy band playing (dial obviously stuck – irony is students just don’t listen to KFM!)… There she would appear, like a vision… Mouth open in a drawn out Savanna-induced whoop of delight. Her nipple catches my eye… It would be love.
But alas, I was usually the sucker holding the bra.
At All Scrubbed, we’re wondering if this great tradition is going to continue – and would like to appeal to our readers to get in touch with any UCT medical student they know. Spread the word – it would be a crime to deprave the M3 of its most exciting yearly onslaught.
"In some cases the best way to fight a fire is to light a fire of your own. But could the best way to fight AIDS possibly be with AIDS?
Researchers at the University of Pennsylvania are testing the idea that a modified strain of the HIV virus, called a lentivirus, could be turned into a sort of anti-AIDS guided missile that could directly target the HIV virus already in patients. Naturally safety was the primary concern.
The Scientist reports:
One safety concern with using lentiviruses as gene delivery vectors is that they might form replication-competent lentiviruses, but Levine and his colleagues found no evidence of this in any of the patients. Another concern is vector mobilization, which the researchers saw in the first 60 days after injection, but not after that. This mobilization probably doesn't mean the vector isn't safe, said Richard Sutton of Baylor College of Medicine in Houston, who was not involved in the study, but he acknowledged that it is "a little bit concerning. Usually we don't like these vectors to jump around once they're inside a person."
While safe, the therapy still has a long way to go before it could be used for treatment. In the trial on 5 patients, only one showed a significant decrease in their viral load. "
Nope. Not part of the Anarchy Cookbook on interesting ways to heat up an anti-inflammatory - but rather some pharmaceutical DRM (that's Doctor Relationship Management for those in the know).
1. You will have a proven, lower risk of contracting STD's - not harbouring crawlies under there will help.
2. You therefore have a lower risk of contracting HIV. Less microtears. And, you did know that STD's and HIV like to hold hands?
3. And finally, come on guys, it just looks better! The "extra inch" it adds is more than compensated by the apparent increase in girth.
Not much more we can say, aside from thanks for the comments that are still coming in about the first post. It's obviously a touchy issue. Cough.
Some interesting foreskin envy links:
- The Fate of the Foreskin: A Study of Circumcision?
- Would you rather be circumcised or uncircumcised?
- The Unkindest Cut of All: Circumcision no longer a popular choice?
This is going to be a one-sided argument. Because I'm writing it. Do you have any idea the kind of gunk that can get underneath a foreskin? An unlopped, useless piece of disease-harbouring flesh? Shudder.
It's actually quite hard to find good medical cartoons on the Internet. A quick Google Image search yielded some horribly poor results. But... we try harder. A some good 'uns we did find!
Hopefully courtesy of McHumor!
We don't have permission to reprint this - the nature of digital blog surgery being so quick and stuff - but kudos to the author / artist - and hope you like the publicity!
