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| BMI but not HIV? | |
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| Tweet Topic Started: Jul 21 2010, 04:38 PM (204 Views) | |
| George K | Jul 21 2010, 04:38 PM Post #1 |
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Finally
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http://cnsnews.com/news/article/69743
But everyone has the right to know how fat you are... http://www.cnsnews.com/news/article/69436
OK, which is the higher health risk to the patient, HIV or obesity? More importantly, which is the higher health risk to everyone else? |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Mikhailoh | Jul 21 2010, 04:41 PM Post #2 |
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If you want trouble, find yourself a redhead
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Your health record is your health record. It should be complete, period. |
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Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball | |
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| Jolly | Jul 21 2010, 04:43 PM Post #3 |
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Geaux Tigers!
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Don't fvck with the chart. Period. An incomplete chart begats mediocre medicine. |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| jon-nyc | Jul 21 2010, 04:46 PM Post #4 |
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Cheers
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What Mik and Jolly said. |
| In my defense, I was left unsupervised. | |
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| George K | Jul 21 2010, 04:55 PM Post #5 |
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Finally
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As someone who deals with an "electronic" medical record every day, let me say that it's a nightmare. Our place went to computers about 3 years ago. It used to be that I could walk up to a chart, pull it, and get all the info I needed. All the progress notes are in the - sit down - "progress notes" section. All the labs are, yep, you guessed it, in the "labs" section. Now, info is scattered. Some is "on the computer", some is in the paper record. Some of it has been dictated, but not transcribed, so I don't have access to the most recent consultations - they might not appear for 6 hours or so. That's a problem when I have to take the patient into the OR in the next 30 minutes. Give me pen and paper (for patients in the hospital, at least).
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| jon-nyc | Jul 21 2010, 05:04 PM Post #6 |
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Cheers
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Yeah, George, all the info is there, except for the info that isn't.... What electronic medical records can deliver is a true consolidation of info from every medical professional I've ever visited. Today its totally isolated - my GP on 71st street has what she has, the one before that has what he has, the one before that has what he has (etc. for at least 10 GPs I've had in adulthood), the hematologist from 5 years ago has what she has, my pulmonologist has what he has, etc. Of course a partial or isolated data conversion makes the problem worse, not better. But when medical records are stored uniformly and comprehensively we'll all be better off for it. (assuming all privacy and anti-trust issues are considered) |
| In my defense, I was left unsupervised. | |
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| Mikhailoh | Jul 21 2010, 05:05 PM Post #7 |
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If you want trouble, find yourself a redhead
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George speaks sooth. The EMR, while a nice concept, falls prey to 'the devil is in the details'. The hospital system I currently work for runs 1007 systems. 1007. Most of which claim to be 'integrated'. What that means in most cases is that the ADT (Admission, Discharge, Transfer)' system feeds into them so they have a reference to the patient. Getting that system's data back to any data repository in a truly useful format is really damn difficult, if it is even attempted. I won't even begin to go into all the factors that make it difficult. |
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Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball | |
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| George K | Jul 21 2010, 05:06 PM Post #8 |
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Finally
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It's like the hardware store that we used to have here in town that had a sign: "We have it...if we can find it." |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| jon-nyc | Jul 21 2010, 05:07 PM Post #9 |
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Cheers
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(edit: To Mik:) All that means is we're not done yet. See my last para to George. |
| In my defense, I was left unsupervised. | |
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| jon-nyc | Jul 21 2010, 05:10 PM Post #10 |
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Cheers
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Seriously, though. As a practical matter you're looking for info pertinent to TODAYs procedure. You want that readily available, and you would just as soon have it on the clip board attached to the guy's bed. I get that. But 'enlarge the problem' as Rummy would say, and imagine what gets missed because of isolated medical records. Also try to imagine what a single comprehensive database of complete medical records could give us (i realize thats an idealized goal) - many questions that today require a special study would be answered with a simple database query. |
| In my defense, I was left unsupervised. | |
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| George K | Jul 21 2010, 05:11 PM Post #11 |
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Finally
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Oh, yeah... I was working with an older ortho guy last night. He's a big donor to the Chicago Symphony, by the way. So much so, that they let him "conduct" once... Anyway, he was having a computer system installed in his home, and some guy was installing it who used to work for IBM (this was about 5 years ago). Surgeon asked about medical records and security, and the installer guy laughed in his face. He said, "It's as secure as printing in the New York Times - on the third page." "Doc, what's your full name? What hospital are you at?" The surgeon told him. Within 15 minutes, this guy had hacked his password, logged into the hospital computer, and printed out a list of all the surgeon's patients who were in. "Would you like me to get lab results on them as well?" |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Copper | Jul 21 2010, 05:12 PM Post #12 |
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Shortstop
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Wait a minute. Are you guys saying that the nationalized healthcare system might somehow be related to your health? |
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The Confederate soldier was peculiar in that he was ever ready to fight, but never ready to submit to the routine duty and discipline of the camp or the march. The soldiers were determined to be soldiers after their own notions, and do their duty, for the love of it, as they thought best. Carlton McCarthy | |
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| jon-nyc | Jul 21 2010, 05:16 PM Post #13 |
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Cheers
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George - so far you and Mik are throwing up implementation issues. Indeed, they need to be resoved. But that's no reason to give up the end goal. |
| In my defense, I was left unsupervised. | |
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| George K | Jul 21 2010, 05:21 PM Post #14 |
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Finally
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Don't get me wrong - I'm not opposed to the "end goal" as you describe it. It's a great idea. But, in my little corner of the world, in my small little hospital, the stuff takes time to get to the chart. And I need it My point is that in the last 5 years that I've been exposed to it, the "end goal" has not been reached, and my faith in the ability to reach it is, well, jaded. "For a list of how technology has failed to improve your life, press 7." |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| jon-nyc | Jul 21 2010, 05:22 PM Post #15 |
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Cheers
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That's all entirely fair criticism. |
| In my defense, I was left unsupervised. | |
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| George K | Jul 21 2010, 05:28 PM Post #16 |
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Finally
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What about the restriction on the HIV status of a patient? Should that be part of the chart? I, for one, would like to know what that is, if I'm going to stick a needle somewhere. I'm sure that anyone who uses sharp things on a patient would feel the same. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| jon-nyc | Jul 21 2010, 05:30 PM Post #17 |
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Cheers
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See my first post in the thread. |
| In my defense, I was left unsupervised. | |
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| George K | Jul 21 2010, 05:30 PM Post #18 |
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Finally
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THNX |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| George K | Jul 21 2010, 05:55 PM Post #19 |
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Finally
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Should this be part of the medical record?My opinion - damn right it should be part of the record. It's a surgical procedure, and most often involves an anesthetic. It can cause (rarely) anatomic changes to the uterus and anyone who takes care of the patient should know what they're getting into. If the patient has had an adverse reaction to an anesthetic, I want to know. Edited by George K, Jul 21 2010, 05:55 PM.
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Mikhailoh | Jul 21 2010, 05:58 PM Post #20 |
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If you want trouble, find yourself a redhead
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Q. What next? What 'sensitive' piece of medical data will be omitted for political convenience? and why would it be a problem if privacy regulations are enforced? A. They can't. HIPAA is a joke. A bureaucratic boondoggle. Edited by Mikhailoh, Jul 21 2010, 06:00 PM.
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Once in his life, every man is entitled to fall madly in love with a gorgeous redhead - Lucille Ball | |
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| Axtremus | Jul 21 2010, 06:45 PM Post #21 |
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HOLY CARP!!!
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Redundant. BMI is merely a function of both height and weight. You have height and weight, you can calculate BMI. If you object to recording BMI, you're in effect objecting to recording height, weight, or both. Now, about the "mandatory complete, centralized, medical record for every one" issue. The libertarian and privacy rights advocate in me say screw the "mandatory" part. I'd rather exempt all healthcare service providers from liabilities stemming from bad results due to incomplete information, and put the onus on patients (or their guardians) to disclose whatever they want or need to disclose when they seek medical care. If some one elects to mess with their own charts by excluding certain information, he does so at his own risk. If there is something so personal that they'd rather risk their lives to keep secret, so be it -- no liability on the part of the providers. |
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| George K | Jul 21 2010, 06:50 PM Post #22 |
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Finally
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Is that a midget in you? Good luck with that. That's worked out so well in the last 30 years.
What country are you living in, again? |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| Kincaid | Jul 21 2010, 06:52 PM Post #23 |
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HOLY CARP!!!
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I rarely get a medical chart that shows me the patient's weight - especially women. As for my job as an insurance adjuster - it is often obvious that we do not get all the records for people that we are trying to evaluate. Most often, to their detriment and it results in a lower settlement. Another pet peeve - and this is mostly with chiropractors - is that they like to run separate records to make it look like someone that has been going to the chiro for years for back pain now has a new auto accident and is listed like a new patient with no pre-existing problems. |
| Kincaid - disgusted Republican Partisan since 2006. | |
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| Jolly | Jul 22 2010, 05:49 AM Post #24 |
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Geaux Tigers!
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Back to the horse and buggy... I once heard an old doc lament the training new residents recieved. He said all we want to focus on in today's medicine is technology and decision trees. He contrasted today's training to his residency days...in his day, residents were required to make house calls. His point was that many times disease clues exist in the patient's environment, and that a physician who visited the patient's home was much more likely to pick up the underlying nuance of disease cause. And that kind of dovetails into the current discussion...much of the need for a comprehensive EMR stems from the fact that today's care is fragmented rather than concentrated. OTOH, medicine has gotten so complicated it's a wonder the GP can even tie his own shoes... |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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4:49 PM Jul 10